Interactions between health and farm-labor productivity:

In the 21st century, agriculture remains fundamental to economic growth, poverty alleviation, improvement in rural livelihood, and environmental sustainability (World Bank 2007). Three-quarters of the world's poor live in rural areas, particularly in Asia and Africa (Ravallion, Chen, and Sangraula 2007), and depend on agriculture as their primary source of livelihood. This report provides an overview of current knowledge of the impact of health issues on farm-level productivity and decisionmaking, and the impact of agriculture on health. Findings are based on a review of the relevant studies of agricultural regions throughout the developing world. Two conceptual frameworks are used to frame this research: (1) Examining the two-way linkages between agriculture and health (2) Tracking the pathway from a disease condition to its effects, including impacts on household decisionmaking and ultimate impacts on livelihood. Agriculture underpins the health of rural households. It provides income that makes households resilient to health shocks; it provides food to meet their nutrient and energy needs; and it provides medicinal plants for treating ailments. But agricultural systems can also have negative effects on health. Agricultural development may lead to environmental change with adverse health impacts: for example, irrigation dams that create suitable conditions for mosquitoes may lead to increased incidence of malaria locally. The use of agricultural inputs such as pesticides by untrained farm personnel often causes illness. Improper food harvesting and storage practices allow mycotoxins to flourish. Lack of diet diversity can lead to malnutrition. Certain animal diseases also can infect humans. Labor migration (including agricultural labor migration) can contribute to high incidence of HIV infection. The effects of ill health on farm households include three broad impacts: absenteeism from work due to morbidity (and eventual death); family time diverted to caring for the sick; and loss of savings and assets in dealing with disease and its consequences. The long-term impacts of ill health include loss of farming knowledge, reduction of land under cultivation, planting of less labor-intensive crops, reduction of variety of crops planted, and reduction of livestock. The ultimate impact of ill health is a decline in household income and possible food insecurity—that is, a severe deterioration in household livelihood. The research found that the household's ability to cope with a shock reflected both its asset portfolio—including human, physical, and financial assets—and its intangible social resources. Good health must be seen as both an investment and consumption asset, like agricultural production, in that it has compounding returns. Health problems, conversely, may trigger a cycle of lowered agricultural productivity and poor health. At the household level, the investment in health can improve resilience and enhance the ability to cope with emergencies, including ill health. But an investment in health in turn requires an adequate livelihood. Access to appropriate inputs (knowledge, land, tools, fertilizer, and seeds) and remunerative markets is necessary to improve the productivity, health, and resilience of farm households.health, Labor, productivity,

Should ‘Climate Change’ Change Health Promoters? Lessons for the Developing World

The threat posed by climate change to global public health is evident and appalling, and its impact is felt on physical, mental and emotional health and well-being of individuals and populations. Evidence on the unusually changing weather conditions and patterns is clear and difficult to ignore. This paper debates a changing global climate. The paper subsequently attempts to discuss the impact of climate change on global health, with examples. Then, the paper argues in favour of ‘thinking globally and acting locally’ as a way to enhance community health. Subsequently, the implications of a globally changing climate for health promotion practice, especially in the developing world are discussed. The changing global climate is well supported by empirical evidence, and poses huge threat to public health. Health promotion researchers and practitioners have a crucial role to play towards climate change mitigation and adaptation to secure the health of current population and posterity. Keywords: Climate change, health promotion, global

Determinants of low birth weight in the Lower Manya Krobo Municipality of the Eastern region of Ghana

Background: Low birth weight refers to new borns weighting less than 2.5 kg at birth. In November 2017, the WHO reported a global prevalence of 15.5% with 96.5% of these cases happening in developing countries. Whilst this is a global canker, the risk factors differ from locality to locality.  This study aims at determining which maternal factors explains low birth weight baby delivery in the Lower Manya Krobo Municipality.Methods: The chi-square test for independence was used to test for independence. The binary logistic model is fitted for the associated factors. The receiver operating characteristic (ROC) is used to classify unbiased estimators.Results: ANC (yes β= -2.769 sig.=0.000); Alcohol (none β=-1.479 sig.=0.000, occasionally β= −2.043 sig.=0.000); Age (<20years β=0.178 sig. =0.676, 20 to 25years β= -1.487 sig.=0.000, 26 to 30 β= -0.941 sig.=0.086); Education level (None β=2.778 sig. =0.000, primary β=3.090 sig.=0.000, JHS β=1.913 sig.=0.002, SHS/Secondary β=1.951 sig.=0.000); Exposure to Heat (Yes β=4.507 sig.=0.000). AUC education=0.67, 95% CI=0.6,0.7 and AUC Exposure to heat=0.73, 95% CI=0.68,0.77 of low birth weight.Conclusions: Social status was not significant factor. Mothers exposed to heat had the highest risk (odds=90 times). Adolescent mothers stand high risk with odds 1.195. Mothers who attended antenatal clinics were at 94% less likelihood. Mild drinkers had lesser risk compared to no and heavy drinkers. Mothers with primary education (odds=21 times) were the riskiest compared to mothers with tertiary education. This differs from researches where no education mothers were riskiest. Only mother’s exposure to heat was found to be fairly good unbiased estimators

Accessibility of tourist sites to persons with disability: the case of Cape Coast and Elmina Castles in Ghana

The term accessibility is used in the context of providing equal opportunity to enter into an environment. Much is not known about the accessibility of tourist sites such as castles and forts to people with disabilities. This study sought to examine the accessibility of the Cape Coast and Elmina Castles to people with disabilities through a qualitative approach which involved in-depth interviews and photovoice to collect data. The study revealed that the castles are inaccessible. Though ramps, spacious pathways and handrails in washrooms existed, there was however, no mutual relation between the design of the castles and the concept of accessibility as defined by the Disability Act. The creation of awareness on the rights of the disabled to participate in the tour of castles can perhaps draw the attention of local government authorities and other relevant stakeholders to effect the necessary changes.Peer Reviewe

Alternative environmentalities: recasting the assessment of Canada’s first Marine Stewardship Council-certified fishery in social terms

We use a Foucault-inspired environmentalities analytical lens to conceptualize alternative sustainability auditing frameworks. The Marine Stewardship Council (MSC) claims to administer the international gold standard for sustainability evaluation of fisheries, yet the livelihoods of many people who depend on Canada’s first MSC-certified fishery are in serious jeopardy. After decades of growth that helped fishers and coastal communities alleviate the social consequences of the infamous cod collapse, the northern shrimp fishery in eastern Canada is experiencing ecological change and social conflict over the distribution of quota reductions. However, recent disputes over the distribution, and social consequences, of quota reductions in this fishery are completely invisible in assessment and auditing documents for the successful recertification of the fishery to the MSC’s standard for “sustainable and well managed fisheries” in 2016. We draw upon aspects of an alternative assessment framework to highlight information and knowledge that a socially attentive sustainability audit of this fishery might consider. The alternative auditing framework renders visible social dimensions of Canada’s northern shrimp fishery, including government decision making that incorporates ethical and moral economy principles, the distribution of access to various interests, uses of access benefits for regional and community development purposes, and conflict over policy and resource access during a period of resource decline and dispossession. Although the spread of auditing frameworks across natural resource sectors tends to reinforce neoliberal interests and undermine social justice aims, we argue that the development of alternative assessment frameworks that clearly make visible materialist social development relationship and knowledge can enable action in support of social justice objectives

Is task-shifting a solution to the health workers’ shortage in Northern Ghana?

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Objective To explore the experiences and perceptions of health workers and implementers of task-shifting in rural health facilities in Upper East Region, Ghana. Methods Data was collected through field interviews. A total of sixty eight (68) in-depth interviews were conducted with health workers’ in primary health care facilities (health centres); Four in-depth interviews with key persons involved in staff management was conducted to understand how task-shifting is organised including its strengths and challenges. The health workers interview guide was designed with the aim of getting data on official tasks of health workers, additional tasks assigned to them, how they perceive these tasks, and the challenges associated with the practice of task-shifting. Findings Task-shifting is a practice being used across the health facilities in the study area to help reduce the impact of insufficient health workers. Generally, health workers had a comprehensive training that supported the organisation of task-shifting. However, staff members’ are sometimes engaged in tasks above their level of training and beyond their actual job descriptions. Adequate training is usually not provided before additional tasks are assigned to staff members. Whilst some health workers perceived the additional tasks they performed as an opportunity to learn new skills, others described these as stressful and overburdening. Conclusion Task-shifting has the potential to contribute to addressing the insufficient health workforce, and thereby improving health delivery system where the procedures are well defined and staff members work in a coordinated and organised manner. The provision of adequate training and supervision for health workers is important in order to improve their expertise before additional tasks are assigned to them so that the quality of care would not be compromised

“We are Seen but not Recognized”; Disability Stigma and Disabled People’s Exclusion from Community Activities: The Case of Disabled People in a Traditional Community in Ghana

Society has a way of categorising and assigning expectations to its members. There are also rules regarding the norms and processes of dealing with problems of daily life. If a rule is broken during interactions between individuals in society resulting in abnormal situation, it can be labelled as stigma. When people perceive individuals as possessing socially unacceptable attributes, they assign negative qualities to the person and results in devaluation of the individual. Data was collected from disabled people and their leaders in the Kumasi Metro who were registered with the Department of Social Welfare. A qualitative study was conducted in which Interview and Focus Group Discussions were employed to collect data from respondents.  Purposive sampling technique was adopted to select 35 respondents for the study. After each data collection activity the recorded audio tapes and field notes taken during the interview were translated into English and later word processed. Data editing and categorisation was done manually based on the research objective. The study found that disability is stigmatised as a result of the reaction of society towards individuals who have impairments, disabled people have been given names based on their disability, disabled people have also lost the opportunity to inherit family wealth and to be installed as chiefs, and are unable to represent their communities and families at social functions. It is recommended that there should be effective public education on disability and the scientific causes of the condition.  Keywords: Stigma, Community-exclusion, Ghana, Disability, Society, Culture and Labelin

Prevalence of Hypertension and Obesity among Women in Reproductive Age in the Ashaiman Municipality in the Greater Accra Region of Ghana

Ghana like many other developing countries is faced with a double burden of infectious and chronic non-communicable diseases. It is increasingly being recognised that unhealthy behavioural patterns such as poor dietary habits, physical inactivity, smoking, and excessive alcohol consumption significantly contribute to the development of many chronic non-communicable diseases such as hypertension, obesity, stroke, type II diabetes and cardiovascular diseases. This study sought to determine the prevalence of hypertension and obesity among women in reproductive age (? 20 ? 45); describe the dietary habits of the women; and ascertain how this may contribute to hypertension and obesity among the respondents. A descriptive cross-sectional study using interviewer-administered questionnaires was carried out among 254 women in reproductive age in the Ashiaman municipality. Study participants were selected through systematic sampling. The weight (kg) of the participants was taken using Salter scale and the height was also measured in cm using a stadiometer. Both weight and height measurements were used to calculate participants’ body mass index (BMI) and blood pressure (BP) readings were performed using a sphygmomanometer. The results showed that the prevalence rate of hypertension and obesity among the respondents was 20.1% and 9.8% respectively. The daily dietary choices of respondents revealed that all the respondents (254) consumed carbohydrates/fats & oils  food daily with  less than a third of the respondents (80) including vitamins and mineral rich food which are mainly fruits and vegetables into daily diet. The results also indicated that 20.5% women who consumed carbohydrates, fats & oils daily were hypertensive whereas the rest (79.5%) were normotensive. Effective and targeted health education and behaviour change interventions directed towards this segment of the population should be developed and implemented urgently. Key Words: Hypertension, obesity, prevalence, dietary habi

Provider-Client Perception and Experiences on the National Health Insurance Scheme (NHIS) Medicines List in Both Public and Private Pharmacy in the Bantama Sub-Metro of Ashanti Region of Ghana

Background: Health insurance schemes are formed in both developed and developing countries as a result of the existing challenges in the health care financing system stemming from uneven social and economic distribution. This study was conducted to find out the perception and experience of providers and clients in both public and private facilities on NHIS medicines list. Methods: A quantitative descriptive study was conducted  through systematic random sampling to recruit 455 participants from both Nimo Pharmacy (Private facility) and Komfo Anokye Teaching Hospital (Public facility). Results: Majority of the clients were aware of NHIS medicines or generics medicines and branded medicines. However, most of them preferred NHIS medicines to branded medicines. The reasons provided for opting for NHI medicines were effective (p-value= 0.088) affordability (p-value= 0.001) availability (p-value= 0.001), safety (p-value=0.645) and less side effects (p-value=0.012). Again, factors that might influence providers’ prescription patterns of NHIS medicines list were; provider’s personal preference, clients’ preference, confidence in the generic company and advertisement by generic company.Conclusion: A database of all generic medicines should be created as well as their inventory level be maintained for every accredited NHIS facility by the Ministry of Health and National Health Insurance Authority. This will make information on NHIS medicines readily available and clients can easily be directed to another accredited facility by the provider to access NHIS medicines if they are not available at the visiting facility. Keywords: Health Insurance, medicines list, client-provider-perceptions, Branded and generic medicines