Date of Award

January 2025

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Jeremy I. Schwartz

Second Advisor

Derek A. Tuoyire

Abstract

BackgroundNon-communicable diseases (NCDs) are expected to become Africa's leading cause of death by 2030. In Ghana, with its limited healthcare resources, hypertension is already the leading cause of death, contributing to 15.3% of total deaths. Student-run free clinics (SRFCs) have become essential components of healthcare systems worldwide, offering primary medical care to underserved populations. This study explores the feasibility of health professional student-led interventions in addressing gaps in NCD screening, early management, and self-care education in Ghana.

MethodsThis research employed an exploratory sequential design, combining qualitative and quantitative phases. Six focus group discussions (FGDs) with 48 health professional students at two Ghanaian universities explored perceptions of NCDs, barriers to care, interest in leading interventions, and recommendations for a student-run clinic. Six key informant interviews with faculty, deans, and four Ghana Health Service (GHS) officials assessed the feasibility of an SRFC. In the quantitative phase, 316 students completed a survey based on FGD themes to evaluate factors affecting student interest, the potential impact of SRFCs, and perceived challenges. Two final FGDs with 12 community members gauged receptiveness and gathered recommendations. Qualitative data were analyzed using a descriptive thematic approach, while logistic regression was applied to quantitative data. Verbal and written consent was obtained from all participants.

FindingsSix main themes emerged: • There was a high level of familiarity of NCDs among all stakeholders. • There was demonstrable interest across all stakeholders in student-led interventions for NCD screening, early management, and self-care education. • The need for onsite supervision was a key requirement from all stakeholders. • There were other sustainability concerns and recommendations. • There was material and immaterial stakeholder support to address elicited concerns. • Proposed Intervention: A weekend, interprofessional, community-based, free clinic focused on NCD screening, education, and linkage to health systems.

InterpretationThe study reveals strong interest and confidence among stakeholders for an interprofessional student-led NCD intervention and informs the development of interprofessional SRFC as a model for enhancing primary NCD care in low-resource settings. The study's strengths include its comprehensive design and stakeholder engagement, although regional focus may limit broader applicability.

Source of FundingOffice of Student Research, Yale School of Medicine.

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This is an Open Access Thesis.

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