BackgroundThere is widespread use of Complementary and Alternative Medicine (CAM) in Ghana, driven by cultural consideration and paradigm to disease causation. Whether there is concurrent use of conventional medicine and CAM in cancer patients is unknown. This study investigates the prevalence, pattern and predictors of CAM use in cancer patients. Overlapping toxicity, sources of information, and whether users inform their doctor about CAM use is examined.MethodCross-sectional study using a questionnaire administered to cancer patients, who were receiving radiotherapy and or chemotherapy or had recently completed treatment at a single institution was used.ResultsNinety eight patients participated in the study with a mean age of 55.5 (18–89), made up of 51% females. Married individuals formed 56% of the respondents, whilst 49% had either secondary or tertiary education. Head and neck cancer patients were 15.3%, breast (21.4%), abdomen/pelvic cancers constituted (52%).Seventy seven (78.6%) patients received radiotherapy only, 16.3% received radiation and chemotherapy and 5.3% had chemotherapy only.Ninety five patients were diagnosed of cancer within the past 24 months,73.5% were CAM users as follows; massage(66.3%), herbal(59.2%), mega vitamins(55.1%), Chinese medicine(53.1%),and prayer(42.9%). Sixty eight percent were treated with curative intent. Overlapping toxicity was reported. Majority (83.3%) of users had not informed their doctor about CAM use.On univariate analysis, female (p=0.004) and palliative patients, p=0.032 were more likely to be CAM users. Multivariate analysis identified female (p<0.01), as significant for use, whilst head and neck site was significant for non use (p<0.028). Young, married and highly educated individuals are more likely to use CAM.Friends and Media are the main sources of information on CAM. There was increase in CAM use after the diagnosis of cancer mainly for Chinese Medicine and vitamins.ConclusionThere is high CAM usage among Cancer patients, comparable to use in the general population, there is concurrent use of CAM and conventional medicine with reported overlapping toxicity but without informing Oncologist about use. Women and palliative patients are more likely to use CAM. Doctor patient communication on herbal-radiotherapy and drug treatment interaction needs to be strengthened. Standardization and regulation of CAM use is paramount.

BackgroundEvidence remains limited on why diabetes and hypertensive patients admitted to long-term drug therapy miss doses or discontinue medication taking. We examined this phenomenon from the perspective of diabetes and hypertension patients at a Ghanaian teaching hospital.MethodsBetween July and December 2015, we conducted a qualitative study targeting caregivers and their patients with chronic diabetes and hypertensive on re-admission at the Korle Bu Teaching Hospital due to non-adherence to prescribed medication. Participants were sampled purposefully and taking through in-depth interviews using an interview guide. Notes and audio recordings of interviews were transcribed, managed and coded for themes guided by the thematic network analysis recommended by Attride-Stirling.ResultsNon-adherence was the result of perceptions that the medications are not effective for managing the conditions. Patients with these perceptions rejected the medications and turned to herbal medicines and spiritual healing as therapeutic alternatives, because of their easy accessibility, perceived efficacy and affordability. Other factors identified to influence non-adherence included polypharmacy practice; tight work schedules; social norms; poor prescription instruction by health providers; and knowledge and experience of medication.ConclusionFindings suggests the need for health providers to adopt therapeutic approaches that take into account patients’ beliefs, values and norms in administering medications. Sensitisation of patients and caregivers during admission on the implication of non-adherence, as well as interventions that monitor and provide feedback mechanisms on patients’ medication taking behaviour holds promise for maximising diabetes and hypertensive medication adherence.

Background: Health is a basic human right necessary for the exercise of other human rights. Every human being is, therefore, entitled to the highest possible standard of health necessary to living a life of dignity. Establishment of patients' Charter is a step towards protecting the rights and responsibilities of patients, but violation of patients' rights is common in healthcare institutions, especially in the developing world. This study which was conducted between May 2013 and May 2014, assessed the operationalization of Ghana's Patients Charter in a peri-urban public hospital. Methods: Qualitative data collection methods were used to collect data from 25 healthcare workers and patients who were purposively selected. The interview data were analyzed manually, using the principles of systematic text condensation. Results:The findings indicate that the healthcare staff of the Polyclinic are aware of the existence of the patients' Charter and also know some of its contents. Patients have no knowledge of the existence or the contents of the Charter. Availability of the Charter, community sensitization, monitoring and orientation of staff are factors that promote the operationalization of the Charter, while institutional implementation procedures such as lack of complaint procedures and low knowledge among patients militate against operationalization of the Charter. Conclusion: Public health facilities should ensure that their patients are well-informed about their rights and responsibilities to facilitate effective implementation of the Charter. Also, patients' rights and responsibilities can be dramatized and broadcasted on television and radio in major Ghanaian languages to enhance awareness of Ghanaians on the Charter.

BackgroundThe concern of all maternal health stakeholders is to improve maternal health and reduce maternal deaths to the barest minimum. This remains elusive in low and middle-income countries as the majority of factors that drive maternal deaths stem from the socio-cultural environment especially in rural settings. This study was aimed at finding out if knowledge on socio-cultural factors related to maternal mortality affects maternal health decisions in rural Ghana.MethodsCommunity-based cross-sectional in design, the study involved 233 participants from 3 rural districts in the Greater Accra Region. Mixed-method of data collection was employed after informed consent. Quantitative data were analyzed using simple statistics, Fisher’s Exact Test of independence and crude odds ratio were used to interpret the results, whilst the FGDs were recorded, transcribed and analyzed based on themes.ResultsStatistically, significant relationship exists between all the socio-cultural factors studied (Traditional Birth Attendants (TBAs), religious beliefs and practices, herbal concoctions, and pregnancy and childbirth-related taboos) and maternal health decisions (p = 0.001 for all the variables) with very strong associations between maternal health decisions and knowledge on pregnancy and childbirth related taboos, TBA patronage, and religious beliefs and practices (OR = 21.06; 13; 7.28 respectively). However, misconceptions on factors associated with maternal mortality deeply rooted in rural communities partly explain why maternal morbidity and mortality are persistent in Ghana.ConclusionMeaningful and successful interventions on maternal mortality can only be achieved if misconceptions on causes of maternal mortality especially in rural areas of the country are tackled through mass education of communities. This should be done consistently over a long period of time for sustained behavioral change.Electronic supplementary materialThe online version of this article (10.1186/s12884-019-2197-7) contains supplementary material, which is available to authorized users.

Background: Almost three decades after the discovery of HIV and AIDS in Ghana, the most obvious impact of the disease is the growing orphan crisis affecting most families and communities, especially in areas that the prevalence of HIV has exceeded the epidemic's threshold of 5%. Studies have indicated that these orphans usually experience a wide range of problems which include education, nutrition, physical and sexual abuse, emotional and psychological distress, stigma and discrimination, among others The aim of the study was to examine the social, cultural, and traditional norms and practices that influence the care of children orphaned by AIDS in Ghana. Methods: The study employed focus group discussions, in-depth interviews and key informant interviews to generate information on the socio-cultural factors that impact orphan care in the Ashanti and Eastern regions of Ghana. Results: The findings indicated that the cultural practices that influence how well an AIDS orphan is taken care of by their caregivers include traditional rituals, ceremonies, and norms like funeral rites, marriage and naming ceremonies, festivals, inheritance, polygyny, and puberty rites. The social factors mentioned to affect orphan care significantly were: excessive alcohol drinking, and tobacco and drug use, dressing with fashion, night club attendance, market days, stigma and discrimination, among others. Conclusion: It is recommended that though some cultural and traditional practices are deeply rooted in communities and cannot be done away completely, orphan care policies on interventions should take into account these factors to mitigate their effects on the care of orphans.

Background: At the University level, the preparation of student nurses involves acquisition of theoretical knowledge and clinical practice, when this is done well, it can serve as a double-edged sword for blending theory and practice. We explored the ability, role, and experiences of nurse academics in balancing theory and practice in training nurses.Method: Using exploratory research with methodical triangulation design, data were collected from nursing lecturers and student nurses using interviews, questionnaires, and focus group discussions. Conclusion:Findings indicate that clinical practice is recognized by lecturers and students as an important measure for enhancing theoretical preparation of nursing students. University academic calendar does not favor inclusion of clinical practice, thus, balancing theory with clinical practice is difficult. University nurse educators in Ghana are obligated to blend theory and practice. However, challenges are encountered in doing so. Curricula for nursing education should be designed to be autonomous to place priority on clinical practice. The Nursing and Midwifery Council of Ghana should also put monitoring mechanisms in place to ensure clinical practice competencies of nursing lecturers.

Closed fishing season for artisanal and inshore fishing is an effective management measure for restoring the fish stock. The study aimed at assessing the impacts of the closed fishing season observed in the Sekondi harbour in Ghana. The findings revealed that the one month closure period was too short and/or lack of strict supervision to realize any significant change in fish population and sizes. A more transparent discussion on the period for the closure, longer closure period up to three months as well as provision of alternative sources of livelihood were suggested to ensure more cooperation from the fisher folks.

Purpose Studies have examined strategies implemented to strengthen quality of emergency care in healthcare provider institutions in Ghana. But few studies have focused on what determines quality of emergency care from the patient’s perspective. The purpose of this paper is to fill that gap by examining factors salient to gauging quality of emergency care and priority areas for care improvement. Design/methodology/approach Cross-sectional data were collected from patients admitted in emergency units of public hospitals in two regions: Greater Accra and Central Regions. A structured questionnaire designed with inputs from emergency medicine physicians and patients was used to collect data from 381 patients. Principal component analysis (PCA) and logistic regression models were computed to respectively determine salient measures of emergency care quality and their association with patient overall perceived quality of emergency care. Findings Using the PCA, four factors (social and relational care, attentive prehospitalised care, ward quality and privacy and medical supplies) were derived as salient measures of emergency care quality. All the factors derived had statistically significant association with patient overall perception of quality. Originality/value Emergency care quality improvement strategies that incorporate the dimensions identified can produce effective therapeutic outcomes.