Ageing, health and health-seeking behaviour in Ghana

Rapid ageing of populations globally following reductions in fertility and mortality rates has become one of the most significant demographic features in recent decades. As a low- and middle-income country, Ghana has one of the largest and fastest growing older populations in sub-Saharan Africa, where ageing often occurs ahead of socioeconomic development and provision of health and social care services. Older persons in these contexts often face greater health challenges and various life circumstances including role loss, retirement, irregular incomes and widowhood, which can increase their demand for both formal and informal support. This thesis addresses the effects of the socio-political structure, informal social support and micro-level factors on health and health-seeking behaviour among community-dwelling older persons in Ghana. The theoretical perspectives draw on political economy of ageing, social convoy theory and Andersen5s behavioural model. Using multi-stage stratified cluster cross-sectional survey data of older cohorts (N= 1,200) aged 50 years and older, multivariate generalised Poisson and logit regression models estimated the associations among variables and interaction terms. Although Ghana’s national health insurance scheme (NHIS) enrollment was significantly associated with increased log count of healthcare use (β = 0.237), the relationship was largely a function of health status. Moreover, the NHIS was related with improved time from onset of illness to healthcare use (β = 1.347). However, even with NHIS enrollment, the intermediate (OR = 1.468) and richer groups (OR = 2.149) had higher odds of seeking healthcare compared with the poor. In addition, features of meaningful informal social support including contacts with family and friends, social participation and remittances significantly improved psychological wellbeing and health services utilisation. Somewhat counter-intuitively, spousal cohabitation was associated with decreased health services use (OR = 0.999). Whilst self-rated health revealed a strong positive association with functional status of older persons (fair SRH: β = 1.346; poor SRH: β = 2.422), the relationship differed by gender and also was moderated by marital status for women but not men. The employed and urban residents somewhat surprisingly had lower odds of formal healthcare use. The findings support the hypotheses that interactive impacts of aspects of structural and functional social support and removal of catastrophic healthcare costs are particularly important in older persons’ psychological health and health service utilisation. Nevertheless, Ghana’s NHIS currently apparently lacks the capacity to improve equitable attendance at health facility between poor and non-poor. In contributing to the public health and social policy discourse, this study proposes that, whilst policies to ensure improved health status of older people are recommended, multidimensional social support and NHIS policy should be properly resourced and strengthened so they may act as critical tools for improving health and health services utilization of this marginalized and vulnerable older people in Ghana. Moreover, policies targeting and addressing economic empowerment including universal social pensions and welfare payments should be initiated and maintained to complement the NHIS for older people. The achievement of age-relevant policies and Universal Health Coverage (UCH) as advocated by WHO could be enhanced by adopting some of these suggestions

The Influence of funds on the Organizational Performance of SMEs in the Tamale Metropolis of Ghana

Small and medium enterprises (SMEs) are critical to the economy's and industry's overall growth. However, in the long run, funding will be required to improve their performance, necessitating the need to fund their operations. This paper examined SMEs access to funds to finance their businesses and its effect on their performance in Tamale Metropolis. A Quantitative approach was used, and questionnaires were administered. The research data were collected from 92 respondents through a simple random sample technique. Descriptive and inferential statistics were used to analyzed. The study found that the main source of funding for SMEs in the Tamale metropolis in Northern Ghana are: self, family and friends; funds sourced from these sources to a large extent did not have much effect on the performance of the SMEs. To enhance the SMEs opportunities to access funds from financial institutions, there is the need for trainings, workshops on business registrations, and entrepreneurship skills building. This will make them more attractive to financial agencies to lend them money to finance their businesses. Research paper Keywords: Funds; Small and Medium Scale Enterprise; SMEs Performance; Ghana Reference to this paper should be made as follows: Abubakari, A., Abdulai, M. S., & Adam, A. (2022). The Influence of funds on the Organizational Performance of SMEs in the Tamale Metropolis of Ghana. Journal of Entrepreneurship, Business and Economics, 10(1), 109–140

Traditional Teachings and Practices for Child Health in Ghana

Majority of rural denizens have limited access to modern medical as well as other health facilities. In the absence of adequate, readily accessible modern medical facilities, traditional teachings and practices concerning child health have proved to be a useful substitute and/or complement. Using qualitative data from selected communities in Central, Greater Accra and Ashanti Regions of Ghana, the paper examined traditional teachings and practices for child health. The results indicated a high level of utilization of both modern and traditional medical services and practices for child illnesses which feign complementary. Information gathered through in-depth interviews, focus group discussions, narratives and conversations found that each society hands down mores from generation to generation by teaching certain attitudes, practices, beliefs, legends, customs, habits and prodigy. The study advanced that there are traditional beliefs and practices in all areas of life, including health in general and child health in parts. These practices include breastfeeding, massaging and postpartum sexual abstinence, for the health of the suckling infant and toddler, while socialization of good hygiene and nutrition practice is initiated and encouraged for the growing child. These reflect the values and beliefs held by members of the community for periods often spanning generations. Such practices recognize the critical importance of children’s right to health and survival, an issue at the heart of the UN charter on the right of the child. These results have implications for health policy and planning regarding the incorporation of traditional health teachings and practices into the child health aspect of Primary Health Care programmes and the UN convention on the rights of the child. Keywords: traditional teachings and practices, child health, breastfeeding, postpartum sexual abstinence, Ghana

Factors associated with loneliness among individuals aged 80 years and over: Findings derived from the nationally representative "Old Age in Germany (D80+)" study

To clarify the factors associated with loneliness in individuals aged 80 years and older in Germany (also stratified by sex). Methods Data from the nationally representative "Old Age in Germany (D80+)" were employed. The analytic sample equaled 10,031 individuals. The D80+ study included community-dwelling and institutionalized individuals ≥ 80 years in Germany. Multiple linear regressions were used (with sociodemographic and health-related explanatory factors). The collection of data occurred between November 2020 and April 2021 (written questionnaire). Results Higher loneliness was significantly associated with not being married (e.g., widowed compared to being married, β=.37, p<.001), being institutionalized (β=.33, p<.001), low education (high education compared to low education, β=-.07, p<.01), a higher number of chronic conditions (β=.02, p<.001), poor self-rated health (β=-.19, p<.001) and greater functional impairment (β=.15, p<.001). Sex-stratified regressions produced comparable results. However, low education was only associated with higher loneliness among men, but not women (with significant interaction: education x sex). Conclusion Several sociodemographic and health-related factors can contribute to loneliness among the oldest old in Germany, with sex-specific associations between education and loneliness. Overall, such knowledge can aid to address individuals with higher loneliness levels

Factors associated with institutionalization among the oldest old: Results based on the nationally representative study 'old age in Germany (D80+)'

To examine the factors associated with institutionalization among individuals aged 80 years and over in Germany (total sample and stratified by sex). Methods/Design: We used data from the nationally representative "Old Age in Germany (D80+)" (analytic sample: n = 9572 individuals), including individuals aged 80 years and over in Germany. Institutionalization (private living vs. institutionalization) served as an outcome measure. For the written interview, data collection took place from November 2020 to April 2021. Multiple logistic regressions of the overall sample (also stratified by sex) were applied. Results In the analytic sample, 10.2% (95% CI: 9.2%?11.3%) of the participants were institutionalized. The odds of being institutionalized were positively associated with being female (OR: 2.02, 95% CI: 1.08 to 3.80), being 90 years and over (compared to 80-84 years, OR: 1.67, 95% CI: 1.17 to 2.40), not being married (e.g., being single compared to being married: OR: 14.06, 95% CI: 6.73 to 29.37), higher education (e.g., high education compared to low education: OR: 1.88, 95% CI: 1.25 to 2.84), more favorable self-rated health (OR: 1.32, 95% CI: 1.07 to 1.62) and greater functional impairment (OR: 15.34, 95% CI: 11.91 to 19.74). Sex-stratified regressions were also conducted, mostly yielding similar results. Conclusion Our study highlighted the role of several sociodemographic factors (particularly marital status, e.g., being single) and functional impairment for the risk of institutionalization among the oldest old in Germany. This study confirms findings in studies in younger samples that functional decline is the main factor associated with institutionalization. As functional decline may be modifiable, efforts to maintain functional abilities may be important. This knowledge is important for relevant groups (such as clinicians and policy-makers) because it may guide early intervention and prevention efforts, can help allocate healthcare resources effectively and shape policies to support independent living. Further insights using longitudinal data is recommended

Pulled in or pushed out : understanding the complexities of motivation for alternative therapies use in Ghana

The impact of strong cultural beliefs on specific reasons for traditional medicine (TRM) use among individuals and populations has long been advanced in health care and spatio-medical literature. Yet, little has been done in Ghana and the Ashanti Region in particular to bring out the precise “pull” and “push” relative influences on TRM utilization. With a qualitative research approach involving rural and urban character, the study explored health beliefs and motivations for TRM use in Kumasi Metropolis and Sekyere South District, Ghana. The study draws on data from 36 in-depth interviews with adults, selected through theoretical sampling. We used the a posteriori inductive reduction model to derive broad themes and subthemes. The “pull factors”—perceived benefits in TRM use vis-à-vis the “push factors”—perceived poor services of the biomedical treatments contributed to the growing trends in TRM use. The result however indicates that the “pull factors,” viz.—personal health beliefs, desire to take control of one’s health, perceived efficacy, and safety of various modalities of TRM—were stronger in shaping TRM use. Poor access to conventional medicine accounted for the differences in TRM use between rural and urban areas. Understanding the treatment and health-seeking behaviour of a cultural-related group is critical for developing and sustaining traditional therapy in Ghana

Abandoned housing projects in Malaysia and the prospect of diminishing partnership: an overview

Owning a house is a dream that every individual cherishes. In Malaysia, both the banking sector and the government have expended relentless efforts to ensure Malaysians have access to financing to acquire and own affordable houses. These efforts are however being derailed by alarming cases of abandoned housing projects (AHPs) that have affected a substantial number of house buyers. Several reasons have been cited for the AHPs. The issues of the Islamic banking debt based home financing products have remained prominent. The literature argues that these products such as BBA and Tawarruq have imbedded features of transferring risks and liabilities to home buyers. This problem becomes acute in cases of AHPs. Musharakah Mutanaqisah or Diminishing Partnership (DP) is suggested as a superior option for Islamic home financing schemes. However, there is hardly any work that has investigated the extent to which DP can provide remedy to addressing the problem of abandoned housing projects. The present paper adopts content analysis and has shown that DP has a bright prospect of mitigating the problem of abandoned housing projects. The paper concludes with suggestions for the future research. Keywords: Diminishing partnership; abandoned housing; Islamic bankin