Background information
The background information of participants is presented in Table 1. The median and mean ages of the participants were 50 and 42 years respectively [15].
Table 1 Background information of participants
Variable
|
Frequency
|
Percentage
|
Age*
16 – 39
≥ 40 years
|
9
12
|
42.86
57.14
|
Marital status
Single
Married
Separated
Widow
|
9
5
2
4
|
45.00
25.00
10.00
20.00
|
Education
No Education
JHS
SHS
Tertiary
|
6
4
8
3
|
28.57
19.05
38.10
14.29
|
Occupation
Unemployed
Trading
Teaching
Student
|
8
3
4
6
|
38.10
14.29
19.05
28.57
|
Role in Community
Community Members
Students
Executives of GFD/GBU
|
12
6
3
|
57.14
28.57
14.28
|
*Mean=42.23 (SD=17.15), Median = 50
Themes
The themes identified in the study is presented in Table 2.
Table 2: Key emerging themes
Themes
|
Sub-themes
|
Quotes
|
Theme 1: Knowledge of SRH services and care
|
Have heard of SRH services and care
|
“I have heard about condom… they say that when you are about to have a sexual encounter with a man, then he will wear it around his penis” (IDI, Participant 6)
|
Sexual intercourse (between a male and a female)
|
“it’s the sexual relationship between males and females and the way you will protect yourselves to prevent you from being infected with diseases [Sexually Transmitted Diseases]” (FGD1, Participant 5)
|
Measures used to prevent unplanned pregnancy
|
“like someone going to do family planning… its excessive childbearing, maybe She has giving birth to an unplanned child and She doesn’t want to give birth again so She can go and do family planning so that the pregnancy will no longer come again or someone may want to space the children, maybe their ages are closer… so she wants to space it for the children to grow” (IDI, Participant 1).
|
“It’s the women who have to use it [SRHR services and care] because the man has no medicine [SRHR services and care methods] to use, the only methods he may use is condom! So it’s the woman who has to use medicine [SRH methods] (FGD1, Participant 2)
|
Measures used to prevent Sexually Transmitted Diseases (STDs)
|
“Right now if we talk about protection, it’s not about family planning alone but also disease prevention[infectious] so it’s necessary that both the man and the woman prevent themselves… if the woman is interested in family planning then it’s the woman who should use such services… thus going to the hospital for injection or pills that you would take… and also concerning the man, there are some of them who engage in sexual intercourse with any woman they come across, so the man is also supposed to protect himself by using something like a condom” (FGD1, Participant 5)
|
Theme 2: Relevance of accessing SRH services and care information
|
Education on STDs
|
“What they say is that if you want to marry, it is better than you and your partner visit the hospital for blood test… when the two [man and woman] conduct the blood test and there is no disease then you can proceed to marry” (FGD1, Participant 2)
|
“before a man proposed to you, the two of you need to have a common understanding to go for medical check-ups at the hospital to confirm that there is no disease before marriage” (FGD1, Participant 6)
|
Education on personal hygiene
|
|
Education on family planning
|
[…] What I understand about family planning is that it protect you from unplanned pregnancy so that when you have any sexual encounter with a man you will not become pregnant (IDI Participant 5, Visually Impaired Woman)
|
Theme 3: Sources of accessing SRH services and care information
|
Formal sources (radio stations, hospitals, information centres, schools, NGOs, churches and disability association)
|
“I hear it from the radio and in our place, they come to the church… I asked that in case we get a cut from the needle, wouldn’t that infect us with the diseases, so the whole congregation said that you cannot be infected through that means (FGD1, Participant 2)
|
“I went to the hospital and they asked me whether I have been pregnant before so he [health professional] tested me to confirm that I am not pregnant but was sick. they ask whether I have used condom before so they advise that when you use it, you will not become pregnant or protect you from unwanted pregnancy” (FGD _ Participant 2)
|
Informal sources (relatives, mothers, siblings and cousins and friends
|
“It is my mother who educated me that I should be very careful with our sexual relationship so that we would not be infected with any disease” (FGD1 _ Participant 2)
|
“They [my siblings] mentioned that when you have many children, you go for injection or insert materials in your body so that you could not give birth... some too they go for injection for every three months (IDI, Participant 1, Visually Impaired woman)
|
Theme 4: Content of SRH information and education
|
Avoidance of sharing blades and injections with others
|
“I went to the hospital and one nurse told us that we should take good care of our children… we shouldn’t allow the children to use blade from the ground and also we shouldn’t seek over-the-counter injections… when you take an over-the-counter injection, you can be infected with the AIDs… so we should educate our children on such issues (FGD1, Participant 2)
|
Practicing safe sexual intercourse
|
“the doctor was educating us that we should be cautious about our sexual encounters… that we will not have sex with anyone in order not to be infected with such diseases… We shouldn’t pick blade lying on the ground” (FGD1, Participant 2)
|
Avoiding unsafe abortion
|
|
Theme 5: Barrier to accessing SRH services and care information
|
Lack of caregivers and support
|
“it may happen that you have been invited by a health worker in a durbar to talk in a community but you the blind person will not be having a caregiver to take you to that gathering to listen to what is going on” (FGD1, Participant 5)
|
“it may happen that they have grouped discussing the issue and you may want to go and listen to it but you may not have a caregiver who will accompany you to the meeting grounds… that becomes a problem so that one is also a barrier” (FGD1, Participant 6)
|
“our barrier is the caregivers… there are some people when you call them to accompany you then he/she will be distancing himself… so that is the biggest difficulty we encounter” (FGD1, Participant 2)
|
Theme 1: Knowledge on SRH services and care
Participants described SRH services and care as sexual intercourse between a male and a female, prevention against Sexually Transmitted Diseases (STDs) and family planning. Most participants understood that SRH services and care are used by both males and females. The females use SRH services and care to prevent unplanned pregnancy whilst males use it to prevent themselves against Sexually Transmitted Diseases. Other participants stated that SRH services and care are used only by females because there are no contraceptive methods for men except condom (see Table 2). A participant described it as follows:
“it’s the sexual relationship between males and females and the way you will protect yourselves to prevent you from being infected with diseases [Sexually Transmitted Diseases]” (FGD1, Participant 5)
Most participants have heard about the various forms of SRH services and care which include family planning methods and STDs (HIV prevention). Some participants explained that a condom is used to prevent pregnancy and STDs. However, none of the participants had ever used a condom or any family planning methods before (See Table 2).
Theme 2: Relevance of accessing SRH services and care
Most participants noted that SRH services and care are important to prevent sexually transmitted diseases, improve personal hygiene among teenagers, and prevent unplanned pregnancy. Couples are expected to conduct a blood test to ensure there are no diseases in their blood prior to marriage. The medical examination helps to prevent any future complications on the couples and their children (see Table 2). A participant echoed on this as follows:
“What they say is that if you want to marry, it is better that you and your partner visit the hospital for blood test… when the two [man and woman] conduct the blood test and there is no disease then you can proceed to marry” (FGD1, Participant 2)
Theme 3: Source of accessing information on SRH services and care
Most participants received SRH service and care information from formal sources such as radio stations, hospitals, information centres, schools, NGOs, churches and disability association (Ghana Blind Union) (Table 2). Other participants received information on SRH services and care information from informal sources, which include relatives (mothers, siblings and cousins) and friends. A participant narrated as follows:
“It is my mother who educated me that I should be very careful with our sexual relationship so that we would not be infected with any disease” (FGD1, Participant 2)
Theme 4: Content of SRH information and education
Most participants received education on SRH service and care, particularly, on how to prevent STDs (eg. HIV). The education provided focused on avoidance of sharing blades and injections with others, the use of condoms in sexual intercourse and unsafe abortion (Table 2). A participant’s narration is captured below:
“I went to the hospital and one nurse told us that we should take good care of our children… we shouldn’t allow the children to use blade from the ground and also we shouldn’t seek over-the-counter injections… when you take an over-the-counter injection, you can be infected with the AIDs… so we should educate our children on such issues (FGD1, Participant 2).
Theme 5: Barriers to accessing information on SRH services and care
Most participants faced barriers in accessing SRH service and care information. The barriers are the lack of family caregivers and support services to accommodate participants during SRH services care meetings and durbars. In some instances, family members are unwilling to accompany participants to SRH service and care centres (Table 2). A participant echoed on this as follows:
“it may happen that you have been invited by a health worker in a durbar to talk in a community but you the blind person will not be having a caregiver to take you to that gathering to listen to what is going on” (FGD1, Participant 5).