Rural-Urban Differences in the Utilization of Maternal Healthcare in Ghana: The Case of Antenatal and Delivery Services

Although maternal health in Ghana has generally improved over the past two decades, the current MMR implies that Ghana‟s MMR is approximately 2.4 times higher than the set target in MDG 5. Using data from the Ghana Demographic and Health Survey 2008, an attempt is made in this study to investigate the rural-urban differences in maternal health care (antenatal and delivery care) service utilization in Ghana. Most previous studies focused more broadly on the utilization of MHC services either in the entire country or some parts of the country. This study fills the gap by looking at women from the rural and urban areas with varying standards of living and other socioeconomic attributes. The study also includes some women autonomy variables to find out their effect on MHC service utilization in both areas. Lastly, an attempt is also made to investigate the effect of informal education on the use of MHC services using a logistic regression model. The results from the rural sample show that, women with some degree of autonomy are more likely to use MHC services than their counterparts who lack such autonomy. Again, informal education through the media is more effective in the rural areas than in the urban areas, and wealth still remains an issue particularly in the urban areas

Design and implementation of community engagement interventions towards healthcare quality improvement in Ghana:a methodological approach

BackgroundNearly four decades after the Alma-Ata declaration of 1978 on the need for active client/community participation in healthcare, not much has been achieved in this regard particularly in resource constrained countries like Ghana, where over 70 % of communities in rural areas access basic healthcare from primary health facilities. Systematic Community Engagement (SCE) in healthcare quality assessment remains a grey area in many health systems in Africa, albeit the increasing importance in promoting universal access to quality basic healthcare services.Purpose/objectiveDesign and implement SCE interventions that involve existing community groups engaged in healthcare quality assessment in 32 intervention primary health facilities.MethodsThe SCE interventions form part of a four year randomized controlled trial (RCT) in the Greater Accra and Western regions of Ghana. Community groups (n = 52) were purposively recruited and engaged to assess non-technical components of healthcare quality, recommend quality improvement plans and reward best performing facilities. The interventions comprised of five cyclical implementation steps executed for nearly a year. Wilcoxon sign rank test was used to ascertain differences in group perceptions of service quality during the first and second assessments, and ordered logistic regression analysis performed to determine factors associated with groups’ perception of healthcare quality.ResultsHealthcare quality was perceived to be lowest in non-technical areas such as: information provision to clients, directional signs in clinics, drug availability, fairness in queuing, waiting times, and information provision on use of suggestion boxes and feedback on clients’ complaints. Overall, services in private health facilities were perceived to be better than public facilities (p < 0.05). Community groups dominated by artisans and elderly members (60+ years) had better perspectives on healthcare quality than youthful groups (Coef. =1.78; 95 % CI = [−0.16 3.72]) and other categories of community groups (Coef. = 0.98; 95 % CI = [−0.10 2.06]).ConclusionsNon-technical components of healthcare quality remain critical to clients and communities served by primary healthcare providers. The SCE concept is a potential innovative and complementary quality improvement strategy that could help enhance client experiences, trust and confidence in healthcare providers. SCE interventions are more cost effective, community-focused and could easily be scaled-up and sustained by local health authorities

The effect of fertility and education on female labour force participation in Ghana

This study examines the forces behind female labour force participation (flfP) in Ghana by focusing on the role played by fertility and education, for both urban and rural dwellers. Applying a logistic regression to the fifth round of the Ghana Living standards survey (Glss 5) we established that women with basic and tertiary education have a higher propensity of participation compared with those with no education. The results further indicate significant positive marginal effects for women with children, suggesting that having more children increases the likelihood of participation. This observation was more pronounced in the rural urban estimates. The paper suggests that women’s labour force participation and home production are complements rather than substitutes considering the dominance of women in self-employment and/or informal sector where women are able to combine work and home production. moreover, the study established a positive relationship between females in good health and the level of participation, and discusses some policy recommendations to encourage participation of women in the Ghanaian labour force

Alcohol Consumption Among Ghanaian Women of Child Bearing Age – What are the Correlates?

Abstract This paper examines the demographic and socio-economic correlates of alcohol consumption and drinking frequency among Ghanaian women aged 15-49 years. The study utilizes the 2008 Ghana Demographic and Health Survey data, which remains the most recent DHS for studying the phenomenon in Ghana. Using logistic regression, our findings indicate that alcohol consumption among Ghanaian women is influenced by age, education, and wealth status. In addition, while health insurance ownership significantly affects alcohol consumption among urban women, employment status is reported to be a significant determinant among rural women. Results from the ordered logistic regression show that age, wealth status, pregnancy status, and place of residence are significant predictors of alcohol drinking frequency among Ghanaian women. Moreover, while secondary educational attainment is significant among urban women, primary educational attainment is significant among rural women. The study concludes that the predictors of alcohol consumption and drinking frequency among women of childbearing age in Ghana vary by place of residence (i.e., rural vs urban)

The Ghanian economy: and Overview

The Ghanaian economy has been on an upward trajectory over the past three decades, yet a number of challenges bedevil growth, redistribution and sustainability. After 56 years of independence, the need for a formal academic and practitioner forum for engaging minds on the past, present and future state of the economy has been lurking in the background. The birth of the Ghanaian Journal of Economics is a response to this urgent quest, providing a platform for cutting edge research on the Ghanaian economy and similar other economies to inform policy design and implementation. As the maiden issue, this review article seeks to retrace developments in the economy a few steps back to bring readers up to date on current state of research. The review is historical, and the scope is to synthesize the diverse developments in the Ghanaian economy within the confines of a relatively brief article. This article is thus not an exhaustive treatment of the topic, and it does not cover all the esoteric details of the Ghanaian economy. In the end, however, we hope to offer some perspectives on the literature for readers of the journal, investors, managers of the economy, regulators and academics while also providing a roadmap for future research endeavours

The Effect of Search Effort on the transition from Unemployment to Work: Evidence from a Cross Section of Ghanaian Formal Sector Workers

While the role of search effort in the transition from unemployment to employment is not contentious, there is paucity of empirical evidence on the nexus between search effort and the duration of unemployment, especially in developing countries. Hence, this paper focuses on the time period in which the individual exits unemployment, using search intensity as a key explanatory variable. Data for the study is sourced from a survey of 404 formal sector workers in Accra who secured their first employment from 2005 and 2012. We disaggregated the transition period into three intervals namely; less than 1 month, between 1 and 12 months and more than 12 months, in order to achieve this objective. Using the multinomial logistic regression, we found that the use of multiple methods (search intensity) in the search process has a highly significant (p<0.001) effect on the probability of entering employment. In particular, using two additional methods decrease the probability of finding employment in less than 1 month by 11.4 percentage points but raises the prospect of entering into employment in the 1–12 months period by 9.8 percentage points. Other variables that significantly explain the duration of unemployment include age, years of schooling, sector of employment (private sector), family support and the year of employment. The paper concludes with a recommendation to realign the Labor Market Information System to the dynamics of the labor market

The effect of community engagement on healthcare utilization and health insurance enrollment in Ghana:Results from a randomized experiment

Health insurance enrollment in many Sub-Saharan African countries is low, even with highly subsidized premiums and exemptions for vulnerable populations. One possible explanation is low service quality, which results in a low valuation of health insurance. Using a randomized control trial in 64 primary health care facilities in Ghana, this study assesses the impact of a community engagement intervention designed to improve the quality of healthcare and health insurance services on households living nearby the facilities. Although the intervention improved the medical-technical quality of health services, our results show that households' subjective perceptions of the quality of healthcare and insurance services did not increase. Nevertheless, the likelihood of illness and concomitant healthcare utilization reduced, and especially households who were not insured at baseline were more likely to enroll in health insurance. The results show that solely increasing the technical quality of care is not sufficient to increase households' subjective assessments of healthcare quality. Still, improving technical quality can directly contribute to health outcomes and further increase health insurance coverage, especially among the previously uninsured

The interactive effect of gender, residence, and socioeconomic status on early sexual debut among sexually active young adults in Ghana

Aim The objective of this study was to examine the interactive effect of gender, rural–urban residence, and socioeconomic status on early sexual debut among young adults in Ghana. Methods The study used the 2014 Ghana Demographic and Health Survey with a sample of 2746 sexually active youth (males = 670 and females = 2076) aged 15–24. We used multivariate logistic regression to analyse the data. Results Our results showed that female youth in urban areas and those from the wealthiest households were less likely to initiate early sexual debut. Additionally, youth resident in urban areas from rich households are less likely to initiate early debut. However, a 3-way interactive effective revealed that female youth resident in urban areas from rich households were found to be more likely to initiate early debut. Conclusion Our findings underscores that gender-based sexual and reproductive health interventions and programmes may be more appropriate for adolescent females in rich households living in urban areas. These intervention should reach these teenagers before they start engaging in sexual intercourse