Introduction: The COVID-19 pandemic has exacted an appreciable burden on health systems globally including adverse psychological impacts on health workers. This study sought to assess COVID-19-related fear, depression, anxiety and stress among hospital staff, potential factors that may help reduce its psychological effects and their personal coping strategies. The study will help to highlight the psychological impact of COVID-19 on Ghanaian health workers and indirectly serve as a needs assessment survey for input to support affected staff and the broader health system. Methods: A cross-sectional survey was conducted among health workers in three hospitals in the Ashanti Region of Ghana from 11 July 2020 to 12 August 2020. Demographic data and scores from the validated DASS-21 and Fear of COVID-19 scales and two other scales developed de novo were entered from 272 self-administered questionnaires and analyzed for means, frequencies and proportions. Fisher’s exact test analysis was done to ascertain associations between selected independent variables and depression, anxiety, stress and fear. Parametric and non-parametric tests were used to compare the mean and median scores of the outcome variables across the three study hospitals. Results and conclusion: Over 40% of respondents had fear while 21.1%, 27.8% and 8.2% had depression, anxiety and stress, respectively. Positive attitudes from colleagues and the government’s tax-free salary relief were some factors said to reduce the psychological effects while over half of participants indicated praying more often as a coping strategy. There is a need for the health system to recognize the presence of these adverse psychological effects in health workers and take pragmatic steps to address them.

Objective:To determine obstetric fistula knowledge among prenatal attendees and midwives in Mfantsiman municipality, Ghana. Methods:An analytical cross-sectional study was conducted among prenatal clinic attendees and midwives in Mfantsiman municipality from March to April, 2016. Women were selected by systematic sampling and consenting midwives were recruited.Respondents were interviewed using a pretested structured questionnaire. Data were analyzed using the χ 2 test and Poisson regression with a robust error variance to generate relative risks (RRs) with 95% confidence intervals (CIs). P<0.05 was considered statistically significant.Results: Altogether, 393 prenatal attendees and 45 midwives were studied. Mean age of attendees was 28.1 ± 7.1 years. About 29% of prenatal attendees knew of, 37.2% had poor knowledge of, and 56.6% had some misconceptions about obstetric fistula.Women who had attained some level of education (P trend=0.001), were employed (adjusted RR 4.92; 95% CI, 1.98-12.21), or had given birth before (P trend=0.01) were more likely to have heard of obstetric fistula. All midwives knew of obstetric fistula and its preventive measures; however, up to 73.3% had some misconceptions about it. Conclusion:Educating prenatal attendees and organizing regular refresher courses on obstetric fistula for midwives should be a priority in the municipality. K E Y W O R D S

Background Prematurity (gestational age <37 completed weeks) accounts for the majority of neonatal deaths worldwide and most of these occur in the low-resource countries. Understanding factors that determine the best chances of preterm survival is imperative in order to enhance the care of neonates and reduce adverse outcomes in such complicated births. Aim This was to find out the proportions of preterm babies who survived at the Special Care Baby Unit (SCBU) in the Cape Coast Teaching Hospital (CCTH) and the factors which influenced their survival. Method This was a retrospective review of data on all the live preterm babies seen at the SCBU of CCTH from 2010 to 2019. Data on 2,254 babies that met the inclusion criteria were extracted. Descriptive statistics were generated and tests of association done with chi-square and multivariable logistic regression. Outcome The main outcome measure was the proportion of live preterm neonates who were discharged after SCBU admissions. Results The CCTH had a total of 27,320 deliveries from 2010 to 2019. Of these, 1,282 were live preterm births, giving a prevalence of live preterm babies over the ten-year period of 4.7% (1,282/27,320). An increasing trend in prevalence was observed with 2019 recording the highest at 9% (271/3027). Most (48.8%) of the deliveries were vaginal, 39.2% were by caesarean section (CS); the mode of birth for 12% of the women were not documented. The mean gestational age was 31.8 (±2.77) weeks. Of the birth weights documented, <1000g babies accounted for 11.9%, 1000–1499g babies made up 34.8%, while 1500g to 2499g babies accounted for 42.6%. The babies with weights >2500g made up only 3.7%. The average length of hospital stay was 8.3 (±9.88) days. Regarding the main outcome variable, 67.6% were discharged alive, 27.6% died and 4.9% were unaccounted for due to incomplete documentation. Factors which influenced survival were: birth weight (p <0.001); gestational age (p <0.001); mode and place of delivery (p <0.001 for both); APGAR scores at 1st and 5th minutes (p <0.001); and length of stay at the SCBU (p <0.001). No association was found for sex of the baby, maternal age and parity. Conclusion This study shows the possibility of achieving good preterm survival rates through the provision of specialised neonatal care, even in resource-constrained countries. This provides an updated benchmark for clinical decision-making and antenatal counselling. It also highlights the problem of inadequate data capture in our part of the world, which needs considerable improvement.

The study assessed the prevalence and determinants of non-fistulous urinary incontinence among gynaecologic care seekers as well as its interference with everyday life activities of affected women. A cross-sectional study involving 400 women was conducted in a tertiary facility in Ghana. Urinary incontinence was assessed using the International Consultation on Incontinence Questionnaire-short form (ICIQ-SF) which has not been validated locally. The questionnaire was administered mostly in the Asante Twi language with translation done at the time of the interview. The data was analysed for proportions and associations between selected variables. The prevalence of urinary incontinence was 12%, the common types being urgency (33.3%), stress (22.9%), and mixed (20.8%). Age ≥60 years compared to 18–39 years (OR 3.66 95%CI 1.48–9.00 P = 0.005), and a history of chronic cough (OR 3.80 95% CI 1.36–10.58 P = 0.01) were associated with urinary incontinence. Women with education beyond the basic level were 72% less likely to experience urinary incontinence (OR 0.28 95%CI 0.08–0.96 P = 0.04). Urinary incontinence interferes with everyday life activities of most affected women. Non-fistulous urinary incontinence is relatively common among gynaecologic care seekers yet very few women were referred with such a diagnosis. Advocacy measures aimed at urging affected women to report the condition and educating the general population on potential causes, prevention and treatment are needed.