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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:
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Recent Submissions
Knowledge, Attitudes and Barriers Towards Cervical Cancer Screening Among Women of Reproductive Age in Lower Manya Krobo Municipality, Eastern Region
(Ensign Global University, 2026-06-01) Narteh, Belinda
Background: Cervical cancer is a serious public health concern globally, with a
disproportionately high burden in low- and middle-income countries, including Ghana. Despite the availability of effective screening methods, uptake remains low, particularly in peri-urban and rural settings. Limited knowledge, negative attitudes, and multiple sociocultural and health system barriers continue to hinder participation in screening programs. Understanding these factors at the Municipality level is essential for designing context-specific interventions.
Aim: This study aimed to assess the knowledge, attitudes, and barriers towards cervical cancer screening among women of reproductive age in the Lower Manya Krobo Municipality, Eastern Region of Ghana.
Methods: A quantitative cross-sectional study design was employed among 314 women aged 15–49 years. Data were collected using a structured interviewer-administered questionnaire. Descriptive statistics were used to summarize variables, while chi-square tests and logistic regression analyses were conducted to examine associations between independent variables and cervical cancer screening uptake. Statistical significance was set at p < 0.05.
Results: Overall, 55.41% of respondents had good knowledge of cervical cancer and
screening, while 44.59% had poor knowledge. Although 65.61% had heard of cervical
cancer screening, awareness of specific screening methods was low, with 61.78% unable to identify any method. Attitudes towards screening were generally positive, with the majority agreeing that screening is necessary and expressing willingness to participate if services were free. However, screening uptake was low, with only 23.25% of respondents having ever undergone screening. The most commonly reported barriers were lack of knowledge about where screening services are provided (30.57%), not being informed about screening (28.66%), perceived lack of need due to absence of symptoms (27.71%), and fear of screening results (27.39%). Knowledge level was significantly associated with screening uptake (p < 0.001), while socio-demographic factors and attitudes were not statistically significant.
Conclusion: Despite moderate levels of awareness and generally positive attitudes,
cervical cancer screening uptake remains low among women in the Lower Manya Krobo
Municipality. Knowledge gaps and informational barriers play a critical role in limiting screening participation. There is a need for targeted health education, improved dissemination of information on screening services, and community-based interventions to enhance screening uptake.
Prevalence And Associated Risk Factors of Preeclampsia Among Pregnant Women Attending Antenatal Clinic in Ho Municipal Hospital, Volta Region, Ghana
(Ensign Global University, 2026-06-01) Atakora, Sirina Jacqueline
Background: Preeclampsia remains a leading cause of maternal and perinatal morbidity and
mortality in low- and middle-income countries, including Ghana. Facility-specific data on its
prevalence and associated risk factors at Ho Municipal Hospital in the Volta Region are
limited.
Aim: This study aimed to determine the prevalence of preeclampsia and identify its associated
risk factors among pregnant women attending the antenatal clinic at Ho Municipal Hospital,
Volta Region, Ghana.
Method: A facility-based cross-sectional study was conducted using a retrospective review of
antenatal records. A total of 438 pregnant women were systematically sampled. Data on
sociodemographic, obstetric, and nutritional variables were extracted using a structured tool.
Preeclampsia was diagnosed according to ACOG (2020) criteria. Data were analysed using
chi-square tests for bivariate associations and binary logistic regression for multivariate
analysis.
Results: The prevalence of preeclampsia was 4.34% (19/438). In bivariate analysis, only
malnutrition was significantly associated with preeclampsia (χ² = 5.536, p = 0.019).
Multivariate logistic regression confirmed that malnutrition was the only independent predictor
(AOR = 5.21, 95% CI: 1.12–24.34, p = 0.036). Age group, educational level, occupation,
income, number of ANC visits, previous caesarean section, primigravidity, and gestational age
were not statistically significant.
Conclusions: Preeclampsia affects approximately 4.34% of pregnant women attending
antenatal care at Ho Municipal Hospital. Malnutrition is the only significant independent risk
factor. Targeted nutritional screening and interventions during antenatal care are recommended
to reduce the burden of preeclampsia in this setting.
Timing Of Introduction of Complementary Foods and Its Association With Stunting in the Ho Municipality, Volta Region.
(Ensign Global University, 2026-06-01) Nutsukpo, Annette Semenyo
Introduction: Malnutrition remains a major global public health concern, particularly among
children under five years. Globally, 45 million children are wasted and 149 million are stunted,
with over half of under-five deaths linked to malnutrition. Appropriate infant and young child
feeding (IYCF) practices, especially complementary feeding (CF), are essential for improving
child survival and growth outcomes. In Ghana, underweight, wasting, and stunting among infants
are estimated at 10.4%, 5.3%, and 18.4%, respectively.
Methodology: A quantitative facility-based cross-sectional study was conducted among 328
caregivers of infants aged 6–24 months at Ho Teaching Hospital. Data were collected using a
structured questionnaire and analyzed using descriptive statistics and inferential methods.
Results: More than half (54.27%) of caregivers introduced complementary feeding at six months, while 24.09% initiated early and 21.65% initiated late. Breastfeeding was widely practiced (96.04%), but only 30.18% adhered to exclusive breastfeeding for six months. Porridge was the most commonly introduced food (51.83%). The prevalence of stunting was 18.29%. Although stunting was lowest among infants introduced at six months, the association between timing of CF and stunting was not statistically significant (p > 0.05).
Conclusion: While timely CF is common, inappropriate timing persists. Timing alone does not
significantly predict stunting, highlighting the importance of dietary quality and socio-economic
factors. Interventions should focus on improving feeding practices and dietary quality.
Health-Seeking Behaviour of People Living With Non-Communicable Diseases in Rural Ghana: A Case Of Dodi Asantekrom, Ghana
(Ensign Global University, 2026-06-01) Amefu, Seth Kwasi
Background: Noncommunicable diseases (NCDs) are a leading cause of morbidity and mortality globally, with a rapidly increasing burden in low- and middle-income countries such as Ghana. In rural settings, limited access to healthcare services and structural barriers often influence how individuals seek care for chronic conditions, affecting timely diagnosis and effective management.
Aim: This study aimed to assess the prevalence of noncommunicable diseases, examine health-seeking behaviours, and identify factors influencing healthcare utilization among individuals living with NCDs in Dodi Asantekrom in the Asuogyaman District.
Methods: A facility-based cross-sectional study was conducted using a purposive sampling
technique. Data was collected from individuals diagnosed with NCDs using a structured,
interviewer-administered questionnaire. Descriptive statistics were used to summarize key
variables, while chi-square tests were conducted to examine associations between health-seeking
behaviour and selected socio-demographic and structural factors. Data analysis was performed
using STATA version 18.
Results: Hypertension was the most prevalent condition (76.39%), followed by asthma (12.13%)
and peptic ulcer disease (11.80%). The majority of respondents had lived with their condition for
four years or more, and most were diagnosed by medical doctors (75.08%). Formal healthcare
utilization was high (98.7%); however, a significant proportion of respondents reported delays in
seeking care (94.43%) and switching between healthcare providers (89.18%). Informal care use
was also widespread (96.7%), mainly as a complementary approach. Socio-demographic factors
were not significantly associated with health-seeking behaviour, while transportation emerged as
the only significant structural determinant (p < 0.05).
Conclusion: The study highlights a high burden of hypertension and widespread reliance on
formal healthcare services, alongside significant delays in care-seeking and extensive use of
informal care. Health-seeking behaviour in this setting is influenced more by structural barriers
than by socio-demographic characteristics. Addressing these structural constraints is essential for
improving timely access to care and strengthening NCD management in rural communities.
Determinants of Incomplete Immunization Among Children Aged 12 to 23 Months in the Lower Manya Krobo Municipality Eastern Region of Ghana
(Ensign Global University, 2026-06-01) Poavri, Victoria Ama
Background: Immunization is a cornerstone of child health, yet coverage gaps persist due to
socioeconomic and health system barriers.
Aim: This study examined determinants of incomplete immunization among children aged 12–
23 months, focusing on demographic, socioeconomic, and health system factors.
Methodology: A cross-sectional survey of 344 caregivers was conducted. Chi-square tests
assessed associations between demographic and health system variables and immunization
status, while binary logistic regression identified independent predictors of incomplete
immunization.
Results: Of the children studied, 68.9% were fully immunized and 31.1% missed at least one
vaccine, with Yellow Fever most frequently missed (13.4%). Chi-square analyses revealed
significant associations with age, income, occupation, marital status, distance to facility,
transport mode, vaccine availability, waiting time, and clinic crowding. Logistic regression
confirmed that age group, income level, vaccine availability, and clinic crowding were
independent predictors of incomplete immunization, while occupation lost significance after
adjustment.
Conclusion: Both socioeconomic status and health system capacity are pivotal determinants
of immunization outcomes. Younger caregivers, low-income households, and those affected by
vaccine shortages or clinic crowding are at greatest risk. Strengthening vaccine supply chains,
reducing clinic congestion, expanding caregiver education, and addressing socioeconomic
inequities are essential strategies to improve immunization coverage and equity.
Contribution: By situating the analysis within the Ghanaian context, this study contributes to
the literature on immunization determinants in low- and middle-income countries. It provides
actionable evidence for policymakers and health practitioners seeking to achieve universal
immunization coverage and safeguard child health.