Sickle cell disease (SCD) is highly prevalent in Africa with a significant public health burden for under-resourced countries. We employed qualitative research methods to understand the ethical, legal, and social implications of conducting genomic research in SCD under the Human Heredity and Health in Africa (H3Africa) initiative. The present study focused on religious and cultural aspects of SCD with the view to identifying beliefs and attitudes relevant to public health interventions in Ghana. Thematic analyses from individual and group interviews revealed six key areas of importance, namely, reliance on a supreme being; religion as a disruptive influence on health behaviors; role of religious leaders in information sharing and decision-making; social, religious, and customary norms; health and religious/supernatural beliefs; and need for social education and support through church and community. Findings suggest that public health programs in Ghana should not only aim at increasing knowledge and awareness about SCD and its management but also create an understanding of the relevance of genomics and alternative technological advancement to diagnosis and ethical decision-making around available options for health seeking. Future research should engage communities to help address the ethical and social implications of a persuasive religious influence on SCD-related health decisions.

Background: More countries are establishing licensing examination systems for nursing education, including clinical competency assessment. In Ghana, clinical competency assessment forms part of the nursing licensing examination and is perceived as the benchmark for nursing licensing examination in the sub-region. The nationalised assessment system is established with some ad hoc changes over the last decade which requires continual evaluation. It is essential to find out how students experience this assessment system. Purpose: This study aimed to explore nursing students’ experiences of the clinical competency assessment in Ghana. Methods: An exploratory descriptive qualitative design was used in this study. Eight focus group discussions (FGDs) were conducted with 68 final year students purposively selected from eight nursing education programs. The FGDs lasted between 90 to 120 minutes. Content analysis was used to analyze the data.Results: Although the pre-examination conference between students and examiners helped lessen students’ anxiety, limited resources, incongruence in teaching, practice and assessment, inherent biases due to the unstandardised assessment system, and a financial burden compromised the quality of the assessment.Conclusion:Clinical competency assessment is central to nursing licensing examinations; hence the ability of the system to discriminate competent and incompetent nurses otherwise cannot be overemphasised. Standardisation, training of the examiners and continuous evaluation of the assessment system are imperative for quality improvement in clinical competency assessment.

Ghanaian nurses require education on the use of validated rating scales to assess procedural pain in children. The inclusion of pain assessment and management in pre-registration curricula could improve knowledge.

It is essential to ensure that nurses are well trained and competent enough to provide safe and quality healthcare because of the critical role they play in the health systems globally. It is against this backdrop that Ghana instituted nursing licensing examination which includes clinical competency assessment. This qualitative exploratory descriptive study sought to explore and describe the perspectives of key informants on the clinical nursing competency assessment in Ghana. A total of 20 purposively selected key informants (nurse educators, nurse clinicians, and nurse managers) were interviewed. Data was analyzed using thematic content analysis. Although the intention of the clinical competency examination conducted by the nursing council is to ensure that only competent nurses are licensed to practice in Ghana, there are inherent issues such as manipulation of examiners, poor training of examiners, unstandardized assessment process, and inadequate resource which compromises the intent of the process. The nursing council admitted to not being aware of some of the challenges found in this study and will work towards improving the quality, validity, reliability, and fairness of the examination system. It is essential that the council institute quality improvement processes, including independent research into the examination process, to continually improve on the process because other countries within the sub-region try to benchmark their nursing licensing examination on that of Ghana.

Sickle cell disease (SCD) is a serious genetic and inherited disorder. It has a physical, psychological, and socioeconomic impact on affected individuals including children and families. Globally, about 275,000 children are born annually with SCD, with an estimated 85% of these births being in Africa. In Ghana, an estimated 2% of infants that were screened were affected by SCD. Although extensive studies have been conducted on the burden on parents of children with SCD, little is known about how parents manage the disease among their children at home in our setting. This qualitative study explored the knowledge of caregivers of children with SCD, how they recognize/monitor complications of the disease and management strategies at home. An explorative qualitative study using the nonprobability purposive method was used to interview fourteen (14) caregivers of children with SCD who were recruited from the Tamale Teaching Hospital. In-depth interviews using an interview guide was used. A tape recorder was used to record each interview yielding a total of fourteen (14) audios. Audiotapes were transcribed verbatim. Data collected during these interviews were analyzed using inductive thematic content analysis. Caregivers have adequate knowledge of the signs and symptoms of SCD, its complications, and the various types their children have but fall short of knowledge on the cause of SCD. Knowledge acquired on SCD does not translate into caregivers’ ability to effectively identify and monitor crises or complications at home. Home management strategies used by caregivers’ were both pharmacological and nonpharmacological, and some used the combination to manage pain and monitor the health of their children. Even though the majority have used traditional medicine before, they prefer orthodox interventions which they consider more effective.