Mathematics Teachers’ Views and Use of Differentiated Instruction: The case of two teachers in the Winneba Municipality, Ghana

To ensure that the global sustainable development goal on education is achieved, the implementation of differentiated instruction (DI) is beginning to gain attention in the Ghanaian education system. But is Ghana embracing and implementing DI effectively in the mathematics classroom? This paper investigated two junior high school (JHS) mathematics teachers’ views and use of DI in their mathematics classrooms. Qualitative data obtained through observations and semi-structured interviews in an embedded mixed methods study that employed the Solomon four group quasi-experiment design were analyzed and in this report. The results show that teachers used flexible grouping, tiered assignment, end of unit assignments, worksheets and ICT tools (though extremely challenging) as the convenient DI strategies. The interview data after the experiment disclosed that, DI impacted students’ performance positively. However, the data showed that DI is time consuming, extremely challenging, expensive and required resources not readily available in public schools. Recommendations are made for the embracing of convenient strategies of DI in Ghanaian classrooms

Effects of Delegated Water Provisioning on Quality of Drinking Water in Low Income Areas of Kisumu County, Kenya

Only 62% of the African population have access to improved water supply. In Kenya 14% of the households in the urban areas, are privately connected to improved water supply systems. However, intermittent water supply has been reported to be a constant constraint in most low income areas in Kenya, making the residents of these areas to seek for alternative water sources such as water cart vendors, with exorbitant water prices and questionable water quality. Intermittent water supply increases the risk of water contamination through breaks and leaks leading to life threatening waterborne diseases. Delegated Management Model was adopted by water utilities in developing countries to address water access and quality issues in low income areas in developing countries. The aim of the study was to investigate the impact of DMM on the quality of drinking water in low-income areas of Kisumu County in Kenya. A descriptive cross-sectional research design was adopted. A total of 80 water samples were collected with 56 collected at the water kiosks while 24 were collected from the households. A two-sample t-test was used to determine if the differences in quality of the drinking water from the two settlements was significant at 95% confidence interval and p value set at .05. The study findings at the point of supply (water kiosks), indicated that, only the PH was within the WHO recommended standards. Turbidity, residual chlorine, total coliforms and Faecal Coliforms were all above the WHO recommended levels, and were statistically significant at p < 0.05. At the household, turbidity (NTU>1), total Coliforms and faecal Coliforms were all above the WHO standards. Both turbidity, total and faecal coliforms recorded significant decrease at p <0.05 though the parameters were still not within the WHO recommended levels. Though the DMM model of water supply in Nyalenda and Manyatta has improved access to water in the two informal settlement areas, findings show alterations in water quality parameters both at the water kiosks and at the household level which indicates contamination in the water supply. The study therefore recommends closer water quality monitoring at the Supply points (water kiosks) and at the households to identify and prevent sources of contamination. Further, health education strategies should be put in place to enhance proper water handling and storage among the residents. Further research should be done to identify the source of contamination. Keywords: Water, Drinking water , Water quality, Water Provisioning, low income areas DOI: 10.7176/JHMN/60-12 Publication date:March 31st 201

MAXIMIZING TECHNOLOGY ACCEPTANCE MODEL IN ACCESSING THE ATTITUDE OF RURAL FARMERS USING ICT TOOLS IN FARMING TO ENHANCE PRODUCTIVITY

The study was conducted using a multi-stage sampling technique involving simple random sampling, a probability sampling method, purposive sampling, and snowball sampling, which are non-probability methods. Two regions, namely, the Greater Accra and Eastern were purposively selected for the study. In the Greater Accra Region, Ada East District was selected while in the Eastern Region Asuogyaman District. In Greater Accra, the study was conducted in six farming villages namely: Big Ada, Dogo, Kasseh, Addokope, Korlekope, and Bedeku. In Eastern regions, the study was conducted in Asogyaman, where Tortibo, Sappor, Yenease, Adina Donor, and Ankyease. A snowball strategy was relied on in selecting small-scale farmers for the study. A total of 390 households, 130 from each district, were sampled randomly. The methodologies used for primary data were household surveys and Focus Group Discussion (FGD) while the instruments used were semi-structured pre-tested Interview Schedules and Checklist respectively. The study concludes that age has an effect on the attitude of small-scale farmers concerning their perceived use of ICT to improve their farming activities. The educational level of an individual plays a significant role in the acceptance and use of ICT

Whole genome sequencing and spatial analysis identifies recent tuberculosis transmission hotspots in Ghana

Whole genome sequencing (WGS) is progressively being used to investigate the transmission dynamics of; Mycobacterium tuberculosis; complex (MTBC). We used WGS analysis to resolve traditional genotype clusters and explored the spatial distribution of confirmed recent transmission clusters. Bacterial genomes from a total of 452 MTBC isolates belonging to large traditional clusters from a population-based study spanning July 2012 and December 2015 were obtained through short read next-generation sequencing using the illumina HiSeq2500 platform. We performed clustering and spatial analysis using specified R packages and ArcGIS. Of the 452 traditional genotype clustered genomes, 314 (69.5%) were confirmed clusters with a median cluster size of 7.5 genomes and an interquartile range of 4-12. Recent tuberculosis (TB) transmission was estimated as 24.7%. We confirmed the wide spread of a Cameroon sub-lineage clone with a cluster size of 78 genomes predominantly from the Ablekuma sub-district of Accra metropolis. More importantly, we identified a recent transmission cluster associated with isoniazid resistance belonging to the Ghana sub-lineage of lineage 4. WGS was useful in detecting unsuspected outbreaks; hence, we recommend its use not only as a research tool but as a surveillance tool to aid in providing the necessary guided steps to track, monitor, and control TB

Universal coverage and utilization of free long-lasting insecticidal nets for malaria prevention in Ghana: a cross-sectional study

BackgroundMalaria continues to be one of the leading causes of mortality and morbidity, especially among children and pregnant women. The use of Long-Lasting Insecticide Nets (LLINs) has been recognized and prioritized as a major intervention for malaria prevention in Ghana. This study aims to establish the factors influencing the universal coverage and utilization of LLINs in Ghana.MethodsThe data used for this study was from a cross-sectional survey carried out to assess LLINs ownership and use in 9 out of the 10 old regions of Ghana from October 2018 to February 2019 where free LLIN distribution interventions were implemented. The EPI “30 × 7” cluster sampling method (three-stage sampling design) was modified to “15 × 14” and used for the study. A total of 9,977 households were interviewed from 42 districts. Descriptive statistics using percentages as well as tests of associations such as Pearson Chi-square and the magnitude of the associations using simple and multivariable logistic regression were implemented.ResultsOf the 9,977 households in the study, 88.0% of them owned at least one LLIN, universal coverage was 75.6%, while utilization was 65.6% among households with at least one LLIN. In the rural and urban areas, 90.8% and 83.2% of households, respectively, owned at least one LLIN. The was a 44% increase in universal coverage of LLINs in rural areas compared to urban areas (AOR: 1.44, 95% CI: 1.02–2.02). There were 29 higher odds of households being universally covered if they received LLIN from the PMD (AOR: 29.43, 95% CI: 24.21–35.79). Households with under-five children were 40% more likely to utilize LLIN (AOR: 1.40, 95% CI: 1.26–1.56). Respondents with universal coverage of LLIN had 25% increased odds of using nets (AOR: 1.25 95% CI: 1.06–1.48). Rural dwelling influences LLIN utilization, thus there was about 4-fold increase in household utilization of LLINs in rural areas compared to urban areas (AOR: 3.78, 95% CI: 2.73–5.24). Household size of more than 2 has high odds of LLINs utilization and awareness of the benefit of LLINs (AOR: 1.42, 95% CI: 1.18–1.71).ConclusionAbout nine in 10 households in Ghana have access at least to one LLIN, three-quarters had universal coverage, and over two-thirds of households with access used LLIN. The predictors of universal coverage included region of residence, rural dwellers, and PMD campaign, while households with child under-five, in rural areas, and with universal coverage were positively associated with utilization

Adapting the Community-based Health Planning and Services (CHPS) to engage poor urban communities in Ghana: protocol for a participatory action research study

Introduction: With rapid urbanisation in low-income and middle-income countries, health systems are struggling to meet the needs of their growing populations. Community-based Health Planning and Services (CHPS) in Ghana have been effective in improving maternal and child health in rural areas; however, implementation in urban areas has proven challenging. This study aims to engage key stakeholders in urban communities to understand how the CHPS model can be adapted to reach poor urban communities.Methods and analysis: A Participatory Action Research (PAR) will be used to develop an urban CHPS model with stakeholders in three selected CHPS zones: (a) Old Fadama (Yam and Onion Market community), (b) Adedenkpo and (c) Adotrom 2, representing three categories of poor urban neighbourhoods in Accra, Ghana. Two phases will be implemented: phase 1 (‘reconnaissance phase) will engage and establish PAR research groups in the selected zones, conduct focus groups and individual interviews with urban residents, households vulnerable to ill-health and CHPS staff and key stakeholders. A desk review of preceding efforts to implement CHPS will be conducted to understand what worked (or not), how and why. Findings from phase 1 will be used to inform and co-create an urban CHPS model in phase 2, where PAR groups will be involved in multiple recurrent stages (cycles) of community-based planning, observation, action and reflection to develop and refine the urban CHPS model. Data will be managed using NVivo software and coded using the domains of community engagement as a framework to understand community assets and potential for engagement

Adapting the Community-based Health Planning and Services (CHPS) to engage poor urban communities in Ghana: protocol for a participatory action research study

Introduction: With rapid urbanisation in low-income and middle-income countries, health systems are struggling to meet the needs of their growing populations. Community-based Health Planning and Services (CHPS) in Ghana have been effective in improving maternal and child health in rural areas; however, implementation in urban areas has proven challenging. This study aims to engage key stakeholders in urban communities to understand how the CHPS model can be adapted to reach poor urban communities.Methods and analysis: A Participatory Action Research (PAR) will be used to develop an urban CHPS model with stakeholders in three selected CHPS zones: (a) Old Fadama (Yam and Onion Market community), (b) Adedenkpo and (c) Adotrom 2, representing three categories of poor urban neighbourhoods in Accra, Ghana. Two phases will be implemented: phase 1 (‘reconnaissance phase) will engage and establish PAR research groups in the selected zones, conduct focus groups and individual interviews with urban residents, households vulnerable to ill-health and CHPS staff and key stakeholders. A desk review of preceding efforts to implement CHPS will be conducted to understand what worked (or not), how and why. Findings from phase 1 will be used to inform and co-create an urban CHPS model in phase 2, where PAR groups will be involved in multiple recurrent stages (cycles) of community-based planning, observation, action and reflection to develop and refine the urban CHPS model. Data will be managed using NVivo software and coded using the domains of community engagement as a framework to understand community assets and potential for engagement

Implementation of the Community-based Health Planning and Services (CHPS) in rural and urban Ghana: a history and systematic review of what works, for whom and why

Background: Despite renewed emphasis on strengthening primary health care globally, the sector remains under-resourced across sub–Saharan Africa. Community-based Health Planning and Services (CHPS) has been the foundation of Ghana's primary care system for over two decades using a combination of community-based health nurses, volunteers and community engagement to deliver universal access to basic curative care, health promotion and prevention. This review aimed to understand the impacts and implementation lessons of the CHPS programme. Methods: We conducted a mixed-methods review in line with PRISMA guidance using a results-based convergent design where quantitative and qualitative findings are synthesized separately, then brought together in a final synthesis. Embase, Medline, PsycINFO, Scopus, and Web of Science were searched using pre-defined search terms. We included all primary studies of any design and used the RE-AIM framework to organize and present the findings to understand the different impacts and implementation lessons of the CHPS programme. Results: N = 58 out of n = 117 full text studies retrieved met the inclusion criteria, of which n = 28 were quantitative, n = 27 were qualitative studies and n = 3 were mixed methods. The geographical spread of studies highlighted uneven distribution, with the majority conducted in the Upper East Region. The CHPS programme is built on a significant body of evidence and has been found effective in reducing under-5 mortality, particularly for the poorest and least educated, increasing use and acceptance of family planning and reduction in fertility. The presence of a CHPS zone in addition to a health facility resulted in increased odds of skilled birth attendant care by 56%. Factors influencing effective implementation included trust, community engagement and motivation of community nurses through salaries, career progression, training and respect. Particular challenges to implementation were found in remote rural and urban contexts. Conclusions: The clear specification of CHPS combined with a conducive national policy environment has aided scale-up. Strengthened health financing strategies, review of service provision to prepare and respond to pandemics, prevalence of non-communicable diseases and adaptation to changing community contexts, particularly urbanization, are required for successful delivery and future scale-up of CHPS. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214006 , identifier: CRD42020214006

Antibody levels to multiple malaria vaccine candidate antigens in relation to clinical malaria episodes in children in the Kasena-Nankana district of Northern Ghana

BACKGROUND: Considering the natural history of malaria of continued susceptibility to infection and episodes of illness that decline in frequency and severity over time, studies which attempt to relate immune response to protection must be longitudinal and have clearly specified definitions of immune status. Putative vaccines are expected to protect against infection, mild or severe disease or reduce transmission, but so far it has not been easy to clearly establish what constitutes protective immunity or how this develops naturally, especially among the affected target groups. The present study was done in under six year old children to identify malaria antigens which induce antibodies that correlate with protection from Plasmodium falciparum malaria. METHODS: In this longitudinal study, the multiplex assay was used to measure IgG antibody levels to 10 malaria antigens (GLURP R0, GLURP R2, MSP3 FVO, AMA1 FVO, AMA1 LR32, AMA1 3D7, MSP1 3D7, MSP1 FVO, LSA-1and EBA175RII) in 325 children aged 1 to 6 years in the Kassena Nankana district of northern Ghana. The antigen specific antibody levels were then related to the risk of clinical malaria over the ensuing year using a negative binomial regression model. RESULTS: IgG levels generally increased with age. The risk of clinical malaria decreased with increasing antibody levels. Except for FMPOII-LSA, (p = 0.05), higher IgG levels were associated with reduced risk of clinical malaria (defined as axillary temperature ≥37.5°C and parasitaemia of ≥5000 parasites/ul blood) in a univariate analysis, upon correcting for the confounding effect of age. However, in a combined multiple regression analysis, only IgG levels to MSP1-3D7 (Incidence rate ratio = 0.84, [95% C.I.= 0.73, 0.97, P = 0.02]) and AMA1 3D7 (IRR = 0.84 [95% C.I.= 0.74, 0.96, P = 0.01]) were associated with a reduced risk of clinical malaria over one year of morbidity surveillance. CONCLUSION: The data from this study support the view that a multivalent vaccine involving different antigens is most likely to be more effective than a monovalent one. Functional assays, like the parasite growth inhibition assay will be necessary to confirm if these associations reflect functional roles of antibodies to MSP1-3D7 and AMA1-3D7 in this population

Inequalities in drinking water quality in urban areas [A case study of Lilongwe, Malawi]

Access to safe drinking water is a basic human right and forms a part of efficient policy for health protection, since poor drinking water quality implies significant negative effects on the health of consumers. The lack of access to potable drinking water in the global south exists in most urban areas where a limited number of people are connected to formal water supply sources. However, ensuring quality of urban water supply is complicated by infrastructural configurations in the city: while parts are served by formal utilities through in-house connections, others are served through kiosks and standpipes and other parts of the city have independent providers who provide water from sources such as shallow wells and boreholes which are different from the formal utility source. Generally, the focus is almost entirely on coverage and availability of water, whereas the sensitive issue of quality is often left in the background, especially in urban areas where piped water is available. Access to water in cities is controlled by institutions with certain ideological frameworks and power who determine how the water flows. This display of power in cities leads to inequalities or unevenness in the various aspects of access to improved drinking water such as cost, quantity, reliability and quality of the drinking water supplied. However, limited studies have been carried out on the aspect of inequalities in drinking water quality and on how these inequalities are produced through the power relations in cities. This study aimed at improving understanding of the socio-environmental dynamics of drinking water quality production in urban water supply systems in the global south within the concept of political ecology. As an effort to move from the narrative approach adopted usually on socio-environmental dynamics, an interdisciplinary approach of combining experimental and qualitative methods in a case study on water quality in urban water supply in Lilongwe was adopted. The study was conducted over a period of three months (November 2014 to January 2015) where water samples were collected from in -house taps in planned settlements, and from kiosks and water storage facilities in low income areas. In parallel, semistructured interviews, observations and reviewing of relevant documents were conducted to bring to light the socio-political aspects influencing the factors producing the water quality observed from the different microbiological and physicochemical analyses. The greater focus of this study was on the assessment of faecal contamination of water supplies, which can be a vector for the transmission of pathogenic diseases and still represents a major burden for human health, as specified by the WHO. From this study, it emerged that drinking water quality changes and deteriorates as it is transported from the treatment plant to the different settlements. However, the level of faecal contamination detected was higher in low income areas, both in kiosks and at household storage level. The study established that existing social power relations embedded in the actors and institutions in the Lilongwe waterscape influence the factors that contribute to changes in drinking water quality and ultimately produce inequalities in this crucial aspect of water supply. Water infrastructure planning and management are influenced by various actors and institutions in the city and the result is water of poor quality supplied to residents of low income settlements. The relevance of this study is that it attempts to link water quality data obtained from experimental analysis to political ecology and unevenness produced in the urban waterscape