Repositioning community-based family planning in Ghana: A case study of Community-based Health Planning and Services (CHPS)

The Population Council conducted a diagnostic appraisal of delivering family planning services using the community-based health planning and services (CHPS model) in Ghana. This study’s results indicate that the CHPS program is well appreciated by rural communities where it is operational. However, the study identified several developments with implications for service delivery: increased community health officer (CHO) workloads and concomitant reductions in outreach services and home visits by community health visitors (CHVs) have weakened the CHO-CHV working relationship, leaving both cadres working in isolation. CHPS has significantly improved health indices but its contribution to increasing family planning is limited and seems to have decreased from the original model’s initial promise, mainly due to CHPS restructuring, change in priority and focus, with increased a range of services required of CHOs. The report recommends interventions and strategies for addressing identified gaps, strengthening the model, and thereby increasing family planning service access

An evolutionary study of production of electricity in Ghana (1900–1960s)

The literature on the history of electricity production have studied the evolution of electricity in both developed and developing countries and its impact on their economies. Some have laid foundations upon which other works are carried out. A close examination of historiography and multidisciplinary research on electricity production in Ghana shows that more efforts are required to improve the electric power landscape in Ghana. From the colonial era, the increasing demand for electricity has been the biggest challenge plaguing the energy sector. Respective governments have made significant strides in ensuring reliable and universal access to electricity throughout Ghana, yet such efforts have been accompanied by different levels of challenges. The study uses a qualitative and exploratory research approach to trace the activities that helped, in many other ways to the creation of a sustainable electric power provision to household and industry in Ghana, particularly in two of Ghana’s cities; Accra and Kumasi, within the period 1900 to the1960s. The work focused mainly on archival sources in its quest to arrive at how indigenous Ghanaians provided power for industrial activities and for household purposes. Results from the study show that local and cottage industries relied predominantly on wood, fuel, and biomass for their operations even before the introduction of the more sophisticated means of power generation. Also, the study revealed that in finding solutions to the challenges of electricity production, policymakers have focused more on current issues with little or no effort to trace the historical foundation of electricity production. This notwithstanding, the little efforts that have been made examined the history of energy production, with a limited focus on the immediate post-independence era

Increasing the use of continuing professional development courses to strengthen trauma care in Ghana

Injury is a major cause of death and disability in Ghana. Strengthening care of the injured is essential to reduce this burden. Trauma continuing professional development (CPD) courses are an important component of strengthening trauma care. In many countries, including Ghana, their use needs to be more uniformly promoted. We propose lowcost strategies to increase the utilization of trauma CPD in Ghana, especially in district hospitals and higher need areas. These strategies include developing plans by regional health directorates and teaching hospitals for the regions for which they are responsible. Lists could be kept and monitored of which hospitals have doctors with which type of training. Those hospitals that need to have at least one doctor trained could be flagged for notice of upcoming courses in the area and especially encouraged to have the needed doctors attend. The targets should include at least one surgeon or one emergency physician at all regional or large district hospitals who have taken the Advanced Trauma Life Support (ATLS) (or locally-developed alternative) in the past 4 years, and each district hospital should have at least one doctor who has taken the Primary Trauma Care (PTC) or Trauma Evaluation and Management (TEAM) (or locally-developed alternatives) in the past 4 years. Parallel measures would increase enrollment in the courses during training, such as promoting TEAM for all medical students and ATLS for all surgery residents. It is important to develop and utilize more “home grown” alternatives to increase the long-term sustainability of these efforts, Keywords: trauma, injury, education, training, continuing professional developmentFunding: Non

An evolutionary study of production of electricity in Ghana (1900 – 1960)

The literature on the history of electricity production have studied the evolution of electricity in both developed and developing countries and its impact on their economies. Some have laid foundations upon which other works are carried out. A close examination of historiography and multidisciplinary research on electricity production in Ghana shows that more efforts are required to improve the electric power landscape in Ghana. From the colonial era, the increasing demand for electricity has been the biggest challenge plaguing the energy sector. Respective governments have made significant strides in ensuring reliable and universal access to electricity throughout Ghana, yet such efforts have been accompanied by different levels of challenges. The study uses a qualitative and exploratory research approach to trace the activities that helped, in many other ways to the creation of a sustainable electric power provision to household and industry in Ghana, particularly in two of Ghana’s cities; Accra and Kumasi, within the period 1900 to the1960s. The work focused mainly on archival sources in its quest to arrive at how indigenous Ghanaians provided power for industrial activities and for household purposes. Results from the study show that local and cottage industries relied predominantly on wood, fuel, and biomass for their operations even before the introduction of the more sophisticated means of power generation. Also, the study revealed that in finding solutions to the challenges of electricity production, policymakers have focused more on current issues with little or no effort to trace the historical foundation of electricity production. This notwithstanding, the little efforts that have been made examined the history of energy production, with a limited focus on the immediate post-independence era

The Importance of Stopping Environmental Dumping in Ghana: The Case of Inefficient New and Used Cooling Appliances With Obsolete Refrigerants

Environmentally harmful product dumping ( environmental dumping ) of new and used low-efficiency cooling appliances with obsolete ozone-depleting and greenhouse gas refrigerants in African countries impoverishes communities, hinders economic development, threatens ecological systems, and harms public health. The use of low-efficiency cooling appliances increases energy demand, leading to higher power plant emissions and limiting affordable energy access in African countries. These low-efficiency appliances and products contain ozone-depleting refrigerants with high global-warming potential (GWP) or ozone-safe refrigerants with high GWP. Environmental dumping of these appliances and products makes it more difficult for countries to meet their international climate obligations and for the world to meet the Paris Agreement\u27s climate change mitigation targets. Ghana faces high levels of environmental dumping, despite a national ban on importing used cooling appliances and established efficiency standards for new air conditioners and refrigerators. Through the Energy Commission\u27s Office of Renewable Energy, Energy Efficiency, & Climate Change (REEECC), the government of Ghana is partnering with the Institute for Governance & Sustainable Development (IGSD) to stop environmental dumping. This article provides a list of interventions that can be implemented by Ghana, by governments in countries that export to Ghana, and by industry and other stakeholders. Notably, these actions focus on the shared responsibility of exporting countries and manufacturers by calling on exporting countries to update and enhance enforcement of their laws, and on global manufacturers to stop exporting inefficient products with obsolete refrigerants to Ghana and other African countries

Biogeographical variation in termite distributions alters global deadwood decay

DATA AVAILABIITY STATEMENT : The data produced from this study and the R-code to reproduce the analyses and figures are archived on the Dryad Digital Repository at https://doi.org/10.5061/dryad.wwpzgmssd.AIM : Termites are a crucial group of macroinvertebrates regulating rates of deadwood decomposition across tropical and subtropical regions. When examining global patterns of deadwood decay, termites are treated as a homogenous group. There exist key biogeographical differences in termite distribution. One such clear distinction is the distribution of fungus-growing termites (FGT, subfamily Macrotermitinae). Considering that climate will have shaped termite distribution and ecosystem processes, we evaluate the roles of termite distribution (presence of FGT) and climate (aridity) on global patterns in deadwood decay. LOCATION : Between 46° N-43° S and 175° E-85° W. TIME PERIOD : Present (between 2016 and 2021). MAJOR TAXA STUDIED : Termites (Blattodea: Termitoidae). METHODS : We add salient data to an existing global dataset on deadwood decomposition, including new data from five existing sites and seven additional African sites. We analyse a dataset spanning six continents, 16 countries and 102 experimental sites. Firstly, we evaluate climatic differences (mean annual temperature, mean annual precipitation and mean annual aridity) between sites with and without FGT. Secondly, using aridity as a single comparative climate metric between sites that accounts for temperature and precipitation differences, we examine the interaction between FGT and aridity on global patterns of termite deadwood discovery and decay through multivariate logistic and linear regressions. RESULTS : Termite-driven decay and wood discovery increased with aridity; however, responses differed between FGT and NFGT sites. Wood discovery increased with aridity in FGT sites only, suggesting a greater role of FGT to deadwood decay in arid environments. On average, both termite discovery and decay of deadwood were approximately four times greater in regions with FGT compared with regions without FGT. MAIN CONCLUSIONS : Termite discovery and decay of deadwood is climate dependent, and higher decay may be through greater discovery of deadwood in FGT sites. Inclusion of biogeographical differences in termite distribution could potentially alter current and future global estimates of deadwood turnover.Royal Society, Africa Capacity Building Initiative; Natural Environment Research Council; National Science Foundation.http://wileyonlinelibrary.com/journal/gebhj2024Zoology and EntomologySDG-15:Life on lan

Quantifying risks and interventions that have affected the burden of diarrhoea among children younger than 5 years : an analysis of the Global Burden of Disease Study 2017

Background Many countries have shown marked declines in diarrhoea! disease mortality among children younger than 5 years. With this analysis, we provide updated results on diarrhoeal disease mortality among children younger than 5 years from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) and use the study's comparative risk assessment to quantify trends and effects of risk factors, interventions, and broader sociodemographic development on mortality changes in 195 countries and territories from 1990 to 2017. Methods This analysis for GBD 2017 had three main components. Diarrhoea mortality was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive, Bayesian, ensemble modelling tool; and the attribution of risk factors and interventions for diarrhoea were modelled in a counterfactual framework that combines modelled population-level prevalence of the exposure to each risk or intervention with the relative risk of diarrhoea given exposure to that factor. We assessed the relative and absolute change in diarrhoea mortality rate between 1990 and 2017, and used the change in risk factor exposure and sociodemographic status to explain differences in the trends of diarrhoea mortality among children younger than 5 years. Findings Diarrhoea was responsible for an estimated 533 768 deaths (95% uncertainty interval 477 162-593 145) among children younger than 5 years globally in 2017, a rate of 78.4 deaths (70.1-87.1) per 100 000 children. The diarrhoea mortality rate ranged between countries by over 685 deaths per 100 000 children. Diarrhoea mortality per 100 000 globally decreased by 69.6% (63.1-74.6) between 1990 and 2017. Among the risk factors considered in this study, those responsible for the largest declines in the diarrhoea mortality rate were reduction in exposure to unsafe sanitation (13.3% decrease, 11.2-15.5), childhood wasting (9.9% decrease, 9.6-10.2), and low use of oral rehydration solution (6.9% decrease, 4-8-8-4). Interpretation Diarrhoea mortality has declined substantially since 1990, although there are variations by country. Improvements in sociodemographic indicators might explain some of these trends, but changes in exposure to risk factors-particularly unsafe sanitation, childhood growth failure, and low use of oral rehydration solution-appear to be related to the relative and absolute rates of decline in diarrhoea mortality. Although the most effective interventions might vary by country or region, identifying and scaling up the interventions aimed at preventing and protecting against diarrhoea that have already reduced diarrhoea mortality could further avert many thousands of deaths due to this illness. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd.Peer reviewe

Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress

Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016