Juvenile sexual offending in Ghana: Prevalence, risks and correlates

Background Sexual violence research in Africa is overwhelmingly focused on victims with little attention given to perpetrators. In the case of juveniles who perpetrate sexual violence the evidence is mainly from studies in Western industrialized societies. The consequence is that interventions for juveniles who commit sexual violence in Ghana and Africa lack evidential basis. Objectives This study investigates prevalence, correlates and risk factors for juvenile sexual offending. Participants and setting The study utilised a sample of 264 male juveniles aged 12–18 in schools and young offender institutions in southern Ghana. Method Prevalence of the juvenile sexual offending was estimated based on self-report. Odds ratio (OR) was used to calculate the risk for the juveniles engaging in sexual violence. The predictive significance of variables within various domains was estimated using logistic regression models. Results Results show that about a fifth (16.7 %) of the juveniles have committed a sexual offense. A deviant sexual tendency such as paying for sex constitutes an important risk marker for juvenile sexual offending (OR: 6.41, 95 % CI [3.28–12.54]). Risk factors for juvenile sexual offending are concentrated in the family domain with parental neglect (OR: 4.55, 95 % CI [2.46–9.44]), parental conflict (OR: 4.45, 95 % CI [2.35–8.44]) alcoholic parents (OR: 3.07, 95 % CI [1.66–5.69] parental abuse (OR: 2.90, 95 % CI [1.63–5.19]), and deprived family economic condition (OR: 2.64, 95 % CI [1.47–4.75]) emerging as statistically significant factors. Conclusion Prevalence estimates of juvenile sexual offending are influenced by types and number of questions with multiple questions eliciting more accurate estimates than a single item measure. Risk factors for juvenile sexual offending vary based on context. Interventions to reduce juvenile sexual violence must be informed by evidence from the social context

Public opinion on the death penalty in Ghana

This publication reports findings from the first empirical study on public opinion on the death penalty in Ghana. The research was inspired by the work of the Constitutional Review Commission, which recommended in its final report to Government the abolition of the death penalty. The Commission advanced four main arguments for its recommendation: the current de facto abolition position does not adequately punish death penalty convicts; the lack of justification for the state arrogating to itself the right to take life; current international trends towards abolition; and belief in utilitarian principles which emphasise reformation as the fundamental aim of the justice system. As can be seen, none of these reasons makes reference to public sentiments about the death penalty. The Commission’s work involved a ‘public’ consultation, but opinion leaders and key stakeholders such as professional bodies and local advocacy groups dominated the process. For various reasons – for example, the structure of the process, lack of awareness of the consultative meetings, and the structure of people’s routine activities – a large section of Ghanaians was unable to participate in the Commission’s work. Yet, a wider public engagement would seem important given the peculiar history of the death penalty in Ghana and concerns about backlash effects in the form of vigilante violence. Moreover, Articles 3(3) and 13(1), which concern the death penalty, are entrenched provisions in the Ghanaian constitution. Therefore, notwithstanding Government’s acceptance of the Commission’s recommendations, a referendum is required to decide whether or not the death penalty should be abolished. Research evidence on the nature of public opinion on the death penalty will contribute to debate preceding the referendum. The research began following a presentation by the authors at the invitation of the European Union Delegation in Ghana and the French Embassy on the 11th World viii Day Against the Death Penalty in 2013. The research was funded by the Smuts Memorial Fund and the Cambridge-Africa Alborada Research Fund, University of Cambridge. The Centre of Criminology and Criminal Justice (Ghana) carried out the study based on a face-to-face survey of 2460 people randomly selected from four communities in Accra. The selected communities reflect the varying socio-economic and ethnic compositions of the capital city and country. The fieldwork was conducted in April and May 2014, and covered a broad range of issues in relation to the death penalty. The results showed that views about the death penalty do not appear to be polarized. The majority of Ghanaian respondents (48.3%) expressed strong opposition to the death penalty. Only 8.6% indicated strong endorsement of this form of punishment. Almost 6 out of every 10 respondents supported abolition of the death penalty in cases of murder. Among those opposed to abolition, 7 in 10 would support a discretionary death penalty in place of the current mandatory death penalty. The most preferred replacement for the death penalty was life imprisonment without the possibility of parole. Approximately, 71% of people interviewed chose life imprisonment without the possibility of parole as the alternative to the death penalty. This is consistent with the recommendations of the Constitutional Review Commission. Popular commentary on the death penalty suggests that Ghanaians support retention of the death penalty for reasons of deterrence. The evidence from this study revealed a tripod of reasons: deterrence; retribution; and justice for victims’ families. Among proponents of abolition, sanctity of life and the possibility of executing innocent people were the two prominent reasons. The data show very little evidence of potential backlash in the form of support for vigilante violence or lynching; 26% said they would take the law into their own hands if the death penalty was abolished. The ix findings from a detailed analysis showed that traditional religious beliefs about supernatural punishments were a powerful force shaping attitudes to the death penalty. People who believed in these punishments were more likely to endorse the death penalty and to resist abolition for murder. This is novel finding in the academic literature on the death penalty. However, more research is required to establish more fully the mechanisms that link these beliefs to anti-abolition attitudes. There is evidence of hotspots of death penalty views from this study. Residents of high-class neighbourhoods were likely to oppose the death penalty and to support its abolition for murder. Support for the death penalty was concentrated in low-class migrant areas. An interesting finding emerged that low-class indigenous areas were more opposed to the death penalty than middle-class areas. Finally, a key issue in death penalty research concerns the role of scientific evidence, especially evidence on deterrence effects and wrongful conviction. The findings show that evidence has both transformative and reinforcement effects. While scientific evidence does not lead to a complete rejection of the death penalty, the findings showed that some anti-abolitionists are open to a reasoned debate, and will reconsider their views in the face of scientific evidence. Taken together, the findings from this public opinion survey show a weak public support for the death penalty in Ghana. On the issue of abolishing the death penalty and possible backlash effect, the evidence suggests this is unlikely to be the case. Importantly, the survey reveals the complexity of public opinion on the death penalty and the need for evidence-based approach to understanding the roots of public concerns in order to prevent any possible backlash effects that might lead to pressure to reinstate the death penalty

Serum Soluble Transferrin Receptor and Transferrin Levels among Regular Blood Donors

Background: The study evaluated the effects of regular blood donation on serum transferrin and soluble transferrin receptor levels at Wenchi Methodist Hospital. Methods: This was a hospital-based cross-sectional study conducted at the Medical Laboratory Department of the Wenchi Methodist Hospital in the Bono Region of Ghana. A total of eighty-nine (89) venous blood samples from apparently healthy blood donors were analyzed. Complete blood count parameters were analyzed using an automated haematology analyzer and serum transferrin and transferrin receptor using ELISA. The data were analyzed using SPSS version 22.0. Results: Haemoglobin (p<0.001) and HCT (p=0.004) were significantly lower among the regular blood donors compared with the first-time donors. Regular blood donors had relatively higher serum transferrin (p<0.001) and soluble transferrin receptor levels (p<0.001). A negative correlation was observed between Hb and serum transferrin (r=-0.552, p<0.001), as well as Hb and serum soluble transferrin receptor (r=-0.552, p<0.001). Remunerated donors had lower Hb (p=0.001) and HCT% (p=0.001) but a higher transferrin receptor (p=0.041) than non-remunerated donors. Conclusion: Regular blood donors had relatively lower erythrocyte parameters but higher serum transferrin and soluble transferrin receptors, indicating a possible reduction in serum iron and iron stores. Moderate negative correlations exist between Hb and both transferrin and soluble transferrin receptors. Again, remunerated donors had lower erythrocyte parameters but higher transferrin and soluble transferrin receptors than non-remunerated donors. Periodic assessment of iron parameters among regular blood donors is recommended. A future longitudinal study to assess the entire iron profile of regular blood donors is recommended.   Doi: 10.28991/SciMedJ-2022-04-03-01 Full Text: PD

“We now have a patient and not a criminal” : An exploratory study of judges and lawyers’ views on suicide attempters and the law in Ghana

This study explored the views of judges and lawyers of the superior courts of Ghana on the law criminalizing attempted suicide. Qualitative data were collected from 12 experienced legal practitioners of the superior courts (five judges and seven lawyers) using a semi-structured interview schedule. Thematic analysis of the data yielded three main perspectives: In defence of the Law, Advocating a Repeal, and Pro-Health Orientation. Although exploratory, the findings of this study offer cues for stepping up suicide literacy and advocacy programmes toward either a repeal of the law or a reform

Circulating Naturally-Occurring Anticoagulants before Treatment and after Recovery from SARS-CoV-2 Infection in Ghana

Background: Disturbance in naturally-occurring anticoagulants may contribute to the hypercoagulable state in COVID-19. This study determined the plasma antigen levels of protein C (PC), protein S (PS), antithrombin-III (AT-III), and thrombomodulin (TM) before treatment and after recovery from COVID-19. Materials and Methods: This cross-sectional study, conducted from February to August 2022 at Kumasi South Hospital, recruited sixty-five RT-PCR-confirmed COVID-19 participants. A venous blood sample was taken for full blood count (FBC) analysis using a 3-part fully automated haematology analyzer, and PC, PS, AT-III, and TM antigen levels measured using ELISA. The data were analyzed using SPSS version 26.0. P<0.05 was considered statistically significant. Results: Severe COVID-19 participants had relatively lower haemoglobin (p<0.001), RBC (p<0.001), HCT% (p<0.001) and platelets (p<0.001), but higher RDW-CV% (p=0.013), WBC (p<0.001), and absolute lymphocyte counts (p<0.001) compared to those with the non-severe form of the disease. The overall prevalence of anaemia among the participants was 58.5%, and 32 (84.2%) and 6 (15.8%) of the anaemic participants had mild and moderate anaemia respectively. Protein C (p<0.001), PS (p<0.001) and ATIII (p<0.001) levels were lower among the severe COVID-19 participants than in the non-severe group. But severe COVID-19 group had higher TM levels (p<0.001) than the non-severe group. Again, participants had higher haemoglobin (p<0.001), RBC (p<0.001), HCT% (p=0.049), absolute neutrophil count (p<0.001) and platelets (p<0.001) after recovery from COVID-19 than the values on admission. Additionally, after recovery, participants had higher levels of PC (p<0.001), PS (p<0.001), and ATIII (p<0.001), but reduced TM (p<0.001). Conclusion: Severe COVID-19 patients had higher PC, PS, and AT-III, but lower TM levels. The changes in circulating anticoagulants may contribute to the hypercoagulable state of COVID-19. Blood cell indices are negatively affected during COVID-19. Complete recovery from the SARS-CoV-2 infection normalised the haematological indices. Assessment of naturally-occurring anticoagulants and the provision of anticoagulants are recommended in the management of COVID-19.   Doi: 10.28991/SciMedJ-2022-04-04-01 Full Text: PD

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

Culture and nondisclosure of child sexual abuse in Ghana: a theoretical and empirical exploration

The phenomenon of child sexual abuse has been widely acknowledged across many societies, including Ghana. Efforts to address this problem in Ghana have yielded limited success because this type of child abuse is severely underreported. This study explores the relevance of three cultural factors, namely, patriarchal nuances, (child) rape myth acceptance, and a “collective shame problem,” to the understanding of the problem of nondisclosure of child sexual abuse in Ghana. Evidence from an exploratory study provides support for the importance of these factors. The findings are discussed and the need for further research highlighted

Attitudes toward rape and victims of rape: A test of the feminist theory in Ghana

This study explores the usefulness of the feminist theory in explaining atti- tudes toward rape and victims of rape in Ghana. The feminist theory of rape posits, inter alia, that patriarchy and gender inequality are major factors in the aetiology of rape and attitudes toward rape and that underlying patriarchy and gender inequality are gender stereotypes and false beliefs (myths) about rape, rapists, and victims of rape. Thus, the theory suggests a relationship between rape myths and less favorable attitudes toward rape and victims of rape. Results from a survey conducted in Ghana show some support for the feminist theory of rape: There is evidence of rape myth acceptance in Ghana; gender is significant in predicting levels of rape myth acceptance; and finally, education or profession and age, but not religion, are associated with levels of rape myth acceptance in a predictable way

Correlates and predictors of juvenile delinquency in Ghana

Research on juvenile delinquency has focused almost exclusively on western societies with the consequence that very little is known about delinquency and its associated fac- tors outside this context. The aim of this study is to investigate correlates and predictors of juvenile delinquency in Ghana, a developing country. Analysis of data from a sample of 264 boys showed theft as the most common juvenile offense in Ghana. Individual factors were strongly related to juvenile delinquency compared with family factors and perceived neighborhood condition. The best predictor of juvenile delinquency was academic difficulties. Most childrearing variables failed to predict delinquency in Ghana. The findings indicate not only similarities but also important differences partic- ularly with regard to conceptualization and relation between parental childrearing and delinquency

Competency to stand trial evaluations in Africa

Competency to stand trial is an important legal safeguard for persons accused of a crime. Defendants have the right to fully participate in any criminal proceedings that involve them. However, for this right to be realized and to ensure procedural fairness, the legal system must ensure that persons accused of crime are of “sound mind” to stand trial. The very nature of the adversarial system of trial requires that defendants are in a position to assist their attorneys by providing them with relevant information about the case and locating witnesses. When issues of incompetency are suspected, or raised, before or during the trial, the court has a duty to request for evaluation from forensic mental health professionals. The outcome of the evaluation is intended to assist the court to decide whether to proceed with a trial or not. Although competency to stand trial is to ensure due process rights and judicial integrity, it has received little scholarly attention across Africa. This chapter will examine competency to stand trial in jurisdictions across Africa