Idiosyncratic shocks, risk management and welfare dynamics in rural Ghana

International Development, Risk and Uncertainty,

Purchasing for high-quality care using national health insurance: evidence from Zambia

Improving the quality of care is essential for progress toward universal health coverage. Health financing arrangements offer opportunities for governments to incentivize and reward improvements in the quality of care provided. This study examines the extent to which the purchasing arrangements established within Zambia's new National Health Insurance can improve equitable access to high-quality care. We adopt the Strategic Purchasing Progress and the Lancet Commission for High-Quality Health Systems frameworks to critically examine the broader health system and the purchasing dimensions of this insurance scheme and its implications for quality care. We reviewed policy documents and conducted 31 key-informant interviews with stakeholders at national, sub-national, and health facility levels. We find that the new health insurance could boost financial resources in higher-levels of care, improve access to high-cost interventions and improve care experiences for its beneficiaries as well as integrate the public and private sectors. Our findings also suggest that the health insurance will likely improve some aspects of structural quality but may not be able to influence process and outcome measures of quality. It is also not clear if health insurance will improve efficiency in service delivery, and whether benefits realized will be distributed in an equitable manner. These potential limitations are attributable to the existing governance and financial challenges, low investments in primary care, and shortcomings in the design and implementation of the purchasing arrangements of health insurance. Although Zambia has made progress in a short span, there is a need to improve its provider payment mechanisms, and monitoring and accounting for higher quality of care

Appraisal of some methods of weed control during initial establishment of cocoa in a semi-deciduous forest zone of Ghana

In appraising the effects of the quantum and quality of weed control required in establishment of young cocoa, six manual methods of controlling weeds were compared with chemical weed control at two stations of the Cocoa Research Institute of Ghana. Growth of cocoa seedlings after 2 years in the field was superior (P < 0.05) in plots which were clean-weeded two or four times per year or treated with paraquat four times per year than when plots were slashed two or four times per year. There was strong evidence to suggest that treatments which ensured a weed-free environment to the cocoa over a long period were favourable to girth increments in the seedlings. Death of seedlings during establishment was generally lower in plots which were either clean-weeded or treated with paraquat. Labour requirement for controlling weeds with paraquat was considerably lower than that required for the other treatments. Considering the equipment and chemical input, paraquat application was expensive compared to high slashing with or without clean-line weeding two times a year, or clean weeding two times a year; but by virtue of its efficacy, it is recommended for cocoa establishment. En évaluant les effets du quatum et de la qualité de désherbage exigé dans la culture de jeune cacao, six méthodes de désherbage manuel étaient comparées avec le désherbage chimique à deux stations de l'Institut de Recherche en cacao du Ghana. La croissance de semis de cacao, après deux années, dans le champ était supérieure (P £ 0.05 ) dans les lots qui étaient complètement désherbés 2 ou 4 fois/an ou traités avec le paraquat 4 fois/an que dans les lots qui étaient entaillés 2 ou 4 fois/an. Il y avait de nombreuses preuves qui laissent penser que les traitements qui assuraient un environnement sans mauvaise herbe pour le cacao sur une longue période étaient favorables aux augmentations de circonférence des semis. La mort de semis pendant la culture était dans l'ensemble plus faible dans les lots, qui étaient soit complètement désherbés soit traités avec le paraquat. L'exigence de main-d'oeuvre pour maîtriser les mauvaises herbes avec le paraquat était considérablement plus faible que celle exigée pour les autres traitements. En ce qui concerne les matériels et les intrants chimiques, l'application de paraquat était chère que les entailles élevées avec ou sans le désherbage complet en ligne deux fois par an ou le désherbage complet deux fois par an mais en vertu de son efficacité il est recommandé pour la culture de cacao. Ghana Journal of Agricultural Science Vol. 40 (1) 2007: pp. 67-7

Effects of Maturity of Coconut Shells on Gold Adsorption Efficiencies of Derived Activated Carbons

AbstractCoconut shells are used as precursors for preparation of activated carbons. The shells could vary in terms of their maturity. The influence of the maturity of the shells on gold adsorption efficiencies of derived activated carbons (ACs) from gold di-cyanide solution was investigated. The shells were pyrolysed at 900 ºC and the resulting chars were activated in steam at the same temperature for different durations. Assessment of the properties of the derived ACs revealed that; the hardness, gold adsorption capacities and rates of gold adsorption of the ACs depended on the maturity of the shells. The more matured the shells the harder the AC. The relative hardness and gold adsorption rates of the mature coconut shells activated carbons, HMand RM, respectively and those of the less mature shells, HLand RL, respectively were in the order of HM &gt;HL and RM &gt;RL. The relative hardness of the ACs derived from the more mature and less mature shells after 3 hrs activation were 99.3% and 94.0%, respectively and the gold adsorption rates were 5.78 mg Au/hr/gand 4.95 mg Au/hr/g, respectively. The adsorption rates and relative hardness depended on the duration of activation, where longer activation times resulted in increase in the adsorption rates and a decrease in relative hardness of the derived ACs. Keywords: Adsorption, Activated Carbon, Coconut Shells, Maturity, Relative Hardnes

Health insurance coverage in low-income and middle-income countries: progress made to date and related changes in private and public health expenditure

INTRODUCTION: Several low-income and middle-income countries (LMICs) have implemented health insurance programmes to foster accessibility to healthcare and reduce catastrophic household health expenditure. However, there is little information regarding the population coverage of health insurance schemes in LMICs and on the relationship between coverage and health expenditure. This study used open-access data to assess the level of health insurance coverage in LMICs and its relationship with health expenditure. METHODS: We searched for health insurance data for all LMICs and combined this with health expenditure data. We used descriptive statistics to explore levels of and trends in health insurance coverage over time. We then used linear regression models to investigate the relationship between health insurance coverage and sources of health expenditure and catastrophic household health expenditure. RESULTS: We found health insurance data for 100 LMICs and combined this with overall health expenditure data for 99 countries and household health expenditure data for 89 countries. Mean health insurance coverage was 31.1% (range: 0%-98.7%), with wide variations across country-income groups. Average health insurance coverage was 7.9% in low-income countries, 27.3% in lower middle-income countries and 52.5% in upper middle-income countries. We did not find any association between health insurance coverage and health expenditure overall, though coverage was positively associated with public health spending. Additionally, health insurance coverage was not associated with levels of or reductions in catastrophic household health expenditure or impoverishment due to health expenditure. CONCLUSION: These findings indicate that LMICs continue to have low levels of health insurance coverage and that health insurance may not necessarily reduce household health expenditure. However, the lack of regular estimates of health insurance coverage in LMICs does not allow us to draw solid conclusions on the relationship between health insurance coverage and health expenditure

Role of small-scale enterprises in agricultural development agendas: Insights from oil palm processing enterprises in the Kwaebibirem District of Ghana

Small-scale oil palm processing enterprises are important avenues of rural employment and livelihoods, but often receive little attention at the policy level. These enterprises are usually characterized as having 'poorly maintained structures', 'very inefficient operations', 'outside the formal economy' and production of 'low quality palm oil'. This article investigates the innovation capacity of small-scale oil palm processing enterprises and their relevance for the development of the oil palm industry in Ghana. The article uses a bottom-up innovation approach through a joint experimentation and profitability analysis, together with a researcher-managed experiment, to help processors learn how to produce quality palm oil and analyse different market options. Findings indicate that, the small-scale processors are capable of experimenting to acquire the knowledge and innovation needed to support agricultural development. The way to go, therefore, is not to 'exclude' these enterprises from the development blueprint, but to assist them build capacity through a bottom-up innovation approach, which integrates science and practice, as well as multistakeholders

Plant-parasitic nematodes associated with sweet potato rhizosphere soil in the Semi- Deciduous Forest and Coastal Savannah Zones of Ghana

A survey was conducted in nine major sweet potato producing districts across the semi-deciduous forest and coastal savannah zones of Ghana to determine the prevalence of plant-parasitic nematodes parasitizing the crop. Soil samples were collected at 90-days after planting from the rhizosphere of sweet potato crop and analysed using Modified Baermann tray method from 100 farms across the study area. Seven plant-parasitic nematode genera were extracted from soil samples collected and morphologically identified under a microscope with four of them, namely Meloidogyne, Pratylenchus, Rotylenchulus, and Helicotylenchus being the most prevalent. Scutellonema sp. occurred in 89% while Tylenchus sp. occurred in 33% of the districts sampled. The ring nematode, Criconemella sp. was found in only two of the nine districts covered; Ketu North and Akatsi South which incidentally recorded 100% of the seven nematodes encountered in the survey. The abundant nematode was Meloidogyne sp. which represented 39% and Criconemella, the least (0.1%) of the total nematodes recovered in the survey. This study has shown that high diversity, incidence and density of economically important plant-parasitic nematodes are associated with sweet potato crop. Development of appropriate management strategies to mitigate the negative effects of plant-parasitic nematodes on sweet potato is recommended. &nbsp

An Econometric Analysis of the Relationship between Gdp Growth Rate and Exchange Rate in Ghana

This study attempts to examine the relationship between GDP growth rate and exchange rate in Ghana from the period 1980 to 2012. The paper employs the graphing of the scatter diagram for the two variables which are GDP growth rate and exchange rate, establishes the correlation between GDP growth rate and exchange rate using the Pearson’s Product Moment Correlation Coefficient (PPMC) and finally estimates the simple linear regression using OLS. Further tests were performed to test for the presence of autocorrelation, heteroscedasticity and multicollinearity. Autocorrelation and heteroscedasticity were found to be absent.  From our analyses, we strongly conclude that there is a positive relationship between GDP growth rate and exchange rate in Ghana which confirms to the theory that undervaluation (high exchange rate) stimulates economic growth in the short run. Therefore, policy makers should stabilise monetary and fiscal policies in the long run. Keywords: GDP growth rate, Exchange rate, Ordinary Least Square

A Two-Dimensional Chebyshev Wavelet Method for Solving Partial Di erential Equations

In this paper, we introduce a two-dimensional Chebyshev wavelet method (TCWM) for solving partial di erential equations (PDEs) in L2(R) space. In this method, the spatial variables appearing in the PDE each has its own kernel, as well as wavelet coecient for approxi- mating the unknown solution of the equation. The approximated solu- tion of the equation is fast and has higher number of vanishing moments as compared to the Chebyshev wavelet method with only one wavelet coecient for two or more separated kernels for the variables appearing in the PDE

PEComa of the Upper Extremity: A Unique Case and Description of an Initial Response to Neoadjuvant Chemotherapy

Purpose. Tumors of the perivascular epithelial cell tumor (PEComa), first described in 1992, represent a rare soft tissue neoplasm of varying malignant potential. Cases of PEComa have been previously described in a few somatic and visceral sites, most notably in the gastrointestinal tract, genitourinary tract, and one extremity case in the thigh. To date, most malignant cases of PEComa have been resistant to chemotherapy, and as such, an appropriate therapy is not known. Case report. Here we describe the first case of PEComa of the upper extremity. Open biopsy revealed a high-grade malignant lesion, and the patient subsequently underwent both neoadjuvant therapy with doxorubicin, ifosfamide and mensa, and radiation therapy prior to wide surgical resection. After six cycles of chemotherapy, the tumor underwent an 80% reduction in size. Subsequent neoadjuvant radiation therapy of 5000 cGy did not further reduce the size of the tumor. Following limb sparing radical resection, pathology showed 20% necrosis within a high-grade malignant lesion. Twenty one months after beginning treatment, the patient shows no sign of local recurrence, but metastatic disease was confirmed after resection of a lung nodule. Conclusion. Given the favorable albeit partial response seen in this patient, the course of therapy outlined here may represent a good starting point for neoadjuvant treatment in a tumor with a historically bleak prognosis. In addition, the diagnosis of PEComa must now be entertained in the differential diagnosis of upper extremity soft tissue sarcoma