BackgroundThe challenges and predictors of exclusive breastfeeding (EBF) have been examined in many parts of the world. Considering the socio-cultural dynamics and the few research studies in Ghana, the factors that hinder and predict EBF practice in other countries may be different in the Ghanaian setting. The study therefore sought to assess the challenges and predictors of EBF among mothers attending a child welfare clinic at a regional hospital in Ghana.MethodsA descriptive cross-sectional study was carried out between January and March, 2015 to elicit information from 240 mothers who were sampled using simple random sampling technique. A validated structured questionnaire was used in collecting data on participants’ socio-demographic characteristics and reported breastfeeding practices. Participants’ breastfeeding challenges were rated on a Likert scale from 1 (not at all), 2 (mild), 3 (moderate), 4 (severe) to 5 (unbearable). In this study, EBF refers to birth of the infants up to six months.ResultsThe top three breastfeeding challenges of mothers were: belief that breast milk alone was not sufficient in meeting their babies’ nutritional needs [mean 3.43 (standard deviation {SD} 1.35)], short maternity leave period [mean 3.41 (SD 1.29)], and socio-cultural pressure to introduce water and artificial feeds [mean 3.39 (SD 1.28)]. Independent predictors of EBF were: infant’s age [Adjusted Odds Ratio (AOR) 0.82 (95% Confidence Interval [CI] 0.71, 0.95)], and self-employment [AOR 2.67 (95% CI 1.11, 6.41)].ConclusionMothers are confronted with numerous EBF challenges both at the individual and societal levels, and stakeholders need to consider these in order to support breastfeeding mothers to maximize outcomes. Reviewing the labour laws on Ghana’s maternity leave to accommodate an extended maternity leave in addition to the employee’s annual leave could further improve EBF practice rates.Electronic supplementary materialThe online version of this article (doi:10.1186/s13006-017-0104-2) contains supplementary material, which is available to authorized users.

Background: Non-pharmacological interventions hold promise in reducing labour pain, with minimal or no harm to the mother, foetus and the progress of labour and are simple and cost-effective. Yet their use has not been adequately explored in clinical settings, especially in sub-Saharan Africa. Methods: This was a descriptive phenomenological study. Fifteen (15) nurses and midwives working in labour wards of two hospitals in Ghana were interviewed. Data analysis was guided by the principles of coding by Bailey and the constant comparative approach to generate themes. Ethics approval was obtained from the 37 Military Teaching Hospital Institutional Review Board in Ghana. Results: Three major themes were identified that described the experiences of nurses and midwives regarding their use of non-pharmacological interventions in managing labour pain. These were familiarity with nonpharmacological interventions, perceived benefits of non-pharmacological interventions, and barriers to the use of non-pharmacological interventions in the management of labour pain. Conclusions: While some non-pharmacological pain management interventions were known and used by the nurses and midwives, they were not familiar with a good number of these interventions. Nurses and midwives perceived these interventions to be beneficial yet a number of barriers prevented easy utilisation.

AimTo describe the lived experiences of mothers with preterm babies at a Mother and Baby Unit (MBU) of a tertiary hospital.DesignA descriptive phenomenological approach.MethodTen mothers were purposively sampled during the month of May, 2017 to describe their experiences of having preterm babies. Recorded in‐depth individual interviews were transcribed verbatim; codes were generated and inductively organised into themes.ResultsFour themes were actively generated: ‘Emotional experiences of mothers’, ‘Mother‐baby interaction’, ‘Perception on care and support’ and ‘Challenges within Mother and Baby Unit environment’. Mothers were anxious about the premature delivery and were afraid of possible infant's death. They cherished interactions with their babies during kangaroo mother care and breastfeeding. Mothers applauded the nurses for their professional competence. They expressed concerns about inadequate accommodation, high cost of care, the frequency and duration of mother–baby interactions.

Background. Despite the relevance of cold chain management in maintaining the potency of vaccines, gaps still exist in the ability of healthcare practitioners to maintain the cold chain system effectively. Thus, the current study sought to assess healthcare providers’ knowledge, attitudes, practices, and challenges regarding cold chain management. Methods. A concurrent mixed methods study was conducted at twelve facilities in the Sekyere Central District of Ghana. Eighty-six (86) participants took part in a survey that assessed their “cold chain management” knowledge and attitudes. Twelve (12) cold chain sites within the district were also observed in respect of their cold chain management practices. Eleven key informants were additionally interviewed to explore their challenges on cold chain management. Quantitative data were analyzed using descriptive (frequencies, percentages, means, standard deviations, ranges) and inferential statistics (Spearman’s rho correlation). Qualitative data were inductively analyzed into themes which described participants’ challenges on cold chain management. Results. Majority of the participants scored ≥70% on knowledge (68.6%) and attitudes (67.4%) toward cold chain management. However, there was a very weak positive and statistically insignificant relationship between participant’s knowledge and attitudes toward cold chain management ( r = 0.109 , p = 0.317 ). Regarding cold chain management practices, majority of the facilities had their vaccine vial monitors attached to the vaccines (8/12, 66.7%), had functional fridge tags (8/12, 66.7%), and an appropriate refrigerator to store vaccines (7/12, 58.3%). However, the study observed that 91.7% (11/12) of the facilities did not have policies and guidelines on cold chain management while all 12 facilities (100%) did not have a contingency plan in place for equipment. With regards to the cold chain management challenges, participants raised concerns about inadequate personnel, erratic power supply, logistical constraints, and transportation difficulties. Conclusion. Although majority of the participants had good knowledge and attitude towards cold chain management, there was a weak association between them. This implies that good knowledge may not necessarily influence good attitudes towards cold chain management and vice versa. The extent to which facilities support cold chain management practices was suboptimal. Participants encountered a number of challenges which prevented them from managing the vaccine cold chain system effectively. We recommend continual professional education for cold chain practitioners, provision of adequate human and material resources for cold chain management, and enhanced monitoring and evaluation of cold chain activities. Future studies should quantitatively measure individual participants’ knowledge, attitudes, practices, and challenges on cold chain management so that we can establish the relationships that exist between these components.

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Background:The knowledge and attitudes of nurses and midwives, as well as nursing and midwifery students on pediatric pain are crucial in the management of hospitalized children's pain. However, few studies have addressed the preparedness of nursing and midwifery students to manage children's pain based on their knowledge and attitudes. This study therefore assessed nursing and midwifery students' knowledge and attitudes pertaining to children's pain management. Methods: This descriptive cross-sectional study was conducted on 554 nursing and midwifery students who were in their last year at four nursing and midwifery training institutions in city Ghana in 2018-2019. Data were collected over a three-month period using the Pediatric Nurses' Knowledge and Attitudes Survey regarding pain (PNKAS). Data analyzed by the SPSS version 25 and presented using descriptive statistics and independent T test and one-way ANOVA. Results: Participants had an average PNKAS score of 42.1% (range: 21.4% to 81.0%). The nursing and midwifery students in either public (44.1%±7.9%) or private (43.7%±9.6%) university had significantly higher scores than those in a public nursing and midwifery training college (40.3%± 6.9%) (p<.001). Conclusion:Nursing and midwifery students in the study generally had insufficient knowledge and attitudes toward children's pain. There is an urgent need to intensify education in this area so as to adequately prepare these students to cater to the pain needs of vulnerable children and their families. Future studies should focus on how student's theoretical knowledge and attitudes are linked to their pediatric pain assessment and management practices.

Introduction The purpose of this study was to assess the prevalence, sources and effect of incivility in a tertiary hospital in Northern Ghana. Methods A descriptive cross-sectional survey was conducted among 321 nurses at a tertiary-level hospital in Northern Ghana. Between October and November 2022, participating nurses responded to an online or self-administered questionnaire using the 43-item incivility scale developed by Guidroz and colleagues. Data collected was cleaned in Microsoft Excel and transported into SPSS version 21 for further statistical analysis. Results Two-fifths of the participants (n=131, 40.8%) were aged 31-35 years. Over 50% of the participants were males (n=161), married (n=187) and had a Bachelor’s degree (n=166). A little over 30% of the participants had worked in the nursing profession for more than 8 years. Conclusion The participants reported an average incidence of 54.5% of incivility sometimes, most of the time, and all the time. Moreover, in terms of incivility reported under the subscales, the average greatest prevalence recorded was displaced frustration under patients/relations, with a rate of 78.9%. The least average prevalence rate indicated under the subscales was from abusive supervision under direct supervisors with a rate of 30.7%. The existence of incivility in healthcare settings does not support a setting where healthcare workers and patients may operate safely. Therefore, it is advised that frequent in-service training sessions on what constitutes incivility is held for nurses and the hospital's general staff in order to raise awareness of the negative impacts of incivility.

Purpose The purpose of the study was to assess the association between iron intake and the incidence of anaemia during pregnancy as well as estimate the prevalence and magnitude of anaemia in pregnancy. Design/methodology/approach A retrospective case-control study was conducted on 383 postnatal women at four health-care facilities. Data on iron supplementation and haemoglobin (Hb) levels during pregnancy was collected from the respondents. Spearman, Pearson Chi-square tests of independence were used to measure associations between variables, a log-linear model was adopted to ascertain the association and level of interaction among variables. All p-values < 0.05 were considered statistically significant. Findings Results show 54.3% prevalence of anaemia at registration and 33.6% at 36 weeks of pregnancy, p < 0.001. Iron supplement intake during pregnancy was 96.3%. The log-linear analysis model retained the Parity × Marital Status interaction across the levels of anaemia (p < 0.001). Compared to married pregnant women, single pregnant women were almost equally likely to be anaemic (OR = 1.06). Research limitations/implications One of the limitations of retrospective studies is recall bias; however, this was likely to be minimal, as participants were approached within 8 days after delivery. Despite this, this study still holds promise as it reports a rather high prevalence of anaemia at 36 weeks even with the high intake of iron. Originality/value Anaemia in pregnancy is a major public health issue because of the consequential outcomes on maternal and child health. The study identified a high prevalence of anaemia at registration; which could be the basis for intensifying pre-natal iron supplementation before pregnancy.