Setting
Eastern region is the sixth largest region of Ghana. However, it is the third most populous region in the country, after Ashanti and Greater Accra region. It occupies an area of about 19,323 km2 representing 8.9 % of the total land area of Ghana. It has a population of 2,633,154 which makes up 10.7 % of the total population of Ghana [19]. Estimates of 50.8 % of the populace are females whereas 49.2 % are males. The region shares boarders with Volta region in the East, Greater Accra region in the south, Central region in the west and Ashanti region in the north [19].
The study was conducted in the main Regional Hospital and four district hospitals comprised of two mission and two Government health facilities. This was to allow for statistical comparison to find out if there are contextual differences in knowledge of mother to child transmission (MTCT) of HBV infection among participants.
Study design, participants and sampling
A quantitative approach using a cross sectional survey was conducted between August and November, 2015. Physicians and midwives working in the Eastern regional hospital and four district hospitals including mission and government owned facilities were recruited for the study. Participants who were full time employees of the selected health facilities with atleast six (6) months working experience in midwifery or medicine were recruited. In addition, participants currently providing maternal and neonatal care who consented to participate in the study were selected. Physicians and midwives undergoing internship and national service were excluded from the study.
A census approach was employed to recruit the physicians. Census approach was used because the entire population of physicians in the selected facilities is small and therefore any physician who met the inclusion criteria and who consented to participate at the time of data collection was included. Oral messages were sent to physicians working in the selected facilities a week prior to data collection date to inform them about the study. On the said day of census, physicians were contacted individually in their consulting room for inclusion after obtaining their written informed consent.
However, a convenience sampling technique was used to select the midwives at both regional and district hospitals. Convenience sampling is a type of a non-probability sampling technique in which members of the target population are chosen based on their availability, accessibility and readiness to voluntarily participate in a study [20]. Verbal announcement was made a week prior to data collection to inform the midwives in their respective unit about the study. On the said date, midwives were contacted at their respective units of work including the antenatal, labour ward, lying-in ward, post-natal unit for inclusion after obtaining written informed consent from them. Using the total number of physicians and midwives in the facilities, proportional quota was used to determine the sample for each hospital.
Sample size determination
Yamane (1967) [21] formula with a level of precision of 0.05 was used to determine the sample size for the study. In all, 130 questionnaires were administered and 126 of them were retrieved indicating a 97 % response rate.
Study procedure and data collection
A semi-structured self- administered questionnaire in English language was administered to eligible participants. The questionnaire was designed by the research team based on literature review and its content validity was established through consultation with three experts in the field. Five physicians and ten midwives were first used to pre-test construct validity of the instrument and the items which were found to be ambiguous and difficult to understand were noted from the responses and corrected. In addition, their experts knowledge was considered. After the correction was done, 30 participants were further given the questionnaires to answer. Using Cronbach alpha to test the internal consistency, the instrument was found to be 0.76 indicating that the instrument is reliable. The questionnaire had three sections. The socio-demographic characteristics, assessment of awareness level of hepatitis B and extent of knowledge of MTCT of hepatitis B among study participants. Twelve (12) questions were asked on both awareness and knowledge. On the knowledge scale, a score ranging from 0–2 is considered poor, 3–5 fair and 6–9 is good. From the current data, the mean score for the sample is 6.10 and a standard deviation of 1.17. The highest possible score on the knowledge is 9.
Data analysis
Data collected was analysed using Statistical Package of Social Science (IBM-SPSS) version 22.0. In analysing the data, descriptive statistic such as means, percentage and standard deviation were examined. Additionally, independent t-test was used to determine the differences in knowledge on MTCT between physicians and midwives. The difference in knowledge on MTCT and participant’s socio-demographic characteristics were analysed using Analysis of the variance (ANOVA). A p- value of 0.05 alpha level was considered statistically significant.