Environment and Health Perceptions in the Vicinty of Surface Mining Concessions in the Upper West Region of Ghana

The emergence of a gold mining industry and the influx of Artisanal Small Scale Mining following recent discoveries of gold deposits in Northern Ghana have posed new socio-cultural, economic, environment and health challenges for residents in a dry savannah zone that is already facing negative consequences of environmental change. Yet, knowledge of the impact of this emerging industry on the health of local population, and the extent to which it makes such a stressed environment more uninhabitable, has been lacking. In addition, studies elsewhere, mostly in the southern part of the country where mining predominates, have largely concentrated on assessing the impact of mining activities on the physical environment (i.e. water bodies, soil/land and air). This thesis examines perceptions of residents on the impact of mining and environmental exposures on individual and community health and wellbeing in the Upper West Region of Ghana. The study utilised cross-sectional data (n=801) collected on household heads in fourteen mining communities in the region, and employed negative log–log and binary logistic regression analytic techniques to examine the impact of environmental exposures from mining on residents’ self-rated health and their desire to relocate from their traditional communities. The findings suggest that, in areas inundated with mining activities, residents closest to mining operations (impacted communities) who were either neutral or believed mining activities caused health problems were more likely to rate their health as poor compared to those who did not believe mining activities caused health problems (OR=2.01, p≤0.001 and OR=1.98, p≤0.001, respectively). Interestingly, only those who were neutral to the impact of odours on poor health in the affected communities were more likely to rate their health as poor compared to those who did not believe it had a health impact (OR=1.53, p≤0.1). On the desire to relocate from the community however, residents who complained they were not adequately informed about the mining operations and those who were of the view that mining operations were not meeting environmental standards, were more likely to consider relocating from the community (OR=2.10, p≤0.001 and OR=1.61, p≤0.1, respectively). Furthermore, the study found that age, gender, education, wealth and religious beliefs have an influence on residents’ self-rated health and their desire to relocate in relation to mining exposures. The emerging mining industry potentially is exacerbating the already stressed environment, contributing to poor health, and forcing local populations to abandon their traditional communities. It also highlights the dichotomy between “expert” versus “lay” understanding of what constitutes substantial health risk during environmental exposures. It is recommended that, aside the urgent need to review Ghana’s Minerals Act and “expert” health risk assessments, there should be a strong enforcement of environmental best practices in mining operations and an effective engagement of communities for partnership in mining activities. Specialized health, environment and food security policies and intervention are recommended to reduce the vulnerabilities of mining communities in the Upper West Region of Ghana and in similar contexts in Sub-Saharan Africa

Persistent misconceptions about HIV transmission among males and females in Malawi

Background: The prevalence of HIV in Malawi is one of the highest in sub-Saharan Africa, and misconceptions about its mode of transmission are considered a major contributor to the continued spread of the virus. Methods: Using the 2010 Malawi Demographic and Health Survey, the current study explored factors associated with misconceptions about HIV transmission among males and females. Results: We found that higher levels of ABC prevention knowledge were associated with lower likelihood of endorsing m

HIV vulnerability and resilience among heterosexual African, Caribbean and Black men in London Ontario, Canada

Since Canada’s first HIV diagnosis in 1981, prevalence rates have remained below endemic levels. This, however, tends to mask realities of HIV infection among sub-populations like heterosexual men of African, Caribbean, and Black (ACB) descent, who experience increased risk of infection compared to other groups. Research to unpack ACB men’s vulnerability to HIV has prioritized behavioral risk factors, including the endorsement of traditional masculinity, partner concurrency, condomless sex, and poor use of preventive health services. As such, recommendations from these studies have centered on behavioral changes, which understate the role of structural risk factors in ACB men’s HIV vulnerability. Furthermore, knowledge from these studies under-represents ACB men’s agency and overly simplifies their vulnerabilities and resilient trajectories in relation to HIV. In advancing knowledge in this area, the weSpeak research project was implemented in four cities in Ontario (i.e., Ottawa, Toronto, London, and Windsor) from 2016 to 2020 to provide a holistic account of HIV vulnerability and resilience among heterosexual ACB men. This dissertation is drawn from the weSpeak project. It specifically focused on unpacking the HIV vulnerability and resilience of heterosexual ACB men at the nexus of behavioral and structural risk factors in London, Ontario, using a qualitative approach. Through snowball and random sampling, thirty self-identified heterosexual ACB men and seven service providers participated in four focus groups (n=24) and thirteen (n=13) in-depth interviews. Analyzing the data using NVivo 12 revealed the overarching role of structural factors in ACB men’s HIV risk. For instance, the perception that masculinity is a sexual performance factor was limited to younger ACB men who had internalized stigmatized and stereotyped Black masculinities. Most ACB men practiced resourceful masculinities that allowed them to engage with their health. Furthermore, some ACB men had limited understanding and awareness of their high-risk of HIV mainly because they were disconnected from institutions providing HIV services. Aside from these hidden vulnerabilities, the research also revealed the high resilience of ACB individuals to HIV. Most ACB men demonstrate resilience by drawing on intrapersonal and interpersonal resources, including friends, families, and religious communities. Health policymakers and stakeholders can leverage these findings to engage ACB men in designing interventions targeted at their HIV needs. Overall, the removal of race-based discrimination in access to health resources will ultimately contribute to HIV risk reduction among ACB men and, therefore, improve their health and wellbeing in Canada

Endorsement of HIV misconceptions over time among females and males in Haiti

To address high HIV prevalence rates in Haiti, disseminating information about HIV transmission has been emphasized. Yet, after several decades, we do not know how effective HIV information dissemination has been in reducing HIV misconceptions. Using the 2005-06, 2012, and 2016-17 Haiti Demographic and Health Surveys and applying logistic regression, we found nuanced gender dynamics in endorsing HIV misconceptions over time. Among females at the bivariate level, the odds of endorsement of HIV misconceptions in 2012 (OR = 0.87, p  0.05). Among males, after controlling for demographic, socioeconomic, and behavioral factors at the multivariate level, those in 2012 (OR = 1.55, p < 0.001) and 2016-17 (OR = 1.24, p < 0.01) were more likely to endorse HIV misconceptions compared to men in 2005-06. We recommend that while improving women’s access to HIV services, it is important to incorporate the HIV needs of males into the National HIV policy priority areas

Geographic disparities in the time to under-five mortality in Ghana.

Globally, there has been tremendous advancement in medicine and child healthcare with increased life expectancy. That notwithstanding, the risk of under-five mortality ─ children dying before their fifth birthday remains relatively high in countries in Sub-Saharan Africa such as Ghana. In Ghana, under-five mortality remains a major public health problem that requires significant policy interventions. Using data from the 2017 Maternal Health Survey (n = 4785), we examined the geographic disparities in the time to under-five mortality in Ghana. The Kaplan Meier estimator showed significant (Log-rank: p< 0.001) rural-urban differences in the time to under-five mortality in Ghana. A disaggregated cox proportional hazards analysis showed that despite wide consensus that children in urban areas have a high survival rate, children in urban areas in northern regions of Ghana, especially the Upper West (HR = 4.40, p < 0.05) and Upper East (HR = 5.37, p < 0.01) Regions were significantly at increased risk of dying before the age of five compared to children in urban areas in the Greater Accra Region. A rural-urban comparison showed that children born in rural areas in all the other regions of Ghana were at a higher risk of dying before the age of five when compared to their counterparts in the rural areas of Greater Accra Region. Other factors such as sex of child, mothers' age and use of the internet, number of household members, ethnicity and household wealth were significantly associated with the timing of under-five mortality in Ghana. Healthcare policies and programs such as immunizations and affordable child healthcare services should be prioritized especially in rural areas of regions with a high risk of child mortality. Also, there is a need to improve healthcare delivery in urban areas, particularly in northern Ghana, where deplorable healthcare service infrastructure and delivery coupled with high poverty rates put children at risk of dying before their fifth birthday

Maternal Tetanus Toxoid Vaccination in Benin: Evidence from the Demographic and Health Survey

Tetanus toxoid vaccination is critical for improving maternal and child health. Yet, the prevalence and correlates of maternal tetanus toxoid vaccination coverage remain largely underexplored in Benin where infant and child mortality rates are high. Using the 2017–18 Benin Demographic and Health Survey, we apply logistic regression analysis to address this void in the literature. We find that overall maternal vaccination coverage is 69%. A range of demographic, health care, and socioeconomic factors are associated with maternal tetanus toxoid vaccination coverage. Women aged 20–34 (OR = 0.84, p p p p p p p < 0.01) are less likely to receive tetanus toxoid vaccination compared to their counterparts with higher education. Based on these findings, we discuss several implications for policymakers

Immigrants&rsquo; Length of Residence and Stalking Victimization in Canada: A Gendered Analysis

Although previous studies have explored the role of gender on stalking victimization, we know very little about how female and male immigrants are exposed to stalking victimization over time after their arrival to their host society. To address this void in the literature, we use the 2014 Canada General Social Survey to compare stalking victimization among native-born individuals, recent immigrants (those who have been in Canada for fewer than 10 years), and established immigrants (those who have been in Canada for 10 years or more) separately for women and men. Applying gender-specific complementary log-log models, we find that female (OR = 0.63, p &lt; 0.05) and male (OR = 0.46, p &lt; 0.01) recent immigrants are less likely to experience stalking victimization than their native-born counterparts. We also find that female established immigrants (OR = 0.65, p &lt; 0.05) are less likely to experience stalking victimization than their native-born counterparts although there is no significance difference for male established immigrants (OR = 1.01, p &gt; 0.05). Overall, this study points to the importance of understanding the intersection between immigrants&rsquo; length of residence and gender in the context of stalking victimization in Canada. Based on these findings, we discuss several implications for policymakers and directions for future research

Immigrants&rsquo; Length of Residence and Stalking Victimization in Canada: A Gendered Analysis

Although previous studies have explored the role of gender on stalking victimization, we know very little about how female and male immigrants are exposed to stalking victimization over time after their arrival to their host society. To address this void in the literature, we use the 2014 Canada General Social Survey to compare stalking victimization among native-born individuals, recent immigrants (those who have been in Canada for fewer than 10 years), and established immigrants (those who have been in Canada for 10 years or more) separately for women and men. Applying gender-specific complementary log-log models, we find that female (OR = 0.63, p &lt; 0.05) and male (OR = 0.46, p &lt; 0.01) recent immigrants are less likely to experience stalking victimization than their native-born counterparts. We also find that female established immigrants (OR = 0.65, p &lt; 0.05) are less likely to experience stalking victimization than their native-born counterparts although there is no significance difference for male established immigrants (OR = 1.01, p &gt; 0.05). Overall, this study points to the importance of understanding the intersection between immigrants&rsquo; length of residence and gender in the context of stalking victimization in Canada. Based on these findings, we discuss several implications for policymakers and directions for future research