Browsing by Author "Asante, Kwaku Oppong."

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Health and well-being of homeless youth in Ghana.
(2015) Asante, Kwaku Oppong.; Meyer-Weitz, Anna.; Petersen, Inge.
Background: Homeless youth have been described as being resilient, and vulnerable to poor mental and behavioural health. However, literature on factors promoting resilience of these homeless youth in an African context, especially in Ghana, is scarce. The main aim of the present study was to examine the mental and behavioural health and well-being of homeless youth and the protective factors that could be strengthened to promote their mental health and reduce risky health related behaviours. Specifically this doctoral thesis investigated: 1) factors fostering resilience among homeless youth, 2) the experiences of homeless youth in relation to their health and well-being, 3) the validation of the factor structure of Connor-Davidson Resilience Scale (CD-RISC), 4) the prevalence of health risk behaviours and status of psychological well-being, and 5) the relationship between resilience and health risk behaviours among homeless youth in Ghana. Method: An exploratory mixed method approach was adopted in which qualitative data was first collected followed by a quantitative survey. For the qualitative study a purposive sample of 16 homeless youth from the Central Business District of Accra were interviewed using a semi-structured interview schedule. A cross-sectional study with an interviewer-administered questionnaire was used to assess the mental health variables from a relatively large sample of 227 conveniently selected homeless youth. The participants were between the ages of 9-19 years, and had lived on the street for a period of between 6 months to 8 years. Interpretive Phenomenological Analysis (IPA) was used to analyse the interview transcripts in the qualitative study whilst exploratory factor analysis, One-Way ANOVA, independent samples t-tests, Chi-Square tests for independence, Pearson- moment correlation coefficient, standard multiple regression and logistic regression models were used to analyse the quantitative data. Data collection lasted for 8 and 12 weeks for the qualitative and quantitative phases of the study respectively. Results: The qualitative results showed that strong religious beliefs, engagement in meaningful activities, peer group support, adherence to cultural norms and support from community-based organizations were important factors that promote resilience among participants. The quantitative results showed that participants exhibited poor mental health with high levels of psychological distress, substance use and suicidal ideation. Clustering of health risk behaviours was found in this study among homeless youth who were using substances and engaging in unprotected sex with multiple sexual partners. Some evidence for the engagement in survival sex was also found. Overall poor psychological functioning was predicted by experiences of perceived stigmatization and discrimination, self-stigma, suicidal ideation and exposure to violence. The results also showed that perceived resilience served as a protective factor for suicidal ideation and having multiple sexual lifetime partners, suggesting that youth with higher perceived resilience were less likely to engage in health risk behaviours. Conclusion: These findings seem to suggest that homeless youth are resilient, but nevertheless are susceptible to various mental health problems, with substance use acting as a gateway for sexual risk behaviours. Development of multilevel prevention interventions are recommended to build resilience in youth through access to psychological counselling and to develop better coping strategies at the individual level; facilitate health enhancing social networks that provide homeless youth with an alternative network to that of gains in social support at the interpersonal level and to address the social determinants of poor mental health at community and societal levels.
Health care service delivery to refugee children from the Democratic Republic of Congo living in Durban, South Africa : a care giver's perspective.
(2016) Bukenge, James Lukobeke.; Meyer-Weitz, Anna.; Asante, Kwaku Oppong.
Background: Access to health care for refugees remains a challenge because of the various personal and health system obstacles they may face i.e. language barriers, poverty, negative attitudes of health care providers and their lack of understanding of the legal status of refugees in South Africa. Psycho-social and economic factors impact negatively on refugees’ general health status including their children (new born and young children). Children’s health vulnerability includes preventable and treatable conditions such as malnutrition and infectious diseases, and conditions related to their experiences of threat to safety, violence and accompanied uncertainties followed fleeing to and settling in the new host country. These children have a greater health and wellbeing vulnerability than the average child. Little information is available about the challenges that refugee care-givers experience regarding child health care services in South Africa. Objectives: The main aim of this study was to investigate refugee caregivers’ perceptions of their children’s health care problems and challenges regarding accessibility and quality of health service delivery to their young children. Methods: This study used an explanatory mixed method design in which a quantitative cross-sectional survey was followed with a small qualitative study to enable a deeper understanding of the quantitative responses. The approach therefore allowed for the examination of the prevalence of health problems reported by caregivers, and exploration of caregiver’s experiences when seeking health care for their children. The research instrument assessed some background information i.e. socio-demographic characteristics, sources of social support and perceived health status of refugee children and perceptions and experiences with health care services. Frequencies were calculated, Chi-square (χ2) test were used to explore the factors associated with refugees’ satisfaction of health care provided as well as non-parametric tests i.e. Mann-Whitney U Tests and Kruskal-Wallis tests to assess the median scores on the satisfaction with health care clinics and private doctors measures for different demographic groups i.e. gender, level of education and English proficiency as well as household resources. Thematic analysis were used for the open ended questions Results: The majority (89%) of the caregivers were women with over 70% of them between 30-35 years. The majority (80%) of the caregivers were married, 65% of them had 3 to 4 children and over two-thirds (74%) reported to have problems in communicating in English. Most caregivers (74%) visit public clinics for their children’s health care needs because it was free of charge (79%) as they were not able to afford private health care (17%). However, over 95% of the participants revealed that most of the health care workers were not receptive of refugees, making access to health care difficult. Satisfaction of health care service delivery was very poor as only 7% indicated to be somewhat satisfied. Despite demographic group differences the caregivers’ level of satisfaction were very similar across the different groups. Caregivers with no English language proficiency reported slightly more positive attitudes towards clinic health care services. Conclusion: The refugees seemed to have very limited household resources making general daily survival challenging. Their strong social networks and cohesion enable them to cope, but also seem to reinforce negative views about public health care service delivery. The existing xenophobia in the South African society play a role in negative perceptions regarding access to health care and their experiences of health care service delivery. Health care workers need to be made aware of their responsibility to deliver quality care not only South Africans alone, but to refugees as well. Refugee caregiver’s should be made aware that many complaints directed at health care workers might be system related and not necessarily addressed at refugees. Greater efforts should be made to foster mutual respect and greater integration.
The psychological well-being and social support of street children in Durban, KwaZulu-Natal.
(2015) Netshiombo, Mashudu Tshifaro.; Meyer-Weitz, Anna.; Asante, Kwaku Oppong.
Introduction: Globally, street children are known to have poor psychological health and engage in risky behaviours as a result of the environment in which they find themselves. The current study was conducted to examine the psychological well-being of street children in Durban, KwaZulu-Natal. The main objectives of the study were to examine the prevalence of psychological problems and to examine the associations between health risk behaviours and psychological functioning. Method: The sample used in this study consisted of 149 street children (128 boys and 21 girls) recruited purposively and responded to an interviewer administered questionnaire which measured varied constructs related to psychological health. The Strength and Difficulty Questionnaire was used to assess the psychological functioning of the street children. The Multidimensional Scale Perceived Social Support was used to assess their perceived social support. Pearson product-moment correlation and binary logistic regression models were fitted in the analysis of the data. Results: This study revealed that among the participants, 99.3% reported using substances with over 84.2% reporting suicidal ideation. Substance use include alcohol, cigarettes, and marijuana and used by 74.3%, 43.6 % and 50% respectively. The majority of the participants (85.4%) were sexually active with 52.1% reporting non-condom use. Over 92.5% reported being victims of violence, with about 84.4 % being perpetrators of violence whilst within the domains of the streets. Suicide ideation was found to be associated with conduct problems and being victims of violent behaviour, whilst perpetrating of violent behaviours was positively associated with conduct problems. Prosocial behaviours was positively related to both emotional problems and suicide ideation but negatively associated with conduct problems, hyperactivity and engagement in violent acts against others. A significant relationship was found between substance use and risky sexual behaviours among the participants. Furthermore, a significant relationship was reported between non-condom use in the last sexual activity and the use of marijuana and between non-condom use in the last sexual activity and the use of other drugs such as glue. Participants who consumed alcohol were three times more likely to have ever engaged in sexual activities whilst under the influence of alcohol. Additionally, street children who used marijuana were four times more likely not to use condoms in their sexual engagements. Furthermore, street children who used marijuana were more likely to engage in sexual activities without condom use. Conclusion: This study contributed to the existing body of knowledge on mental health and health risk behaviours among street children. The findings of this study could be used to develop appropriate interventions that support the mental health of children living on the streets.
Skills shortages and challenges in the employment of foreign professionals in the selected KwaZulu-Natal higher education institutions.
(2016) Ngonyama, Thulie Lillian.; Buitendach, Johanna Hendrina.; Asante, Kwaku Oppong.
This study examines the challenge of academic skills shortage in South Africa as represented in the selected institutions of higher learning in the KwaZulu-Natal province. Further to the shortage of academic skills, the study examines the challenges encountered in the mediation of attracting and recruiting academic expatriates who in turn encounter their own obstacles in adjusting into and settling in their host country, host academic institutions and host communities. The term “academic expatriates” as reflecting throughout this study is being used interchangeable with the term “foreign professionals” reflecting in the title of this study. The selected institutions of higher education are the University of KwaZulu-Natal (UKZN), Durban University of Technology (DUT), Mangosuthu University of Technology (MUT) and the University of Zululand (UNIZULU). Methodologically the study deploys a mixed methods approach to research. The merits of the mixed methods approach to research are chiefly that it employs both the quantitative and qualitative techniques of inquiry. For that reason, the study is able to examine and interrogate its subject from a multiplicity of quantitative and qualitative vantage points, yielding a much more enriched and enriching illumination. The results, observations, arguments and conclusions of a mixed methods study tend to enjoy more credibility, reliability and dependability than the outcomes of a study that employs a singular and narrow approach. Mixing the strengths of both the quantitative and the qualitative techniques delivers much more durable articulation and understanding of the subject. The study used both qualitative and quantitative research measures to collect and analyse data. The explanatory sequential design approach was used. The researcher amended and validated a 5 point Likert scale questionnaire originally developed by Black to study expatriates’ adjustment challenges. This questionnaire was then used to collect data relating to interaction adjustment, general adjustment and work adjustment from academic expatriates. One hundred and forty-two (142) academic expatriates from all the four institutions under study participated in the quantitative study. The qualitative study collected data relating to an academic skills shortage, disciplines that experience skills shortage, academic labour turnover, employment process and support offered to academic expatriate. Qualitative data was collected through a structured questionnaire and semi-structured interviews. A total of 48 respondents; including, line managers, human resources practitioners and academic expatriates participated in the qualitative study. The results revealed that the institutions under study are confronted by academic skills shortage in almost all academic disciplines especially in the disciplines associated with Science, Engineering and Accounting. As a result difficulties are experienced in attracting academic talent in these fields/disciplines. Therefore, academic talent is brought in from outside the borders of the country. But, delays in work permit application process makes it difficult for these institutions to finalise their recruitment and selection process on time. Furthermore, academic expatriates experience general and interaction adjustment challenges associated with the use of local language and understanding of local culture. However, female academic expatriates were found to be better adjusted in the two areas as compared to male academic expatriates. Moreover, significant mean differences were found between institutions suggesting that academic expatriates based at UNIZULU experience adjustment challenges differently from the academic expatriated based at DUT and UKZN. But, these institutions assist academic expatriates to adjust through their induction programme. Additional to this, the results revealed that the institutions under study are faced with higher labour turnover which could be attributed to uncompetitive salaries for academic staff, poor job satisfaction and stringent academic appointment and promotion criteria. In summation, the study gestured to the need for policy revisions in the area of immigration, human resources and academic administration in the Republic of South Africa.