Knowledge and occupational practices of beauticians and barbers in the transmission of viral hepatitis: a mixed-methods study in Volta Region of Ghana

Background Although Ghana is endemic for hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, the National Policy on Viral Hepatitis stipulates that there is unreliable data, limited knowledge, and deficiency in research on viral hepatitis, especially among high-risk workers in the eastern part of the country. This study therefore assessed the knowledge level and occupational practices of beauticians and barbers in the transmission of HBV and HCV in the Volta Region of Ghana. Methods A cross-sectional mixed methods study was conducted in Volta Ghana from April to June 2021. While an in-depth interview was used to collect data from five environmental health officers who were selected as key informants in the qualitative stage, structured questionnaires/checklists, and direct observations were employed to collect data from 340 beauticians and barbers in the quantitative stage. During the qualitative stage, the process of coding, and mind mapping via thematic analysis was carried out. Furthermore, descriptive and inferential analyses were performed using Stata version 17.0 at a 95% significance level in the quantitative stage. Results Most beauticians and barbers reported poor knowledge levels about HBV and HCV (67.0%), although the awareness of this viral hepatitis was high (88.2%). While almost one-third of the observed participants practiced safe occupational activities (31.5%), 29.0%, 49.4%, and 55.3% of them observed hand hygiene, wore protective clothes/gloves, and sterilized or disinfected tools after use respectively. Beauticians and barbers with higher (tertiary) education (AOR=11.4; 95%CI=1.44–27.5; p=0.021) and those with heavy workload per day (AOR=4.34; 95%CI=1.31– 14.4; p=0.016) were more likely to report good knowledge level about HBV and HCV. Additionally, beauticians were more likely to practice safe occupational activities as compared to barbers (AOR=14.2; 95%CI=4.11–28.8; p<0.001). The key informant interviews revealed that there was little or no licensing, monitoring, and training organized for beauticians and barbers. Conclusion Participants showed high awareness but limited knowledge about HBV and HCV. The general safety practices among the participants were poor. Our study results suggest possible viral transmission through the activities of beauticians and barbers which could be attributed to the lack of regulatory systems and training of beauticians and barbers.