File photo of some nurses in Ghana

The target audience of mainstream media, and to a large extent social media is the general public. The language and diction used in communication are deliberately selected to make the content intelligible to both lay and specialised audiences.

On the other hand, scientific journals are specially curated for the scientific community. The language used and the jargon employed are targeted at the scientists.

However, the central themes of academic conversations ongoing in scientific journals are about the general public, and ultimately for the benefit of the public. In fact, the pieces of information around which scientific conversations revolve are obtained from the general public – ordinary persons who enrol in research as research participants.

Yet scientific conversations are not designed for the consumption of the public. Even though the approach to communication used in science inherently precludes the lay public, academic conversations in scientific journals are relevant for public policy decisions and deliberations.

How can articles in scientific journals perform the all-important objective of influencing public discourse when only a few groups of people can participate? It is at the backdrop of this question that this article sets its aim, to attempt to briefly review and discuss for the non-science community a recent publication in one Ghanaian scientific journal, Postgraduate Medical Journal of Ghana.

The publication revealed some relevant pieces of information about depression amongst some health workers in Ghana. I will unpack some recommendations, and then hope that this exercise helps brings this scientific discourse into the public domain. 

Research conducted by Dr. Emmanuel Dziwornu with his Ghanaian and German research collaborators, on depression amongst 127 Ghanaian health workers revealed that 37%, 20% and 7% of the research participants had moderate, moderate-to-severe, and severe levels of depression respectively.1

These make a total of 64% of the participants. In other words, about 6 out of 10 health workers involved in the study had various levels of depression. This finding is worrying, and importantly it is relevant to Ghana’s policy decision-making. It is also a significant addition to the limited information about depression amongst health workers in Ghana.

In addition to throwing more light on depression in Ghanaian society, the study also reveals a worrying public health and mental health crisis amongst healthcare workers.

According to the researchers, depression is a significant cause of disability, and reduced productivity. The outcome of the research reminds the public and policymakers that healthcare workers may also be in need of care, as the neglect of their well-being affects work output, healthcare delivery, and ultimately patient satisfaction.

The researchers aptly posited in their journal article, Depression Amongst Health Workers: A Study at the Ho Teaching Hospital in Ghana, published in the March 2022 edition of the Postgraduate Medical Journal of Ghana that,

“Healthcare workers such as physicians, nurses, pharmacists, and laboratory technicians have healthcare opportunities at their disposal. Comparatively, they are expected to have easier access to healthcare than non-healthcare workers.

“However, this opportunity does not always amount to utility (perhaps it does for physical health), especially with regards to mental health among health workers. The mental health of healthcare providers/workers is crucial as this translates into how they render their services to patients.”1

To have a snapshot of the current extent of depression amongst health workers, a cross-sectional study design was used by the researchers to conduct this study. The use of a cross-sectional study design can be crudely compared to a movie critic who interprets a movie from a single scene.

The challenge associated with this approach is that the critic may miss previous scenes, leading to inadequate appreciation of the movie. In research, the use of a cross-sectional study design is associated with similar challenges faced by movie critics who critique movies from a single scene.

Because of these challenges, researchers who use cross-sectional study design encounter difficulties in proving causality and risk association between past (or ongoing) events and the disease or disorder under study. Nevertheless, the prevalence of diseases and disorders amongst a group of people can be evaluated with a cross-sectional study design.

Researchers who would want to use a cross-sectional study design to reveal a relationship between past events/factors and diseases/disorders may ask questions about past events, or they may choose an entirely different study design that is fit for purpose.2

In this research, the researchers assessed important sociodemographic factors like sex, marital status, age, and the kind` of health professionals of the research participants, to understand depression amongst the study population.

They also used Patient Health Questionnaire 9 (PHQ-9);1 a diagnostic tool that has been shown by other research works to be an effective tool for diagnosing depression.3 This approach used by the researchers was good because it has been shown that these kinds of diagnostic tools fare better than merely an unaided interrogation in the consulting room.3

Because of the nature of the study design used, the method used in selecting research participants (convenience sampling), and the small number of research participants; it was difficult to generalise the research findings to the larger population of health workers in Ghana. It was also difficult to adequately prove the risk factors associated with the development of depression amongst health workers in the study population.

The impact of sociodemographic characteristics like sex, marital status, age, and job category on depression amongst the health workers was revealing; though in statistical sense, most of them did not show significant association with depression. For example, the study showed that more women had various degrees of depression as compared to men. The research revealed that for every 8 females with severe depression, 1 male experienced severe depression.

This finding deserves to be given close attention in future research because its interpretation in this particular research was affected by the fact that 70.1% of the research participants were females. 

Also, single/divorced/separated health workers experienced depression and depressive symptoms as compared to married health workers. This finding needs to be unpacked as in the context of public health and mental health, an unmarried health worker is different from a divorced health worker and a health worker who is separated from the partner. In the context of job category, nurses were more likely to experience depression as compared to other health workers.

This finding is worrying and deserves to be given close attention for possible intervention because nurses are the largest number of health workers in the Ghanaian healthcare system, and they are the professionals who spend a lot of time with the patient as compared to other healthcare professionals like medical doctors, pharmacist, medical laboratory scientists, and others.

In conclusion, the research conducted by Dr. Dziwornu and his collaborators has brought to the fore a very worrying public health concern amongst health workers in Ghana that needs to be looked at critically and investigated to help improve the wellbeing of health workers; and ultimately improve patient satisfaction and health care delivery.

There is a need to also find out what may be accounting for the gender disparity in the pattern of distribution of depression amongst health workers. There is also a need to determine the underlying risk factors of depression amongst health workers in Ghana.

Amongst others, it could be due to poor working conditions, poor remuneration, unfulfilling career progression, bullying at the workplace,4 or emotional exhaustion from handling both biomedical challenges and ethical dilemmas in clinical practice.5

The concluding remarks of Dr. Dziwornu and his collaborators cannot be truer. They said, “Mental health needs more attention in Ghana. No population in Ghana and every other country is immune to mental health challenges. Several factors form the basis for the development of mental health challenges. Though these factors explored in this study did not give significant and distinguishable outcomes, there are still many others that require scientific exploration.”1

Further Reading

1.     Dziwornu E, Dordoye E, Hohl JE, Oboh L, Addae AK. Depression Among Health Workers: A Study at the Ho Teaching Hospital in Ghana. Postgraduate Medical Journal of Ghana. 2022;11(1).

2.     Thelle DS, Laake P. Epidemiology: Concepts and Methods. In: Laake P, Benestad HB, Olsen BR, eds. Research Methodology in the Medical and Biological Sciences. Elsevier; 2007:256-261.

3.     Pettersson A, Boström KB, Gustavsson P, Ekselius L. Which instruments to support diagnosis of depression have sufficient accuracy? A systematic review. Nordic Journal of Psychiatry. 2015;69(7):497-508. doi:10.3109/08039488.2015.1008568

4.     Carlasare LE, Hickson GB. Whose Responsibility Is It to Stop Bullying? American Medical Association Journal of Ethics. 2021;23(12):E931-936. doi:10.1177/2372732215624218

5.     Ahenkan A, Afari MB, Buabeng T. Ethical Dilemma of health professionals in Ghana: experiences of doctors and nurses at the Korle Bu Teaching Hospital. African Journal of Management Research. 2018;25:28-44. Accessed April 10, 2022. https://www.ajol.info/index.php/ajmr/article/view/176337

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Anthony Gyening-Yeboah is a Medical doctor and writer.