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Objective: This study used the Geographic Intelligent Systems to examine the location of cervical cancer screening (CCS) facilities and their proximity to the residential location of Women Living with HIV (WLWH) and how they could influence WLWH CCS behaviors. Methods: We used deidentified existing data from Komfo Anokye Teaching Hospital (KATH) on WLWH and geocoded them to their community of residence as points using Google Earth Pro version 7.3.0. Transport fares from KATH to communities identified in the screening database were also obtained. The location of KATH was digitized from google earth and validated from the GIS database from the Remote Sensing and GIS application Laboratory, University of Ghana. We calculated distances and other proximity information between each point from the KATH. We used the spatial-analytical tool of kernel density for the density analysis and fitted a smoothly tapered surface using Esri’s ArcGIS Desktop 10.8. We performed Shapiro-Wilk normal distribution test to assess the significance of the clustering. Results: Data on 708 WLWH’s residential locations and transportation fares were analyzed. We find a significant clustering near KATH. Close to 50% cluster within 5km from KATH whiles 85.8% of the respondents live within 10.2 km from KATH. Shapiro-Wilk normality test shows W=0.30221, p-value < 0.05. The minimum cost per commercial transportation is approximately GHC 2.00 (US dollar ~ $0.26 whiles those living beyond 3-5 km will pay approximately GHC 3.00 (~$0.39). The highest cost payable by the farthest distance using a commercial bus is GHC 50.00. (~$ 6.00). The majority of respondents will pay about GHC 10.00 (~$1.50) for transportation (i.e., round trip) to access SCC facilities. Conclusions: In an economy where a family lives on less than $2.00 per day, any additional cost resulting from transportation will likely create CCS hesitancy and that self-sampling may be a recommended solution.

This study reviewed the design and deployment of relational geodatabase on mobile GIS application, using collector for ArcGIS and survey 123 for ArcGIS platforms for COVID-19 contact tracing in Ghana during the lockdown. The study assessed whether cases spread by physical neighborhood contacts, defined by a 2km buffer of initial known 60 cases location. The application was deployed on the android tablet, which was used by field workers. Application Post-deployment review shows that from 30th March to 4th April 2020, 828 samples were collected with 34 confirmed cases, of which 61% occurred outside the 2km buffer. From 1-30 April 2020, 8,748 individuals with 16,087 contacts were tested within the physical neighbourhoods, 2.4% turned positive. Similarly, 7,501 individuals with 17,071 contacts were tested outside the physical neighbourhoods with 4.3% positives. Results suggest that more infections occurred outside the case’s physical neighbourhoods possibly due to; (1) existence of unknown cases prior to lockdown; (2) cases were moving outside their physical neighborhood and infecting others; (3) panic movements of cases within the 3 days window between announcement and enforcement of lockdown; (4) movement of cases into the country through unapproved routes. New cases were identified outside the lockdown areas, which could not be explained. This study raises questions about (1) the understanding of the mode of spread of the virus (2) the implementation of the lockdown, including the geographic coverage and timing. It is recommended that future decisions on contact tracing and lockdown should be guided by an understanding of the disease geography.

We describe the use of integrated geospatial applications for the provision of access to timely and accurate data on samples, visualisation of Spatio-temporal patterns of cases and effective communication between field sample collectors, testing laboratories, Regional Health directors and Government Decision Makers.This study describes how an integrated geospatial platform based on case location and intelligence was developed and used for effective COVID-19 response during the initial stages of COVID-19 in Ghana.Collector for ArcGIS, ArcGIS Survey123.successful development and deployment of integrated geospatial applications and analytics.The Collector for ArcGIS app was customised to collect COVID-19 positive cases location information. Survey 123 was introduced as a COVID-19 contact tracing application to digitise the case-based forms and provide real-time results from the laboratories to GHS and other stakeholders. The laboratory backend allowed the testing laboratories access to specific information about each patient (sample) collected by the fieldworkers. The regional supervisors' backend web application provided accessing test results for confidentiality and timely communication of results.Geospatial platforms were successfully established in Ghana to provide timely results to Regional Health Directors and Government decision-makers. This helped to improve the timeliness of response and contact tracing at the district level.The development and deployment of the application, COVID-19 pandemic response and writing workshop by the Ghana Field Epidemiology and Laboratory Training Programme (GFELTP) was supported with funding from President Malaria Initiative - CDC, and Korea International Cooperation Agency (on CDC CoAg 6NU2GGH001876) through AFENET and the United States Agency for International Development (USAID) through Results for Development (R4D).

Flooding is one of the most destructive climatic hazards which has affected agricultural activities in the world, especially Sub-Saharan Africa. This article investigated the impact of the recurrent annual floods on food production and how subsistent farmers have adapted to resultant food insecurity in the Sudan Savannah agroecological zone of Ghana. The specific objectives of the study were to understand the nature of flooding (frequency, period and extent of coverage of flood water), how the perennial floods contribute to food insecurity, how farmers adapt to it to contribute towards policy development on flood control and improve food security. Primary data were collected using questionnaires, interviews, focus group discussions and field observation. Secondary data were obtained from documents and reports from NADMO and MOFA. The questionnaires were analyzed using Statistical Package for Social Science and the focus group discussions, interviews, and fieldwork were analyzed manually using content analysis. The findings show that the study areas experience floods every year. Between 2007 and 2018, eleven floods event occurred in the study communities. The floods usually occur around August and September when rainfall is torrential coupled with overflow from the spillage of the Bagre dam upstream. The flooding has resulted in a decline in food production among subsistent farmers. As a result, households in study communities are food insecure. Farmers have learned to cope with floods/food insecurity by engaging in alternative livelihoods such as flood recession farming, dry season farming, petty trading. They have also employed other means such as rationings of food and social networks cope with food insecurity. In all these strategies, women play a critical role as they are largely in charge of food preparation and dishing. The study recommends strengthening of the alternative livelihoods, introduction of short maturing crop varieties, sensitisation of women on the preparation of healthy meals.

BackgroundIn an era of the global pandemic and social media dominance, trying to control the narrative on COVID-19 has been a challenging task for most governments particularly with news about the disease on various social media platforms. There have even been instances where people have sent false information about the number of confirmed cases, precautionary measures, drugs that boost the immune system which can threaten the lives of some users who are accessing this false information and misconceptions.Method This study analyzed spatial differences in Twitter misinformation on COVID-19 across 16 regions of Ghana by scraping 1,167 tweets from Twitter using API access. A total of 514 tweets were analyzed. The data were categorized into three namely; accurate information, misinformation, and other information. ResultsThe study results show that 72% of the tweets were accurate, 14% were misinformation and 14% represented other information. Among the regions, Greater Accra had the highest number of accurate information (45 tweets), and the Upper West Region recording the highest number of misinformation (12 tweets).ConclusionSpatial monitoring and management of information dissemination are useful for target setting and achievement of direct results in terms of diffusing misinformation and propagating accurate information. We, therefore, recommend official usage of Twitter for COVID-19 information dissemination as this usage will help offset possible misinformation from unformed individuals.

Background: Adolescent health has assumed greater significance globally since adolescents bear a considerable proportion of the global disease and injury burden. Thus investing in their health can yield substantial benefit. Community surveys are useful tools for identifying the needs of adolescents and promoting their health. Objective: This study was part of a medical education programme with the objective of identifying health and social problems of adolescents living in Korle Worko, a suburb of Accra, Ghana. Methods: This cross-sectional study was conducted in 2015 using structured questionnaires which were administered to 729 heads of households and 228 adolescents. Weight and height measurements were performed on the adolescents, while key informant interviews were also conducted among community elders and adolescents. Community mapping and pair-wise matrix construction were done. The data was summarized using SPSS and Geographic Information Systems. Results: The most commonly reported health complaints of adolescents were stomach ache, common cold, skin rashes, sadness or crying a lot, lack of concentration and hearing problems or earache. Asthma was the most common chronic diseases reported. Whereas 22.7% of the females were either overweight or obese, 7.4% of the males were overweight or obese and the difference was statistically significant (p=0.002). The spatial pattern of alcohol use correlates with drug abuse, suggesting that adolescent risky behaviour may be influenced by antisocial behaviour in the community at large. Conclusion: Over-nutrition, under-nutrition, abdominal, respiratory and mental health problems were prominent findings in this study. Therefore, adolescent health services should target these diseases. Additionally, efforts at preventing lifestyle related risk factors should also target the areas of influence within the community.

The main objective of the study was to identify high flood risk zones in AMA. The study also used questionnaires to assess local knowledge on what accounts for the high flood risk in their community. Spatial analysis techniques were used to model flood risk based on the following contributory factors; land cover, soil, drainage density, topography and proximity to rivers. The results show that high flood risk areas covered 46.3km2(20%), moderate risk area, 72.9km2(31.6%), low risk area 41.5km2(18%) and very low risk areas, about 6.7km2(2.9%). The high flood risk zones were low-lying areas below 50 meters above sea level and closely associated with poor drainage systems. People perceived not just low-lying areas as a paramount reason accounting for flooding but also very bad waste disposal habit of the public. These offsets the efforts of waste management companies to keep drains free of refuse.

The essential role played by urban vegetation in making urban areas livable is often overlooked in many developing cities. This is the case of Ghana where its capital, Accra is developing at the expense of urban vegetation. This study was conducted at the metropolitan area of Accra to estimate how the extent of vegetation cover has changed in the period of 1986-2013, using remote sensing satellite data from Landsat TM and ETM+. Furthermore, views of key informants were assessed on changes in the livability of the city of Accra which may be attributed to loss of urban green vegetation in the city. It was found that between 1986 and 2013, 42.53 km2 of vegetation was lost representing 64.6% of total vegetation in 1986. The rate of change in vegetation cover between 1986 and 1991 measured around 2.14% of the total land area annually. This however, reduced in the subsequent years measuring 0.26% between 2002 and 2008. Key informants interviewed, also believe that the loss of vegetation in the city creates livability concerns relating to ecosystem functioning, temperature rise and air quality. It is therefore recommended for urban planners and decision makers to address three critical concerns of resilience, sustainability and livability, which are the missing links in the city development agenda.

The two most important factors constantly impinging on the net movement of shorelines are erosion and accretion. This study analyzed the role of erosion and accretion in shoreline changes along the coast between Cape Coast and Sekondi in the central and western regions of Ghana, respectively. Aerial photographs, satellite images, and topographical maps were used. In addition, field survey using Global Positioning System (GPS) was conducted at selected locations due to the unavailability of satellite image for 2013. Shoreline change analysis was conducted using Digital Shoreline Analysis Systems based on End Point Rate formula. In addition, community interactions were also conducted to get first-hand information from the local inhabitants. The study finds that the shoreline under study has been fluctuating. The sea advanced inland between 1972 and 2005, which is attributed mainly to intense erosion. The study further reveals that, in the past five years, the shoreline had been retreating mainly due to increased accretion. It is recommended that the shoreline under study should be monitored regularly to keep abreast with net movements that will occur in either the short term or the long term so as to factor the net effect into the management of the coastal zone.

HPV vaccines are efficacious in preventing HPV related cancers. However, the vaccination uptake in Ghana is very low. Studies that utilize theoretical frameworks to identify contributory factors to HPV vaccination uptake in Ghana are understudied. We used multi-theory model (MTM) constructs to predict initiation and completion of HPV vaccination series in Ghanaian adolescents. Adolescents (n = 285) between the ages of 12 and 17 years old were recruited from four selected schools in Ghana to participate in the cross-sectional study. Linear regressions were used to analyze the data. Most participants were female (91.2%) and senior high school students (60.0%). Many of the participants had neither heard about HPV (92.3%) nor HPV vaccinations (95.4%). Significant predictors of adolescents&rsquo, likelihood of getting the first dose of HPV vaccination were perceived beliefs and change in a physical environment (p &lt, 0.001), with each variable accounting for 6.1%and 8.8% of the variance respectively. Significant predictors of adolescents&rsquo, likelihood of completing HPV vaccination recommended series were perceived beliefs, practice for change, and emotional transformation (p &lt, 0.001), with each variable accounting for 7.8%, 8.1%, and 1.1% of the variance respectively. Findings underscore important opportunities for developing educational interventions for adolescents in Ghana to increase the HPV vaccination uptake.

The optimal management of water resources requires that the collected hydrogeological, meteorological, and spatial data be simulated and analyzed with appropriate models. In this study, a catchment-scale distributed hydrological modeling approach is applied to simulate water stress for the years 2000 and 2050 in a data scarce Pra Basin, Ghana. The model is divided into three parts: The first computes surface and groundwater availability as well as shallow and deep groundwater residence times by using POLFLOW model; the second extends the POLFLOW model with water demand (Domestic, Industrial and Agricultural) model; and the third part involves modeling water stress indices—from the ratio of water demand to water availability—for every part of the basin. On water availability, the model estimated long-term annual Pra river discharge at the outflow point of the basin, Deboase, to be 198 m3/s as against long-term average measurement of 197 m3/s. Moreover, the relationship between simulated discharge and measured discharge at 9 substations in the basin scored Nash–Sutcliffe model efficiency coefficient of 0.98, which indicates that the model estimation is in agreement with the long-term measured discharge. The estimated total water demand significantly increases from 959,049,096 m3/year in 2000 to 3,749,559,019 m3/year in 2050 (p

In recent years, land use (LU) and landscape structure in ecoregions around the world have been faced with enormous pressures, from rapid population growth to urban sprawl. A preliminary account of changes in land cover (LC) and landscape structure in the ecoregions of Ghana is missing from the academic and research literature. The study therefore provides a preliminary assessment of the changing LU and landscape structure in the ecoregions of Ghana, identifying the causes and assessing their impact on land-based resources, and on urban and agricultural development. LU/LC maps produced from 30 m resolution Landsat TM5 in 1990 and ETM+ in 2000 were classified into dominant land cover types (LCTs) and used to survey the changing landscape of Ghana. LC-changemap preparation was done with change detection extension “Veränderung” (v3) in an ArcGIS 10.1 environment. At the class level, Patch Analyst version 5.1 was used to calculate land use (LU) statistics and to provide landscape metrics for LU maps extracted from the satellite imagery. The results showed that commonly observed LCCs in the ecoregions of Ghana include conversion of natural forest land to various forms of cultivated lands, settlements, and open land, particularly in closed and open forest and savannah woodland. The dominant LU types in the ecoregions of Ghana are arable lands, which increased by 6168.98 km2. Forest and plantation LCTs decreased in area and were replaced by agricultural land, forest garden, and open land. Afforestation rarely occurred except in the rainforests. The mean patch size (MPS), ameasure of fragmentation, was generally reduced consistently from 1990 to 2000 in all the ecoregions. Similar results that indicated increased fragmentation were an increased number of patches (NumP) and the Shannon diversity index (SDI). Habitat shape complexity inferred from mean shape index (MSI) decreased in all ecoregions except for rainforest and wet evergreen. The SDI and Shannon evenness index (SEI) showed that habitat diversity was highest in the coastal savannah and the deciduous forest ecoregions. The main drivers of changes in the LUs and landscape structure are demand for land and land-based natural resources to support competing livelihoods and developmental activities in the different ecoregions.

This chapter explores which community-based technologies have the greatest potential for reducing poverty and vulnerability among many smallholder farmers in Ghana. To this end, the stochastic dominance test was applied to rank outcomes from the different technologies used by the smallholder farmers in the study area. To show the effect of the technology on smallholder farmers’ income, propensity score matching was used to test for differences in income of technology adopters and non-adopters. Based on the findings of the study, we conclude that the dominant technologies that have the potential to reduce smallholder farmers’ level of poverty and marginality are: inorganic fertilizers for Afigya-Kwabre; zero tillage for Amansie-West; storage facilities for Atebubu-Amantin; marketing facilities for Kintampo South; improved varieties for Gonja East; and pesticides for the Tolon Districts.

Coastal towns along the coast of Africa are among the most vulnerable to climate change impacts such as flooding and sea level rise. Yet, because coastal conditions in many parts of the region are poorly understood, knowledge on which population groups are at the most risk is less known, particularly in the Greater Accra Metropolitan Area (GAMA) of Ghana, where the capital city Accra is located. Without adequate information about the risk levels and why, the implementation of locally appropriate adaptation plans may be less effective. This study enriches our understanding of the levels of flood risks along the coast of GAMA and contributes knowledge to improve understanding of place-specific adaptation plans. The study uses data from a 300-household survey, stakeholder meetings, and interviews with local community leaders to construct an integrated vulnerability index. The index includes seven components made up of: dwelling type; house and house environment; household socioeconomic characteristics; experience and perception of flood risk; household and community flood adaptation strategies; house location, and physical characteristics. Our findings show that exposure to floods, particularly from local flash floods is relatively high in all communities. However, significant differences in sensitivity and adaptive capacity of the communities were observed due to differences in location, socioeconomic characteristics, and perception of risks to flooding and sea level rise. The complexity of factors involved in the determination of local-level vulnerability requires that the implementation of adaptation strategies needs to involve cross-sectorial partnerships, involving local communities, in building a comprehensive multi-risk adaptation strategy.

To the street hawker, it is a means of making a living but to the managers of the metropolis, street hawking is a menace. These differences in perception have led to a game plan tied to spatio-temporal diurnal traffic regimes. While the city authorities plan may be to evict the street hawkers, the plan of the hawkers is to outwit the city authorities through make-shift hawking patterns in order to make a living. The difference in the two positions can be characterized by the city manager’s need for clean and less congested city streets, and the hawker’s desire to sell wares at locations that maximize income. The factors contributing to street hawking include traffic congestion, profitability, the lack of employable skills and minimal-capital entry requirement into the hawking trade. While the city needs proper spatial planning in the long run, in the short term, city managers and hawkers must develop a relationship that considers public perceptions and the use of public space to make the Accra metropolitan area livable. This calls for new approaches that address the aesthetic and open space needs while at the same time meeting the socio-economic and survival needs of city dwellers and new immigrants.

Floods have become localised and unpredictable, hence the need for local level assessment to improve smallholder farmers' resilience and strengthen their capacity to adapt. This study investigated the degree of smallholder farmers' vulnerability to floods in Tolon District, Ghana. The study revealed that a farmer's location is the principal determinant of flood vulnerability. Floods in study communities are the result of continuous heavy rainfall over days, causing floods near river valleys and low-lying areas. Households in Communities of Tampia and Kpalisogu-Kura, which are closer to the White Volta River are highly vulnerable compared to Yoggu and Kpalgun, which are inland. Also planning towards reducing farmers' losses from floods in the study communities is negligible. This is attributed to limited knowledge, financial and material resources to adapt. Addressing flood vulnerability must consider improving adaptive capacities of smallholder farmers in food production, processing and craft work, and providing financial and technical assistance.