Electronic Thesis and Dissertation Repository


Master of Arts



Collaborative Specialization

Global Health Systems in Africa


Luginaah, Isaac


This thesis sought to examine factors influencing Hepatitis B transmission and voluntary screening in the Upper West Region (UWR) of Ghana. It analyzed a cross-sectional data collected on household heads (n=1374), and health facility (n=42) in four districts using multinomial logit regression and hierarchical multilevel regressions. Overall, only a quarter (25%) of respondents possessed correct knowledge of HBV transmission, while disparities in HBV knowledge was explained by both individual and health facility level factors. Further, the analysis showed that approximately 28% of respondents reported ever testing for HBV. For instance, although the source of healthcare influenced HBV testing, traders (RRR=0.29, p≤0.001) and farmers (RRR=0.34, p≤0.01) were significantly less likely to test voluntarily. Based on these findings, Ghana’s national hepatitis policy should target lower level primary health facilities such as CHPS, and also reduce financial barriers by covering cost of HBV testing under the national health insurance scheme.