Ghana’s New Stoma Support Group

By: Ach’sah Gubena and Rowena Kannaiyan

On September 19, 2025, the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana launched a Stoma Support Group for individuals who have undergone an ostomy, a surgical procedure creating an opening on the abdomen (stoma) to permit bodily waste to exit the body. The program was launched by Ghana’s Community, Engagement, and Involvement team, funded by the United Kingdom’s National Institute for Health and Research. [1] Despite the severe need across low- and middle-income countries (LMICs), this initiative is one of very few aimed at providing support to individuals living in these countries.

Background of Stomas in LMICs

LMICs often face similar challenges in their healthcare systems due to a generalized lack of available resources, training, trained staff, and hospitals. Many LMICs face an increased burden of patient overcrowding; in Ghana, for example, the majority of the nation's population funnels into a few large hospitals located in central cities. The Komfo Anokye Teaching Hospital (KATH) is one such example. As the second-largest hospital in Ghana, it serves as a major referral center for most of northern and central Ghana, taking patients from over a dozen regions. [2] KATH has been reported to cover roughly 9.7 million people with a bed capacity of around 1,200 beds. [2,3] Additionally, a lack of established registries in LMICs means that the prevalence of conditions—in this case, stomas—goes severely underreported, contributing to the lack of resources those communities may receive. [4] All of these factors contribute to a wide gap in the health of those who live in LMICs compared to those living in high-income countries (HICs). This discrepancy in healthcare infrastructure doesn’t just impact patients within the hospitals, but it also affects those living with chronic conditions that require continuous care, such as patients with stomas. In fact, the overall complication rate for stoma patients in LMICs exceeds 50% as compared to the 20-43% typically reported in HICs. [5]

A mixed-methods study was conducted in six hospitals across a two-year interval for four different LMICs: Philippine General Hospital (PGH) and Makati Medical Center (MMC) in the Philippines; Lagos University Teaching Hospital (LUTH) in Nigeria; Kamuzu Central Hospital (KCH) in Malawi; and Christian Medical College and Hospital (CMCH) and Government Medical College-Patiala (GMC-P) in India. [6] Qualitative interviews across all hospitals reflected that patients with ostomies lacked general knowledge about daily stoma management and emotional and psychosocial support.

Across the 446 patients included in the study, only 13.9% received pre-operative stoma counseling. Furthermore, only 44.4% received post-operative support, and 23.5% had experienced in-hospital complications.1,6 Without the proper pre- and post-operative care, ostomates encounter detrimental health outcomes and a reduced quality of life, facing skin irritation, leakage, stoma prolapse, parastomal hernia, or pain and discomfort around the stoma site. [7, 8] In addition to physical complications, patients with inadequate stoma care may also face stigmatization, increased anxiety regarding leakage, reduced mobility, and diminished participation in life activities. [9, 10] Stoma complications, inadequate preparation and care, and the resulting psychological and physiological complications are highly correlated to reduced quality of life, underscoring the importance of supporting proper stoma care in ostomates. [11]

Exacerbating these conditions, access to resources for patients with stomas in Ghana has historically been minimal. According to a clinical report from the Ghana College of Physicians and Surgeons, many peripheral facilities in Ghana lack stoma care nurses with adequate training and low rates of follow-ups. [12] These conditions may negatively impact healthcare experiences for patients, leading to declining frequencies of healthcare treatment and follow-up attendance. [12] Patient experience is a crucial, yet overlooked, aspect of healthcare that contributes heavily to patient adherence to treatment schedules and treatment-seeking behavior. [12] To address these barriers to adequate care and treatment often faced by stoma patients, the Komfo Anokye Teaching Hospital launched a stoma support group designed to empower and uplift the ostomy community.1

Komfo Anokye Teaching Hospital’s Stoma Support Group

KATH’s innovative support group for patients with stomas has been piloted with 42 eligible pediatric and adult patients, caregivers, and healthcare professionals. Filling a previous gap in psychosocial support available for ostomates, this new initiative cultivates a safe and collaborative environment where ostomates can share personal testimonies about challenges they face, including stigma, school exclusion, and lack of insurance coverage for stoma care, providing a much-needed sense of community and support.1 In combination with providing and facilitating support, the team at Komfo Anokye Teaching Hospital expanded its work by forming a national network via WhatsApp to reach stoma users across Ghana and provide them with remote education and support. This addresses the previous accessibility challenges where peripheral healthcare centers in Ghana faced a more severe lack of stoma care resources. By utilizing telecommunication platforms, such as WhatsApp, the KATH team is able to provide remote education and support to these healthcare centers, better equipping them to care for patients with stomas.

Providing remote access to educational materials is an impactful way to sustainably support and connect with healthcare workers and providers in LMICs globally. [13] With these improvements in telecommunication, previously isolated healthcare facilities are now able to receive external training and support, narrowing the gap of inequity between central hospitals and peripheral healthcare centers. KATH’s new stoma support group represents an initiative that aims to improve patient access to education and psychosocial care, fundamental features of comprehensive healthcare. This underscores a remarkable milestone for healthcare, providing sustainable patient-oriented care and expanding it to a national scale.

What will the future look like?

KATH’s new initiative serves as a crucial blueprint for other nations with similarly structured healthcare systems to provide remote and in-person care for people with stomas. The focus on stoma users serves as a reminder that healthcare encapsulates more than just a surgical procedure or follow-up appointment. Psychosocial care remains an underemphasized but essential component of healthcare. [14, 15] Not only is psychosocial care crucial for patient mental health, but it can improve the patient experience by reducing treatment barriers, thus improving adherence to treatment schedules and follow-ups. [16] KATH’s Stoma Support Group demonstrates the transformational impact that increased accessibility to training and education can have on both healthcare professionals and their patients.

References

[1] Leigh, G. (2025). CEI in action: Ghana’s new stoma support group. Global Surgery Unit. https://www.globalsurgeryunit.org/cei-in-action-ghanas-new-stoma-support-group/

[2] Komfo Anokye Teaching Hospital. (n.d.). About us. https://kath.gov.gh/about-us/

[3] PIMR Journal. (2025). Paediatric cardiac surgeries at Komfo Anokye Teaching Hospital: A 15-year retrospective study. https://doi.org/10.47799/pimr.1303.25.72

[4] Mowafi H, Ngaruiya C, O'Reilly G, Kobusingye O, Kapil V, Rubiano AM, et al. Emergency care surveillance and emergency care registries in low-income and middle-income countries: conceptual challenges and future directions for research. BMJ Global Health. 2019;4:e001442. https://doi.org/10.1136/bmjgh-2019-001442

[5] Williams, A., et al. (2024). Global perspectives on stoma care in low-resource settings. British Journal of Surgery, 112(Suppl. 15), xv62. https://academic.oup.com/bjs/article/112/Supplement_15/xv62/8376602

[6] Lapitan, M. C. M., Sacdalan, M. D. P., Lopez, M. P. J., Cruz, M. F. P., Msosa, V. J., Ademuyiwa, A. O., Alakaloko, F. M., Jain, R., Mahajan, A., Michael, V., Ghosh, D. N., Haque, P. D., Kumar, A., Aggarwal, M., & Glasbey, J. C. (2024). Mixed-methods exploration of challenges to stoma care for people with ostomies in four low- and middle-income countries: STomacARe For Improvement reSearcH (STARFISH) study. Journal of Global Health Reports, 8, e2024017. https://doi.org/10.29392/001c.117626

[7] Burch, J. (2005). The pre- and postoperative nursing care for patients with a stoma. British Journal of Nursing, 14(6), 310–318. https://doi.org/10.12968/bjon.2005.14.6.17799

[8] Nichols, T. R., & Riemer, M. (2008). The impact of peristomal skin complications on the quality of life of persons with an ostomy. Journal of Wound, Ostomy, and Continence Nursing, 35(2), 159–165.

[9] Bekkers, M. J., van Knippenberg, F. C., van den Borne, H. W., Poen, H., Bergsma, J., & van Berge Henegouwen, G. P. (1995). Psychosocial adaptation to stoma surgery: A review. Journal of Behavioral Medicine, 18(1), 1–31. https://doi.org/10.1007/BF01857702

[10] Marcomini, I., Iovino, P., Rasero, L., Manara, D. F., Vellone, E., & Villa, G. (2024). Self-care and quality of life of ostomy patients: A structural equation modeling analysis. Nursing Reports, 14(4), 3417–3426. https://doi.org/10.3390/nursrep14040247

[11] Pittman, J., Kozell, K., & Gray, M. (2009). Should WOC nurses measure health-related quality of life in patients undergoing intestinal ostomy surgery? Journal of Wound, Ostomy, and Continence Nursing, 36(3), 254–265. https://doi.org/10.1097/WON.0b013e3181a39347

[12] University of Ghana. (n.d.). [Title unavailable]. https://repository.gcps.edu.gh/server/api/core/bitstreams/a45572da-2ad7-43e2-93dc-240f91b2d7bd/content

[13] Karamagioli, E., Pikouli, A., Chatzi, E., Lykoudis, P. M., & Schizas, D. (2025). A review of remote surgical technologies and training strategies in low- and middle-income countries. Telemedicine and e-Health. https://doi.org/10.1177/15305627251395121

[14] Jordans, M. J. D., & Kohrt, B. A. (2020). Scaling up mental health care and psychosocial support in low-resource settings: A roadmap to impact. Epidemiology and Psychiatric Sciences, 29, e189. https://doi.org/10.1017/S2045796020001018

[15] Lovero, K. L., Giusto, A. M., & Wainberg, M. L. (2020). Evidence for efficacy of psychosocial interventions in LMICs. The Lancet Psychiatry, 7(2), 113–114. https://doi.org/10.1016/S2215-0366(19)30531-0

[16] Reiss, M., & Sandborn, W. J. (2015). The role of psychosocial care in adapting to health care reform. Clinical Gastroenterology and Hepatology, 13(13), 2219–2224. https://doi.org/10.1016/j.cgh.2015.09.010