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

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

‘In this job, you cannot have time for family’: Work–family conflict among prison officers in Ghana

This paper documents the experience of work-family conflict (WFC) among prison officers in Ghana. Although the term WFC has been used in relation to prison officers in the UK (Crawley, 2002) and the US (Triplett et al., 1999), the context of WFC in Ghana is unusual. In this predominantly collectivist culture, family responsibilities include obligations to the extended family. WFC is mainly unidirectional, with interference running from work to the family. Officers are thus impaired in fulfilling their family responsibilities, which consequently impairs their daily work and mental well-being. The ‘crisis controlling’ or ‘paramilitary’ organisational structure of the Ghana Prisons Service (GPS) makes it very difficult for the work domain of prison officers to accommodate family responsibilities. Female officers appear to bear a heavier WFC burden than male officers, mainly on account of their traditionally unpaid housekeeping role in addition to their paid employment in a masculine organisational culture. The findings are significant, as they show that the promulgation of family-friendly policies to alleviate WFC-associated stress lies in the hands of the GPS, since WFC emanates solely from the work domain

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

A Blind Spot in Girls’ Education: Menarche and its Webs of Exclusion

Despite notable progress in girls' education over the last decade, gender-based differences continue to shape educational outcomes. One of the most overlooked of these differences is the process of maturation itself, including menstruation. This paper presents the findings of a study that assessed the impact of sanitary care on the school attendance of post-pubertal girls, as well as the implications of menarche for their well-being. The study found that the provision of adequate sanitary care represents a relatively unrecognized but potentially fruitful tool in strategies that aim to improve girls' educational outcomes, one that warrants policy consideration among development planner

Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: user acceptability

<p>Abstract</p> <p>Background</p> <p>Malaria in pregnancy is associated with increased risks of maternal and foetal complications. Currently, intermittent preventive treatment (IPT) of malaria during pregnancy with sulphadoxine-pyrimethamine (SP) is recommended by the WHO as part of a package of interventions also including insecticide-treated nets and effective case management. However, with increasing resistance to SP, the effectiveness of SP-IPT has been questioned. A randomized controlled trial (RCT) to investigate the relative efficacy of an alternative strategy of intermittent screening and treatment (IST), which involves a rapid diagnostic test for malaria at scheduled ANC visits and treatment of women only if positive, versus SP-IPT has been conducted in Ashanti region, Ghana. This paper reports on a complementary study investigating the acceptability of the different strategies to women enrolled in the trial.</p> <p>Methods</p> <p>Data were collected through twelve focus group discussions with women selected at random from the different arms of the RCT, exploring their experiences and perceptions about antenatal care and their involvement in the trial. Content analysis was used to identify relevant themes to structure the results.</p> <p>Results</p> <p>Five main themes emerged from participants' experiences of ANC and the RCT that would influence their acceptability of malaria prevention strategies during pregnancy: health benefits; drugs received; tests received; other services received; and health worker attitude. Their own health and that of their baby were strong motivations for attending ANC, and reported favourably as an outcome of being in the RCT. Women were not always clear on the biomedical function of drugs or blood tests but generally accepted them due to strong trust in the health staff. Home visits by staff and free ITNs as part of the trial were appreciated. Politeness and patience of health staff was a very strong positive factor.</p> <p>Conclusions</p> <p>Overall, both intermittent screening and treatment and intermittent preventive treatment appeared equally acceptable to pregnant women as strategies for the control of malaria in pregnancy. The women were more concerned about quality of services received, in particular the polite and patient attitude of health staff, and positive health implications for themselves and their babies than about the nature of the intervention.</p

Determinants of epidemiologic transition in rural Africa: the role of socioeconomic status and drinking water source

Public Health and primary carePrevention, Population and Disease management (PrePoD

Home birth without skilled attendants despite millennium villages project intervention in Ghana: insight from a survey of women’s perceptions of skilled obstetric care

BACKGROUND: Skilled birth attendance from a trained health professional during labour and delivery can prevent up to 75 % of maternal deaths. However, in low- and middle-income rural communities, lack of basic medical infrastructure and limited number of skilled birth attendants are significant barriers to timely obstetric care. Through analysis of self-reported data, this study aimed to assess the effect of an intervention addressing barriers in access to skilled obstetric care and identified factors associated with the use of unskilled birth attendants during delivery in a rural district of Ghana. METHODS: A cross-sectional survey was conducted from June to August 2012 in the Amansie West District of Ghana among women of reproductive age. Multi-stage, random, and population proportional techniques were used to sample 50 communities and 400 women for data collection. Weighted multivariate logistic regression analysis was used to identify factors associated with place of delivery. RESULTS: A total of 391 mothers had attended an antenatal care clinic at least once for their most recent birth; 42.3 % of them had unskilled deliveries. Reasons reported for the use of unskilled birth attendants during delivery were: insults from health workers (23.5 %), unavailability of transport (21.9 %), and confidence in traditional birth attendants (17.9 %); only 7.4 % reported to have had sudden labour. Other factors associated with the use of unskilled birth attendants during delivery included: lack of partner involvement aOR = 0.03 (95 % CI; 0.01, 0.06), lack of birth preparedness aOR = 0.05 (95 % CI; 0.02, 0.13) and lack of knowledge of the benefits of skilled delivery aOR = 0.37 (95 % CI; 0.11, 1.20). CONCLUSIONS: This study demonstrated the importance of provider-client relationship and cultural sensitivity in the efforts to improve skilled obstetric care uptake among rural women in Ghana