Female genital schistosomiasis in Ghana: An exploration of knowledge, attitudes, and practice among women of reproductive age

Abstract

Objective

Female genital schistosomiasis (FGS) affects about 11 % of women of reproductive age in Ghana. The disease remains insignificant and poorly understood in endemic communities and healthcare professionals across Sub-Saharan Africa. The objective was to assess the knowledge, attitudes, and practices among women of reproductive age towards FGS.

Study design

A cross-sectional design based on mixed-method approach was conducted in two schistosomiasis endemic districts in Ghana, Lower Manya-Krobo and Shai Osudoku districts.

Methods

The study surveyed 856 women of reproductive age and conducted focused group discussions with 88 opinion leaders, adolescent girls, and women of reproductive age in 20 communities along the Volta Lake. A descriptive analysis, Chi-square test, and inferential statistics were employed on the survey data using STATA SE-18, while thematic analysis was used for the qualitative content using NVivo 20.

Results

The findings revealed that many of the participants had poor knowledge, attitudes, and practices related to FGS, with the Lower Manya-Krobo exhibiting slightly worse scores than Shai Osudoku. Only 17.9 % had heard of FGS before among the 856 participants, and factors such as age above 40 years (AOR6.91, 95 %CI:1.98, 11.84, p < 0.00), 6–10 years stay in community (AOR3.22, 95 %CI:0.49, 5.94, p < 0.00), farmers (AOR9.69, 95 %CI:6.23, 13.17, p < 0.00) statistically predicted knowledge in SOD. Compared to LMK, all age groups, farmers (AOR15.95, 95 %CI:11.72, 20.24, p < 0.00), and heard of FGS (AOR-5.42, 95 %CI: 8.51, −2.34, p < 0.00) influenced their knowledge, attitudes, and practices. The poor knowledge, attitudes, and practices and financial constraints were major barriers that led to self-treatment and delay in seeking care from hospitals.

Conclusion

The study highlighted significant gaps in KAP towards FGS among women in LMK and SOD districts. These findings reflect broader challenges observed in other schistosomiasis-endemic regions, where inadequate education, financial barriers, and limited healthcare infrastructure hinder the effective management of FGS. Addressing these gaps is crucial to improving reproductive health issues and calls for enhanced community-based health education, improved healthcare facility capabilities and resources, training healthcare professionals, and the development of context-specific strategies to address the identified gaps to improve FGS case reporting and management.