Ensign Digital Repository
Ensign Digital Repository is a digital service that collects, preserves, and distributes digital materials of the University. Repositories are important tools for preserving an organization's legacy; they facilitate digital preservation and scholarly communication.The Ensign Digital Repository platform enables the University to:
- easily ingest documents, audio, video, datasets and their corresponding Dublin Core metadata
- open up this content to local and global audiences, thanks to the OAI-PMH interface and Google Scholar optimizations
- issue permanent urls and trustworthy identifiers, including optional integrations with handle.net and DataCite DOI
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Recent Submissions
Sanitation in Selected Hospitals in the Accra Metropolis: A Public Health Assessment from the Perspectives of Users (Patients/Caregivers and Staff)
(Ensign Global University, 2026-06-01) Davordzie, Sally Pearl
Background:
Sanitation and hand hygiene are fundamental to safe healthcare delivery and infection prevention, yet urban hospitals frequently struggle with infrastructure, supply, and maintenance gaps. This study assessed the functionality, management, and user experiences of sanitation facilities across four hospitals in the Accra Metropolis.
Methods:
Using a descriptive cross-sectional design, stratified systematic sampling surveyed 311 patients and caregivers, while 13 key sanitation and infection prevention staff were conveniently sampled. Data were analyzed using descriptive statistics and univariate summaries of user perceptions, facility conditions, and staff practices.
Result:
The study revealed that while 70.7% of users found toilets easily locatable, 56.3% reported them as non-functional. Cleanliness perceptions were evenly distributed across good, fair, and poor categories, with 63.3% noting unpleasant odors and 44.1% experiencing inconsistent water supply. Notably, 64.0% rated their ability to wash hands effectively as poor. Although staff confirmed structured cleaning schedules and regular supervision, 87.5% cited severe shortages of cleaning materials. Key institutional challenges included inadequate cleaning staff (76.9%), funding constraints, weak supervision, and high patient loads. Despite management’s stated commitment to sanitation, systemic logistical gaps severely compromise service delivery.
Conclusion:
This study highlights an urgent need for targeted investments in hygiene supplies, staffing, maintenance responsiveness, and standardized monitoring tools. Addressing these operational constraints is essential to enhancing user satisfaction, reducing healthcare-associated infection risks, and ensuring dignified, safe clinical environments in high-density urban settings.
Assessing Male Involvement in Maternal and Newborn Health in Ghana
(Ensign Global University, 2026-06-01) Safoaa, Naana Adwoa
Background:
Although global and national policies increasingly recognise the importance of involving men in maternal and newborn care, male participation continues to be limited due to socio-cultural beliefs and gendered decision-making structures. This study aims to assess men’s involvement in MNH in Ghana by examining their attitudes toward gender norms and shared decision-making in in maternal and reproductive health within households.
Methodology:
They adopted a cross-sectional secondary data analysis approach, drawing on nationally representative data from the men’s questionnaire of the GDHS 2022. Measures of gender attitudes and participation in household decision-making were used to assess men’s involvement in maternal and reproductive health. Descriptive statistics were used to summarize key attitudes, while chi-square tests and logistic regression will assess associations between sociodemographic characteristics and gender-equitable views. All analyses will be conducted using Stata version 18.
Results/Findings:
A total of 3,726 men aged 15–59 years were included in the analysis. The majority of respondents (83.3%) exhibited gender-equitable attitudes, with over 90% rejecting the justification of wife-beating across all scenarios. Gender-equitable attitudes were significantly associated with age, education, wealth status, place of residence, religion, and region (p < 0.001), with more equitable attitudes observed among older, more educated, and wealthier men. Male involvement in maternal health was relatively high, with 73.6% of respondents reporting participation. At the bivariate level, involvement was significantly associated with gender-equitable attitudes, age, education, place of residence, and region (p < 0.05), but not with wealth status. Multivariate analysis showed that men with gender-equitable attitudes were significantly more likely to be involved in antenatal care (AOR = 1.65; 95% CI: 1.12–2.44). Increasing age was also associated with higher involvement, with men aged 35–44 years having the highest odds (AOR = 2.63; 95% CI: 1.37–5.03). Only tertiary education was significantly associated with involvement (AOR = 2.23; 95% CI: 1.18–4.20). Additionally, Muslim men (AOR = 1.74; 95% CI: 1.12–2.69) had higher odds of involvement compared to Christians.
Conclusion:
The study demonstrates that while gender-equitable attitudes are prevalent among Ghanaian men, these do not fully translate into equitable household practices, particularly indecision-making. The findings highlight the critical role of gender norms in shaping male
participation in maternal health and the need for gender-transformative interventions that address both individual attitudes and broader socio-cultural dynamics.
Assessing The Impact of Occupational Stress on the Mental Health of Staff At Focos Orthopaedic Hospital
(Ensign Global University, 2026-06-01) Annan, Percy Reginald
Background:
Occupational stress is a significant public health concern among healthcare workers globally, contributing to adverse mental health outcomes including anxiety, depression, and burnout. In Ghana, existing research has concentrated largely on general hospital settings, leaving a critical gap in evidence from specialised healthcare institutions. Staff working in orthopaedic and surgical facilities face distinct occupational demands that may heighten vulnerability to psychological distress. Despite this, no prior study has examined occupational stress and its mental health consequences specifically among staff at FOCOS Orthopaedic Hospital.
Aim:
This study assessed the impact of occupational stress on the mental health of staff at FOCOS Orthopaedic Hospital, Accra, Ghana.
Methods:
A quantitative cross-sectional design was employed. Using Yamane's formula applied to a known total staff population of 350, a sample of 206 participants was recruited through stratified random sampling across professional cadres. Data was collected via a structured, self-administered questionnaire incorporating adapted items from the Generalised Anxiety Disorder 7-item Scale (GAD-7), the Patient Health Questionnaire (PHQ-9), and a set of six burnout items informed by the Maslach Burnout Inventory framework. Descriptive statistics summarised participant characteristics and outcome distributions. Chi-square tests and multivariable logistic regression were used to examine associations between occupational stress and mental health outcomes.
Results:
A total of 206 respondents participated (response rate: 100%). The majority were female (58.74%), and nurses constituted the largest professional group (49.51%). Over 95% of respondents reported moderate to high levels of occupational stress, with a mean stress score of 3.30 ± 0.48. The most frequently reported stressors were lack of supervisory and collegial support (34.47% always), fear of making clinical errors (30.58% always), long working hours (29.13% always), and inadequate resources (29.13% always). Regarding mental health outcomes, the majority of respondents screened positive for clinically relevant anxiety (61.66% moderate to severe on GAD-7, mean = 10.36 ± 3.04), while depressive symptoms were particularly severe, with 91.26% of respondents falling in the moderate-to-severe range on the PHQ-9 (mean = 13.98 ± 3.30). Burnout was widespread, with 90.29% of respondents experiencing moderate to high burnout (mean = 3.06 ± 0.54). Multivariable logistic regression revealed that occupational stress was significantly associated with depression (AOR = 2.54, 95% CI: 1.97–6.64, p = 0.048), indicating that staff with high stress levels were approximately 2.5 times more likely to report depressive symptoms. No statistically significant associations were found between occupational stress and anxiety (AOR = 0.66, 95% CI: 0.39–1.12, p = 0.127) or burnout (AOR = 1.03, 95% CI: 0.58–1.84, p = 0.916).
Conclusion:
Occupational stress is highly prevalent among staff at FOCOS Orthopaedic Hospital, and is significantly associated with depressive symptoms. Anxiety and burnout, while widespread, did not show statistically significant associations with stress levels in this study, possibly reflecting ceiling effects and limitations in burnout measurement. These findings underscore the urgent need for targeted mental health interventions, including workload management strategies, structured supervisory support systems, and accessible psychosocial services, to protect the psychological wellbeing and professional sustainability of staff in specialised hospital settings in Ghana.
Assessing the Prevalence, Distribution and Association Between Sickle Cell Disease and Growth Outcomes Among Children in Oti and Volta Regions, Ghana: A Community-Based Cross-Sectional Study
(Ensign Global University, 2026-06-01) Gbormittah, Noble Selorm
Background:
Sickle cell disease (SCD) is one of the most common inherited blood disorders globally and remains a significant public health concern in sub-Saharan Africa. Ghana is among the countries with a high burden of the disease, with a considerable proportion of the population carrying the sickle cell gene. The study aimed to determine the prevalence, demographic distribution, and growth-related impacts of sickle cell disease among children aged 3-14 years in selected communities in the Oti and Volta Regions of Ghana.
Methods:
A community cross-sectional study design was used. The study analyzed secondary data obtained from sickle cell disease screening activities conducted by Medlook Ghana in collaboration with Compassion Ghana using Stata version 17. The dataset included hemoglobin genotype results, demographic characteristics, and anthropometric measurements of children aged 3-14 years screened in selected communities. A total of 1,226 children with complete records were included in the analysis.
Results:
The prevalence of SCD and its genotypes was calculated. The results showed that 76.75% of participants had the AA genotype, while 11.42% had AS and 9.79% had AC. Genotypes associated with SCD included SS (0.65%), SC (0.57%), and FS (0.08%), giving an overall SCD prevalence of 1.31%. Nutritional assessment showed that stunting was present in 0.33% of participants, underweight in 0.49%, and wasting in 1.47%. Chi-square tests indicated no statistically significant association between SCD status and stunting (χ² = 0.053, p = 0.818), underweight (χ² = 0.080, p = 0.778), or wasting (χ² = 0.242, p = 0.623).
Conclusion:
The study highlights the importance of strengthening community-based screening, early diagnosis, and genetic counseling programmes to improve the detection and management ofsickle cell disease among children in Ghana.
Assessing the Awareness of Antimicrobial Resistance Among Patients at the Ho Teaching Hospital, Ho Municipality, Volta Region, Ghana
(Ensign Global University, 2026-06-01) Opoku, Samuel Kwasi
Background:
Antimicrobial resistance (AMR) is a major public health concern driven by inappropriate antibiotic use and limited patient awareness. This study assessed awareness of antimicrobial resistance among patients at Ho Teaching Hospital.
Methods:
A descriptive cross-sectional study was conducted among 422 patients using a structured questionnaire. Data were analyzed using STATA version 18. Descriptive statistics summarized variables, while chi-square tests assessed associations between socio-demographic factors and AMR awareness (p < 0.05).
Results:
Most respondents were young (35.5% aged 18–29 years) and female (55.0%). Overall, 64.0% had heard of AMR. Knowledge was moderate: 73.5% knew antibiotics treat bacterial infections, 69.9% understood AMR, and 71.1% recognized self-medication as a cause. However, only 28.4% correctly identified that antibiotics do not treat viral infections. Overall, 59.2% had good knowledge. Doctors (30.8%) and nurses (23.7%) were the main information sources, with doctors most trusted (42.7%). Knowledge was significantly associated with age, education,
occupation, residence, and NHIS status (p < 0.05).
Conclusion:
Although awareness exists, significant knowledge gaps remain, highlighting the need for strengthened public education and antimicrobial stewardship.