Is abortion justified to save the life or health of a woman? Evidence of public opinion from Accra, Ghana

ObjectiveIn this study, we sought to determine to what extent the abortion law in Ghana is reflective of public opinion.MethodsIn a cross‐sectional, community‐based survey, individuals in two fishing communities in Accra were interviewed about their beliefs on abortion between May and July 2016, and sociodemographic, attitudinal, and experience data were collected. Factors associated with the outcome variable (abortion is justified to save the life/health of the woman: Yes/No) were entered into a multivariate logistic regression.ResultsA total of 508 participants completed the survey. Thirty‐nine percent (n=198) of the sample agreed that abortion was justified to save the life/health of the woman, with no significant differences in this finding when controlling for understanding of the law, gender, marital status, or personal experience of abortion in multivariate analysis. Higher education (odds ratio [OR] 1.64 [P<0.001]) and older age (OR 1.28 [P<0.001]) are positively associated with abortion being justified to save life/health, while those who have had an experience of unwanted sex are less likely to believe that (OR 0.60 [P=0.029]).ConclusionThe participants held conservative views about the justification of abortion to save a woman’s life and/or health. Improving access to safe abortion services will require acknowledgment of the broader social and cultural context that may make accessing such services difficult.In a cross‐sectional survey, residents of urban Accra, Ghana, held relatively conservative views toward the justification of abortion.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151335/1/ijgo12927.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151335/2/ijgo12927_am.pd

Household and market survey on availability of adequately iodized salt in the Volta region, Ghana

This is an Accepted Manuscript of an article published by Taylor & Francis in International Journal of Health Promotion and Education on 27/10/2016, available online: http://www.tandfonline.com/doi/full/10.1080/14635240.2016.1250658Consumption of adequately iodized salt (AIS) ≥15ppm is one of the criteria for measuring progress towards universal salt iodization (USI) and sustainable elimination of iodine deficiency disorders. After series of health promotion activities, this survey was conducted to evaluate the extent to which USI was achieved. Cross-sectional survey was conducted in 1,961 households and 350 markets to estimate the iodine levels of salt consumed or sold. Three degrees of iodization were estimated from fine, coarse and granular texture salt using MBI rapid field test kits. Differences in iodization levels were determined using Bonferroni test in STATA. Determinants for household utilization of AIS were identified using regression analysis and reported as odds ratio (OR). Availability of AIS in households (24.5%) and markets (30.9%) was far below the 90% recommendation. No differences where observed in urban (26.8%) and rural (24.1%) households. Households that used fine-texture salt (OR: 40.13; CI: 30.1-53.4) or stored salt in original packs (OR: 8.02; CI: 6.01-10.70) were more likely to consume AIS. Across districts, highest household availability of AIS was 51.7% while the least was 7.5%. The district with the highest market availability of AIS was 85.7% while the least was 8.3%. Almost 32% of the traders were aware that selling non-iodized salt was unauthorized but out of this, only 12% sold AIS. Public education should emphasis appropriate handling and storage of salt throughout the supply chain. To ensure adequate salt fortification with iodine, improved surveillance of factories and mining sites is recommended

Ghana's evolving protein economy

This paper provides an initial analysis of Ghana's protein economy in the light on current debates about nutritional transition and livestock revolution. Ghana's strong economic growth and reducing levels of poverty make it a particularly interesting case. Protein-rich foods, including fish and livestock products, supply 20-40 percent of protein consumed. Overall fish is becoming less important and poultry more important; but there also are large difference in household expenditure on protein-rich foods across wealth categories, regions and areas. Specifically, the protein element of the nutritional transition and the consumption side of the livestock revolution would appear to be unfolding at different speeds and in different ways, along an axis that is urban-south-non-poor at one end, and rural-north-poor at the other. We explore the policy and political economy dimensions of these change

Distributional analysis of rural-urban household healthcare expenditure differentials in developing countries: evidence from Ghana

Equity in access to and use of healthcare resources is a global development agenda. Policy makers’ knowledge of the sources of differences in household healthcare spending is crucial for effective policy. This paper investigates the differences in the determinants of household healthcare expenditure across space and along selected quantiles of healthcare expenditure in Ghana. The determinants of rural-urban healthcare expenditure gap are also explored. Data was obtained from the sixth round of the Ghana Living Standards Survey (GLSS 6) conducted in 2013. An unconditional quantile regression (UQR) and a decomposition technique based on UQR, adjusted for sample selection bias, were applied. Findings indicate that differences in the determinants of household healthcare expenditure across space and along quantiles are driven by individual-level variables. Besides, the rural-urban health expenditure gap is greatest among households in the lower quantiles and this gap is largely driven by differences in household income per capita and percentage of household members enrolled on health insurance policies. To reduce rural-urban healthcare expenditure inequality, targeted policies should be prioritised in addition to efforts to narrow rural-urban differences in household per capita income and enrolment in health insurance policies

Spatio-temporal analyses of impacts of multiple climatic hazards in a savannah ecosystem of Ghana

Ghana’s savannah ecosystem has been subjected to a number of climatic hazards of varying severity. This paper presents a spatial, time-series analysis of the impacts of multiple hazards on the ecosystem and human livelihoods over the period 1983-2012, using the Upper East Region of Ghana as a case study. Our aim is to understand the nature of hazards (their frequency, magnitude and duration) and how they cumulatively affect humans. Primary data were collected using questionnaires, focus group discussions, in-depth interviews and personal observations. Secondary data were collected from documents and reports. Calculations of the standard precipitation index (SPI) and crop failure index used rainfall data from 4 weather stations (Manga, Binduri, Vea and Navrongo) and crop yield data of 5 major crops (maize, sorghum, millet, rice and groundnuts) respectively. Temperature and windstorms were analysed from the observed weather data. We found that temperatures were consistently high and increasing. From the SPI, drought frequency varied spatially from 9 at Binduri to 13 occurrences at Vea; dry spells occurred at least twice every year and floods occurred about 6 times on average, with slight spatial variations, during 1988-2012, a period with consistent data from all stations. Impacts from each hazard varied spatio-temporally. Within the study period, more 70% of years recorded severe crop losses with greater impacts when droughts and floods occur in the same year, especially in low lying areas. The effects of crop losses were higher in districts with no/little irrigation (Talensi, Nabdam, Garu-Tempane, Kassena-Nankana East). Frequency and severity of diseases and sicknesses such as cerebrospinal meningitis, heat rashes, headaches and malaria related to both dry and wet conditions have increased steadily over time. Other impacts recorded with spatio-temporal variations included destruction to housing, displacement, injury and death of people. These impacts also interacted. For example, sicknesses affected labour output; crop losses were blamed for high malnutrition; and reconstruction of properties demanded financial resources largely from sale of agricultural produce. These frequent impacts and their interactions greatly explain the persistent poverty in the area

Following the footsteps: Urbanisation of Wa Municipality and its synergism in risk accumulation, uncertainties and complexities in urban Ghana.

Global demographic characteristics have witnessed a significant shift with more than half of the world's population crossing the rural-urban threshold in 2008. In Ghana, the 2010 census report revealed 50.9% urban population. While the many benefits of organised and efficient cities are well understood, it must be recognised that rapid, often unplanned urbanisation brings risk of profound social instability, risk to critical infrastructure, potential water crises and the potential for devastating spread of disease. These risks can only be further exacerbated as this unprecedented transition from rural to urban areas continues. This also means stakes are high for public and private interventions to ensure that urbanisation reinforces rather than retards prosperity. In spite of these past experiences, urban governance policies in emerging smaller cities are frequently ambivalent and piecemeal, exhibiting similar negative tendencies, a development that has received less academic attention. This study adopted multiple research techniques and the data were generated through a structured questionnaire survey, personal interviews and discussions. Based on our conviction that the development trajectory of any city hinges on the quality of its physical foundation, we seek to fill the knowledge gap using the Wa Municipality, the least urbanised but one of the fastest urbanising cities in Ghana today, as a case study. The results reveal emerging tendencies that indicate that Wa appears to be following in the footsteps of its predecessors - experiencing an inefficient potable water supply system and chronic sanitation situation, making diarrhoea one of many challenges for residents. It is ultimately suggested that a collaborative partnership with all key stakeholders is a better option to reap the potential for urbanisation to strengthen economic growth and development

Public health and education spending in Ghana in 1992-98 : issues of equity and efficiency

Using primary data from the health and education ministries, and household survey data from the Ghana Statistical Service, the authors analyze equity, and efficiency issues in public spending on health, and education in Ghana in the 1990s. Public expenditures in the education sector, declined in the second half of the 1990s. Basic education enrollment has been stagnant, or declining in public schools, but increasing in private schools, resulting in a moderate increase in total enrollment. Regional disparities are significant, with lower public resource allocations, and lower enrollment ratios in the three poorest regions. The quality of basic education in public schools remains poor, while it has steadily improved in privateschools. Enrollments in higher levels are lagging behind those in basic education. Ghana ranks high among West African countries in health indicators, although its health expenditures tend to favor the non-poor. While more of the rural population have gained access to health services in recent years, many still have limited access, or none. Moreover, there is no link between the pattern of public expenditures - especially the pattern of immunization across Ghana - and health outcomes. To ensure that social services are efficiently, and equitably delivered in a fiscally constrained economy, the authors argue, public expenditures need to be linked to outcomes.Primary Education,Curriculum&Instruction,Teaching and Learning,Public Health Promotion,Health Monitoring&Evaluation,Primary Education,Teaching and Learning,Gender and Education,Health Monitoring&Evaluation,Curriculum&Instruction

Socio-economic and Cultural Determinants of Health Care Services Utilization in Ghana

The study examines the relationship between socio-economic and cultural determinants of health care service utilization in Ghana using Ghana Demographic and Health Survey (GDHS) 2008 data collected by Ghana Statistical Service (GSS) in which a two-stage sample design was used. The first stage involved a systematic sampling, with probability proportional to size, of 412 clusters using the 2000 Ghana Population and Housing Census as the sampling frame. At the second stage, systematic samples of 30 households from each cluster were selected, making a total of 12,360 sampled households. According to the GSS, data were not collected in some of the selected households due to security reasons, resulting in a final sample of 12,323 selected households. This study uses the individual dataset in which data on individual household members between the ages of 15 and 49 are compiled. These filters result in a sample of 4,913 individuals who reported sick as the sample for this study. The older people are known to be the usual utilizers of health care services; therefore the study concentrates on younger group... Binary logistic regression model was used with healthcare utilization as the dependent variable. Health care service utilization was measured as a binary variable among those who fell sick in the past three months. The socio-economic and cultural factors that determine health care service utilization were identified based on Andersen (1968). The results indicated that age, sex, social status, marital status, education, ethnicity, religion, and family size, employment, and type of occupation were statistically significant in determining health care service utilization in Ghana. Based on these findings, there is the need for creation of more job opportunities to address the unemployment problem in Ghana. This will improve people\u27s social status and there improve their health care utilization. Also the labor law of Ghana should make provision for employees to be able to utilize health care services when they get sick since those working are less likely to utilize health care service

Science-based health innovation in Ghana: health entrepreneurs point the way to a new development path

<p>Abstract</p> <p>Background</p> <p>Science, technology and innovation have long played a role in Ghana’s vision for development, including in improving its health outcomes. However, so far little research has been conducted on Ghana’s capacity for health innovation to address local diseases. This research aims to fill that gap, mapping out the key actors involved, highlighting examples of indigenous innovation, setting out the challenges ahead and outlining recommendations for strengthening Ghana’s health innovation system.</p> <p>Methods</p> <p>Case study research methodology was used. Data were collected through reviews of academic literature and policy documents and through open-ended, face-to-face interviews with 48 people from across the science-based health innovation system. Data was collected over three visits to Ghana from February 2007 to August 2008, and stakeholders engaged subsequently.</p> <p>Results</p> <p>Ghana has strengths which could underpin science-based health innovation in the future, including health and biosciences research institutions with strong foreign linkages and donor support; a relatively strong regulatory system which is building capacity in other West African countries; the beginnings of new funding forms such as venture capital; and the return of professionals from the diaspora, bringing expertise and contacts. Some health products and services are already being developed in Ghana by individual entrepreneurs, which are innovative in the sense of being new to the country and, in some cases, the continent. They include essential medicines, raw pharmaceutical materials, new formulations for pediatric use and plant medicines at various stages of development.</p> <p>Conclusions</p> <p>While Ghana has many institutions concerned with health research and its commercialization, their ability to work together to address clear health goals is low. If Ghana is to capitalize on its assets, including political and macroeconomic stability which underpin investment in health enterprises, it needs to improve the health innovation environment through increasing support for its small firms; coordinating policies; and beginning a dialogue with donors on how health research can create locally-owned knowledge and be more demand-driven. Mobilizing stakeholders around health product development areas, such as traditional medicines and diagnostics, would help to create trust between groups and build a stronger health innovation system.</p