Assessing health-related quality of life and clinical outcomes of patients with diabetes accessing healthcare in two public hospitals in south-eastern Ghana: a cross-sectional descriptive study

BACKGROUND

Diabetes is a significant contributor to kidney failure, heart attack, strokes, lower limb amputation, blindness, and other complications that negatively impact health-related quality of life (HRQOL). This study assessed the HRQOL and clinical outcomes of patients with diabetes accessing healthcare in south-eastern Ghana.

METHODS

This was a hospital-based cross-sectional descriptive study conducted in the Ho Municipal and Ho Teaching Hospitals in Ghana among patients with type 2 diabetes who were seeking healthcare at both hospitals for at least 12 months. Systematic random sampling technique was used to select 310 respondents out of the total sample size of 326 patients with type 2 diabetes and data were collected using diabetes-39 questionnaire. The data were analysed using STATA 16.0. Socio-demographic and clinical variables were expressed as frequencies and percentages. Differences between proportions were tested using Chi-square to identify predictors of poor HRQOL and Pearson correlation for association. The p < 0.05 was considered significant.

RESULTS

Out of 310 respondents, 171 (55.0%) had poor HRQOL. The predictors of poor HRQOL were age (p < 0.008), education (p < 0.028), employment (p < 0.001), residence (p < 0.01), duration of diabetes (p < 0.002), diabetes education (p < 0.001), BMI (p < 0.005), and glycaemic control (p < 0.001). Energy and mobility (63.2%), anxiety and worry (53.9%), and diabetes control (49.6%) dimensions were the most prevalent of poor HRQOL. Diabetes education, complications, being diabetic for 16 years and above, earning income, resident in rural area, being married, being pensioner and national Service Personnel, and diabetes comorbidities were significantly associated with HRQOL.

CONCLUSIONS

More than half of the respondents had poor HRQOL. Clinical and public health efforts should focus on effective control and screening measures for the individual patients and general population.

Factors associated with glycaemic control among patients with type 2 diabetes mellitus in Ho, Ghana: A cross-sectional study

Background

The purpose of this study was to assess the status of glycaemic control and associated factors among patients with type 2 diabetes mellitus patients.

Methods

This was a hospital-based cross-sectional descriptive study of 326 patients with type 2 diabetes at the Ho Municipal and Teaching Hospitals. The adequate sample size was calculated using Yamane formula N/1 + Ne2, with 95 % confidence interval, 5 % margin of error and 10 % non-response rate and a sample size of 326 was determined. Using the sampling frame of patients chart, systematic random sampling technique was used to select the study participants. Glycaemic level was assessed using fasting blood glucose (FBG) readings. A poor glycaemic control was when an average of three months blood glucose level was above 130 mg/dl (7 mm/L). Data was analysed using STATA version 15.0.

Results

Out of 310 patients who participated in the study, more than two-thirds (76.1 %) had poor glycaemic control. Patients who use combination of oral medication and insulin (AOR = 3.67, 95 % CI: 1.34-8.74), patients with diabetes for 16 years or more (AOR = 4.67, 95 % CI: 2.44-9.29), patients who did not practised diabetes self-care activities (AOR = 4.32, 95 % CI: 2.82-9.31) and patients with complications were (AOR = 2.47, 95%CI: 1.45-8.66) more likely to have poor glycaemic control. Age, employment, diabetes education, comorbidities, diabetes self-care activities, treatment type, complications, resident and duration of diabetes were significantly associated with poor glycaemic control.

Conclusion

Based on this findings, teaching and counselling provided by nurses, physicians, dietitians and pharmacists should focus on improving adherence to diabetes self-care activities to attain good glycaemic control.

Determinants of health facility delivery among young mothers in Ghana; insights from the 2014 Ghana Demographic and Health Survey

Background

Globally, young women deliver at home, often under unhygienic conditions and without skilled birth attendants. This study identified the determinants of health facility delivery among young mothers in Ghana.

Methods

We analysed secondary data from the 2014 Ghana Demographic and Health Survey, which collected data across the former ten administrative regions of Ghana. This study analysed data from the ‘women file’ by adjusting for the sample weight. STATA/SE version 16 was employed to analyse the data by computing descriptive statistics, Chi-square, and Binary Logistic Regression.

Results

Seven in ten young mothers gave birth in a health facility. Young mothers who had secondary school education were over three-fold more likely to deliver in a health facility (AOR = 3.5, 95% CI: 1.33–9.23) compared with young mothers with no formal education. Young mothers who resided in rural areas had lower odds (73%) of delivering in a health facility (AOR = 0.27; 95% CI: 0.14–0.514) compared with those in urban areas. Young mothers within the richest wealth quintile also had higher odds (8 times) of delivering in a health facility (AOR = 8.24; 95% CI: 0.95–71.77) compared with those within the poorest wealth quintile. Young mothers who obtained four to seven antenatal visits (AOR = 0.53; 95% CI: 0.27–1.03) had lower odds of delivering in a health facility compared with those who obtained eight or more antenatal visits.

Conclusion

The majority of young mothers in Ghana gave birth in a health facility. The likelihood of delivering in a health facility was influenced by socio-demographic factors, economic factors and utilization of antenatal care services. Therefore, interventions aimed at increasing utilization of skilled delivery among young women should focus on promoting girl child education, economic status and antenatal care visits.

Utilization of antenatal care among adolescent and young mothers in Ghana; analysis of the 2017/2018 multiple indicator cluster survey

Background

Complications during pregnancy and childbirth are the leading cause of death among adolescent girls. In Ghana, the prevalence of adolescent pregnancy remains high. Yet, little is known about ANC utilization among adolescent and young mothers. This study aimed to assess the prevalence of obtaining 4 or more ANC visits and associated factors among adolescent and young mothers.

Methods

We analysed secondary data from the sixth round of the Ghana Multiple Indicator Cluster Survey. A total of 947 adolescent and young mothers were included in this study. Data were analysed using STATA/SE, version 16, employing descriptive statistics and Binary Logistic Regression.

Results

It was found that majority of the participants were aged 20-24 years (70%), married/in union (61%) and non-insured (64%). The prevalence of obtaining 4 or more ANC visits was 84%. Adolescent and young mothers with junior high school education, in the second wealth quintile, exposed to the internet, and resided in the Upper East region had a higher likelihood of obtaining 4 or more ANC visits (p < 0.05).

Conclusions

This study demonstrated that optimal ANC utilization among adolescent and young mothers were determined by socio-economic factors. Going forward, maternal healthcare interventions must prioritize adolescent and young mothers from poor socio-economic backgrounds.

Correlates of absenteeism at work, school and social activities during menstruation: Evidence from the 2017/2018 Ghana Multiple Indicator Cluster Survey

Background

Menstruation is a biological process which is crucial for human reproduction. Menstruation is a source of absenteeism, yet the subject matter has not been well explored. This study aimed to assess the correlates of absenteeism at school, work and social activities during menstruation among Ghanaian women of reproductive age.

Methods

This study was an analysis of secondary data from the 2017/18 Ghana Multiple Indicator Cluster Survey. Data were analysed using descriptive statistics, Chi-square and Binomial Logistic Regression with the aid of Stata/SE, version 16.

Results

The majority of the participants were aged 25–49 years (63%), married/in union (55%) and resided in urban areas (52%). Nine in ten participants had access to privacy at home and 98% used menstrual materials during their last period. Eight in ten participants used disposable menstrual materials. Exactly 19% of the participants missed school, work or social activities during their last period. Participants who used disposable menstrual materials (AOR = 0.67; 95% CI: 0.52–0.85) were less likely to miss school, work or social activities during menstruation compared to those who used reusable menstrual materials.

Conclusion

This study demonstrated that a significant minority of women in Ghana miss academic, economic or social activities during menstruation. Therefore, there is a need for effective interventions to help reduce menstruation-related absenteeism among women and girls in Ghana.