Women's autonomy in healthcare decision-making and healthcare seeking behaviour for childhood illness in Ghana: Analysis of data from the 2014 Ghana Demographic and Health Survey.

IntroductionThe capacity of women to decide on their healthcare plays a key role in their health. In this study, we examined the association between women's healthcare decision-making capacity and their healthcare seeking behaviour for childhood illnesses in Ghana.Materials and methodsWe used data from the 2014 Ghana Demographic and Health Survey. A total sample of 2,900 women with children less than 5 years was used for the analysis. Data were processed and analysed using STATA version 14.0. Chi-square test of independence and binary logistic regression were carried out to generate the results. Statistical significance was pegged at 95% confidence intervals (CIs). We relied on the 'Strengthening the Reporting of Observational Studies in Epidemiology' (STROBE) statement in writing the manuscript.ResultsOut of the 2,900 women, approximately 25.7% could take healthcare decisions alone and 89.7% sought healthcare for childhood illnesses. Women who decided alone on personal healthcare had 30% reduced odds of seeking healthcare for childhood illnesses compared to those who did not decide alone [AOR = 0.70, CI = 0.51-0.97]. With age, women aged 45-49 had 69% reduced odds of seeking healthcare for childhood illnesses compared to those aged 25-29 [AOR = 0.31, CI = 0.14-0.70]. Women from the Northern and Upper West regions had 72% [AOR: 0.28, CI: 0.11-0.70] and 77% [AOR: 0.23, CI: 0.09-0.58] reduced odds of seeking healthcare for childhood illnesses respectively, compared to those from the Western region.ConclusionGhanaian women with autonomy in healthcare decision-making, those who were older and those from the Northern and Upper West regions were less likely to seek healthcare for childhood illness. To reduce childhood mortalities and morbidities in Ghana, we recommend educating women such as those who take healthcare decisions alone, older women and women from deprived regions like the Northern and Upper West regions on the need to seek healthcare for childhood illnesses

Trends in the prevalence of female genital muti-lation and its effect on delivery outcomes in the kassena-nankana district of northern Ghana

Rational: Female genital mutilation (FGM) is prevalent in northern Ghana, as the practice is seen as a passage rite to women adulthood and thus undertaken just before marriage. Objectives: We determined the changes in trend of FGM in deliveries at the Navrongo War Memo-rial hospital, and compared the outcomes and FGM status.Design: Retrospective extraction and analysis of delivery data at the hospital from 1st January 1996 to 31st December 2003. Results: Of the 5071 deliveries, about 29% (1466/5071) were associated with FGM. The high-est prevalence (95% CI) of 61.5% (50.9, 71.2) was in women aged 40 years and above, and the lowest of 14.4% (11.7, 17.0) was in women below 20 years. The all-age prevalence of FGM showed a significant decline (p-value for linear trend < 0.01) from 35.2% in 1996 to 21.1% in 2003. About 6% (89/1466) of mothers with FGM had stillbirths compared with about 3% (123/3605) of mothers without FGM. Again FGM was associated with 8.2% (120/1466) caesarean section rate compared with 6.7% (241/3605) in mothers without FGM. Mean birth weight and frequency of low birth weights were not significantly associated with FGM status. Conclusion: Although there is a high rate of FGM among mothers in the district and is associated with a higher proportion of stillbirths and caesar-ean sections, practice has shown a significant de-cline in the district in recent years due to the pre-vailing campaigns and intervention studies. There is therefore the need to sustain the ongoing inter-vention efforts

Roasting effects on phenolic content and free-radical scavenging activities of pulp preconditioned and fermented cocoa (Theobroma cacao) beans

Polyphenols are phytochemicals responsible for the astringency, bitterness, green flavours and antioxidant activities in Theobroma cacao beans. Polyphenols degradation in cocoa beans during roasting is crucial to the flavour outcome and it is influenced by factors such as temperature, time and pod storage. Antioxidants are compounds that help to inhibit oxidation reactions caused by free radicals such as singlet oxygen, superoxide, peroxyl radicals, hydroxyl radicals and peroxynitrite thereby preventing damage to the cells and tissues. Their mechanisms of action include scavenging reactive oxygen and decreasing localised oxygen concentration thereby reducing molecular oxygen’s oxidation potential, metabolising lipid peroxides to non-radical products and chelating metal ions to prevent generation of free radicals in humans. The study aimed at investigating changes in total polyphenols, anthocyanins, o-diphenols and antioxidant activity (free-radical scavenging activities) after roasting of pulp preconditioned and fermented cocoa beans using standard analytical methods. A 4×4 full factorial design with the principal experimental factors as pod storage time (0, 3, 7 and 10 days) and roasting duration (0, 15, 30 and 45 minutes) at 120oC were used to study the changes in the total polyphenols, anthocyanins, o-diphenols and % free-radical scavenging activities of the cocoa beans. Variable decrease in total polyphenols, odiphenols and anthocyanins were observed with increase in pre-conditioning (pod storage time) and roasting duration. However, variable trends were observed for the % free-radical scavenging activities. The total polyphenols, anthocyanins and o-diphenols in the cocoa beans after 45 minutes roasting decreased in the range 132.24 to 57.17 mg/g, 6.71 to 1.07 mg/kg and 15.94 to 8.25 mg/g respectively at all pod storage treatments. The total polyphenols of the fermented, dried and unstored (freshly harvested) cocoa beans was 132.25 mg/g which reduced to 122.14 mg/g (7.6% degradation), 116.721 mg/g (11.7% degradation) and 92.22 mg/g (30.3% degradation) after storage for 3, 7 and 10 days, respectively. The optimum decrease in the % freeradical scavenging activity was 7 days and above of pods storage. Increasing roasting time caused a continuous decrease in the % free-radical scavenging activity from 89.10% to 74.31% after 45 minutes for beans from the unstored (freshly harvested) pods. However, pod storage caused an increase in the % free radical scavenging activities during roasting. Pulp pre-conditioning (pod storage) and roasting duration could be used to reduce the astringency and bitterness caused by polyphenols, o-diphenols and anthocyanins in cocoa beans as well as increase the antioxidant activity imparted by cocoa.Key words: Cocoa, pod storage, roasting, polyphenols

What has women's reproductive health decision-making capacity and other factors got to do with pregnancy termination in sub-Saharan Africa? evidence from 27 cross-sectional surveys.

INTRODUCTION:Pregnancy termination is one of the key issues that require urgent attention in achieving the third Sustainable Development Goal (SDG) of ensuring healthy lives and promoting well-being for all at all ages. The reproductive health decision-making (RHDM) capacity of women plays a key role in their reproductive health outcomes, including pregnancy termination. Based on this premise, we examined RHDM capacity and pregnancy termination among women of reproductive age in sub-Saharan Africa (SSA). MATERIALS AND METHODS:We pooled data from the women's files of the most recent Demographic and Health Surveys (DHS) of 27 countries in SSA, which are part of the DHS programme. The total sample was 240,489 women aged 15 to 49. We calculated the overall prevalence of pregnancy termination in the 27 countries as well as the prevalence in each individual country. We also examined the association between RHDM capacity, socio-demographic characteristics and pregnancy termination. RHDM was generated from two variables: decision-making on sexual intercourse and decision-making on condom use. Binary logistic regression analysis was conducted and presented as Crude Odds Ratios (COR) and Adjusted Odds Ratios (AOR) with their corresponding 95% confidence intervals (CI). Statistical significance was declared p<0.05. RESULTS:The prevalence of pregnancy termination ranged from 7.5% in Benin to 39.5% in Gabon with an average of 16.5%. Women who were capable of taking reproductive health decisions had higher odds of terminating a pregnancy than those who were incapable (AOR = 1.20, 95% CI = 1.17-1.24). We also found that women aged 45-49 (AOR = 5.54, 95% CI = 5.11-6.01), women with primary level of education (AOR = 1.14, 95% CI = 1.20-1.17), those cohabiting (AOR = 1.08, 95% CI = 1.04-1.11), those in the richest wealth quintile (AOR = 1.06, 95% CI = 1.02-1.11) and women employed in the services sector (AOR = 1.35, 95% CI = 1.27-1.44) were more likely to terminate pregnancies. Relatedly, women who did not intend to use contraceptive (AOR = 1.47, 95% CI = 1.39-1.56), those who knew only folkloric contraceptive method (AOR = 1.25, 95% CI = 1.18-1.32), women who watched television almost every day (AOR = 1.16, 95% CI = 1.20-1.24) and those who listened to radio almost every day (AOR = 1.11, 95% CI = 1.04-1.18) had higher odds of terminating a pregnancy. However, women with four or more children had the lowest odds (AOR = 0.5, 95% CI = 0.54-0.60) of terminating a pregnancy. CONCLUSION:We found that women who are capable of taking reproductive health decisions are more likely to terminate pregnancies. Our findings also suggest that age, level of education, contraceptive use and intention, place of residence, and parity are associated with pregnancy termination. Our findings call for the implementation of policies or the strengthening of existing ones to empower women about RHDM capacity. Such empowerment could have a positive impact on their uptake of safe abortions. Achieving this will not only accelerate progress towards the achievement of maternal health-related SDGs but would also immensely reduce the number of women who die as a result of pregnancy termination in SSA

Public choice theory and rental housing: an examination of rental housing contracts in Ghana

This paper extends both the literature on rental housing in Ghana and the global literature on the critique of public choice analyses in terms of focus, methods, and positioning. It argues that, contrary to the assumption that all housing policy changes are driven by internal national processes, in the case of Ghana at least, neither tenants (through their use of their greater numbers) nor landlords (through the use of their stronger financial and hence political power) exclusively influence housing policy. Both parties have some power, but landlords use theirs to change rents arbitrarily and decide whom to invite or keep as tenants, while tenants seek to use their power by lodging complaints with the state, albeit to little effect as the power of landlords is overwhelming. There is a strong basis to call into question the public choice argument that it is fair for landlords to extract windfall rent from tenants since their efforts or talents do not increase rent

TRACKING THE GODZILLA DUST PLUME USING GOOGLE EARTH ENGINE PLATFORM

As part of Earth’s nutrient cycle, a layer of air travels every summer from Africa across the Atlantic Ocean. In June 2020, the thickest and densest dust plume traveled over 5000 miles along with the Saharan Air Layer (SAL) from Africa towards the USA and the Caribbean. Due to its gravity and impact, it was nicknamed “Godzilla”. While the cause of this event remains unclear, the advantage of using remote sensing applications to monitor aerosol concentrations and movement provides future opportunities to leverage machine learning technologies to build predictive models with the goal of early forecasting and public health interventions. The Sentinel-5P satellite instrument measures the air quality, ozone, and Ultraviolet (UV) radiation, and can be used for climate monitoring, and forecasting. Available on this platform is the UV Aerosol Index (AI) product, a qualitative index that indicates the presence of elevated layers of aerosols in the atmosphere. In this paper, we used Google Earth Engine to monitor the transatlantic movement of this historic dust plume across the Sahara Desert and estimate the aerosol concentrations throughout June 2020. The flexibility of the platform enabled us to generate time series maps to visualize the movement of the Godzilla dust storm from the Sahara Desert across the ocean. The results obtained are relevant for effective planning and interventions to ameliorate the health threats associated with the movement of the dust plume. The outcome is useful for defining the relationship between aerosol concentrations, human health, and aquatic life

Adult non-communicable disease mortality in Africa and Asia: evidence from INDEPTH Health and Demographic Surveillance System sites.

BACKGROUND: Mortality from non-communicable diseases (NCDs) is a major global issue, as other categories of mortality have diminished and life expectancy has increased. The World Health Organization's Member States have called for a 25% reduction in premature NCD mortality by 2025, which can only be achieved by substantial reductions in risk factors and improvements in the management of chronic conditions. A high burden of NCD mortality among much older people, who have survived other hazards, is inevitable. The INDEPTH Network collects detailed individual data within defined Health and Demographic Surveillance sites. By registering deaths and carrying out verbal autopsies to determine cause of death across many such sites, using standardised methods, the Network seeks to generate population-based mortality statistics that are not otherwise available. OBJECTIVE: To describe patterns of adult NCD mortality from INDEPTH Network sites across Africa and Asia, according to the WHO 2012 verbal autopsy (VA) cause categories, with separate consideration of premature (15-64 years) and older (65+ years) NCD mortality. DESIGN: All adult deaths at INDEPTH sites are routinely registered and followed up with VA interviews. For this study, VA archives were transformed into the WHO 2012 VA standard format and processed using the InterVA-4 model to assign cause of death. Routine surveillance data also provide person-time denominators for mortality rates. RESULTS: A total of 80,726 adult (over 15 years) deaths were documented over 7,423,497 person-years of observation. NCDs were attributed as the cause for 35.6% of these deaths. Slightly less than half of adult NCD deaths occurred in the 15-64 age group. Detailed results are presented by age and sex for leading causes of NCD mortality. Per-site rates of NCD mortality were significantly correlated with rates of HIV/AIDS-related mortality. CONCLUSIONS: These findings present important evidence on the distribution of NCD mortality across a wide range of African and Asian settings. This comes against a background of global concern about the burden of NCD mortality, especially among adults aged under 70, and provides an important baseline for future work