Sustaining Water Systems in Rural and Small Towns in Ghana: The Role of Traditional Authorities in the Krachi West District

The sustainability of water systems in rural communities and small towns in Ghana has been a major challenge that has engaged the attention of government, Non-governmental Organisations, and academics. There have been several attempts at developing models that will ensure the sustainability of water systems in Ghana. This study examined the role of traditional authorities in the management of water systems in rural communities and small towns in the Krachi West District in the Oti Region of Ghana. Using a qualitative research design, the study purposely selected and interviewed 69 respondents. The study revealed that traditional authorities play critical roles in ensuring the sustainable management of water systems in rural communities and small towns in Ghana. It also revealed that respondents want a community management model that has traditional authorities as members of an official advisory board to the Water and Sanitation Management Teams (WSMTs). It further revealed that the traditional authorities and the WSMTs have a cordial working relationship. The study, therefore, recommends that traditional authorities should officially be recognised and their roles spelled out in the community management model of water systems in Ghana

Social Accountability for Local Government in Ghana

Social accountability is considered as one strategy of deepening Ghana’s decentralised development administration. Some attempts have been made to empower local people to demand transparency and accountability from the local government system as required by law. The purpose of this paper was to assess the effectiveness of these attempts in 14 Metropolitan and Municipal Assembles. The data for the analyses were sought through key informant interviews with core Assembly staff, and focus group discussions with selected Assembly Members. The analyses revealed that the legal provisions made room for social accountability but the weak capacity of Assembly Members in terms of resources, the understanding of legislative provisions, and the acceptability of the concept challenged its implementation. It is thus recommended that service provision in local communities should have capacity-building components that promote social accountability

Implementation challenges of social protection policies in four districts in Ghana: The case of the District Assembly Common Fund meant for Persons with Disabilities

This study explores Ghana’s implementation of a policy of two per cent of the District Assembly Common Fund (DACF) meant for persons with disabilities (PWDs) in four districts. It employed in-depth interviews with PWDs and offi cers in the District Assembly. The study revealed that the District Assemblies did not fully comply with directives from the central government to implement the policy. There were inconsistencies in the implementation of the policy and many PWDs received amounts that were less than they required. Further, fi xed amounts were allocated to PWDs for diff erent purposes and even though the purposes for requests were not clear, payments were made. The study recommends the need to compile and maintain a database of all PWDs in all the Districts in Ghana, implementing uniform format for allocation of the DACF to PWDs, providing support in the form of inputs rather than cash, and mobilising PWDs into cooperatives. The District Assemblies might consider engaging independent evaluators to monitor and evaluate the implementation of the policy to give the much-needed direction to the policy

Promoting Green Infrastructure in Kumasi: Challenges and Strategies

The study investigated the causes and effects of the reduction of green spaces in the city of Kumasi,  as well as the challenges in the management of green spaces. Data for the study were gathered through interviews, documentary reviews and observation. The causes and challenges of maintaining green spaces included inadequate collaboration between institutions engaged in the planning and management of the city, inadequate capacity and lack of control by the city management over a greater part of the city’s lands.  The effects included the near loss of the garden city status of the city and reduction in the number of green spaces for recreation, parties and relaxation. To help promote and preserve green spaces in the city, it is recommended that the managers of the city develop various policies, programmes and projects to support green living and create a participation strategy for all major stakeholders in the creation and management of green spaces. City authorities should institute an annual Green Space Awareness education in the city, encourage private developers, owners of housing facilities and educational institutions to maintain private gardens and green spaces and help improve the collaboration between and among key stakeholders and institutions in the management of green spaces in the city. Keywords: Green Infrastructure, Green space, Cities, Kumasi, land use, climate chang

The Effects of Natural Resource Conservation on the Development of Fringe Communities around the Barekese Catchment Area

The study sought to assess the effects of nature resource conservation on fringe communities in the Barekese conserved area in Ghana. A sample of 82 household heads was randomly selected from four fringe communities and interviewed to gather the needed primary data. Also focused group discussions were held with farmers, fishers, hunters and chain-saw operator groups in the sampled communities. The findings were that the Barekese catchment area conservation project had resulted in the reduction in farmlands of the people living in the fringe communities. It has also brought about some natural resource use conflicts, poverty and the undermining of livelihood opportunities of the fringe communities. It is therefore recommended that alternative livelihood opportunities, especially nonfarm businesses need to be encouraged and supported by the government and other local authorities among the resource fringe communities to minimize the negative effects of conservation. Active involvement of the fringe communities in the decision making process, before, during and after the conservation, could have engendered local ownership and reduced the antagonistic tendencies from the fringe communities. Keywords: natural resource, conservation, fringe communities, Barekes

The Nexus between Communication and Development Planning. Exploring the Communication Methods Used by Development Planners in Ghana

The nexus between Planning and communication especially in Africa is barely explored despite suggestions by renowned writers such as Habermas, whose communicative action theory has informed several Planning strategies that focus on providing more practical frameworks for understanding and practicing in the field.  Using the case study methodology, this study explored the case of four agencies engaged in development planning activities in the Kumasi Metropolis, Ghana. It was found out the Planners hardly employ the wide range of communication methods available. This study reveals that the situation results from Planners’ preference for keeping to comfort-zones shaped by their limited levels of awareness, knowledge and competence and recommends that Planner employ the broad range of options to achieve greater efficacy in the communicative process of development planning. Keywords: Communicative planning, communication methods, development planning, participation, Ghan

Safety of intravitreal ziv-aflibercept in choroido-retinal vascular diseases: A randomised double-blind intervention study

AIM:To evaluate the safety of 1.25mg and 2mg intravitreal ziv-aflibercept (IVZ) in Ghanaian eyes with choroido-retinal vascular diseases. DESIGN:Prospective, randomised, double blind, interventional study. METHODS:Twenty patients with centre involving macular oedema in diabetic retinopathy, retinal vein occlusion, and neovascular age-related macular degeneration were assigned to 2 groups receiving 3 doses of 1.25mg/0.05ml (group 1) and 2mg/0.08ml IVZ (Group 2) at 4 weekly intervals. Safety data was collected after 30 minutes, 1 and 7 days, and 4, 8 and 12 weeks after injection. Changes in continuous variables were compared using paired t-test and categorical variables were compared using chi-square test of proportions. Repeated-Measures ANOVA with nesting test was used to compare variations in continuous variables by IVZ dose over time. Primary outcome measures were ocular and systemic adverse events at 4 weeks. RESULTS:Eleven females and nine males, with mean age of 63.2± 7.3 years were included. Ocular adverse events included subconjunctival haemorrhage in 1 eye, intraocular pressure (IOP) >21mmHg at 30 minutes in 6 eyes and mild pain in 3 eyes at 1-day. There was no significant difference in IOP rise between the 2 groups at 30 minutes (p = 0.21). No other ocular or systemic adverse events were observed. There was significant improvement in the best corrected visual acuity (LogMAR) from 0.95±0.6 to 0.6±0.4 (p<0.01) and 0.47±0.3 (p<0.01), reduction in central subfield foveal thickness from 405.9±140 um at baseline to 255.6±75 um (p<0.01) and 238±88 um (p<0.01) at 4 and 12 weeks respectively, although no difference was observed between the 2 groups (p = 0.34). CONCLUSION:IVZ at 1.25mg and 2mg had similar safety profiles, and did not have any major unexpected adverse events. Further studies with larger cohorts are required to confirm efficacy

Development and international validation of custom-engineered and code-free deep-learning models for detection of plus disease in retinopathy of prematurity: a retrospective study

BACKGROUND: Retinopathy of prematurity (ROP), a leading cause of childhood blindness, is diagnosed through interval screening by paediatric ophthalmologists. However, improved survival of premature neonates coupled with a scarcity of available experts has raised concerns about the sustainability of this approach. We aimed to develop bespoke and code-free deep learning-based classifiers for plus disease, a hallmark of ROP, in an ethnically diverse population in London, UK, and externally validate them in ethnically, geographically, and socioeconomically diverse populations in four countries and three continents. Code-free deep learning is not reliant on the availability of expertly trained data scientists, thus being of particular potential benefit for low resource health-care settings. METHODS: This retrospective cohort study used retinal images from 1370 neonates admitted to a neonatal unit at Homerton University Hospital NHS Foundation Trust, London, UK, between 2008 and 2018. Images were acquired using a Retcam Version 2 device (Natus Medical, Pleasanton, CA, USA) on all babies who were either born at less than 32 weeks gestational age or had a birthweight of less than 1501 g. Each images was graded by two junior ophthalmologists with disagreements adjudicated by a senior paediatric ophthalmologist. Bespoke and code-free deep learning models (CFDL) were developed for the discrimination of healthy, pre-plus disease, and plus disease. Performance was assessed internally on 200 images with the majority vote of three senior paediatric ophthalmologists as the reference standard. External validation was on 338 retinal images from four separate datasets from the USA, Brazil, and Egypt with images derived from Retcam and the 3nethra neo device (Forus Health, Bengaluru, India). FINDINGS: Of the 7414 retinal images in the original dataset, 6141 images were used in the final development dataset. For the discrimination of healthy versus pre-plus or plus disease, the bespoke model had an area under the curve (AUC) of 0·986 (95% CI 0·973-0·996) and the CFDL model had an AUC of 0·989 (0·979-0·997) on the internal test set. Both models generalised well to external validation test sets acquired using the Retcam for discriminating healthy from pre-plus or plus disease (bespoke range was 0·975-1·000 and CFDL range was 0·969-0·995). The CFDL model was inferior to the bespoke model on discriminating pre-plus disease from healthy or plus disease in the USA dataset (CFDL 0·808 [95% CI 0·671-0·909, bespoke 0·942 [0·892-0·982]], p=0·0070). Performance also reduced when tested on the 3nethra neo imaging device (CFDL 0·865 [0·742-0·965] and bespoke 0·891 [0·783-0·977]). INTERPRETATION: Both bespoke and CFDL models conferred similar performance to senior paediatric ophthalmologists for discriminating healthy retinal images from ones with features of pre-plus or plus disease; however, CFDL models might generalise less well when considering minority classes. Care should be taken when testing on data acquired using alternative imaging devices from that used for the development dataset. Our study justifies further validation of plus disease classifiers in ROP screening and supports a potential role for code-free approaches to help prevent blindness in vulnerable neonates

CONFLICT SENSITIVE PLANNING IN THE NANUMBA NORTH DISTRICT OF GHANA

ABSTRACT Conflicts have, for a long time, been considered as constraints rather than development problems. Consequently, District Development planning in conflict prone areas has failed to adopt conflict sensitive development strategies. This paper is based on a study that utilized key informant interviews, focused group discussions, and historical documentations in the Nanumba North District to determine the prospects of adopting a conflict sensitive planning framework. The study revealed that although 67% of the respondents indicated that there was the possibility of another outbreak of violent conflict, conflicts were considered security issues and thus isolated from development. All stakeholders were unanimous in their view that the challenges of mainstreaming conflict into the development planning process could be surmounted through political commitment and the allocation of resources