Case 1 : The Fire Under the Shed: The Cornerstone Fuelling Our Plight

In Ghana, smoke from biomass fuel cook stoves leads to acute lower respiratory infections (ALRI) in children under five. Akosua Agborson, a research fellow, had the opportunity to work with the Ghana Randomized Air Pollution and Health Study (GRAPHS) team at the Kintampo Health Research Centre to address this public health issue. The GRAPHS team is responsible for reducing air pollution and improving cook stoves for households in Ghana. Akosua decided to support the GRAPHS team by doing a case research study on gari processing involving biomass fuel. She focused on gari processors because Ghana is the sixth largest producer of gari (cassava grits) in the world. Akosua and the GRAPHS team interviewed gari processors, community leaders, and the district government officer in order to understand the levels of knowledge about health risks and the perceptions of air pollution attributable to biomass fuel used in the gari processing industry

Barriers and facilitators to nationwide implementation of the malaria vaccine in Ghana.

Interventions such as antimalarial drugs, bed nets and insecticides have helped curb the burden of malaria in the past decade, yet malaria remains a leading cause of morbidity and mortality in children below the age of five years. In 2019, Ghana, Malawi, and Kenya in sub-Saharan Africa (countries with moderate to high transmission areas of malaria and deaths) started piloting the RTS,S/AS01E malaria vaccine in selected regions. Using qualitative methods, this study examined the main factors (forces) that will influence or hinder the nationwide implementation of the malaria vaccine, if approved, in Ghana. We conducted in-depth interviews with 12 key individuals (national, research/academia, and program implementing partners) in the public health sector in Ghana in October 2018 to February 2019. Results were analyzed using Kurt Lewin's force field analysis (FFA) to understand how organizations interact with their external environment in the delivery of health policies such as the implementation of the malaria vaccine. We found that the disease burden of malaria deaths in Ghana, efficacy of the vaccine, stakeholder involvement, and evidence for feasibility of vaccine delivery generated by the consortium of researchers (body of researchers) that can track the implementation were the driving forces to scale up the vaccine into routine health system. On the other hand, the needed logistics, funding, administration of the 4-dose vaccine and follow up were identified as potential barriers. The most influential force collectively highlighted by the respondents was the disease burden, and the most influential barrier was the logistics of delivering the vaccine. Our findings provide decision-makers with key barriers and facilitators to guide policy and decision-making for malaria control in Ghana and other similar settings in low middle-income countries

Exposure to carbon monoxide and particulate matter among cassava grits processors in the middle belt of Ghana: a cross-sectional study.

INTRODUCTION: exposure to smoke from biomass combustion during economic activities is a major health risk. One of such commercial activities that use biomass fuel is gari (cassava grits) processing. Cassava grits is a staple food produced from grated and fermented cassava. Several studies have depicted exposure to carbon monoxide (CO) and particulate matter (PM2.5) at the household level and fewer studies on small-scale industries such as the aforementioned one. METHODS: a cross-sectional study was conducted among 17 cassava grits processors (CGPs) using Lascar CO monitors for 24 hours and micro personal exposure monitoring devices for 72 hours, in the Kintampo South District of Ghana. CGPs were monitored during working hours and off-working hours. Two focus groups were conducted among CGPs and five in-depth interviews among community gatekeepers. RESULTS: CGPs were exposed to high CO and PM2.5 levels during working hours from 6:00 AM - 5:00 PM and off-working hours from 5:00 PM - 5:59 AM. CGPs, community gatekeepers shared different opinions on health effects of biomass fuel use. CONCLUSION: traditional cookstoves are used due to the liquefied petroleum gas (LPG) cost, the quantity and the quality of cassava grits from biomass fuel. This activity exposes CGPs to CO and PM2.5 concentrations above the 14 ppm safe levels recommended by the World Health Organisation