Assessing Information and Counselling Provision for Medical Abortion Care in Pharmacies Versus Clinics: Secondary Analysis of Two Non-Inferiority Cohort Studies.

Objective: To evaluate aspects of information provision and counselling for medical abortion as provided through clinics compared with pharmacies.

Design: Secondary analysis of data from two non-randomised, non-inferiority cohort studies.

Population: Women seeking medical abortion at less than nine weeks gestational duration from either clinics or pharmacies in Cambodia and Ghana.

Pathways to care: Factors predicting women's access to clinic versus pharmacy-based medication abortion in Ghana.

Background: Women's decision to access medication abortion (MA) in clinics or pharmacies may be shaped by several factors, but is an area that has not been adequately researched. Little is also known about the primary predictors of choice of MA provider.

Objectives: Our study examined the factors associated with choice of MA provider and identified the primary predictors.

Who pays more? Exploring cost disparities in medication abortion access across socio-demographic groups in Ghana.

Background: Medication abortion (MA) may be accessed covertly in private pharmacies and clinics due to abortion-related stigma. Stigmatization may lead to information asymmetry, resulting in price discrimination. The existing literature on abortion in Ghana has primarily focused on factors associated with abortion stigma.

Medical abortion in Ghana: A non-randomized, non-inferiority study of access through pharmacies compared with clinics.

Objectives: To compare self-reported clinical outcomes following medical abortion with mifepristone and misoprostol sourced from either a pharmacy or health clinic.

Study Design: We conducted a prospective, non-randomized, non-inferiority cohort study across four regions in Ghana, from high-volume pharmacies and health clinics. Participants seeking medical abortion (less than nine weeks' gestation) who met usual medical abortion eligibility criteria were recruited.

Impact of health system strengthening interventions on child survival in sub-Saharan Africa: a systematic review protocol.

Background: Strengthening healthcare systems is a practical approach to enhance healthcare delivery and services. Although there has been a rise in the number of health systems strengthening (HSS) interventions in sub-Saharan Africa (SSA), there is limited evidence on the causal effect of these activities on child survival. Furthermore, the findings reported so far have been varied, and how they relate to each other remains unclear.

Postpartum contraceptive initiation and use: Evidence from Accra, Ghana.

Background: Postpartum contraceptive use reduces unintended pregnancies and results in better health outcomes for children and women. However, there is a dearth of knowledge on postpartum contraceptive use in Ghana, particularly among women in low-income urban settings. To shed light on strategies that might enhance access to postpartum family planning services in low-income urban settings, we examined contraceptive use among postpartum women in Accra, Ghana, at 1, 3, 6, and 12 months following the birth and the methods used.

Covert Contraceptive Use amongst the urban poor in Accra, Ghana: experiences of health providers.

Background: An estimated one-third of women in Ghana use contraceptives without the knowledge of their partners, a phenomenon known as Covert Contraceptive Use (CCU). Most research on CCU to date has focused on individual women to the neglect of the role of health system. This study explores CCU in urban poor communities of Accra, Ghana, from the experiences and perspectives of health providers.

Partner support and women's contraceptive use: insight from urban poor communities in Accra, Ghana.

Background: Despite the benefits associated with contraceptive use, there is a low prevalence of contraceptive use in sub-Saharan Africa and Ghana. Previous studies have partly and consistently attributed the low prevalence of contraceptive use to partner opposition. However, little is known about the influence of men in contraceptive related choices of their partners, particularly within the context of urban poverty.

Impact of Covid-19 on Maternal Health Seeking in Ghana.

The Covid-19 pandemic is widely speculated to have disrupted the delivery of primary health care in low-income countries. Yet, there is little rigorous empirical research identifying this effect. This paper estimates the impact of Covid-19 on facility and skilled delivery and utilisation of antenatal care (ANC) services by comparing these outcomes for women who were pregnant/delivered before and during the Covid-19 period.

Contraception before and after induced abortion: Trajectories of women in selected urban-poor settlements of Accra, Ghana.

This paper examined women's pre- and post-induced abortion contraceptive use and predictors of post-abortion modern contraceptive uptake in selected poor settlements of Accra, Ghana. Data from a cross-sectional study of 251 women aged 16-44 years were used. Patterns of contraceptive use were analysed descriptively while the predictors of modern contraceptive use in the month following induced abortion were examined using a binary logistic regression model.

Methods women use for induced abortion and sources of services: insights from poor urban settlements of Accra, Ghana.

Background: Increasing access to safe abortion methods is crucial for improving women's health. Understanding patterns of service use is important for identifying areas for improvement. Limited evidence is available in Ghana on factors associated with the type of method used to induce abortion.

Dynamics of Emergency Contraceptive Use in Accra, Ghana.

Recent data suggest increasing rates of emergency contraception (EC) use in Ghana, particularly in urban areas. In 2018, we collected survey data from 3,703 sexually experienced women aged 16-44 years living in low-income settlements of Accra. We estimated the prevalence of lifetime and current EC use.

Contraceptive method use, discontinuation and failure rates among women aged 15-49 years: evidence from selected low income settings in Kumasi, Ghana.

Background: This paper provides estimates of contraceptive discontinuation and failure rates in a poor urban setting in Ghana. Contraceptive use is for the purposes of preventing unintended or mistimed pregnancies. Unfortunately, evidence abounds in many parts of the world where there is considerable levels of contraceptive failure and high levels of discontinuation resulting in unintended pregnancies.

Correlates and spatial distribution of the co-occurrence of childhood anaemia and stunting in Ghana.

Childhood anaemia and stunting are major public health concerns in Ghana. Using the 2014 Ghana Demographic and Health Survey, we evaluated whether childhood anaemia (Haemoglobin concentration < 110 g/L) and stunting (height-for-age z score < -2) co-occur beyond what is expected in Ghana, and employed spatial analysis techniques to determine if their co-occurrence is spatially correlated. There was no statistically significant difference between the observed and expected frequency of co-occurrence.

The impact of a personalized, community-based counselling and referral programme on modern contraceptive use in urban Ghana: a retrospective evaluation.

Community-based demand-generation family planning programmes have been associated with increased contraceptive use in rural areas of Ghana. However, rigorous evaluations of such programmes in urban contexts are lacking. We used a retrospective, cross-sectional with comparison group design to estimate the immediate and sustained impact of the Willows intervention on modern contraceptive use in Kumasi, Ghana.

Enhancing healthy ecosystems in northern Ghana through eco-friendly farm-based practices: insights from irrigation scheme-types.

Background: Farming practices vary from farmer to farmer and from place to place depending on a number of factors including the agroclimatic condition, infrastructure (e.g. irrigation facilities) and management mechanisms (private versus state management).

Out-of-pocket payment for primary healthcare in the era of national health insurance: Evidence from northern Ghana.

Background: Ghana introduced a national health insurance program in 2005 with the goal of removing user fees, popularly called "cash and carry", along with their associated catastrophic and impoverishment effects on the population and ensuring access to equitable health care. However, after a decade of implementation, the impact of this program on user fees and out-of-pocket payment (OOP) is not properly documented. This paper contributes to understanding the impact of Ghana's health insurance program on out-of-pocket healthcare payments and the factors associated with the level of out-of-pocket payments for primary healthcare in a predominantly rural region of Ghana.