Research Article | | Peer-Reviewed

Exploring Information Sources on Malaria Prevention and Their Impact on Knowledge Among Pregnant Women in Urban Ghana

Received: 21 September 2024     Accepted: 11 October 2024     Published: 31 October 2024
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Abstract

Background: Adequate knowledge of malaria prevention among pregnant women is crucial for mitigating the associated risks. This study aimed to explore the various information sources on malaria preventive measures and assess their impact on the knowledge of malaria prevention among pregnant women in an urban district of Ghana. Methods: A cross-sectional study involving 300 pregnant women was conducted to evaluate their knowledge of malaria prevention. Chi-square tests were utilized to assess the relationships between these educational sources and levels of knowledge. To quantify the influence of each educational source on knowledge, logistic regression models were employed, providing adjusted odds ratios (AORs) with 95% confidence intervals (CIs). All analyses were conducted using Statistical Package for the Social Sciences (SPSS) version 20 and Microsoft Excel version 2026. Results: Overall, 88.7% of participants demonstrated adequate knowledge of malaria prevention. Education at health posts by trained workers was linked to higher knowledge (AOR = 7.82, 95% CI [1.26, 48.35], p = 0.027). In contrast, education from family or friends was associated with lower knowledge levels (AOR = 0.34, 95% CI [0.15, 0.76], p = 0.008). Media and written materials did not significantly affect knowledge levels (χ² (1, N = 300) = 0.44, p = 0.51). Conclusion: The findings highlight the pivotal role of health posts and health workers in enhancing malaria prevention knowledge among pregnant women. Strategies aimed at strengthening health facility-based education could significantly improve maternal health outcomes in malaria-endemic regions. Further research is recommended to explore effective approaches for augmenting education from family networks and media to complement health facility-based efforts.

Published in World Journal of Public Health (Volume 9, Issue 4)
DOI 10.11648/j.wjph.20240904.12
Page(s) 322-334
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Malaria Prevention, Pregnancy, Information Sources, Healthcare Providers, Social Networks, Mass Media

1. Introduction
Malaria remains a severe threat to pregnant women, especially in sub-Saharan Africa . Pregnant women are more susceptible to severe forms of malaria, such as placental malaria, due to physiological changes during pregnancy . This condition can lead to serious complications like maternal anaemia, low birth weight, and even maternal mortality . The high malaria burden in Ghana highlights the urgent need for effective prevention strategies targeted at pregnant women .
Health education is crucial for malaria prevention among pregnant women. Understanding malaria transmission, symptoms, and preventive measures such as using insecticide-treated bed nets (ITNs), following intermittent preventive treatment in pregnancy (IPTp), and seeking prompt treatment can significantly reduce malaria's impact . Studies show that well-informed pregnant women are more likely to use preventive measures, which decreases malaria-related complications .
The effectiveness of health education depends on the sources of information. In Ghana, information comes from healthcare providers, community health workers, and mass media. Each source has strengths and limitations. Healthcare providers and community health workers offer personalized advice, while mass media can reach a broad audience but may not provide detailed guidance .
Urban areas, such as Asunafo North, pose unique challenges for malaria prevention. The complexities of urban environments such as varying healthcare access, fragmented information dissemination, and diverse community dynamics can affect how effectively health education reaches pregnant women. Integrating information across multiple channels is often necessary in urban settings to ensure widespread understanding and adoption of preventive measures.
Despite the importance of these factors, there is a notable gap in research on how different sources of malaria prevention education impact pregnant women in urban settings. Existing studies have explored malaria prevention among pregnant women , but few have specifically examined how various information sources affect malaria knowledge in urban districts like Asunafo North. Addressing this gap is essential for developing targeted interventions and improving malaria prevention strategies for pregnant women in urban areas.
Malaria remains a critical public health issue worldwide, particularly in sub-Saharan Africa, where it significantly affects vulnerable populations such as pregnant women . Despite various interventions aimed at reducing malaria's prevalence and impact, it continues to pose a major health challenge in Ghana . Pregnant women are especially vulnerable to malaria due to physiological changes that weaken their immune systems, making them more susceptible to severe forms of the disease, including placental malaria This condition can result in adverse pregnancy outcomes such as maternal anaemia, low birth weight, and even maternal mortality .
Most regions of West Africa like Ghana, experience substantial malaria transmission throughout the year. The prevalence of malaria varies by region and is influenced by climate, geography, and socioeconomic factors . According to the , Ghana represents a significant proportion of malaria cases and deaths in West Africa, underscoring the urgent need for effective prevention and control measures, particularly for vulnerable groups like pregnant women.
Pregnant women are at heightened risk for malaria due to the physiological changes during pregnancy that affect their immune response to the malaria parasite. Plasmodium falciparum, the primary malaria parasite in Ghana, can sequester in the placenta, leading to placental malaria with severe consequences for both the mother and the fetus . Malaria during pregnancy can result in maternal anaemia, intrauterine growth restriction, preterm birth, and increased infant mortality .
Effective malaria prevention and control among pregnant women heavily rely on their knowledge and awareness of preventive measures . Understanding malaria transmission, symptoms, and preventive strategies such as the use of insecticide-treated bed nets (ITNs), intermittent preventive treatment in pregnancy (IPTp), and prompt treatment with antimalarial drugs is essential for reducing malaria-related morbidity and mortality . Research indicates that adequate knowledge among pregnant women leads to better adherence to preventive measures, thereby decreasing the incidence and severity of malaria during pregnancy .
The effectiveness of malaria prevention efforts among pregnant women is influenced by the sources from which they receive information. In urban settings in Ghana, common sources include healthcare providers, community health workers, mass media (such as radio and television), and interpersonal communication within communities. The accuracy and timeliness of information from these sources can significantly affect the adoption of preventive measures and help reduce malaria-related complications.
Despite numerous studies on malaria prevention among pregnant women , there is a lack of research on how different sources of prevention education affect malaria knowledge in urban districts such as Asunafo North. Urban environments present unique challenges and opportunities compared to rural areas, including variations in healthcare access, information dissemination, and community dynamics. Investigating how various information sources impact malaria prevention knowledge in urban settings is essential for developing targeted interventions to improve maternal health outcomes effectively.
2. Materials and Methods
2.1. Study Setting
This study was conducted in the Asunafo North Municipality, located in the Ahafo Region of Ghana. Goaso, the regional capital, serves as the administrative centre. Established in 2018, the Asunafo North Municipality is bordered by the Tano North Municipality to the north, the Asutifi North District to the east, the Asunafo South Municipality to the south, and the Bia East District in the Western Region to the west. Local FM radio stations, including Nananom FM, Genesis FM, Success FM, and Hammers Radio, provide important communication channels for health information. Within the municipality, approximately eight of the twenty health facilities offer antenatal care (ANC), delivery, and post-partum services. These facilities serve both the municipality's residents and those from neighbouring communities, forming the study’s catchment area.
2.2. Study Design
This study employed a cross-sectional design to explore the sources of information on malaria preventive measures and their impact on malaria prevention knowledge among pregnant women in an urban district of Ghana.
2.3. Study Population
The study focused on pregnant women residing in the Asunafo North District who were receiving ANC services at health facilities within the district.
2.4. Inclusion Criteria
Pregnant women residing in the Asunafo North District, who were receiving antenatal care ANC at one of the eight selected health facilities, and who provided informed consent to participate were included in the study.
2.5. Exclusion Criteria
Pregnant women residing in the Asunafo North District, receiving ANC at one of the eight selected health facilities, were excluded if they did not provide informed consent or had severe health conditions that could impede their participation or affect their well-being.
2.6. Sample Size Calculation
The sample size for this study was calculated using Yamane's formula:
n=N1+N(e)2
In this formula, n represents the required sample size, N is the total population, and e denotes the acceptable margin of error. For this study, the margin of error was set at 0.05, or 5%. The population of interest comprised pregnant women attending antenatal clinics and maternity wards in the district, which was recorded as 991 in 2019. Applying Yamane's formula with these parameters, the initial calculation yielded a sample size of 285.
To ensure that the final sample size would adequately account for potential non-responses and maintain the study's statistical power, an adjustment was made. Specifically, a 5% non-response rate was anticipated. Therefore, the final sample size was increased to 300 to compensate for this anticipated non-response and to ensure the robustness of the study results. This adjustment was made to mitigate the risk of insufficient sample size and to enhance the reliability and validity of the study's findings.
2.7. Sampling Procedure
The study purposefully included all eight health facilities in the municipality that provide antenatal care (ANC) to ensure comprehensive coverage of available services. A stratified random sampling method was employed to determine the final sample size. Each health facility offering ANC was designated as a separate stratum, resulting in eight distinct strata. The sample size for each stratum was calculated by determining the proportion of the study population served by each facility and applying this proportion to the overall sample size of 300 participants. Within each facility, participants were selected through a simple random sampling technique. For this process, 300 slips marked ‘Yes’ and 300 slips marked ‘No’ were prepared and placed into a container, which was then thoroughly mixed to ensure randomness. Participants who consented to take part in the study were asked to draw a slip from the container without seeing its content. Those who drew a slip marked ‘Yes’ were included in the study sample, while those who drew a slip marked ‘No’ were excluded from participation. To maintain the integrity of the randomization process, each drawn slip was discarded immediately and not returned to the container, thereby ensuring that each draw remained independent and random. This approach facilitated an unbiased selection of participants from each stratum, aligning with the study’s objective of obtaining a representative sample across all facilities.
2.8. Data Collection Tool and Procedure
Between August 3 and November 30, 2020, a structured questionnaire was employed to gather quantitative data from pregnant women. This questionnaire, meticulously pretested and researcher-administered, was used to ensure accurate data collection. Trained research assistants administered the questionnaires during antenatal clinic visits to capture a comprehensive range of information. The questionnaire comprised several sections designed to gather detailed data on demographic characteristics, sources of information about malaria preventive measures, and knowledge related to malaria susceptibility, severity, and prevention during pregnancy. Before the full-scale data collection, the questionnaire underwent an extensive pretesting phase involving a pilot study with a small, representative sample of participants. This pretesting aimed to evaluate and refine the questionnaire's clarity, flow, and overall structure. Feedback from the pilot study led to necessary revisions to enhance the questionnaire's clarity, coherence, and effectiveness. The questionnaire was also adapted for cultural relevance and language to ensure that it was understandable and applicable to the participants, minimizing the risk of misinterpretation. To ensure the reliability of the data collected, a test-retest method was employed. A subgroup of respondents completed the questionnaire at different intervals to assess the consistency of their responses over time. Items that showed inconsistencies were reviewed and adjusted to improve the reliability of the instrument. This rigorous approach ensured that the data collected were both accurate and dependable, providing a solid foundation for subsequent analysis.
2.9. Variables Studied
2.9.1. Demographic Characteristics
The study assessed various demographic characteristics of participants to better understand their profiles. Age was categorized into three groups: under 20 years, 20 to 35 years, and over 35 years. Occupation was classified into three categories: self-employed, unemployed, and salaried workers. Marital status was categorized as cohabiting, married, separated/widowed, or single. Educational attainment was divided into four levels: basic, non-formal, secondary/vocational, and tertiary. Religion was primarily classified into two groups: Christianity and Islam. Additionally, gestational age was categorized into two groups: less than 16 weeks and 16 weeks or more.
2.9.2. Sources of Information on Malaria Preventive Measures
The study investigated how pregnant women receive education and information about malaria prevention during pregnancy, focusing on three main sources. First, Health Posts, where health workers offer crucial guidance on prevention and treatment. Second, Family and Friends, highlighting the influence of personal networks and informal channels. Third, Media and Written Materials, which include information from television, radio, billboards, as well as pamphlets, brochures, fact sheets, and leaflets. These diverse sources collectively contribute to shaping pregnant women’s knowledge and practices regarding malaria prevention.
2.9.3. Knowledge of Malaria Preventive Measures
The study assessed participants' knowledge of malaria preventive measures through a structured questionnaire focusing on three key areas. Susceptibility was evaluated using four questions to gauge participants' perceptions of their risk of contracting malaria. Severity was examined through six questions aimed at understanding participants' views on the seriousness and potential health impacts of malaria. General Prevention knowledge was measured with seven questions covering a range of preventive practices and strategies. For all questions, participants responded using a Likert scale with the options Agree, No Idea, and Disagree. This method provided a comprehensive assessment of participants' understanding and perceptions of malaria prevention.
2.9.4. Dependent Variable
The primary outcome of the study was the level of knowledge regarding malaria preventive measures, which was classified into two categories: adequate and inadequate knowledge. This classification was based on participants' responses to questions assessing their understanding of malaria prevention strategies and practices.
2.9.5. Explanatory Variables
The study examined various sources of information that might influence participants' knowledge of malaria prevention during pregnancy. These explanatory variables were categorized into three distinct types: information received from health posts, where health workers provide direct educational input; information obtained from family members or friends, reflecting informal and interpersonal communication channels; and information sourced from media and written materials, including television, radio, billboard signs, pamphlets, brochures, fact sheets, and leaflets. Analyzing these variables helped determine the impact of different information sources on participants' knowledge levels.
2.10. Data Analysis
The data analysis involved several statistical techniques to comprehensively examine the study variables. Descriptive statistics were utilized to summarize the demographic characteristics of participants and the various sources of information they used. To assess the levels of malaria preventive knowledge, proportions were calculated, providing a clear picture of how many participants had adequate versus inadequate knowledge. The knowledge level scores were computed based on algorithms illustrated in Figure 1. Associations between sources of information and levels of malaria knowledge were analyzed using chi-square tests and logistic regression models, both considered significant at a p-value of 0.05. The chi-square tests assessed the statistical significance of relationships, while logistic regression estimated crude and adjusted odds ratios with 95% confidence intervals to evaluate the impact of information sources on malaria prevention knowledge. All statistical analyses were conducted using IBM SPSS Statistics version 20, ensuring robust and reliable results in evaluating the impact of informational sources on malaria preventive knowledge.
Figure 1. Algorithms for Scoring Knowledge of Malaria Preventive Measures.
3. Results
3.1. Demographic and Health Characteristics of the Study Population
The study included participants predominantly aged 20-35 years (75.0%), with 12.0% under 20 years and 13.0% over 35 years. Self-employment was the primary occupation (49.0%), followed by unemployment (36.7%) and salaried employment (14.3%). Cohabiting women accounted for 43.0%, married women for 30.7%, and single women for 25.3%, while a smaller percentage were separated or widowed (1.0%). In terms of education, 44.0% completed secondary or vocational education, 34.0% had basic education, 15.7% had tertiary education, and 6.3% reported non-formal education. Christianity was the predominant religion (86.7%), with Islam comprising 13.3% of participants. Gestational periods were distributed with 58.0% in the first trimester (less than 16 weeks) and 42.0% in the second trimester or beyond (16 weeks or more) (Table 1).
Table 1. Demographic and Health Characteristics of the Study Population.

Variables

Frequency

Percent

Age group

< 20yrs

36

12.0

20 - 35yrs

225

75.0

> 35yrs

39

13.0

Occupation

Salaried Worker

43

14.3

Self-employed

147

49.0

Unemployed

110

36.7

Marital Status

Cohabiting

129

43.0

Married

92

30.7

Separated/widowed

3

1.0

Single

76

25.3

Educational Level

Basic

102

34.0

Non-formal

19

6.3

Secondary/Vocational

132

44.0

Tertiary

47

15.7

Religion

Christianity

260

86.7

Islam

40

13.3

Total number of SP received

2 or less doses

169

56.3

3 or more doses

131

43.7

Gestational age

< 16 weeks

174

58.0

16 weeks or more

126

42.0

3.2. Sources of Information on Malaria Prevention Among Respondents
In the study, the majority of respondents, 79.5%, acquired information about malaria preventive measures from health posts through health workers, totaling 294 individuals. A smaller proportion, 16.2%, received information from family members or friends, comprising 60 individuals. Media and written materials were accessed by 4.3% of respondents, totaling 16 individuals. These findings highlight health posts as the primary source of information on malaria prevention, with family and friends and media playing lesser roles in information dissemination (Figure 2).
Figure 2. Sources of Information on Malaria Prevention Among Respondents. Sources of Information on Malaria Prevention Among Respondents.
3.3. Association Between Source of Information and Knowledge Levels on Malaria Prevention During Pregnancy
The chi-square analyses assessed the relationship between different sources of information on malaria prevention and the level of knowledge among pregnant women. The results indicated a significant association between information received at Health Posts by health workers and knowledge levels, with χ² (1, N = 300) = 18.65, p < 0.001). Similarly, information from Family or Friends was significantly associated with knowledge levels, yielding χ² (1, N = 300) = 13.94, p < 0.001). In contrast, information from media sources and written materials did not show a significant association with knowledge levels, as evidenced by χ² (1, N = 300) = 0.44, p = 0.51). Overall, the majority of participants demonstrated adequate knowledge of malaria prevention, with 266 out of 300 individuals (88.7%) achieving this level (Table 2). (See Supplementary1 and 2 for questions and score on knowledge).
Table 2. Association Between Source of Information and Knowledge Levels on Malaria Prevention During Pregnancy.

Variables

Knowledge Level n = 300 (%)

X2

P-value

Source of information on malaria prevention during pregnant

Inadequate knowledge

Adequate knowledge

At Health Post By Health Worker

30(8.1)

264(71.4)

18.65

p<0.001**

Family or Friend

15(4.1)

45(12.2)

13.94

p<0.001**

T. V., radio, billboard signs, pamphlets, brochures, fact sheets, leaflets

1(0.3)

15(4.1)

0.44

0.51

Knowledge Level Score

34(11.3)

266(88.7)

**statistically significant at p-value <0.001, X2 = Chi-Square value, n= number of observations, % = percentage of observation
The logistic regression analysis revealed significant findings regarding the impact of different sources of education on malaria knowledge among pregnant women. Education received at health posts by trained workers was significantly associated with higher malaria knowledge (AOR = 7.82, 95% CI [1.26, 48.35], p = 0.027). Conversely, education from family or friends correlated with lower knowledge levels (AOR = 0.34, 95% CI [0.15, 0.76], p = 0.008) (Table 3).
Table 3. Logistic Regression Analysis of Adequate Knowledge on Malaria Prevention Among Pregnancy by Source of Education.

Variables

Response (n = 300)

Adequate Knowledge

Source of information on malaria prevention during pregnant

Crude OR (95% CI)

P-value

Adjusted OR (95% CI)

P-value

At Health Post By Health Worker

No

1

0.001*

1

0.027*

Yes

17.6(3.09 - 100.16)

7.82(1.26 - 48.35)

No

1

P<0.001**

1

0.008*

Family Member or Friend

Yes

0.26(0.12 - 0.55)

0.34(0.15 - 0.76)

*statistically significant at <0.05, **statistically significant at p-value <0.001, CI = Confident Interval, OR= Odds Ratio
4. Discussion
Malaria remains a critical threat to maternal and fetal health in endemic areas, necessitating effective preventive strategies during pregnancy. This discussion integrated recent findings on the knowledge levels of pregnant women concerning malaria prevention, emphasizing the roles of various educational sources and their implications for public health interventions.
The study revealed that 88.7% of pregnant women had adequate knowledge about malaria prevention, while 11.3% exhibited inadequate knowledge. These findings highlight both the successes and limitations of current educational strategies. This finding collaborates with other studies in Ghana , Southwestern Uganda , and Northwestern Ethiopia but higher compared to another study conducted in Ethiopia and elsewhere in Uganda . The high percentage of adequate knowledge suggests that existing educational efforts are making a positive impact. However, the significant proportion with inadequate knowledge indicates that there is still a need to refine and enhance these strategies to reach all pregnant women effectively.
Pregnant women who received education from health workers are approximately 7.82 times more likely to have adequate knowledge of malaria compared to those who did not. This underscores the significant impact of structured, facility-based education on enhancing malaria knowledge . The study confirms that education at health posts by trained health workers is strongly associated with higher knowledge levels about malaria prevention among pregnant women . This result demonstrates the effectiveness of structured education programs. Health workers provide accurate and tailored information, improving both comprehension and application of malaria prevention practices . Recent research supports these findings. reported similar positive outcomes in rural Malawi and in the Tano North District, Ghana, where health worker-led programs significantly enhanced maternal health knowledge. Their research highlights the effectiveness of structured, facility-based education in addressing health knowledge gaps, reinforcing the value of formal educational interventions in health facilities.
The effectiveness of health post education can be attributed to several factors. Health workers are trained to deliver evidence-based information and can clarify doubts immediately. Facility-based education provides a controlled environment for systematic and reinforced learning. The success of health post education suggests that investing in training and resources for health workers can lead to substantial improvements in health knowledge and outcomes . Expanding these programs, particularly in underserved areas, could further enhance malaria prevention efforts. However, gaps in coverage and accessibility, especially in remote regions, may limit the effectiveness of these programs. Addressing these gaps could involve deploying mobile health units, increasing the number of trained health workers, and incorporating digital health tools to supplement in-person education.
In this current study, education from family members or friends was associated with lower knowledge levels regarding malaria prevention, highlighting the limitations inherent in informal educational sources. While informal networks such as family and friends play a role in disseminating health information, the quality and accuracy of this information can be inconsistent. This variability can undermine the effectiveness of malaria prevention efforts. The study's findings are consistent with recent research , which also identified limitations in informal education sources. Their study further elaborated, that information about malaria prevention from family and friends often lacked reliability, as these sources may not be well-informed or may disseminate outdated or incorrect information. The informal nature of such education can lead to gaps and inconsistencies in the information provided. These studies underscore that while informal networks are influential in health information dissemination, they frequently fall short of providing the structured and accurate information needed for effective malaria prevention. The implications of relying on informal educational sources are significant. Inadequate or inaccurate information from family and friends can lead to misconceptions or insufficient knowledge about malaria prevention. This gap can negatively impact health outcomes, as pregnant women may not receive the comprehensive guidance required to effectively protect themselves and their unborn children from malaria.
To address the limitations of informal information sources, it is crucial to integrate formal educational interventions. Enhancing malaria prevention education can be achieved through several strategies. First, combining informal networks with formal education can boost effectiveness; for example, community health workers could partner with family members to reinforce key messages and correct misinformation. Second, training and supporting informal educators, such as family and friends, can improve their understanding of malaria prevention and the accuracy of the information they share. Third, targeted educational campaigns that address common misconceptions and provide clear, actionable advice can counteract the risks of misinformation, using diverse media and communication channels to reach various audiences. Lastly, regular monitoring and evaluation of educational interventions are essential to identify areas for improvement, ensuring that strategies remain effective and relevant. Feedback from the target population can be instrumental in refining and adapting educational content and methods. In conclusion, while informal education from family and friends can play a role in health information dissemination, its limitations necessitate the integration of formal educational programs. Addressing the gaps identified in informal education and implementing strategies to improve the accuracy and effectiveness of health messages are crucial for enhancing malaria prevention efforts and achieving better health outcomes for pregnant women.
The current study found that education delivered through media and written materials did not significantly enhance malaria knowledge among pregnant women. This finding does not conform to another study conducted in Ghana , Nigeria and in sub-Sahara Africa . Although these channels have broad reach, they often fail to address the specific needs of this demographic. In the study setting, malaria education is typically broadcast on radio stations at times when many people, including pregnant women, are either preparing to leave home or returning from daily activities. This timing reduces the impact of these programs. Additionally, malaria prevention flyers and banners are often displayed only at health facilities, limiting access for those who do not visit these locations. Consequently, most pregnant women interviewed did not consider mass media a regular source of malaria prevention information. One reason for the limited impact of media and written materials could be their general nature, which does not always align with the particular needs and contexts of pregnant women. These sources often do not provide the detailed, actionable information required to address specific concerns related to malaria prevention during pregnancy. Consequently, the effectiveness of these educational tools may be diminished when they do not resonate with the target audience’s immediate and practical needs. This suggests that while media and written materials offer accessibility, their lack of specificity can limit their effectiveness in enhancing knowledge acquisition.
To address these gaps, strategies should focus on several key strategies. First, developing targeted media content that specifically addresses the unique concerns and situations of pregnant women can improve the relevance and effectiveness of the information . This approach should include creating specialized campaigns that concentrate on aspects of malaria prevention that are particularly relevant to pregnant women. Additionally, campaigns on radio and other media outlets should use the CHAP concept to identify optimal times when pregnant women are most likely to engage with the content. This strategy will enhance the planning of media education efforts, thereby increasing their impact on malaria prevention among pregnant women in the study setting. Second, ensuring that written materials are both accessible and tailored to the needs of this group is crucial. Materials should be designed to be user-friendly, engaging, and directly relevant to the challenges faced by pregnant women. Finally, ongoing research should evaluate the effectiveness of these targeted approaches to ensure that educational content remains impactful and responsive to the needs of pregnant women. By implementing these strategies, the potential of media and written materials to improve knowledge levels among pregnant women can be significantly enhanced.
5. Conclusions
This study highlights the importance of effective educational strategies in malaria prevention for pregnant women. Although most participants demonstrated adequate knowledge, a significant proportion still had gaps, indicating the need for improved educational efforts. Structured education from health workers at health posts was highly effective, reinforcing previous findings on the value of facility-based interventions. However, media and written materials had limited impact, largely due to their general nature and timing issues.
Informal education from family and friends was also less effective possible due to inconsistent and unreliable information. To address these issues, future efforts should focus on creating targeted media content, optimizing educational timing, and ensuring that written materials are accessible and relevant. Regular evaluation of these strategies is essential to enhance their effectiveness and better meet the needs of pregnant women, ultimately improving malaria prevention outcomes.
6. Strengths and Limitations of This Study
The study benefits from a broad sample of pregnant women, providing a comprehensive view of malaria prevention knowledge across diverse sources. It offers valuable insights into the effectiveness of various educational sources, such as health posts, family, friends, and media. The findings align with recent research, reinforcing their validity and relevance. Additionally, the study identifies key gaps in knowledge, particularly related to informal and media-based education, which is essential for developing targeted interventions.
The cross-sectional design restricts causal inference and generalizability to other urban settings in Ghana. Furthermore, the lack of existing literature on sources of information about malaria prevention among pregnant women limits the understanding of educational interventions' impact. Future research should adopt longitudinal methods to assess long-term effects on knowledge retention and behavioural change and explore the roles of socioeconomic factors and prior health education experiences in shaping malaria prevention knowledge.
7. Recommendations
To effectively combat malaria and enhance public health outcomes, targeted educational strategies are essential. These strategies should empower communities, particularly pregnant women, with accurate information and resources. The following recommendations aim to strengthen health education initiatives and ensure consistent messaging across both formal and informal networks:
Enhance Health Post Education: The District Health Department should expand and strengthen health post education programs by increasing the number of trained health workers and enhancing their training. Investing in mobile health units, coordinated by the Community Health Services Division, can further extend educational outreach to remote areas, improving malaria prevention knowledge among pregnant women.
Integrate Informal and Formal Education: The Education and Health Promotion Unit should integrate informal educational sources, such as vibrant individuals within the community, with formal health education. Community health workers, supported by the Local Health Promotion Team, can collaborate with informal networks to reinforce accurate malaria prevention messages and correct misinformation, ensuring consistent information dissemination.
Develop Targeted Campaigns: The Communication and Public Health Campaigns Unit should design and implement educational campaigns tailored to the specific needs of pregnant women. These campaigns should address common misconceptions and provide clear, actionable advice on malaria prevention, utilizing diverse media and communication channels for effective outreach.
Monitor and Evaluate: The District Monitoring and Evaluation Office should establish regular assessments of both informal and formal educational interventions. Utilizing feedback from pregnant women and health workers, the Evaluation Unit can refine strategies to ensure that educational efforts remain effective and relevant.
8. Ethical Considerations
Ethical approval was obtained from the Ethical clearance was secured from the Ghana Health Service Ethics Review Committee. Informed consent was obtained from all participants before their inclusion in the study, ensuring voluntary participation and confidentiality of responses.
Abbreviations

CHAP

Community Health Action Plan

FM

Frequency Modulation

SP

Sulfadoxine-Pyrimethamine

TV

Television

Acknowledgments
We express our heartfelt gratitude to the Ghana Health Service of the Asunafo North District for their essential support and collaboration throughout this research. We also want to thank the heads of the healthcare facilities involved for their assistance and cooperation. Our deep appreciation goes to the postpartum mothers who participated, as their willingness to share their experiences was vital to the study's success. This research could not have been accomplished without the contributions of these individuals and organizations.
Author Contributions
Akua Kumi Yeboah: Conceptualization, Data curation, Formal Analysis, Investigation, Software, Supervision, Validation, Writing – review & editing
Richmond Bediako Nsiah: Conceptualization, Data curation, Formal Analysis, Methodology, Software, Validation, Visualization, Writing – original draft, Writing – review & editing
Patrick Larbi-Debrah: Data curation, Formal Analysis, Methodology, Software, Supervision, Validation, Visualization
Lynna Naa Adade Obeng: Project administration, Supervision, Writing – review & editing
Florence Owusuaa Peprah: Investigation, Methodology, Project administration, Resources
Frank Prempeh: Conceptualization, Supervision, Validation
Charlotte Yeboah Domfeh: Data curation, Resources, Writing – review & editing
Isaac Ayirebi: Data curation, Formal Analysis, Software
Jonathan Mawutor Gmanyami: Formal Analysis, Investigation, Methodology, Software, Supervision, Writing – review & editing
Dominic Nyarko: Methodology, Project administration, Software
Isaac Morrison: Data curation, Formal Analysis, Writing – review & editing
Margaret Morrison: Project administration, Supervision. Validation, Visualization
Geoffrey Akungoe Ayambire: Formal Analysis, Investigation, Methodology, Software, Supervision, Validation, Visualization, Writing – review & editing
Daniel Ike Adinkrah: Formal Analysis, Investigation, Methodology, Software, Supervision, Writing – review & editing
Priscilla Sarkodie: Project administration, Resources, Supervision, Writing – review & editing
Obed Atsu-Ofori: Data curation, Formal Analysis, Software
Kwame Kusi Agyemang: Project administration, Supervision, Writing – review & editing
Gabriel Tchatchouang Mabou: Data curation, Formal Analysis, Writing – review & editing
Gilbert Elara Dagoe: Project administration, Supervision. Validation, Visualization
Samuel Malogae Badiekang: Formal Analysis, Investigation, Methodology, Software, Supervision, Writing – review & editing
Funding
This work was not supported by any external funding.
Data Availability Statement
The data is available from the corresponding author upon reasonable request.
Conflicts of Interest
The authors declare no conflicts of interest.
Supplementary Material

Below is the link to the supplementary material:

Supplementary Material 1.doc

Supplementary Material 2.doc

References
[1] Dwumfour, C. K., Bam, V. B., Owusu, L. B., Poku, C. A., Kpabitey, R. D., Aboagye, P., & Ibrahim, A. S. (2023). Prevalence and determinants of malaria infection among pregnant women attending antenatal clinic in Ejisu government hospital in Ghana: A cross-sectional study. PLoS ONE, 18(10 October), 1–16.
[2] World Health Organization. (2020). World malaria report 2020: 20 years of global progress and challenges. In American Journal of Medical Genetics (Vol. 73, Issue 1). World Health Organization.
[3] Mbishi, J. V., Chombo, S., Luoga, P., Omary, H. J., Paulo, H. A., Andrew, J., & Addo, I. Y. (2024). Malaria in under-five children: prevalence and multi-factor analysis of high-risk African countries. BMC Public Health, 24(1), 1–10.
[4] Ouédraogo, M., Kangoye, D. T., Samadoulougou, S., Rouamba, T., Donnen, P., & Kirakoya-Samadoulougou, F. (2020). Malaria case fatality rate among children under five in burkina faso: An assessment of the spatiotemporal trends following the implementation of control programs. International Journal of Environmental Research and Public Health, 17(6), 1–22.
[5] Ahenkorah, B., Nsiah, K., Baffoe, P., Ofosu, W., Gyasi, C., & Owiredu, E. W. (2020). Parasitic infections among pregnant women at first antenatal care visit in northern Ghana: A study of prevalence and associated factors. PLoS ONE, 15(7 July), 1–14.
[6] Falade, C. O., Tongo, O. O., Ogunkunle, O. O., & Orimadegun, A. E. (2010). Effects of malaria in pregnancy on newborn anthropometry. Journal of Infection in Developing Countries, 4(7), 448–453.
[7] Siagian, F. E. (2020). A literature study of anemia among malaria cases reported in Indonesia, from west to east: a parasito-epidemiology perspective. International Journal Of Community Medicine And Public Health, 7(10), 4135.
[8] Osarfo, J., Ampofo, G. D., & Tagbor, H. (2022). Trends of malaria infection in pregnancy in Ghana over the past two decades: a review. Malaria Journal, 21(1), 1–12.
[9] Goshu, Y. A., & Yitayew, A. E. (2019). Malaria knowledge and its associated factors among pregnant women attending antenatal clinic of Adis Zemen Hospital, North-western Ethiopia, 2018. PLoS ONE, 14(1), 1–11.
[10] Taremwa, I. M., Ashaba, S., Adrama, H. O., Ayebazibwe, C., Omoding, D., Kemeza, I., Yatuha, J., Turuho, T., MacDonald, N. E., & Hilliard, R. (2017). Knowledge, attitude and behaviour towards the use of insecticide treated mosquito nets among pregnant women and children in rural Southwestern Uganda. BMC Public Health, 17(1), 4–11.
[11] Imboumy-Limoukou, R. K., Maghendji-Nzondo, S., Sir-Ondo-Enguier, P. N., Niemczura De Carvalho, J., Tsafack-Tegomo, N. P., Buekens, J., Okouga, A. P., Mouinga-Ondeme, A., Kwedy Nolna, S., & Lekana-Douki, J. B. (2020). Malaria in children and women of childbearing age: infection prevalence, knowledge and use of malaria prevention tools in the province of Nyanga, Gabon. Malaria Journal, 19(1), 1–8.
[12] Onyinyechi, O. M., Mohd Nazan, A. I. N., & Ismail, S. (2023). Effectiveness of health education interventions to improve malaria knowledge and insecticide-treated nets usage among populations of sub-Saharan Africa: systematic review and meta-analysis. Frontiers in Public Health, 11, 1–11.
[13] Lalmalsawma, P., Balasubramani, K., James, M. M., Pautu, L., Prasad, K. A., Sarma, D. K., & Balabaskaran Nina, P. (2023). Malaria hotspots and climate change trends in the hyper-endemic malaria settings of Mizoram along the India–Bangladesh borders. Scientific Reports, 13(1), 1–16.
[14] Anaba, M. K., Ibisomi, L., Owusu-Agyei, S., Chirwa, T., & Ramaswamy, R. (2019). Determinants of health workers intention to use malaria rapid diagnostic test in Kintampo North Municipality, Ghana - A cross-sectional study. BMC Health Services Research, 19(1), 1–8.
[15] Adum, P., Agyare, V. A., Owusu-Marfo, J., & Agyeman, Y. N. (2023). Knowledge, attitude and practices of malaria preventive measures among mothers with children under five years in a rural setting of Ghana. Malaria Journal, 22(1), 1–12.
[16] Addis, D., & Gebeyehu Wondmeneh, T. (2023). Assessment of malaria prevention knowledge, attitude, and practice and associated factors among households living in rural malaria-endemic areas in the Afar Pastoral Region of Ethiopia. Frontiers in Public Health, 11, 1–12.
[17] Musoke, D., Karani, G., Ssempebwa, J. C., Etajak, S., Guwatudde, D., & Musoke, M. B. (2015). Knowledge and practices on malaria prevention in two rural communities in Wakiso district, Uganda. African Health Sciences, 15(2), 401–412.
[18] Gontie, G. B., Wolde, H. F., & Baraki, A. G. (2020). Prevalence and associated factors of malaria among pregnant women in Sherkole district, Benishangul Gumuz regional state, West Ethiopia. BMC Infectious Diseases, 20(1), 1–8.
[19] Owusu-Addo, E., & Owusu-Addo, S. B. (2014). Effectiveness of Health Education in Community-based Malaria Prevention and Control Interventions in sub Saharan Africa: A Systematic Review. Journal of Biology, Agriculture and Healthcare, 4(3), 22–34.
[20] Sonibare, O. O., Bello, I. S., Olowookere, S. A., Shabi, O., & Makinde, N. O. (2020). Effect of malaria preventive education on the use of long-lasting insecticidal nets among pregnant females in a Teaching Hospital in Osun state, south-west Nigeria. Parasite Epidemiology and Control, 11, 1–12.
[21] Enyi, E. O., Ifeanyichukwu Romanus Iroha, Moses Nkechukwu Ikegbunam, & Charles Okechukwu Esimone. (2023). Effects of age and gender on malaria knowledge among people attending Federal Medical Centre, Owerri, Imo and University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Southeast Nigeria. Magna Scientia Advanced Biology and Pharmacy, 10(2), 060–067.
[22] Malpass, A., Chinkhumba, J., Davlantes, E., Munthali, J., Wright, K., Ramsey, K., Troell, P., Kayange, M., Kachale, F., Mathanga, D. P., Chatata, D., & Gutman, J. R. (2020). Malaria knowledge and experiences with community health workers among recently pregnant women in Malawi. Malaria Journal, 19(1), 1–13.
[23] Amponsah, E., Fusheini, A., & Adam, A. (2021). Influence of information, education and communication on prenatal and skilled delivery in the Tano North District, Ghana: A cross-sectional study. Heliyon, 7(6), e07245.
[24] Onigbogi, O. O. (2019). Malaria in pregnancy: A community–based study on the knowledge, perception, and prevention among Nigerian women. Journal of Family Medicine and Primary Care, 8(4), 1359–1364.
[25] Afoakwah, C., Deng, X., & Onur, I. (2018). Malaria infection among children under-five: The use of large-scale interventions in Ghana. BMC Public Health, 18(1), 1–13.
[26] Omaka-Amari, L. N., & Obande-Ogbuinya, N. E. (2016). Sources of malaria information among pregnant women in Ebonyi State and implications for malaria health education. Journal of Education and Practice, 7(15), 33–39.
[27] Yaya, S., Uthman, O. A., Amouzou, A., & Bishwajit, G. (2018). Mass media exposure and its impact on malaria prevention behaviour among adult women in sub-Saharan Africa: results from malaria indicator surveys. Global Health Research and Policy, 3(1), 1–9.
[28] Lopez, A. R., & Brown, C. A. (2023). Knowledge, attitudes and practices regarding malaria prevention and control in communities in the Eastern Region, Ghana, 2020. PLoS ONE, 18(8 August), 1–17.
Cite This Article
  • APA Style

    Yeboah, A. K., Nsiah, R. B., Obeng, L. N. A., Sarkodie, P., Nyarko, D., et al. (2024). Exploring Information Sources on Malaria Prevention and Their Impact on Knowledge Among Pregnant Women in Urban Ghana. World Journal of Public Health, 9(4), 322-334. https://doi.org/10.11648/j.wjph.20240904.12

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    ACS Style

    Yeboah, A. K.; Nsiah, R. B.; Obeng, L. N. A.; Sarkodie, P.; Nyarko, D., et al. Exploring Information Sources on Malaria Prevention and Their Impact on Knowledge Among Pregnant Women in Urban Ghana. World J. Public Health 2024, 9(4), 322-334. doi: 10.11648/j.wjph.20240904.12

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    AMA Style

    Yeboah AK, Nsiah RB, Obeng LNA, Sarkodie P, Nyarko D, et al. Exploring Information Sources on Malaria Prevention and Their Impact on Knowledge Among Pregnant Women in Urban Ghana. World J Public Health. 2024;9(4):322-334. doi: 10.11648/j.wjph.20240904.12

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  • @article{10.11648/j.wjph.20240904.12,
      author = {Akua Kumi Yeboah and Richmond Bediako Nsiah and Lynna Naa Adade Obeng and Priscilla Sarkodie and Dominic Nyarko and Jonathan Mawutor Gmanyami and Isaac Ayirebi and Charlotte Yeboah Domfeh and Isaac Morrison and Margaret Morrison and Florence Owusuaa Peprah and Geoffrey Akungoe Ayambire and Patrick Larbi-Debrah and Obed Atsu-Ofori and Frank Prempeh and Kwame Kusi Agyemang and Samuel Malogae Badiekang and Daniel Ike Adinkrah and Gilbert Elara Dagoe and Gabriel Tchatchouang Mabou},
      title = {Exploring Information Sources on Malaria Prevention and Their Impact on Knowledge Among Pregnant Women in Urban Ghana
    },
      journal = {World Journal of Public Health},
      volume = {9},
      number = {4},
      pages = {322-334},
      doi = {10.11648/j.wjph.20240904.12},
      url = {https://doi.org/10.11648/j.wjph.20240904.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20240904.12},
      abstract = {Background: Adequate knowledge of malaria prevention among pregnant women is crucial for mitigating the associated risks. This study aimed to explore the various information sources on malaria preventive measures and assess their impact on the knowledge of malaria prevention among pregnant women in an urban district of Ghana. Methods: A cross-sectional study involving 300 pregnant women was conducted to evaluate their knowledge of malaria prevention. Chi-square tests were utilized to assess the relationships between these educational sources and levels of knowledge. To quantify the influence of each educational source on knowledge, logistic regression models were employed, providing adjusted odds ratios (AORs) with 95% confidence intervals (CIs). All analyses were conducted using Statistical Package for the Social Sciences (SPSS) version 20 and Microsoft Excel version 2026. Results: Overall, 88.7% of participants demonstrated adequate knowledge of malaria prevention. Education at health posts by trained workers was linked to higher knowledge (AOR = 7.82, 95% CI [1.26, 48.35], p = 0.027). In contrast, education from family or friends was associated with lower knowledge levels (AOR = 0.34, 95% CI [0.15, 0.76], p = 0.008). Media and written materials did not significantly affect knowledge levels (χ² (1, N = 300) = 0.44, p = 0.51). Conclusion: The findings highlight the pivotal role of health posts and health workers in enhancing malaria prevention knowledge among pregnant women. Strategies aimed at strengthening health facility-based education could significantly improve maternal health outcomes in malaria-endemic regions. Further research is recommended to explore effective approaches for augmenting education from family networks and media to complement health facility-based efforts.
    },
     year = {2024}
    }
    

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  • TY  - JOUR
    T1  - Exploring Information Sources on Malaria Prevention and Their Impact on Knowledge Among Pregnant Women in Urban Ghana
    
    AU  - Akua Kumi Yeboah
    AU  - Richmond Bediako Nsiah
    AU  - Lynna Naa Adade Obeng
    AU  - Priscilla Sarkodie
    AU  - Dominic Nyarko
    AU  - Jonathan Mawutor Gmanyami
    AU  - Isaac Ayirebi
    AU  - Charlotte Yeboah Domfeh
    AU  - Isaac Morrison
    AU  - Margaret Morrison
    AU  - Florence Owusuaa Peprah
    AU  - Geoffrey Akungoe Ayambire
    AU  - Patrick Larbi-Debrah
    AU  - Obed Atsu-Ofori
    AU  - Frank Prempeh
    AU  - Kwame Kusi Agyemang
    AU  - Samuel Malogae Badiekang
    AU  - Daniel Ike Adinkrah
    AU  - Gilbert Elara Dagoe
    AU  - Gabriel Tchatchouang Mabou
    Y1  - 2024/10/31
    PY  - 2024
    N1  - https://doi.org/10.11648/j.wjph.20240904.12
    DO  - 10.11648/j.wjph.20240904.12
    T2  - World Journal of Public Health
    JF  - World Journal of Public Health
    JO  - World Journal of Public Health
    SP  - 322
    EP  - 334
    PB  - Science Publishing Group
    SN  - 2637-6059
    UR  - https://doi.org/10.11648/j.wjph.20240904.12
    AB  - Background: Adequate knowledge of malaria prevention among pregnant women is crucial for mitigating the associated risks. This study aimed to explore the various information sources on malaria preventive measures and assess their impact on the knowledge of malaria prevention among pregnant women in an urban district of Ghana. Methods: A cross-sectional study involving 300 pregnant women was conducted to evaluate their knowledge of malaria prevention. Chi-square tests were utilized to assess the relationships between these educational sources and levels of knowledge. To quantify the influence of each educational source on knowledge, logistic regression models were employed, providing adjusted odds ratios (AORs) with 95% confidence intervals (CIs). All analyses were conducted using Statistical Package for the Social Sciences (SPSS) version 20 and Microsoft Excel version 2026. Results: Overall, 88.7% of participants demonstrated adequate knowledge of malaria prevention. Education at health posts by trained workers was linked to higher knowledge (AOR = 7.82, 95% CI [1.26, 48.35], p = 0.027). In contrast, education from family or friends was associated with lower knowledge levels (AOR = 0.34, 95% CI [0.15, 0.76], p = 0.008). Media and written materials did not significantly affect knowledge levels (χ² (1, N = 300) = 0.44, p = 0.51). Conclusion: The findings highlight the pivotal role of health posts and health workers in enhancing malaria prevention knowledge among pregnant women. Strategies aimed at strengthening health facility-based education could significantly improve maternal health outcomes in malaria-endemic regions. Further research is recommended to explore effective approaches for augmenting education from family networks and media to complement health facility-based efforts.
    
    VL  - 9
    IS  - 4
    ER  - 

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Author Information
  • Public Health Department, Ghana Health Service, Goaso-Wiawso-Kumasi, Ghana

    Biography: Akua Kumi Yeboah is a key member of the Public Health De-partment at the Asunafo North Municipal Health Directorate, spe-cializing in malaria prevention and control. She holds a Master of Public Health in Monitoring and Evaluation and has extensive experience as the Health Information Officer. Akua has pursued professional development at the University of California, Los An-geles, and the University of Washington. Currently, she coaches health care professionals on malaria interventions and supervises health information systems. Additionally, she leads initiatives to educate adolescent girls on sexual health and malaria prevention, promoting overall quality of life and reducing early pregnancies.

    Research Fields: Maternal and child nutrition, Reproductive health services, Child immunization, Health education programs, Health access disparities.

  • Public Health Department, Ghana Health Service, Goaso-Wiawso-Kumasi, Ghana

    Biography: Richmond Bediako Nsiah (Corresponding Author), is a prominent member of the Public Health Department at the Asokore Mampong Municipal Health Directorate. He holds a Master of Public Health in Health Information and has over a decade of experience managing malaria intervention projects. His recent work as a consultant for JSI on the USAID MRITE and Global Vax projects has further enhanced his expertise, complemented by professional certificates in Monitoring and Evaluation, Project Management, and Leadership and Management from the University of Washington. In his current role, he mentors healthcare professionals in effective health planning, oversees health information systems and data management related to malaria interventions, and leads capacity-building initiatives aimed at improving skills in malaria prevention, diagnosis, and treatment. Additionally, Richmond actively engages in community outreach to raise awareness about malaria prevention and control measures, guiding a group of young health practitioners dedicated to enhancing health service delivery through research and community engagement strategies.

    Research Fields: Health information management, Data management practices, Maternal and child health research, Immunization program evaluation, Health access disparities.

  • Clinical Department, Ghana Health Service, Ashanti, Ghana

  • Public Health Department, Ghana Health Service, Goaso-Wiawso-Kumasi, Ghana

    Research Fields: Maternal and child nutrition, Reproductive health services, Child immunization, Health education programs, Health access disparities.

  • Public Health Department, Ghana Health Service, Goaso-Wiawso-Kumasi, Ghana

    Research Fields: Maternal health policies, Child health promotion, Immunization effectiveness, Health access disparities, Health service delivery.

  • Global Health and Infectious Diseases Research Group, Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana

    Research Fields: Non-communicable disease control, Health education campaigns, Chronic illness management, Health access disparities, Disease prevention research.

  • Saint Pauline Clinic, Accra, Ghana

  • Midwifery Department, Seventh-day Adventist Nursing and Midwifery College, Asamang, Ghana

    Research Fields: Maternal and child health services, Health access disparities, Immunization coverage rates, Pediatric health interventions, Maternal health outcomes.

  • National Health Insurance Authority, Accra, Ghana

    Research Fields: Non-communicable disease research, Health policy analysis, Health access disparities, Lifestyle disease prevention, Chronic disease epidemiology.

  • Administrative Department, Ghana Health Service, Tema, Ghana

    Research Fields: Non-communicable disease research, Health policy analysis, Health access disparities, Lifestyle disease prevention, Chronic disease epidemiology.

  • Public Health Department, Ghana Health Service, Goaso-Wiawso-Kumasi, Ghana

    Research Fields: Child health services, Health data integration, Public health interventions, Health access disparities, Disease prevention strategies.

  • Department of Computer Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

    Research Fields: Maternal health policies, Child health promotion, Immunization effectiveness, Health access disparities, Health service delivery.

  • Centre for Vaccine Innovation and Access Policy, Access and Introduction Functional Area, PATH, Accra, Ghana

    Research Fields: Maternal health interventions, Immunization, Infectious disease control, Health access disparities, Health system strengthening.

  • Department of Epidemiology and Biostatistics, University of Ghana, Accra, Ghana

    Research Fields: Non-communicable disease research, Health policy analysis, Health access disparities, Lifestyle disease prevention, Chronic disease epidemiology.

  • Clinical Department, Komfo Anokye Teaching Hospital, Kumasi, Ghana

    Research Fields: Non-communicable disease research, Health policy analysis, Health access disparities, Lifestyle disease prevention, Chronic disease epidemiology.

  • Clinical Department, Ghana Health Service, Ashanti, Ghana

    Research Fields: Child health services, Communicable disease surveillance, Vaccination programs, Maternal health research, Health access disparities.

  • Public Health Department, Ghana Health Service, Goaso-Wiawso-Kumasi, Ghana

  • Public Health Department, Ghana Health Service, Goaso-Wiawso-Kumasi, Ghana

    Research Fields: Health information management, Data management practices, Maternal and child health research, Immunization program evaluation.

  • Public Health Department, Ghana Health Service, Goaso-Wiawso-Kumasi, Ghana

    Research Fields: Child health services, Communicable disease surveillance, Vaccination programs, Maternal health research, Health access disparities.

  • Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon

  • Abstract
  • Keywords
  • Document Sections

    1. 1. Introduction
    2. 2. Materials and Methods
    3. 3. Results
    4. 4. Discussion
    5. 5. Conclusions
    6. 6. Strengths and Limitations of This Study
    7. 7. Recommendations
    8. 8. Ethical Considerations
    Show Full Outline
  • Abbreviations
  • Acknowledgments
  • Author Contributions
  • Funding
  • Data Availability Statement
  • Conflicts of Interest
  • Supplementary Material
  • References
  • Cite This Article
  • Author Information