Information Sharing and Decision-Making: Attempts by Ghanaian Return Migrants to Enter through Libya

This article examines the relationship between irregular migration, access to information and migration decisions. Using semi-structured interviews of thirty irregular return migrants who failed to reach their European destinations through Libya, I show that irregular return migrants from Ghana rely predominantly on interpersonal sources, including colleagues, neighbors, friends and relatives, for information on migration. Return migrants seek information from those who have relevant experience with that kind of migration. Existing research focuses on information from ‘formal’ sources such as traditional print media, social media, library or workshops. Here I argue that this focus on access to information conceals the activities and practices of irregular return migrants who perceive European destinations as ‘greener pastures’ and seek information to travel through dangerous routes. Most irregular return migrants interviewed in this study indicated they had access to information from ‘informal’ sources often shared as ‘jokes.’ Although irregular return migrants perceive the information they gather through their everyday activities as reliable, their interactions involve complex and unstructured social processes

Transformining Customary System in Ghana: Women's Participation in Small-Scale Gold Mining Activities in the Talensi District

The overall goal of my interdisciplinary dissertation research in social work and anthropology is to explore how the socio-economic roles of women involved in the Talensi small-scale gold mining activities in Ghana produce opportunities and challenges for them. In the context of women’s work in the Talensi small-scale gold mining industry in Ghana, I investigate: 1) the intersection between women’s expected socio-economic roles in the mining activities and the Talensi social organization; 2) women’s rights to the mining resources (income, land, mining pits, and houses); and 3) women’s response to the challenges of gender roles and rights to mining resources. This research examines the intersection of women’s participation in the Talensi small-scale gold mining industry in Ghana, and the benefits and challenges of the mining activities. It is based on 12 months of fieldwork in the Talensi small-scale gold mining communities between 2014 and 2015. I used ethnographic methods of semi-structured interviews with female and male workers and other community members and leaders; participants’ observation of the organization of gold production activities; focus group discussions; and archival materials, to collect and analyze the data. I have focused my research and scholarship on exploring the everyday practices of women involved in the male-dominated small-scale gold mining activities. This research provides a micro-level view of Talensi women’s everyday experiences in the small-scale gold mining industry. I provide a theoretical framework for rethinking how the informal space of the small-scale gold mining industry offers opportunities for womenand, at the same time, undergirds the negotiations women make between the idealized gender relationships within the larger social organization and everyday practices. Overall findings from this research indicate that women are becoming key players in the gold mining industry. Still, gender roles that women experience in Talensi households shape gender roles in the mining industry. Limitations placed on women’s roles in the mining industry constrain them from enjoying the full benefits of that industry, relative to men, such as women’s inability to access and own mining pits and engage in tasks that yield high economic rewards. However, women in the mining industry are resisting unfair treatment relating to their gender, such as organizing collective activities that favor their interests, forming social networks for welfare and savings through rotating credit and savings schemes, or simply “stealing” gold rocks to add to their wages. These findings suggest three recommendations: 1) policy interventions promoting gender-specific resources to support women in the work organization; 2) analysis, evaluation, and intervention for the organization of small-scale informal economies; and 3) policy and intervention for women’s economies that recognize and incorporate programs with transformational capacity to redefine the normative practices that shape women’s lives.PHDSocial Work & AnthropologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttps://deepblue.lib.umich.edu/bitstream/2027.42/138706/1/nanambra_1.pd

Key factors leading to reduced recruitment and retention of health professionals in remote areas of Ghana: a qualitative study and proposed policy solutions

Background: The ability of many countries to achieve national health goals such as the Millennium Development Goals remains hindered by inadequate and poorly distributed health personnel, including doctors. The distribution of doctors in Ghana is highly skewed, with a majority serving in two major metropolitan areas (Accra and Kumasi), and inadequate numbers in remote and rural districts. Recent policies increasing health worker salaries have reduced migration of doctors out of Ghana, but made little difference to distribution within the country. This qualitative study was undertaken to understand how practicing doctors and medical leaders in Ghana describe the key factors reducing recruitment and retention of health professionals into remote areas, and to document their proposed policy solutions. Methods: In-depth interviews were carried out with 84 doctors and medical leaders, including 17 regional medical directors and deputy directors from across Ghana, and 67 doctors currently practicing in 3 regions (Greater Accra, Brong Ahafo, and Upper West); these 3 regions were chosen to represent progressively more remote distances from the capital of Accra. Results and discussion: All participants felt that rural postings must have special career or monetary incentives given the loss of locum (i.e. moonlighting income), the higher workload, and professional isolation of remote assignments. Career 'death' and prolonged rural appointments were a common fear, and proposed policy solutions focused considerably on career incentives, such as guaranteed promotion or a study opportunity after some fixed term of service in a remote or hardship area. There was considerable stress placed on the need for rural doctors to have periodic contact with mentors through rural rotation of specialists, or remote learning centers, and reliable terms of appointment with fixed end-points. Also raised, but given less emphasis, were concerns about the adequacy of clinical equipment in remote facilities, and remote accommodations. Conclusions: In-depth discussions with doctors suggest that while salary is important, it is career development priorities that are keeping doctors in urban centers. Short-term service in rural areas would be more appealing if it were linked to special mentoring and/or training, and led to career advancement

Using Photovoice to Illuminate Challenges Facing Children with Disabilities in Inclusive Education in Ghana.

Achieving inclusive and quality education for all children remains a significant problem amidst several policies in sub-Saharan Africa. This study explores challenges facing children with disabilities in mainstream inclusive education-based basic schools in a sub-Saharan Ghanaian context. A qualitative photovoice approach was employed to highlight the experiences of six (6) pupils with disabilities. Findings revealed three main themes: unfriendly environments, inaccessible physical structures, and lack of assistive equipment, reflecting significant challenges confronting children with disabilities in inclusive education settings. Social support from colleagues without disabilities, however, acted as a major coping resource for pupils with disabilities. The study has implications for policy a

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways