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Background: Several health systems developed interventions and strategies in response to the COVID-19 pandemic, some of which were broad-based, some of which focused on service delivery, and others on frontline health workers. The goal of this study was to see how COVID-19 interventions affected the motivation of frontline health workers in Ghana and Uganda. Methods: The research was undertaken during the period of May to July 2020, coinciding with the initial three months of the global response to the COVID-19 pandemic. This was a critical juncture when the majority of the proposed strategies were in the nascent stages of execution. The research methodology employed was cross-sectional study design, utilizing a qualitative phenomenological approach. The study was conducted across two regional referral hospitals located in Ghana and Uganda. Sixteen frontline healthcare workers from both Uganda and Ghana were selected for interviews, which were conducted both in-person and telephonically. Additionally, one managerial staff member from each hospital was also interviewed. The collected data were subsequently subjected to a deductive thematic analysis. Results: The three themes that emerged from the study include the interventions mentioned by the healthcare workers, the interventions that serve as motivators, and those interventions that act as demotivators. The conceptualization and implementation of the COVID-19 response interventions resulted in differential perceptions regarding their impact on the motivation of healthcare workers in the two hospitals under study. The primary catalysts for healthcare professionals' motivation were the leadership exhibited by their respective governments and supervisors, coupled with certain promises made. These included financial incentives that initially appeared to be motivational, as well as proposals to offer complimentary services. However, the failure to fulfill some of these commitments, along with the unequal distribution of the financial incentives, led to a decrease in motivation among the healthcare workers. Certain human resources for health strategies were perceived as poorly planned and impracticable, resulting in a demotivation among COVID-19 frontline healthcare providers. Conclusion: The COVID-19 response interventions' implementation yielded varied perceptions on healthcare workers' motivation both positive and negative. These were attributed to leadership quality, promises like financial incentives and complementary services, and unmet commitments. The COVID-19 pandemic response strategies in both countries underscore the need for preparedness in the face of unforeseen outbreaks. Failure to sustain healthcare worker motivation may compromise future response effectiveness. Governments must learn from this and come up with well sought of response strategies incorporating health workers' input for comprehensive crisis management. They should establish well-resourced, multisectoral units with specific incentives to handle the response.
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BACKGROUND: Globally, human rights violations experienced by persons with psychosocial, intellectual or cognitive disabilities continue to be a concern. The World Health Organization's (WHO) QualityRights initiative presents practical remedies to address these abuses. This paper presents an overview of the implementation of the initiative in Ghana. AIMS: The main objective of the QualityRights initiative in Ghana was to train and change attitudes among a wide range of stakeholders to promote recovery and respect for human rights for people with psychosocial, intellectual and cognitive disabilities. METHOD: Reports of in-person and online training, minutes of meetings and correspondence among stakeholders of the QualityRights initiative in Ghana, including activities of international collaborators, were analysed to shed light on the implementation of the project in Ghana. RESULTS: In-person and online e-training on mental health were conducted. At the time of writing, 40 443 people had registered for the training, 25 416 had started the training and 20 865 people had completed the training and obtained a certificate. The team conducted 27 in-person training sessions with 910 people. The successful implementation of the project is underpinned by a committed partnership among stakeholders, strong leadership from the coordinating agency, the acceptance of the initiative and the outcome. A few challenges, both in implementation and acceptance, are discussed. CONCLUSIONS: The exposure of the WHO QualityRights initiative to a substantial number of key stakeholders involved in mental healthcare in Ghana is critical to reducing human rights abuses for people with psychosocial, intellectual and cognitive disabilities.
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BACKGROUND: The maltreatment of people with mental illness in Ghana's traditional and faith-based healing centres, including shackling, flogging, and forced fasting, has been documented by numerous sources. Such treatment is potentially traumatising and may exacerbate mental health problems. Despite widespread use, few studies have focused on experiences and characteristics of people who seek traditional healing for mental illness or healers' perspectives treatment of these conditions. METHOD: Purposeful sampling was used to recruit 82 individuals who were treated in healing centres and 40 traditional healers; all took part in semi-structured interviews. Those treated were asked about experiences in centres and assessed for prior trauma exposure, posttraumatic stress, and functional impairment. Healers were asked about beliefs and practices related to the treatment of mental illness. RESULTS: Individuals treated in centres and healers generally believed that mental illness has a spiritual cause. Approximately 30.5% of those treated in centres were exposed to maltreatment; despite this, half would return. Individuals with a history of trauma were more likely to report maltreatment in the centre and had higher symptoms of posttraumatic stress. Most participants had impaired functioning. Healers who used practices like shackling believed they were necessary. Most healers were willing to collaborate with the official health structure. CONCLUSION: Results provide insight into the treatment of mental illness by traditional healers in Ghana and the need for trauma-informed mental health services. Findings also highlight the importance of considering cultural beliefs when attempting to implement mental health interventions in the region.
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BACKGROUND: Prayer camps and traditional healers have emerged recently as alternative sources of mental health care in Ghana. To increase their knowledge and collaboration between formal and informal mental health care providers, training and sensitization was organized for them. AIMS: This study aimed at assessing beneficiaries' views about the impact of this intervention. METHODS: We adopted narrative approach to qualitative enquiry using purposive sampling strategy to recruit formal and informal mental health care providers in Ghana for an in-depth interview. We analyzed the data thematically using QSR NVivo 12. RESULTS: Participants enhanced their knowledge about mental health and illness. They reported increased collaboration between formal and informal health care providers. Community psychiatric nurses (CPNs) give injections to patients instead of chaining and using shackles as was initially practiced. There are also regular visits by CPNs to traditional and spiritual healers to discuss the care of the mentally ill patients in their facilities. CONCLUSION: There has been an increased collaboration among healers of mental illness resulting in quick recovery of patients who seek care at traditional and spiritual healers. There is also abolition of chaining and using of shackles by these healers, with increasing respect for the human rights of patients.