{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T17:07:14Z","timestamp":1788282434984,"version":"build-2803163510"},"reference-count":51,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":55,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Stellenbosch Institute for Advanced Study"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Equity Health"],"DOI":"10.1186\/s12939-026-02855-6","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T09:35:58Z","timestamp":1778578558000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["\u2018They don\u2019t see us to be sexual beings\u2019: barriers to sexual intimacy and reproductive rights among women with disabilities in northern Ghana"],"prefix":"10.1186","volume":"25","author":[{"given":"John Kuumuori","family":"Ganle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Ofori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward Akolgo","family":"Adimazoya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"2855_CR1","volume-title":"World Report on Disability","author":"World Health Organization and World Bank","year":"2011","unstructured":"World Health Organization and World Bank. World Report on Disability. Geneva: World Health Organization; 2011."},{"issue":"8","key":"2855_CR2","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1016\/j.nurpra.2016.06.005","volume":"12","author":"L Byrnes","year":"2016","unstructured":"Byrnes L, Hickey M. Perinatal care for women with disabilities: clinical considerations. J Nurse Practitioners. 2016;12(8):503\u20139.","journal-title":"J Nurse Practitioners"},{"issue":"8","key":"2855_CR3","doi-asserted-by":"publisher","first-page":"1606","DOI":"10.1007\/s10995-016-2250-3","volume":"21","author":"LT Bloom","year":"2017","unstructured":"Bloom LT, Mosher W, Alhusen J, Lantos H, Hughes BR. Fertility Desires and Intentions Among U.S. Women by Disability Status: Findings from the 2011\u20132013 National Survey of Family Growth. Matern Child Health J. 2017;21(8):1606\u201315. https:\/\/doi.org\/10.1007\/s10995-016-2250-3.","journal-title":"Matern Child Health J"},{"key":"2855_CR4","volume-title":"Ghana 2021 Population and Housing Census General Report Volume 3F: Difficulty in Performing Activities","author":"Ghana Statistical Service","year":"2021","unstructured":"Ghana Statistical Service. Ghana 2021 Population and Housing Census General Report Volume 3F: Difficulty in Performing Activities. Accra: GSS; 2021."},{"key":"2855_CR5","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1002\/oti.303","volume":"17","author":"S Reynolds","year":"2010","unstructured":"Reynolds S. Disability culture in West Africa: qualitative research indicating barriers and progress in the Greater Accra region of Ghana. Occup Therapy Int. 2010;17:198\u2013207.","journal-title":"Occup Therapy Int"},{"key":"2855_CR6","doi-asserted-by":"publisher","unstructured":"Otte WM, Nahaga AA, Tchuda DL, Abna B, der Maas F. Cultural beliefs among people with epilepsy or physical impairment in Guinea-Bissau: differences and similarities. Epilepsy Behav. 2013;29:504\u2013507. https:\/\/doi.org\/10.1016\/j.yebeh.2013.09.001. PMID: 24094843.","DOI":"10.1016\/j.yebeh.2013.09.001"},{"key":"2855_CR7","doi-asserted-by":"crossref","unstructured":"Otte WM, Nahaga AA, Tchuda DL, Abna B, der Maas F. Cultural beliefs among people with epilepsy or physical impairment in Guinea-Bissau: differences and similarities. Epilepsy Behav. 2013;29:504\u2013507.","DOI":"10.1016\/j.yebeh.2013.09.001"},{"key":"2855_CR8","doi-asserted-by":"publisher","unstructured":"Seidu, McBain-Rigga K, Emeto TI. Perceptions and attitudes towards people with disabilities in Ghana: a qualitative study among healthcare providers. Crit Public Health. 2025;35(1):2497354. https:\/\/doi.org\/10.1080\/09581596.2025.2497354.","DOI":"10.1080\/09581596.2025.2497354"},{"key":"2855_CR9","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1186\/s12978-020-01000-y","volume":"17","author":"JK Ganle","year":"2020","unstructured":"Ganle JK, Apolot RR, Rugoho T, Sumankuuro J. \u2018They are my future\u2019: childbearing desires and motivations among women with disabilities in Ghana - implications for reproductive healthcare. Reproductive Health, 2020; 17:151, https:\/\/doi.org\/10.1186\/s12978-020-01000-y.","journal-title":"Reproductive Health"},{"key":"2855_CR10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.worlddev.2012.05.024","volume":"41","author":"S Mitra","year":"2013","unstructured":"Mitra S, Posarac A, Vick B. Disability and poverty in developing countries: a multidimensional study. World Dev. 2013;41:1\u201313.","journal-title":"World Dev"},{"key":"2855_CR11","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1186\/s12978-021-01253-1","volume":"18","author":"JK Ganle","year":"2021","unstructured":"Ganle JK, Ofori C, Dery S. Testing the effect of an integrated-intervention to promote access to sexual and reproductive healthcare and rights among women with disabilities in Ghana: a quasi-experimental study protocol. Reproductive Health, 2021; 18:206 https:\/\/doi.org\/10.1186\/s12978-021-01253-1.","journal-title":"Reproductive Health"},{"key":"2855_CR12","volume-title":"Convention on the Rights of Persons with Disabilities and Optional Protocol","author":"United Nations","year":"2006","unstructured":"United Nations. Convention on the Rights of Persons with Disabilities and Optional Protocol. Nairobi, Kenya: United Nations; 2006."},{"key":"2855_CR13","unstructured":"Persons with Disability Act, 2006 (Act 715) (Ghana). 2006."},{"issue":"6","key":"2855_CR14","doi-asserted-by":"publisher","first-page":"e0158361","DOI":"10.1371\/journal.pone.0158361","volume":"11","author":"JK Ganle","year":"2016","unstructured":"Ganle JK, Otupiri O, Obeng B, Edusie KA, Ankomah A, Adanu R. Challenges women with disability face in accessing and using maternal healthcare services in Ghana. PLoS ONE. 2016;11(6):e0158361. https:\/\/doi.org\/10.1371\/journal.pone.0158361.","journal-title":"PLoS ONE"},{"key":"2855_CR15","doi-asserted-by":"publisher","first-page":"1477","DOI":"10.1016\/j.socscimed.2011.08.040","volume":"73","author":"J Trani","year":"2011","unstructured":"Trani J, Browne J, Kett M, Bah O, Morlai T, Bailey N, Groce N. Access to health care, reproductive health and disability: a large-scale survey in Sierra Leone. Soc Sci Med. 2011;73:1477\u201389.","journal-title":"Soc Sci Med"},{"key":"2855_CR16","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1186\/1742-4755-11-59","volume":"11","author":"SA Ahumuza","year":"2014","unstructured":"Ahumuza SA, Matovu KBJ, Ddamulira JB, Muhanguzi KF. Challenges in accessing sexual and reproductive health services by people with physical disabilities in Kampala, Uganda. Reproductive Health. 2014;11:59.","journal-title":"Reproductive Health"},{"key":"2855_CR17","doi-asserted-by":"publisher","first-page":"1132","DOI":"10.1016\/j.midw.2014.03.012","volume":"30","author":"J Morrison","year":"2014","unstructured":"Morrison J, Basnet M, Budhathoki B, Adhikari D, Tumbahangphe K, Manandhar D, Costello A. Groce N. Disabled women\u2019s maternal and newborn health care in Nepal: A qualitative study. Midwifery. 2014;30:1132\u20139.","journal-title":"Midwifery"},{"key":"2855_CR18","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1186\/s12905-014-0146-1","volume":"14","author":"VSG Murthy","year":"2014","unstructured":"Murthy VSG, Neena J, Sagar J, South India Disability Evidence Study Group. Reproductive health of women with and without disabilities in South India, the SIDE study (South India Disability Evidence) study: a case control study. BMC Women\u2019s Health. 2014;14:146.","journal-title":"BMC Women\u2019s Health"},{"issue":"50","key":"2855_CR19","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1080\/09688080.2017.1336375","volume":"25","author":"R Addlakha","year":"2017","unstructured":"Addlakha R, Price J, Heidari S. Disability and sexuality: claiming sexual and reproductive rights. Reprod Health Matters. 2017;25(50):4\u20139. https:\/\/doi.org\/10.1080\/09688080.2017.1336375.","journal-title":"Reprod Health Matters"},{"issue":"50","key":"2855_CR20","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1080\/09688080.2017.1329607","volume":"25","author":"E Burke","year":"2017","unstructured":"Burke E, K\u00e9b\u00e9 F, Flink I, van Reeuwijk M, le May AS. A qualitative study to explore the barriers and enablers for young people with disabilities to access sexual and reproductive health services in Senegal. Reprod Health Matters. 2017;25(50):43\u201354. https:\/\/doi.org\/10.1080\/09688080.2017.1329607.","journal-title":"Reprod Health Matters"},{"issue":"50","key":"2855_CR21","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1080\/09688080.2017.1331684","volume":"25","author":"C Peta","year":"2017","unstructured":"Peta C. Disability is not asexuality: the childbearing experiences and aspirations of women with disability in Zimbabwe. Reprod Health Matters. 2017;25(50):10\u20139. https:\/\/doi.org\/10.1080\/09688080.2017.1331684.","journal-title":"Reprod Health Matters"},{"issue":"50","key":"2855_CR22","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1080\/09688080.2017.1331690","volume":"25","author":"N Alexander","year":"2017","unstructured":"Alexander N, Gomez TM. Pleasure, sex, prohibition, intellectual disability, and dangerous ideas. Reprod Health Matters. 2017;25(50):114\u201320. https:\/\/doi.org\/10.1080\/09688080.2017.1331690.","journal-title":"Reprod Health Matters"},{"issue":"50","key":"2855_CR23","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1080\/09688080.2017.1332949","volume":"25","author":"X Hunt","year":"2017","unstructured":"Hunt X, Carew TM, Braathen HS, Swartz L, Chiwaula M, Rohleder P. The sexual and reproductive rights and benefit derived from sexual and reproductive health services of people with physical disabilities in South Africa: beliefs of non-disabled people. Reprod Health Matters. 2017;25(50):66\u201379. https:\/\/doi.org\/10.1080\/09688080.2017.1332949.","journal-title":"Reprod Health Matters"},{"key":"2855_CR24","doi-asserted-by":"publisher","unstructured":"Dean L, Tolhurst R, Khanna R, Jehan K. \u201cYou\u2019re disabled, why did you have sex in the first place?\u201d An intersectional analysis of experiences of disabled women with regard to their sexual and reproductive health and rights in Gujarat State, India. Glob Health Action. 2017;10(Suppl 2). https:\/\/doi.org\/10.1080\/16549716.2017.1290316.","DOI":"10.1080\/16549716.2017.1290316"},{"key":"2855_CR25","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s12884-019-2171-4","volume":"19","author":"RH Devkota","year":"2019","unstructured":"Devkota RH, Kett M, Groce N. Societal attitude and behaviours towards women with disabilities in rural Nepal: pregnancy, childbirth and motherhood. BMC Pregnancy Childbirth. 2019;19:20. https:\/\/doi.org\/10.1186\/s12884-019-2171-4.","journal-title":"BMC Pregnancy Childbirth"},{"issue":"10","key":"2855_CR26","doi-asserted-by":"publisher","first-page":"e0238585","DOI":"10.1371\/journal.pone.0238585","volume":"15","author":"JK Ganle","year":"2020","unstructured":"Ganle JK, Baatiema L, Quansah R, Danso-Appiah A. Barriers facing persons with disability in accessing sexual and reproductive health services in sub-Saharan Africa: A systematic review. PLoS ONE. 2020;15(10):e0238585. https:\/\/doi.org\/10.1371\/journal.pone.0238585.","journal-title":"PLoS ONE"},{"issue":"1","key":"2855_CR27","doi-asserted-by":"publisher","first-page":"21","DOI":"10.2190\/IQ.35.1.c","volume":"35","author":"KW Mprah","year":"2014","unstructured":"Mprah KW, Anafi P, Sekyere OF. Does disability matter? Disability in sexual and reproductive health policies and research in Ghana. Int Q Community Health Educ. 2014;35(1):21\u201335.","journal-title":"Int Q Community Health Educ"},{"key":"2855_CR28","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1186\/s12939-014-0076-4","volume":"13","author":"M Mulumba","year":"2014","unstructured":"Mulumba M, Nantaba J, Brolan EC, Ruano LA, Brooker K, Hammonds R. Perceptions and experiences of access to public healthcare by people with disabilities and older people in Uganda. Int J Equity Health. 2014;13:76.","journal-title":"Int J Equity Health"},{"issue":"4","key":"2855_CR29","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1363\/46e2514","volume":"46","author":"CL Shandra","year":"2014","unstructured":"Shandra CL, Hogan DP, Short SE. Planning for motherhood: Fertility attitudes, desires and intentions among women with disabilities. Perspect Sex Reprod Health. 2014;46(4):203\u201310. https:\/\/doi.org\/10.1363\/46e2514.","journal-title":"Perspect Sex Reprod Health"},{"key":"2855_CR30","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-78852-4","volume-title":"Diverse Voices of Disabled Sexualities in the Global South","author":"P Chappell","year":"2019","unstructured":"Chappell P, de Beer M. Diverse Voices of Disabled Sexualities in the Global South. Switzerland: Palgrave Macmillan; 2019."},{"key":"2855_CR31","volume-title":"The Sexual Politics of Disability","author":"T Shakespeare","year":"1996","unstructured":"Shakespeare T, Gillespie-Sellis K, Davies D. The Sexual Politics of Disability. London: Cassell; 1996."},{"issue":"3","key":"2855_CR32","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1023\/A:1026409613684","volume":"18","author":"T Shakespeare","year":"2000","unstructured":"Shakespeare T. Disabled Sexuality: Towards Rights and Recognition. Sex Disabil. 2000;18(3):159\u201366.","journal-title":"Sex Disabil"},{"key":"2855_CR33","volume-title":"Sex and Disability: Politics, Identify and Access","author":"R Shuttleworth","year":"2010","unstructured":"Shuttleworth R, Sanders T. Sex and Disability: Politics, Identify and Access. Leeds: Disability; 2010."},{"issue":"3","key":"2855_CR34","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1080\/15240650701226490","volume":"8","author":"M Shildrick","year":"2007","unstructured":"Shildrick M. Dangerious Discourses: Anxiety, desire and disability. Stud Gend Sexuality. 2007;8(3):221\u201344.","journal-title":"Stud Gend Sexuality"},{"key":"2855_CR35","doi-asserted-by":"publisher","DOI":"10.1515\/9780822394877","volume-title":"Sex and Disability","author":"R McRuer","year":"2012","unstructured":"McRuer R, Mollow A. Sex and Disability. Durham: Duke University Press; 2012."},{"key":"2855_CR36","doi-asserted-by":"crossref","unstructured":"Chisi F. How disability \u201ckilled\u201d my sexuality. In: Chappel P, de Beer M, editors. Diverse voices of disabled sexualities in the Global South. Switzerland: Palgrave Macmillan; 2019. p. 103\u2013108.","DOI":"10.1007\/978-3-319-78852-4_7"},{"key":"2855_CR37","doi-asserted-by":"crossref","unstructured":"Boersma FMJ, Tardi R, Lockwood E, Ayansa GW. Informed sexuality: the influence of lack of information on the sexuality, relationships and reproductive health of deaf women in Addis Ababa. In: Chappel P, de Beer M, editors. Diverse voices of disabled sexualities in the Global South. Switzerland: Palgrave Macmillan; 2019. p. 167\u2013184.","DOI":"10.1007\/978-3-319-78852-4_12"},{"key":"2855_CR38","doi-asserted-by":"crossref","unstructured":"Bartley M. Navigating dating and relationship with a disability in Jamaica. In: Chappel P, de Beer M, editors. Diverse voices of disabled sexualities in the Global South. Switzerland: Palgrave Macmillan; 2019. p. 109\u2013126.","DOI":"10.1007\/978-3-319-78852-4_8"},{"key":"2855_CR39","doi-asserted-by":"publisher","unstructured":"Agbenyeavu JK, Eshun G, Aboagye GR, Ganle JK. Awareness and barriers to accessing sexual and reproductive healthcare services among deaf women in Krachi West District of Ghana: a qualitative study. Reprod Health. 2025;22:138. https:\/\/doi.org\/10.1186\/s12978-025-02063-5.","DOI":"10.1186\/s12978-025-02063-5"},{"key":"2855_CR40","doi-asserted-by":"crossref","unstructured":"Peta C. Sexuality education in Zimbabwe: why leave disabled girls and disabled women behind? In: Chappel P, de Beer M, editors. Diverse Voices of Disabled Sexualities in the Global South. Switzerland: Palgrave Macmillan; 2019. p. 257\u2013276.","DOI":"10.1007\/978-3-319-78852-4_18"},{"key":"2855_CR41","unstructured":"Hosking LD. Critical disability theory. Paper presented at: 4th Biennial Disability Studies Conference; 2008 Sep 2\u20134; Lancaster University, UK."},{"key":"2855_CR42","unstructured":"Tremain S. Foucault, Governmentality, and Critical Disability Theory: An Introduction. Ann Arbor (MI): The University of Michigan Press; 2005."},{"key":"2855_CR43","volume-title":"Disability: A Life Course Approach","author":"M Priestley","year":"2003","unstructured":"Priestley M. Disability: A Life Course Approach. Cambridge: Polity; 2003."},{"key":"2855_CR44","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-349-20895-1","volume-title":"The Politics of Disablement","author":"M Oliver","year":"1990","unstructured":"Oliver M. The Politics of Disablement. London: Macmillan Education; 1990."},{"key":"2855_CR45","doi-asserted-by":"publisher","DOI":"10.1080\/0142159X.2025.2478871","author":"M Tavakol","year":"2025","unstructured":"Tavakol M, Sandars J. Twelve tips for using phenomenology as a qualitative research approach in health professions education. Med Teach. 2025. https:\/\/doi.org\/10.1080\/0142159X.2025.2478871.","journal-title":"Med Teach"},{"key":"2855_CR46","volume-title":"2010 Population and Housing Census: Regional analytical Report - Northern Region","author":"Ghana Statistical Service","year":"2013","unstructured":"Ghana Statistical Service. 2010 Population and Housing Census: Regional analytical Report - Northern Region. Accra: Ghana Statistical Service; 2013."},{"issue":"6","key":"2855_CR47","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","volume":"19","author":"A Tong","year":"2007","unstructured":"Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349\u201357.","journal-title":"Int J Qual Health Care"},{"key":"2855_CR48","first-page":"1","volume-title":"Disability and Mothering: Liminal Spaces of Embodied Knowledge","author":"C Lewiecki-Wilson","year":"2011","unstructured":"Lewiecki-Wilson C, Cellio J. Introduction: On Liminality and Cultural Embodiment. In: Lewiecki-Wilson C, Cellio J, editors. Disability and Mothering: Liminal Spaces of Embodied Knowledge. Syracuse, New York: Syracuse University; 2011. pp. 1\u201317."},{"key":"2855_CR49","first-page":"113","volume-title":"Disability and Mothering: Liminal Spaces of Embodied Knowledge","author":"MJ Rodas","year":"2011","unstructured":"Rodas MJ, Diagnosable. Mothering at the Threshold of Disability. In: Lewiecki-Wilson C, Cellio J, editors. Disability and Mothering: Liminal Spaces of Embodied Knowledge. Syracuse, New York: Syracuse University; 2011. pp. 113\u201326."},{"issue":"7","key":"2855_CR50","doi-asserted-by":"publisher","first-page":"1672","DOI":"10.1111\/jan.12635","volume":"17","author":"D Lawler","year":"2015","unstructured":"Lawler D, Begley C, Lolar J. (Re)constructing myself: The process of transition to motherhood for women with a disability. J Adv Nurs. 2015;17(7):1672\u201383.","journal-title":"J Adv Nurs"},{"issue":"10","key":"2855_CR51","doi-asserted-by":"publisher","first-page":"1510","DOI":"10.1080\/09687599.2017.1361385","volume":"32","author":"B Tefera","year":"2017","unstructured":"Tefera B, Van Engen M, Van der Klink J, Schippers A. The grace of motherhood: disabled women contending with societal denial of intimacy, pregnancy, and motherhood in Ethiopia. Disabil Soc. 2017;32(10):1510\u201333. https:\/\/doi.org\/10.1080\/09687599.2017.1361385.","journal-title":"Disabil Soc"}],"container-title":["International Journal for Equity in Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12939-026-02855-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12939-026-02855-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12939-026-02855-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T15:05:58Z","timestamp":1783350358000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12939-026-02855-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,12]]},"references-count":51,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2855"],"URL":"https:\/\/doi.org\/10.1186\/s12939-026-02855-6","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-6409751\/v1","asserted-by":"object"}]},"ISSN":["1475-9276"],"issn-type":[{"value":"1475-9276","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,12]]},"assertion":[{"value":"9 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was obtained from the Ghana Health Service Ethics Review Committee (Protocol ID NO. GHS-ERC:007\/07\/18). The study was conducted in accordance with the terms of the Helsinki Declaration. Before each interview, research assistants first reviewed participants\u2019 information sheet and informed consent form with each participant. In particular, the benefits and risks of participation were communicated to each participant. No biological samples were collected, and participants were not exposed to any physical danger. However, a few participants (4) experienced distress when discussing some aspects of their experiences (e.g. physical or sexual abuse). In all such situations, participants were referred for appropriate psychological counselling and support. Appropriate financial support was provided to help pay the cost associated with travel and service. Written informed consent was obtained from each participant either by signing or thumbprinting the informed consent form. All interviews were conducted in places that ensured maximum anonymity, confidentiality and privacy. No third parties were present during interviews, except four visually impaired participants who were accompanied by personal assistants. Neither the name\/address of participants nor any voice identifiers were used to identify individual participants in interview transcripts. Transcripts and field notes were entered into access-controlled computers, accessible only to the principal investigator.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"All participants gave consent for the study\u2019s findings to be published. All authors also consented to the publication of this manuscript.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"162"}}