The Real Exchange Rate Regime and Economic Growth in Ghana

An empirical research that aims at investigating the interplay between real exchange rate and economic growth is imperative in the study of modern international economics. The real exchange rate regime plays a critical role in the economic growth of a country. The research focusses on the interaction that exist between Real Exchange Rate and Economic Growth in Ghana. Real GDP was used as a measure of Economic Growth Rate. Results from the empirical analysis revealed a statistically significant and positive association existing between real exchange rate and the growth of Ghana’s economy (Real GDP). This affirms the major hypothesis. Results from the data analysis also showed a statistically significant and positive association between labour force and economic growth. Results from the analysis also revealed an inverse relation between government’s consumption expenditure patterns and economic growth. The study finally considered the theoretical and practical contributions of the study

Improving Support Systems for Cocoa Farmers beyond Cocoa Swollen Shoot Virus Disease Infestation

Cocoa swollen shoot virus disease (CSSVD) has severely hampered the production of cocoa in Ghana since pre-colonial days. The Ghana Cocoa Board has put several measures in place to support cocoa farmers in the fight against the CSSVD. This present study captures how the CSSVD affects cocoa farmers and the support systems for such situations. Using a survey design, the study employed the multi-stage sampling technique to select 413 cocoa farmers. A structured questionnaire was used to seek information from the cocoa farmers. A multiple linear regression model was estimated to analyse the data. The CSSVD affects the living standards of cocoa farmers through their economic wellbeing, thus, household income and assets accumulation. The social wellbeing of farmers is also affected by the CSSVD through their socio-cultural (participation in cooperatives and communal activities) and educational activities (participation in extension education activities). The implication is that the current support systems given to cocoa farmers after being affected by the CSSVD need to be strengthened, enhanced and made holistic to cover their economic and social wellbeing. Economic and social interventions aimed at increasing the resilience of cocoa farmers in the face of the CSSVD will be helpful in this direction

Dimensions of Accessibility and Use of Information Communication Technology Among Cocoa Farmers in Atwima Mponua District, Ghana

This research examined the drivers of accessibility and use of information communication technologies (ICTs) by cocoa farmers. A sample size of four hundred (400) cocoa farmers was selected using a multi-stage random sampling procedure. Data were analysed using percentage, means, standard deviation, Kendall’s coefficient of concordance and multiple linear regression model. The study revealed that mobile phones, radio and television are the most available (Mean=4.99, 4.95 and 4.85 respectively), accessible (Mean=4.97, 4.83 and 4.40 respectively) and utilised (Mean=4.97, 4.81 and 4.30 respectively) ICT tools by cocoa farmers. There is a relatively high level of availability of ICT (Mean=3.57), a moderate level of accessibility (Mean=2.90) and low use (Mean=2.19) of ICT tools. Cocoa farmers’ mainly used ICTs tools to acquire information on their cocoa farm activities (Mean=4.82). Gender, age, education and farmer-based organisation participation affected farmers accessibility of ICT tools. Age, education and farm experience significantly affected farmers’ use of ICT tools. The greatest challenge faced by cocoa farmers in accessing and using ICT tools is a lack of skills in operating the tools (Mean rank=2.24). Training on ICT use should be intensified by all relevant stakeholders to enable cocoa farmers to increase their use of ICT tools

Dimensions of Accessibility and Use of Information Communication Technology Among Cocoa Farmers in Atwima Mponua District, Ghana

This research examined the drivers of accessibility and use of information communication technologies (ICTs) by cocoa farmers. A sample size of four hundred (400) cocoa farmers was selected using a multi-stage random sampling procedure. Data were analysed using percentage, means, standard deviation, Kendall’s coefficient of concordance and multiple linear regression model. The study revealed that mobile phones, radio and television are the most available (Mean=4.99, 4.95 and 4.85 respectively), accessible (Mean=4.97, 4.83 and 4.40 respectively) and utilised (Mean=4.97, 4.81 and 4.30 respectively) ICT tools by cocoa farmers. There is a relatively high level of availability of ICT (Mean=3.57), a moderate level of accessibility (Mean=2.90) and low use (Mean=2.19) of ICT tools. Cocoa farmers’ mainly used ICTs tools to acquire information on their cocoa farm activities (Mean=4.82). Gender, age, education and farmer-based organisation participation affected farmers accessibility of ICT tools. Age, education and farm experience significantly affected farmers’ use of ICT tools. The greatest challenge faced by cocoa farmers in accessing and using ICT tools is a lack of skills in operating the tools (Mean rank=2.24). Training on ICT use should be intensified by all relevant stakeholders to enable cocoa farmers to increase their use of ICT tools

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Perception Matters: Exploring Climate Variability, Mitigation and the Effect on Cocoa Productivity in Adansi Brofoyedru, Ghana

In a rapidly changing climate, understanding the dynamics of cocoa farming and its vulnerability to climate variability is of paramount importance. By recognizing the power of perception and the complex interplay between climate factors and farming practices, we unlock novel pathways to build resilience among cocoa farmers. This innovative study aims to explore farmers' perceptions of various climate change issues. Using a quantitative approach, data were collected from a sample of 400 cocoa farmers. The analysis reveals four dimensions of perceptions: (1) the most influential climatic variable was rainfall, (2) the most adopted mitigation intervention practiced by the farmers was pest control, (3) mitigation interventionsaffects cocoa productivity and (4) high cost of inputs constraints their use of the interventions. Identifying rainfall as the most influential climatic variable highlights the need for targeted interventions where policymakers focus on water management and irrigation systems to help farmers adapt to changing rainfall pattern

Mobile agricultural extension delivery and climate-smart agricultural practices in a time of a pandemic: Evidence from southern Ghana

During the Covid-19 era, Ghana's cocoa sector relied heavily on mobile phone agriculture for extension delivery services, aiming to enhance climate-smart agricultural activities and overcome physical limitations. However, there is limited literature on the role of mobile phones in extension delivery during the pandemic. The study investigated the effectiveness of mobile phone agriculture in extension delivery and its relationship with climate-smart agricultural practices in Ghana's cocoa sector during the pandemic. The study selected 152 community extension agents in the Ashanti Region. The cross-sectional data was estimated using frequencies, percentages, means, standard deviations Pearson, Point Biserial, Spearman rho, and ordinary least squares regression. The result indicates a positive correlation between mobile phone agriculture extension delivery and climate-smart agricultural practices. Additionally, there was a significant relationship between climate-smart practices and factors such as knowledge, skills, frequency, and intensity of phone use. However, years of experience and age showed a negative relationship. The findings showed that funding, knowledge of use, and years of experience as influential factors in climate-smart agricultural activities facilitated by mobile phone extensions. To reach underserved cocoa communities, the Ghana Cocoa Board must enhance the capacity of community extension agents. Countries considering an intensive adoption of mobile phone agriculture for innovative extension services in climate-smart agriculture should consider factors like knowledge, skills, duration, frequency, and financial investments in acquiring, converting, applying, protecting, and distributing climate-smart agricultural information. The study contributes to mitigating the negative impact of climate change through the application of climate-smart information in agriculture

Resilience against climate variability: The application of nature based solutions by cocoa farmers in Ghana

This study delves into the crucial intersection of climate resilience and sustainable agriculture by investigating the application of nature-based solutions (NBS) as adaptive strategies employed by cocoa farmers in Ghana. A total sample of 381 cocoa farmers were selected using the multi-stage sampling technique. Farmers perceive notable changes (increase) in amount of rainfall, degree of temperature and number of rainy days. While the planting of shade trees is adopted by majority of the cocoa farmers to fight climate variability, they also perceive it to be the most effective. Factors that influence cocoa farmers' extent of adopting nature-based solutions are religion, age, years of formal education, land ownership, access to climate information, farm size and income. Climate variability (temperature, rainfall, wind) makes cocoa farmers vulnerable by affecting their social, financial and physical capitals. Nature based solutions (planting shade trees, climate-resilient varieties, early warning systems, knowledge sharing and efficient water management) increase cocoa farmers' resilience against climate variability. Ultimately, the study's outcomes hold implications for both local and global efforts to enhance agricultural resilience and secure livelihoods in an era of climate uncertainty

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe