Bardoe Dennis, Bio Robert Bagngmen, Hayford Daniel, Yar Denis Dekugmen
Department of Public Health Education, Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development, Mampong, Ghana.
Department of Integrated Science Education, Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development, Mampong, Ghana.
PLOS Glob Public Health. 2025 Jun 24;5(6):e0004826. doi: 10.1371/journal.pgph.0004826. eCollection 2025.
To effectively reduce the impact of hepatitis B and malaria during pregnancy, consistent adherence to key preventive interventions such as vaccination, the use of long-lasting insecticidal nets (LLINs), and the administration of Sulfadoxine-Pyrimethamine (SP) is essential. Achieving high coverage of these interventions, however, requires a clear understanding of the factors that hinder compliance. Therefore, this study investigated the psychological determinants of non-compliance with these interventions among pregnant women in the Bono East Region. A prospective cross-sectional mixed-method study was conducted among 1,430 pregnant women. Data were collected through serological screening, questionnaires, in-depth interviews, and focus group discussions. Quantitative analysis included descriptive statistics, Chi-square tests, and logistic regression with results shown as crude and adjusted odds ratios at 95% confidence intervals. The quantitative analysis involved a four-step thematic analysis with a focus on transcription, profiling, coding, and thematic framework. The study revealed a series of psychological barriers to compliance. The fear of side effects (AOR = 2.17; 95% CI: 1.78 - 4.06), forgetfulness (AOR = 6.02; 95% CI: 2.13 - 9.91), and pain (AOR = 2.95; 95% CI: 1.97 - 4.94) increased the odds of hepatitis B infection. Likewise, fear of side effects (AOR = 2.07; 95% CI: 1.66 - 3.72), absence of symptoms (AOR = 1.82; 95% CI: 1.53 - 2.26), forgetfulness (AOR = 2.41; 95% CI: 1.48 - 3.90), perceived efficacy of herbs (AOR = 2.35; 95% CI: 1.49 - 3.68), pain (AOR = 2.52; 95% CI: 1.48 - 4.27), uncertainty (AOR = 2.38; 95% CI: 1.48 - 3.84), and prolonged adherence (AOR = 1.71; 95% CI: 1.10 - 2.66) increased the odds of malaria. The identified barriers and their strong association with increased odds of infections call for a groundbreaking and policy-driven public health response. Consequently, integrating psychosocial support and mental health services into antenatal care could play a crucial role in overcoming these barriers.
为有效降低孕期乙型肝炎和疟疾的影响，持续坚持关键的预防干预措施至关重要，如接种疫苗、使用长效驱虫蚊帐（LLINs）以及服用磺胺多辛-乙胺嘧啶（SP）。然而，要实现这些干预措施的高覆盖率，需要清楚了解阻碍依从性的因素。因此，本研究调查了博诺东区孕妇不遵守这些干预措施的心理决定因素。对1430名孕妇进行了一项前瞻性横断面混合方法研究。通过血清学筛查、问卷调查、深入访谈和焦点小组讨论收集数据。定量分析包括描述性统计、卡方检验和逻辑回归，结果以95%置信区间的粗比值比和调整后的比值比表示。定性分析采用了四步主题分析法，重点在于转录、剖析、编码和主题框架。该研究揭示了一系列依从性方面的心理障碍。对副作用的恐惧（调整后比值比=2.17；95%置信区间：1.78 - 4.06）、健忘（调整后比值比=6.02；95%置信区间：2.13 - 9.91）和疼痛（调整后比值比=2.95；95%置信区间：1.97 - 4.94）增加了感染乙型肝炎的几率。同样，对副作用的恐惧（调整后比值比=2.07；95%置信区间：1.66 - 3.72）、无症状（调整后比值比=1.82；95%置信区间：1.53 - 2.26）、健忘（调整后比值比=2.41；95%置信区间：1.48 - 3.90）、对草药疗效的认知（调整后比值比=2.35；95%置信区间：1.49 - 3.68）、疼痛（调整后比值比=2.52；95%置信区间：1.48 - 4.27）、不确定性（调整后比值比=2.38；95%置信区间：1.48 - 3.84）和长期依从性（调整后比值比=1.71；95%置信区间：1.10 - 2.66）增加了感染疟疾的几率。所确定的障碍及其与感染几率增加的强烈关联需要一种开创性的、政策驱动的公共卫生应对措施。因此，将社会心理支持和心理健康服务纳入产前护理可能在克服这些障碍方面发挥关键作用。
