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Background: Globally, childhood diarrhea is a major public health concern. Despite numerous interventions that have been put in place to reduce its incidence over the years, childhood diarrhea remains a problem and is the fourth leading cause of child mortality in Ghana. This study examined the predictors of diarrhea among children under the age of five in Ghana. Methods: Data from the 2014 Ghana Demographic and Health survey, a cross-sectional survey, was used for the purpose of this study. A total of 2,547 children under the age of five were included in this study. Logistic regression analysis was performed to establish the factors associated with childhood diarrhea and ascertain explanatory variables. Results: The prevalence of diarrhea was 11.7%. Male children (13.4%) and those living in rural areas (12%), particularly in the Brong Ahafo region (17%) recorded the highest prevalence of diarrhea. Children aged 6 to 35 months of age, maternal age and education, sex of children and region of residence were the predictors of diarrhea among children under the age of five years in this study. Conclusion: To lessen the prevalence of diarrhea among children under five in Ghana, existing interventions must be evaluated in the context of the predictors identified. Based on observations deduced from this study, the Ministry of Health, Ghana Health Service and other health regulatory agencies should intensify monitoring and awareness in the various regions, particularly in the transition and savannah zones on the causes, risk factors, and methods of preventing diarrhea in children under five. Various stakeholders including government and non-governmental organizations should take into account the predictors of diarrhea identified in the design of interventions to effectively reduce morbidity and mortality associated with childhood diarrhea. [ABSTRACT FROM AUTHOR]

Background: Under-five mortality (U5M) rates are among the health indicators of utmost importance globally. It is the goal 3 target 2.1 of the Sustainable Development Goals that is expected to be reduced to at least 25 per 1000 livebirths by 2030. Despite a considerable reduction in U5M observed globally, several countries especially those in sub-Saharan Africa (SSA) like Ghana are struggling to meet this target. Evidence-based targeting and utilization of the available limited public health resources are critical for effective design of intervention strategies that will enhance under-five child survival. We aimed to estimate and map U5M risk, with the ultimate goal of identifying communities at high risk where interventions and further research can be targeted.Methods: The 2014 Ghana Demographic and Health Survey data was used in this study. Geostatistical analyses were conducted on 5884 children residing in 423 geographical clusters. The outcome variable is child survival status (alive or dead). We employed a geostatistical generalised linear mixed model to investigate both measured and unmeasured child specific and spatial risk factors for child survival. We then visualise child mortality by mapping the predictive probability of survival.Results: Of the total sampled under 5 children, 289 (4.91%) experienced the outcome of interest. Children born as multiple births were at increased risk of mortality with an adjusted odds ratio (aOR) (aOR: 8.2532, 95% CI: [5.2608-12.9477]) compared to singletons. Maternal age increased risk of mortality (aOR: 1.0325, 95% CI: [1.0128-1.0527]). Child's age (aOR: 0.2277, 95% CI: [0.1870-0.2771]) and number of children under 5 within each household (aOR: 0.3166, 95% CI: [0.2614-0.3835]) were shown to have a protective effect. Additionally, mothers with secondary education level (aOR: 0.6258, 95% CI: [0.4298-0.9114]) decreased the risk of U5M. The predicted U5M risk in 2014 was at 5.98%. Substantial residual spatial variations were observed in U5M.Conclusion: The analysis found that multiple births is highly associated with increased U5M in Ghana. The high-resolution maps show areas and communities where interventions and further research for U5M can be prioritised to have health impact. [ABSTRACT FROM AUTHOR]

Background: Child marriage is a human rights violation disproportionately affecting girls in lower- and middle-income countries and has serious public health implications. In Ghana, one in five girls marry before their 18th birthday and one in 20 girls is married before her 15th birthday. This paper uses a unique dataset from Northern Ghana to examine the association between child marriage and adverse outcomes for women among a uniquely vulnerable population.Methods: Baseline data from on ongoing impact evaluation of a government-run cash transfer programme was used. The sample consisted of 1349 ever-married women aged 20-29 years from 2497 households in the Northern and Upper East regions of Ghana. We estimated a series of ordinary least squares (OLS) and logistic regression models to examine associations of child marriage with health, fertility, contraception, child mortality, social support, stress and agency outcomes among women, controlling for individual characteristics and household-level factors.Results: Child marriage in this sample was associated with increased odds of poorer health, as measured by difficulties in daily activities (OR = 2.08; CI 1.28-3.38 among women 20-24 years and OR = 1.58; CI 1.19-2.12 among women 20-29 years), increased odds of child mortality among first-born children (OR = 2.03; CI 1.09-3.77 among women 20-24 years) and lower odds of believing that one's life is determined by their own actions (OR = 0.42; CI 0.25-0.72 among women 20-24 years and OR = 0.54; CI 0.39-0.75 among women 20-29 years). Conversely, child marriage was associated with lower levels of reported stress (regression coefficient = - 1.18; CI -1.84--0.51 among women 20-29 years).Conclusions: Child marriage is common in Northern Ghana and is associated with poor health, increased child mortality, and low agency among women in this sample of extremely poor households. While not much is known about effective measures to combat child marriage in the context of Ghana, programmes that address key drivers of early marriage such as economic insecurity and school enrolment at the secondary level, should be examined with respect to their effectiveness at reducing early marriage.Trial Registration: Registered in the Registry for International Development Impact Evaluations (RIDIE) on 01 July 2015, with number RIDIE-STUDY-ID- 55942496d53af . [ABSTRACT FROM AUTHOR]