Innovation, Environmental Antecedents and Performance Outcomes of Metropolitan, Municipal and District Assemblies in Ghana

The purpose of the study was to ascertain the effects of innovation types and environmental antecedents on performance outcomes of Metropolitan, Municipal and District Assemblies in Ashanti region, Ghana. Specifically, the study measures the mediating effects of environmental antecedents on the performance outcomes of the MMDAs. A total of 280 responses received from interested workers of the MMDAs were used for the study. As a result of the Covid-19 and its related restrictions, the questionnaire was developed using Google forms. Data were collected through social media and the responses received were screened and used for the analysis. The questionnaire was based on measurement scales for the key variables (innovation types, environmental antecedent, performance outcomes) understudy. SPSS and Sobel Test were used to estimate the mediation effect. The study results revealed that there is a significant but negative relationship between innovation types and performance outcomes at the MMDAs. Similarly, a significant and positive relationship was found between environmental antecedent and performance outcomes of the MMDs. Again, the results showed that there is a relationship between innovation types and performance outcomes of the MMDAs. Finally, the results showed that environmental antecedents mediate the relationship between innovation types and performance outcomes of the MMDAs. Based on the findings, the study recommends that managers of the MMDAs should continue to monitor and control the various environmental (public demands, political demand, regulatory frameworks, competition) forces within the public sector in order to realize the full potential of innovation and its role in facilitating performance outcome. Also, the MMDAs should embrace the innovation types (process innovation, process innovation, governance innovation, and conceptual innovation) in order to achieve higher performance outcomes (effectiveness, efficiency, citizen involvement and participation and customer satisfaction)

Financial Inclusion and Digital Financial Services: Empirical evidence from Ghana

The paper examines the relationship between increasing accessibility to digital financial services (DFS) and financial inclusion in lower income countries (LICs). Banks and non-bank organisations use DFS and the analysis indicates non-bank-based DFS emerges as the most efficient means of delivering cost effective financial services to the previously unbanked. Mobile cellular penetration and internet usage are mutually inclusive means through which digital financial services foster financial inclusion. Analysis of data for Ghana, as a case study, uses ordinary least squares and logistic regression models. The results in Difference-In-Difference method confirms the positive significant trend of mobile money usage and negative trend of bank-based DFS facilities over the period 2011-2014 in Ghana. Unambiguous policy ramifications are emphasised, paying attention to technological deepening stimulate positive outcomes of a broader and inclusive financial system

A search for Theory of Financial Market Failure in Lower Income Countries (LICs) and implication for Financial Exclusion.

We demonstrate in this paper using transdisciplinary approach that the same theory of information asymmetry that explains the raison d’être of financial intermediaries also explains why financial exclusion exists. This paper synthesises some elements of theories of finance and economics in developing a theoretical framework towards the understanding of why financial exclusion exists, and appears to be widespread in lower-income countries (LICs). The paradigm emphasises that financial market frictions that generate information asymmetry, risk and transaction cost associated with lending, contribute significantly to why exclusion occurs. The role fiscal deficit financing that crowds-out the private sector completely plays towards exclusion is also emphasised. The model predicts that excessive fiscal borrowing, market imperfection that allows ‘arbitrage value’ to be exploited, and excessive taxation, tend to widen the financial exclusion gap for the private agent. In contrast, growth in income and private investments tend to reduce the exclusion gap, hence, inclusion stimulating. The policy direction is curved towards choices that will minimise the tendencies and prevalence of financial exclusion in economies, especially the developing world

Enhancement of Syngas Production in Co-Pyro-Gasification of Biomass and Plastic Waste Materials: Computational Study

The process of co-pyro-gasification of biomass and plastics appears to have the potential for increasing syngas production for power generation and thus minimizing the impact of plastic waste on the environment. This study was based on co-pyro-gasification of selected natural/synthetic polymers and cocoa pod husks as biomass material to ascertain the optimal ratios for enhanced volatile yields. The results showed that gasification of pure biomass commenced at 1500 K, whereas gasification of mixed plastics and biomass started at much lower temperature of 1000 K accompanied with higher syngas yield. Single and multiple plastics produced the most syngas while double plastics had detrimental impact on syngas production. For instance, single plastics with polyethylene terephthalate achieved 65% increase in syngas yield. Mixed-plastics consisting of high-density polyethylene, low-density polyethylene, polypropylene, and polyethylene terephthalate, achieved an increase of 40% - 55% in syngas yield. Whereas antagonistic effects were observed in some double plastics systems such as polyethylene terephthalate and polypropylene. The results indicate that although plastics are instrumental in the thermodynamic equilibrium yields of syngas, the type of plastics and their groupings do also have a significant effect on the yields. Experimental study is recommended to validate the feed proportions for high syngas production

Exploring Overlaps Between the Genomic and Environmental Determinants of LVH and Stroke: A Multicenter Study in West Africa

Background Whether left ventricular hypertrophy (LVH) is determined by similar genomic and environmental risk factors with stroke, or is simply an intermediate stroke marker, is unknown. Objectives We present a research plan and preliminary findings to explore the overlap in the genomic and environmental determinants of LVH and stroke among Africans participating in the SIREN (Stroke Investigative Research and Education Network) study. Methods SIREN is a transnational, multicenter study involving acute stroke patients and age-, ethnicity-, and sex-matched control subjects recruited from 9 sites in Ghana and Nigeria. Genomic and environmental risk factors and other relevant phenotypes for stroke and LVH are being collected and compared using standard techniques. Results This preliminary analysis included only 725 stroke patients (mean age 59.1 ± 13.2 years; 54.3% male). Fifty-five percent of the stroke subjects had LVH with greater proportion among women (51.6% vs. 48.4%; p \u3c 0.001). Those with LVH were younger (57.9 ± 12.8 vs. 60.6 ± 13.4; p = 0.006) and had higher mean systolic and diastolic blood pressure (167.1/99.5 mm Hg vs 151.7/90.6 mm Hg; p \u3c 0.001). Uncontrolled blood pressure at presentation was prevalent in subjects with LVH (76.2% vs. 57.7%; p \u3c 0.001). Significant independent predictors of LVH were age \u3c45 years (adjusted odds ratio [AOR]: 1.91; 95% confidence interval [CI]: 1.14 to 3.19), female sex (AOR: 2.01; 95% CI: 1.44 to 2.81), and diastolic blood pressure \u3e 90 mm Hg (AOR: 2.10; 95% CI: 1.39 to 3.19; p \u3c 0.001). Conclusions The prevalence of LVH was high among stroke patients especially the younger ones, suggesting a genetic component to LVH. Hypertension was a major modifiable risk factor for stroke as well as LVH. It is envisaged that the SIREN project will elucidate polygenic overlap (if present) between LVH and stroke among Africans, thereby defining the role of LVH as a putative intermediate cardiovascular phenotype and therapeutic target to inform interventions to reduce stroke risk in populations of African ancestry

Prevalence and Prognostic Features of ECG Abnormalities in Acute Stroke: Findings From the SIREN Study Among Africans

Background Africa has a growing burden of stroke with associated high morbidity and a 3-year fatality rate of 84%. Cardiac disease contributes to stroke occurrence and outcomes, but the precise relationship of abnormalities as noted on a cheap and widely available test, the electrocardiogram (ECG), and acute stroke outcomes have not been previously characterized in Africans. Objectives The study assessed the prevalence and prognoses of various ECG abnormalities among African acute stroke patients encountered in a multisite, cross-national epidemiologic study. Methods We included 890 patients from Nigeria and Ghana with acute stroke who had 12-lead ECG recording within first 24 h of admission and stroke classified based on brain computed tomography scan or magnetic resonance imaging. Stroke severity at baseline was assessed using the Stroke Levity Scale (SLS), whereas 1-month outcome was assessed using the modified Rankin Scale (mRS). Results Patients\u27 mean age was 58.4 ± 13.4 years, 490 were men (55%) and 400 were women (45%), 65.5% had ischemic stroke, and 85.4% had at least 1 ECG abnormality. Women were significantly more likely to have atrial fibrillation, or left ventricular hypertrophy with or without strain pattern. Compared to ischemic stroke patients, hemorrhagic stroke patients were less likely to have atrial fibrillation (1.0% vs. 6.7%; p = 0.002), but more likely to have left ventricular hypertrophy (64.4% vs. 51.4%; p = 0.004). Odds of severe disability or death at 1 month were higher with severe stroke (AOR: 2.25; 95% confidence interval: 1.44 to 3.50), or atrial enlargement (AOR: 1.45; 95% confidence interval: 1.04 to 2.02). Conclusions About 4 in 5 acute stroke patients in this African cohort had evidence of a baseline ECG abnormality, but presence of any atrial enlargement was the only independent ECG predictor of death or disability

Longitudinal estimation of Plasmodium falciparum prevalence in relation to malaria prevention measures in six sub-Saharan African countries.

BACKGROUND: Plasmodium falciparum prevalence (PfPR) is a widely used metric for assessing malaria transmission intensity. This study was carried out concurrently with the RTS,S/AS01 candidate malaria vaccine Phase III trial and estimated PfPR over ≤ 4 standardized cross-sectional surveys. METHODS: This epidemiology study (NCT01190202) was conducted in 8 sites from 6 countries (Burkina Faso, Gabon, Ghana, Kenya, Malawi, and Tanzania), between March 2011 and December 2013. Participants were enrolled in a 2:1:1 ratio according to age category: 6 months-4 years, 5-19 years, and ≥ 20 years, respectively, per year and per centre. All sites carried out surveys 1-3 while survey 4 was conducted only in 3 sites. Surveys were usually performed during the peak malaria parasite transmission season, in one home visit, when medical history and malaria risk factors/prevention measures were collected, and a blood sample taken for rapid diagnostic test, microscopy, and haemoglobin measurement. PfPR was estimated by site and age category. RESULTS: Overall, 6401 (survey 1), 6411 (survey 2), 6400 (survey 3), and 2399 (survey 4) individuals were included in the analyses. In the 6 months-4 years age group, the lowest prevalence (assessed using microscopy) was observed in 2 Tanzanian centres (4.6% for Korogwe and 9.95% for Bagamoyo) and Lambaréné, Gabon (6.0%), while the highest PfPR was recorded for Nanoro, Burkina Faso (52.5%). PfPR significantly decreased over the 3 years in Agogo (Ghana), Kombewa (Kenya), Lilongwe (Malawi), and Bagamoyo (Tanzania), and a trend for increased PfPR was observed over the 4 surveys for Kintampo, Ghana. Over the 4 surveys, for all sites, PfPR was predominantly higher in the 5-19 years group than in the other age categories. Occurrence of fever and anaemia was associated with high P. falciparum parasitaemia. Univariate analyses showed a significant association of anti-malarial treatment in 4 surveys (odds ratios [ORs]: 0.52, 0.52, 0.68, 0.41) and bed net use in 2 surveys (ORs: 0.63, 0.68, 1.03, 1.78) with lower risk of malaria infection. CONCLUSION: Local PfPR differed substantially between sites and age groups. In children 6 months-4 years old, a significant decrease in prevalence over the 3 years was observed in 4 out of the 8 study sites. Trial registration Clinical Trials.gov identifier: NCT01190202:NCT. GSK Study ID numbers: 114001

Determinants of attending antenatal care at least four times in rural Ghana: analysis of a cross-sectional survey.

BACKGROUND: Improving maternal health is a global challenge. In Ghana, maternal morbidity and mortality rates remain high, particularly in rural areas. Antenatal care (ANC) attendance is known to improve maternal health. However, few studies have updated current knowledge regarding determinants of ANC attendance. OBJECTIVE: This study examined factors associated with ANC attendance in predominantly rural Ghana. METHODS: We conducted a cross-sectional study at three sites (i.e. Navrongo, Kintampo, and Dodowa) in Ghana between August and September 2013. We selected 1500 women who had delivered within the two years preceding the survey (500 from each site) using two-stage random sampling. Data concerning 1497 women's sociodemographic characteristics and antenatal care attendance were collected and analyzed, and factors associated with attending ANC at least four times were identified using logistic regression analysis. RESULTS: Of the 1497 participants, 86% reported attending ANC at least four times, which was positively associated with possession of national health insurance (AOR 1.64, 95% CI: 1.14-2.38) and having a partner with a high educational level (AOR 1.64, 95% CI: 1.02-2.64) and negatively associated with being single (AOR 0.39, 95% CI: 0.22-0.69) and cohabiting (AOR 0.57, 95% CI: 0.34-0.97). In site-specific analyses, factors associated with ANC attendance included marital status in Navrongo; marital status, possession of national health insurance, partners' educational level, and wealth in Kintampo; and preferred pregnancy timing in Dodowa. In the youngest, least educated, and poorest women and women whose partners were uneducated, those with health insurance were more likely to report at least four ANC attendances relative to those who did not have insurance. CONCLUSIONS: Ghanaian women with low socioeconomic status were less likely to report at least four ANC attendances during pregnancy if they did not possess health insurance. The national health insurance scheme should include a higher number of deprived women in predominantly rural communities