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Seidu AA, Malau-Aduli BS, McBain-Rigg K, Malau-Aduli AEO, Emeto TI. "Nothing about us, without us": stakeholders perceptions on strategies to improve persons with disabilities' sexual and reproductive health outcomes in Ghana. Int J Equity Health 2024; 23:192. [PMID: 39334419 PMCID: PMC11438302 DOI: 10.1186/s12939-024-02269-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 09/06/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Persons with disabilities (PwDs) experience various adverse sexual and reproductive health (SRH) outcomes. However, there is a paucity of evidence on the strategies to improve their SRH outcomes. This study, therefore, used a pluralistic approach to explore PwDs and healthcare providers' (HPs) perspectives on how to improve the SRH of PwDs in Ghana. METHODS In-depth interviews were conducted with 62 purposively selected stakeholders (37 PwDs and 25 HPs) in the Kumasi Metropolis and Offinso North District. The data was subjected to reflexive thematic analysis. RESULTS Six major themes were generated from the data: Training for disability-sensitive and inclusive healthcare, Healthcare inclusivity - 'nothing about us, without us', Raising awareness for accessibility and equity, Impactful continuous monitoring and evaluation, Vital empowerment for self-reliance and Educating for disability-inclusive healthcare environment. These recommendations were synthesised to develop the THRIVE model-a comprehensive data driven framework from stakeholders that emphasises the importance of factors such as Training for disability-sensitive and inclusive healthcare, Healthcare inclusivity - 'nothing about us, without us', Raising awareness for accessibility and equity, Impactful continuous monitoring and evaluation, Vital empowerment for self-reliance and Enforcement of physical accessibility to improve their SRH outcomes. CONCLUSION Using the evidence based THRIVE model could facilitate the development and strengthening of existing interventions and policies including the disability Act 715 to improve the SRH access and outcomes of PwDs in Ghana and other low-and middle-income countries.
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Affiliation(s)
- Abdul-Aziz Seidu
- Public Health and Tropical Medicine, James Cook University, Townsville, QLD, 4811, Australia.
| | - Bunmi S Malau-Aduli
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2308, Australia
| | - Kristin McBain-Rigg
- Public Health and Tropical Medicine, James Cook University, Townsville, QLD, 4811, Australia
| | - Aduli E O Malau-Aduli
- School of Environmental and Life Sciences, The University of Newcastle, Newcastle, NSW, 2308, Australia
| | - Theophilus I Emeto
- Public Health and Tropical Medicine, James Cook University, Townsville, QLD, 4811, Australia.
- World Health Organization Collaborating Center for Vector-Borne and Neglected Tropical Diseases, James Cook University, Townsville, QLD, 4811, Australia.
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Seidu AA, Malau-Aduli BS, McBain-Rigg K, Malau-Aduli AEO, Emeto TI. A mixed-methods study of the awareness and functionality of sexual and reproductive health services among persons with disability in Ghana. Reprod Health 2023; 20:162. [PMID: 37907933 PMCID: PMC10619320 DOI: 10.1186/s12978-023-01700-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/13/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Persons with disabilities (PwDs) face barriers in accessing sexual and reproductive health (SRH) services due to lack of knowledge and awareness, stigma and discrimination, and inadequate service provision. This study aimed to examine the determinants of SRH knowledge and awareness among PwDs in Ghana, and to explore their perceptions of the functionality of SRH services. METHODS A sequential explanatory mixed-methods study design was used to collect and analyse quantitative (n = 402) and qualitative (n = 37) data from PwDs in two districts in Ghana. Quantitative data were analysed using descriptive and inferential statistics, while qualitative data was analysed thematically. RESULTS Most of the participants had high awareness of SRH (94.3%), sexually transmitted infections (STIs) (92.5%) and HIV/AIDS (97.0%). Employment status was positively associated with SRH awareness [aOR = 1.62; 95% CI = 1.02, 2.59]. Disability type was a significant predictor of STI [aOR = 2.02; 95% CI = 1.39, 2.94] and HIV/AIDS [aOR = 2.32; 95% CI = 1.21, 4.44] awareness, with the visually impaired having higher odds than the physically disabled. Age group was also a significant predictor of STI awareness, with older respondents having higher odds than younger ones [aOR = 1.76; CI = 1.01,3.05 for 30-39 years; aOR = 2.48; CI = 1.22, 5.05 for 40-49 years]. The qualitative findings revealed four main themes: conceptualisation of SRH, active engagement in SRH information seeking, tensions between knowledge and religious beliefs and perceived utility of SRH services. CONCLUSION Despite the high levels of SRH knowledge and awareness among PwDs, there are significant gaps and challenges related to disability type, age group, misconceptions, beliefs, and service non-functionality that limit the utility of SRH services. The findings call for tailored education to reduce misconceptions and put in pragmatic steps to deliver quality SRH services and information to PwDs. Further research is needed to assess the sexual lives of PwDs and explore the perspectives of all relevant stakeholders, including service providers and policymakers on how to enhance SRH outcomes for PwDs in Ghana.
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Affiliation(s)
- Abdul-Aziz Seidu
- Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia.
- Department of Population and Health, University of Cape Coast, P.O. Box UC 182, Cape Coast, Ghana.
| | - Bunmi S Malau-Aduli
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2308, Australia
| | - Kristin McBain-Rigg
- Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia
| | - Aduli E O Malau-Aduli
- School of Environmental and Life Sciences, The University of Newcastle, Newcastle, NSW, 2308, Australia
| | - Theophilus I Emeto
- Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia.
- World Health Organization Collaborating Center for Vector-Borne and Neglected Tropical Diseases, James Cook University, Townsville, QLD, 4811, Australia.
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Özdemir H, Kılıç Uçar A. Determining the genital hygiene behaviours of visually impaired women. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2022. [DOI: 10.1177/02646196221091302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Genital hygiene is one of the most important factors in the protection of women’s reproductive health. Thus, detailed knowledge of the genital hygiene behaviours of visually impaired women is crucial for preventive and curative health services. This descriptive study was conducted to determine the genital hygiene behaviours of visually impaired women. The study was conducted with 90 visually impaired women who were members of the ‘Altı Nokta Körler’ association. A data collection form was developed within the scope of the study. The data were collected through the face-to-face interview method between October 2018 and June 2019. The results show that the ratios of women who think that self-care and genital hygiene behaviours are affected by their visual impairment are 18.9% and 21.1%, respectively. Of those who think that visual impairment affects their self-care, 76.5% need someone else to notice their lack of self-care, and the remaining women notice this lack through their bodily reactions, such as bad odours and dirt. It was found that more than half of the women (58.9%) had a vaginal shower only after sexual intercourse. Among women, 35.6% of them thought that visual impairment was an obstacle to gynaecological examination. The regular gynaecological examination rates of these women were only 8.9%. It was found that the majority of women (78.9%) experienced abnormal vaginal discharge, but only 23.9% applied to a health institution. Visually impaired women have similar deficient genital hygiene behaviours to non-disabled women. In addition, visually impaired women face difficulties in maintaining personal and genital hygiene and in receiving health services.
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Li P, Xu L, Tang T, Wu X, Huang C. Willingness to Adopt Health Information Among Social Question-and-Answer Community Users in China: Cross-sectional Survey Study. J Med Internet Res 2021; 23:e27811. [PMID: 33970865 PMCID: PMC8143873 DOI: 10.2196/27811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/10/2021] [Accepted: 05/08/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND COVID-19 has spread around the world and has increased the public's need for health information in the process. Meanwhile, in the context of lockdowns and other measures for preventing SARS-CoV-2 spread, the internet has surged as a web-based resource for health information. Under these conditions, social question-and-answer communities (SQACs) are playing an increasingly important role in improving public health literacy. There is great theoretical and practical significance in exploring the influencing factors of SQAC users' willingness to adopt health information. OBJECTIVE The aim of this study was to establish an extended unified theory of acceptance and use of technology model that could analyze the influence factors of SQAC users' willingness to adopt health information. Particularly, we tried to test the moderating effects that different demographic characteristics had on the variables' influences. METHODS This study was conducted by administering a web-based questionnaire survey and analyzing the responses from a final total of 598 valid questionnaires after invalid data were cleaned. By using structural equation modelling, the influencing factors of SQAC users' willingness to adopt health information were analyzed. The moderating effects of variables were verified via hierarchical regression. RESULTS Performance expectation (β=.282; P<.001), social influence (β=.238; P=.02), and facilitating conditions (β=.279; P=.002) positively affected users' willingness to adopt health information, whereas effort expectancy (P=.79) and perceived risk (P=.41) had no significant effects. Gender had a significant moderating effect in the structural equation model (P<.001). CONCLUSIONS SQAC users' willingness to adopt health information was evidently affected by multiple factors, such as performance expectation, social influence, and facilitating conditions. The structural equation model proposed in this study has a good fitting degree and good explanatory power for users' willingness to adopt health information. Suggestions were provided for SQAC operators and health management agencies based on our research results.
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Affiliation(s)
- PengFei Li
- Medical Informatics College, Chongqing Medical University, Chongqing, China.,Medical Data Science Academy, Chongqing Medical University, Chongqing, China
| | - Lin Xu
- Medical Informatics College, Chongqing Medical University, Chongqing, China.,Medical Data Science Academy, Chongqing Medical University, Chongqing, China
| | - Tingting Tang
- Medical Informatics College, Chongqing Medical University, Chongqing, China.,The Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoqian Wu
- Medical Informatics College, Chongqing Medical University, Chongqing, China.,Medical Data Science Academy, Chongqing Medical University, Chongqing, China
| | - Cheng Huang
- Medical Informatics College, Chongqing Medical University, Chongqing, China.,Medical Data Science Academy, Chongqing Medical University, Chongqing, China
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Evaluation of a Web-Based Sexual Health Education Program for Individuals with Visual Impairments. SEXUALITY AND DISABILITY 2021. [DOI: 10.1007/s11195-021-09692-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Aslan E, Yılmaz B, Acar Z. Reproductive Health, Sexual Function and Satisfaction Levels in Women with Physical, Hearing, and Visual Disabilities. SEXUALITY AND DISABILITY 2021. [DOI: 10.1007/s11195-021-09690-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kumi-Kyereme A. Sexual and reproductive health services utilisation amongst in-school young people with disabilities in Ghana. Afr J Disabil 2021; 10:671. [PMID: 33824858 PMCID: PMC8007993 DOI: 10.4102/ajod.v10i0.671] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 01/07/2021] [Indexed: 11/02/2022] Open
Abstract
Background Sexual and reproductive health (SRH) of young people including those with disabilities is a major public health concern globally. However, available evidence on their use of sexual and reproductive health services (SRHS) is inconsistent. Objective This study investigated utilisation of SRHS amongst the in-school young people with disabilities (YPWDs) in Ghana using the healthcare utilisation model. Methods Guided by the cross-sectional study design, a questionnaire was used to obtain data from 2114 blind and deaf pupils or students in the age group 10-24 years, sampled from 15 purposively selected special schools for the deaf and the blind in Ghana. Results About seven out of every 10 respondents had ever utilised SRHS. The proportion was higher amongst the males (67.8%) compared with the females (62.8%). Young persons with disabilities in the coastal (OR = 0.03, 95% CI = 0.01-0.22) and middle (OR = 0.06, 95% CI = 0.01-0.44) zones were less likely to have ever utilised SRHS compared with those in the northern ecological zone. The blind pupils or students were more likely to have ever utilised SRHS than the deaf (OR = 1.45, 95% CI = 1.26-3.11). Conclusions Generally, SRHS utilisation amongst the in-school YPWDs in Ghana is high but significantly associated with some predisposing, need and enabling or disabling factors. This underscores the need for policymakers to consider in-school YPWDs as a heterogeneous group in the design and implementation of SRHS programmes. The Ghana Education Service in collaboration with the Ghana Health Service should adopt appropriate pragmatic measures and targeted interventions in the special schools to address the SRH needs of the pupils or students.
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Affiliation(s)
- Akwasi Kumi-Kyereme
- Department of Population and Health, Faculty of Social Sciences, University of Cape Coast, Cape Coast, Ghana
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Abodey E, Vanderpuye I, Mensah I, Badu E. In search of universal health coverage - highlighting the accessibility of health care to students with disabilities in Ghana: a qualitative study. BMC Health Serv Res 2020; 20:270. [PMID: 32234049 PMCID: PMC7106671 DOI: 10.1186/s12913-020-05138-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 03/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accessibility of health care to students with disabilities is a global concern. This is no less important in Ghana, however, to date, no study has been undertaken regarding access to health care to students with disabilities. This study, therefore, aims to explore the accessibility of health care to students with disabilities, in the quest of achieving universal health coverage in Ghana. METHODS Qualitative methods, involving in-depth interviews were employed to collect data from 54 participants (29 students with disabilities, 17 health workers and 8 school mothers), selected through purposive sampling. Thematic analysis was used to analyze the data. RESULTS The study identified three themes - accessibility, adequacy, and affordability. The study findings highlighted that universal health coverage for students with disabilities has not been achieved due to barriers in accessing health care. The barriers faced by students with disabilities were unfriendly physical environments, structures, equipment, limited support services and poor health insurance policy to finance health care. CONCLUSION The study concludes that the government should prioritize disability-related issues in health policy formulation, implementation and monitoring. The current provisions and requirements in the disability act should be prioritized, enforced and monitored to ensure adequate inclusion of disability issues in health services. Further, the current exemption policy under the National Health Insurance Scheme should be revised to adequately address the needs of people with disabilities.
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Affiliation(s)
- Eric Abodey
- Department of Education and Psychology Studies, University of Cape Coast, Cape Coast, Ghana
| | - Irene Vanderpuye
- Department of Education and Psychology Studies, University of Cape Coast, Cape Coast, Ghana
| | - Isaac Mensah
- Department of Special Education, University of Education, Winneba, Ghana
| | - Eric Badu
- Department of Health Promotion and Disability Studies; School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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