BackgroundModern contraceptive use remains an important public health intervention and a cost-effective strategy to reduce maternal mortality, avert unintended pregnancies and to control population explosion, especially in developing countries. Despite these benefits, there are reports of low usage among reproductive-aged women in most developing countries. This study examined the prevalence and predictors of use of modern contraceptive among reproductive-aged women in an urban center with a high density population in Ghana.MethodsA cross-sectional, interviewer-administered survey was conducted with 217 randomly selected reproductive-aged women. Data was analyzed with STATA. Logistic regression was performed to identify factors influencing modern contraceptive use.ResultsAlthough we found high levels of knowledge and awareness (98%; n = 213) of modern contraception use, only 21% of participants were using modern contraceptives. Marital status, partner consent and support, and religious beliefs strongly predicted usage.ConclusionUsage of modern contraceptives among reproductive-aged women in the Ledzokuku Krowor Municipality is lower than the national target. A multilevel family planning intervention program that primarily focuses on promoting inclusive participation of husbands, targets the unmarried and non-literates reproductive-aged women, and dispels misconceptions, misinformation and religious myths about modern contraceptives has been discussed.

Purpose The purpose of this paper is to determine the factors that influence patients’ long-term relationship with healthcare providers in healthcare delivery at hospitals. Design/methodology/approach Data were gathered using 170 patients in a cross-sectional survey with quantitative research methods at a public regional hospital. Results were obtained using descriptive analysis and regression analysis. Findings Generally, the study found that the health-related factors (the reception of staff, providers’ attitude, waiting time, competence and expertise and the hospital environment) that influence patients’ long-term relationship with the healthcare providers/hospital were statistically significant (p < 0.001). The findings showed that overall 90.0 per cent of the patients were very satisfied with the overall healthcare services at the hospital. Research limitations/implications Limited sample size, lack of examination of healthcare providers’ perspectives and non-application of qualitative methods make it difficult to give a true picture of how these can enhance patients’ intent to keep a long-term relationship with the healthcare providers/hospital. Practical implications The paper suggests that health policymakers and practitioners need to enhance measures that will make patients satisfied leading to their long-term commitment and cordial relationship with the healthcare providers/hospital. Social implications The study demonstrated how health-related factors will be associated with the patients’ agreement/intent to keep a long-term relationship with their service providers at hospitals. Thus, the overall hypothesis was true that there is a relationship between patients’ satisfaction with the healthcare experienced and their long-term relationship with healthcare providers/hospital. Originality/value This is one of the few studies conducted on the topic in the context of Ghana’s health sector. It recommends that there should be a good interpersonal relationship between healthcare providers and patients, as patients’ satisfaction is not based on only receiving treatment at the health facility.

Purpose The purpose of this paper is to assess available human resources for neonatal care and their skills, in order to explore health providers' perceptions of quality of neonatal care in health facilities in Ghana. Design/methodology/approach Data were gathered using qualitative interviews with health providers working in the maternity and paediatric wards and midwives; direct observation; and documentary review at a regional hospital, a municipal hospital and four health centres in a municipality in a region in Southern Ghana. Data were analysed using thematic framework through the process of coding in six phases to create and establish meaningful patterns. Findings The study revealed that health providers were concerned about the number of staff available, their competence and also equipment available for them to work more efficiently. Some essential equipment for neonatal care was either not available or was non-functional where it was available, while aseptic procedures were not adhered to. Moreover, personal protective equipment such as facemask, caps, aprons were not used except in the labour wards where staff had to change their footwear before entering. Research limitations/implications Limited number of health providers and facilities used, lack of exploration of parents of neonates' perspective of quality of neonatal care in this study and other settings, including the teaching hospitals. The authors did not examine issues related to the ineffective use of IV cannulation for neonates by nurses as well as referral of neonates. Additionally, the authors did not explore the perspectives of management of the municipal and regional health directorates or policy makers of the Ministry of Health and Ghana Health Service regarding the shortage of staff, inadequate provision of medical equipment and infrastructure. Practical implications This paper suggests the need for policy makers to redirect their attention to the issues that would improve the quality of neonatal health care in health facilities in Ghana and in countries with similar challenges. Social implications The study found that the majority of nursing staff catering for sick newborns were not trained in neonatal nursing. Babies were found sleeping in separate cots but were mixed with older children. The study suggests that babies should be provided with a separate room and not mixed with older babies. Originality/value There seemed to be no defined policy framework for management of neonatal care in the country's health care facilities. The study recommends the adoption of paediatric and neonatal care nursing as a specialty in the curricula of health training institutions. In-service trainings should encompass issues related to management of sick babies, care of preterm babies, neonatal resuscitation and intravenouscannulation, among others.

Back Background groundPost exposure prophylaxis remains the single most important means of decreasing HIV infection upon occupational exposure. It offers over 80% protection against HIV sero-conversion when initiated within 72 hours of exposure and if the treatment regimen followed diligently for 28 days. This study assessed the level of knowledge and usage of post exposure prophylaxis among healthcare workers in the Eastern Regional Hospital, Koforidua, Ghana where HIV prevalence is high. Methods MethodsA cross-sectional study was conducted among 185 HealthCare Workers (HCWs) between May and July 2016. Data was collected using self-administered structured questionnaires and analyzed with Stata-13. Bivariate associations were tested using chi-square or Fisher's exact test as appropriate. Multivariate analysis was conducted with logistic regression. A P-value of ≤0.05 was considered statistically significant. R Results esultsOut of the 185 HCW interviewed, 96.8% considered themselves at risk of occupational exposure with 83.2% reporting occupational exposure within the last 12 months. Nearly all participants (97.3%) knew about the existence of post exposure prophylaxis (PEP). A majority (90.8%) acknowledged the effectiveness of PEP in preventing HIV infection. About 89% knew that the exposed area should be washed with soap and water or flushed with copious amounts of water and 65.4% knew whom to contact after exposure. Although about 93% knew PEP should be started within 72 hours of exposure, only 38.9% knew the duration of treatment to be four weeks. The accurate drug regime following a high-risk needle stick injury was known by 25.1% while the proportion of needle stick injuries could result in HIV transmission was unknown by 65.9%. Although 51.9% were eligible to take PEP, only 33.8% reported having received PEP.

Purpose The purpose of this paper is to explore the influence of health system factors on access to a quality healthcare among prisoners in Ghana. Design/methodology/approach Data were gathered using different qualitative methods (interviews and participant observation) with staff of the James Camp Prison, Accra. Findings were analyzed using a framework method for the thematic analysis of the semi-structured interview data; and interpreted with the theoretical perspective of health systems thinking and innovation. Findings The study concludes that health system factors such as inadequate funding for health services, lack of skilled personnel and a paucity of essential medical supplies and drugs negatively affected the quality of healthcare provided to inmates. Research limitations/implications The limited facilities available and the sample size (healthcare workers and prison administrators) impeded the achievement of varied views on the topic. Practical implications The paper recommends the need for health policy makers and authorities of the Ghana Prison Service to collaborate and coordinate in a unified way to undertake policy analysis in an effort to reform the prisons healthcare system. Social implications The national health insurance scheme was found to be the financing option for prisoners’ access to free healthcare with supplementation from the Ghana Prison Service. The study recommends that policy makers and healthcare stakeholders should understand and appreciate the reality that the provision of a quality healthcare for prisoners is part of the entire system of healthcare service delivery in Ghana and as such should be given the needed attention. Originality/value This is one of few studies conducted on male only prisoners/prison in the context of Ghana. It recommends the need for an integrated approach to ensure that the entire healthcare system achieves set objectives in response to the primary healthcare concept.