Search

Settlement expansion and commercial agriculture affect landscape sustainability and ecosystem service provision. Integrated landscape approaches are promoted to negotiate trade-offs between competing land uses and their reconciliation. Incorporating local perceptions of landscape dynamics as basis for such negotiations is particularly relevant for sub-Saharan Africa, where most people depend on natural ecosystems for livelihoods and well-being. This study applied participatory scenario building and spatially explicit simulation to unravel perceptions of the potential impact of rubber and settlement expansion on the provision of selected ecosystem services in southwestern Ghana under a business-as-usual scenario. We collected data in workshops and expert surveys on locally relevant ecosystem services, their indicator values, and the probable land-use transitions. The data was translated into an assessment matrix and integrated into a spatially explicit modeling platform, allowing visualization and comparison of the impact on ecosystem service provision of land-use scenarios under rubber plantation and settlement expansion. The results show the capacity of current (2020) and future land-use patterns to provide locally relevant ecosystem services, indicating a decline in capacity of ecosystem service provisioning in the future compared to the 2020 land-use patterns, a threat to the benefits humans derive from ecosystems. This highlights urgent need for policies and measures to control the drivers of land-use/land-cover change. Furthermore, the results emphasize the importance of diversifying land-use/land-cover types for sustainable landscape development. The paper contributes new insights into how spatially explicit and semi-quantitative methods can make stakeholder perceptions of landscape dynamics explicit as a basis for implementing integrated landscape approaches. [ABSTRACT FROM AUTHOR]

In a landscape, perceptions can influence people's actions and behavior toward natural resource use. Improving landscape governance, therefore, requires understanding the different concerns of stakeholders operating within the landscape. This paper analyzes the perceptions of local stakeholders—local landscape users, practitioners engaged in conservation and sustainable resource use, and private actors—regarding the landscape governance system, using the Q-methodology to identify common concern entry points for the implementation of a landscape approach in the Western Wildlife Corridor (WWC) in northern Ghana. To this end, individual interviews and focus groups were conducted with local communities and organizations operating in three Community Resource Management Areas (CREMAs). They identified destructive livelihood activities, constrained livelihoods, and a weak governance system as the main challenges, and the need to balance livelihoods with conservation, strengthening landscape governance through the CREMA initiative, and awareness raising as the main solutions. Thus, the Q-method allowed identifying common concern entry points regarding landscape challenges, governance issues, and potential solutions. I argue that consensus among stakeholders regarding these challenges and solutions could lay the groundwork for a multi-stakeholder process in the area, which could help foster the implementation of an integrated landscape approach in the WWC landscape. It is crucial to support the livelihoods of local people to reduce pressures on natural resources. It is also important to strengthen the functioning of local CREMA management bodies with technical, logistical, and financial support. Implementing a participatory monitoring and evaluation mechanism is critical in this regard. [ABSTRACT FROM AUTHOR]

Background: This study assessed knowledge, behaviors, and perceptions towards hypertension following community dissemination on cardiovascular disease (CVD) risk within the Navrongo Health and Demographic Surveillance Site in Northern Ghana. Methods: A cross-sectional mixed methods study was conducted among middle aged men and women following education on CVD and their risk factors. Knowledge and attitudes of participants regarding hypertension were measured in 310 participants using a survey tool and the resultant data was analyzed with descriptive statistics. Focus group discussions (FDG) were used to assess perceptions of 40 study participants on their lived experiences with hypertension. Recorded interviews were transcribed verbatim and coded into themes using Nvivo 12 software before thematic analysis. Results: Of the 310 surveyed participants, 54% were women and the mean age was 50 ± 6 years. The results showed that 84% of participants had heard about hypertension, 70% knew it was an increase in blood pressure and could be caused by excess salt intake, poor diet and physical inactivity. About 22.3% of participants were aware of the had hypertension. In terms of management, majority of the participants were aware that hypertension could be treated with antihypertensive medication and that untreated or uncontrolled hypertension could result in adverse health consequences. Few participants had ever had their blood pressure measured and did not access screening or healthcare care services and rather perceived the health system as inadequate to screen, and manage hypertension. Conclusion: Though, knowledge on hypertension was high, awareness of hypertension status and access to screening and healthcare services was low. Community beliefs and perceptions strongly influence treatment, and control of hypertension. Effective sustained community dissemination efforts addressing misperceptions could improve hypertension treatment and control. [ABSTRACT FROM AUTHOR]

Introduction: Scabies is an underdiagnosed skin infestation caused by the Sarcoptes scabiei mite. The infection causes severe itching and a skin rash but can be effectively treated using topical or systemic drugs. Scabies outbreaks are commonly reported in resource‐poor countries, including Ghana. Traditional healers play an important role in primary care in rural areas. The role of these traditional healers in the management of scabies has so far not been explored. The aim of this study was therefore to investigate the perceptions of traditional healers regarding the causation and management of scabies. Methods: A phenomenological qualitative approach was employed. Traditional healers in the Asante Akim North and Central districts in Ghana were approached with an interview request. Using a semi‐structured interview protocol, 15 traditional healers were interviewed. The results were coded and analysed, after which seven themes were extrapolated. Results: Scabies infections were frequently reported by traditional healers. Itching and skin rash were unanimously regarded as the major symptoms of scabies. The majority acknowledged the infectious nature of scabies, but no participant reported the causative organism. A dichotomous disease classification was noted, consisting of 'natural' and 'spiritual' variants each with a unique disease profile and management requirements, as reported by the traditional healers. All but two traditional healers reported to treat scabies using almost exclusively herbs and spiritual rituals. Conclusion: The majority of traditional healers were open to collaboration with allopathic healthcare providers. Collaboration could broaden the primary care network in rural areas, but mistrust and lack of transparency form potential barriers to collaboration. We, therefore, emphasise the need for additional efforts to investigate strategies for future collaboration. [ABSTRACT FROM AUTHOR]

Despite the crucial role of human labour in Ghana's cocoa farming sector, the industry grapples with pressing challenges that threaten its sustainability and productivity. This study considers the intricate dynamics of labour scarcity and rising costs, focusing on the Tafo District, Ghana. We specifically collected data from 100 cocoa farmers who have been farming for over 20 years in the Tafo District using the purposive sampling method, and selected 10 cocoa labourers using a snowball technique. We conducted a descriptive analysis of the data using SPSS and Excel spreadsheet. Labour scarcity, attributed to 'galamsey'1 and 'okada'2activities, was acknowledged by 95% of respondents, and 84% noted high labour costs. Farmers pointed out that labour shortages affect the timing and frequency of their farm operations. With labour scarcity attributed to illegal mining and commercial motorcycle transportation, effective government intervention to regulate these activities in agricultural areas will be required. [ABSTRACT FROM AUTHOR]

Rapid urbanization has become a more prevalent reality in our cities, posing complex challenges to the surrounding environmental systems. As the built environment surges, ecological lands that are essential to cities' sustainability are displaced by other land uses such as residential. This has implications for the sustainability of these ecologically sensitive areas. Employing a mixed research approach, and case studying three communities; including Ahinsan, Ayigya, and Danyame in the Greater Kumasi Metropolis, this study explored local perceptions and attitudes on the sustainable functional roles of ecologically sensitive areas in the Greater Kumasi Metropolis of Ghana from a socio-economic purview. Overall, the study divulges that city residents generally have relatively positive perceptions towards ecologically sensitive areas, however, their attitudes towards these ecologically sensitive areas are negative. This study conclusively answered questions vis-à-vis the functions of ecologically sensitive areas, the effects of human activities on the sustainability of these ecologically sensitive areas, and theperceptions and attitudes of city residents toward these ecologically sensitive areas. Further studies are needed to appraise the fate of effective land use planning and environmental sustainability in cities' political economy. [ABSTRACT FROM AUTHOR]

This paper seeks to gain insights into teachers' perceptions, and readiness to integrate information and communication technology (ICT) tools in mathematics instruction. A mixed-methods approach was employed, involving surveys and interviews with a sample of high school mathematics teachers. The study involved 90 mathematics teachers working in three senior high schools in Kumasi metropolis in Ghana. The study revealed that teachers generally hold positive perceptions of the benefits of ICT tools in mathematics teaching. They strongly agree that ICT tools enhance students' understanding of mathematical concepts and improve their engagement and motivation in mathematics classes. Teachers also recognize the potential of ICT tools in promoting problem-solving skills and providing opportunities for differentiation and personalized learning. However, opinions regarding student-centered learning, exploration, and creativity through ICT tools were more varied, suggesting a need for further investigation and support in these areas. In addition teachers expressed the need for continuous training on specific tools, curriculum alignment, and assessment methods. [ABSTRACT FROM AUTHOR]

The majority of literature on cervical cancer (CC) and cervical cancer screening (CCS) focused on women all over the world. However, research has indicated that men's involvement in CCS can lead to improved health outcomes for women. Despite this, there is limited information available in the literature regarding men's attitudes toward CCS. This highlights the need for further study on the subject to increase understanding and improve outcomes. The purpose of this study was therefore to explore the perceptions and attitudes toward partners' support for CCS among married men from the Adentan Municipality. An exploratory descriptive qualitative approach was used in the study to explore the perceptions of married men about male involvement in CCS. Thirty-four married men were purposively selected to be part of the interviews. A semistructured interview guide was used to collect data, which were recorded. The tape-recorded data were reproduced verbatim, and content analysis was carried out to generate the themes and subthemes. Three themes and nine subthemes were constructed from the data analysis. The study revealed that the perceptions of males about cervical cancer had a positive or a negative influence on women's behaviors toward CCS. It was interesting that some men constantly reminded their wives to participate in CCS. However, some barriers to men's support included fear of trauma to the wife's vagina during screening and concerns about exposure to the wife's nakedness. It was therefore recommended that healthcare facilities should roll out sustainable programs and policies to involve men in CC prevention. In addition, health workers should devise innovative ways to make male involvement in CCS more attractive to men. [ABSTRACT FROM AUTHOR]

Recent years have witnessed a growth in research on urban green spaces given their significance to human wellbeing and environmental management. This paper explores the perceived health benefits of urban green areas by drawing on the experiences of 95 participants sampled from three urban communities in the Kumasi Metropolis of Ghana. It is a qualitative study employing a cross-sectional design. The paper argues that participants' perceptions straddle physical and non-physical dimensions of health. From the physical perspective, the participants revealed that green spaces improved physical activity and reduced incidence of cardiovascular diseases and high blood pressure. The non-physical health benefits included improved attention, reduced stress and positive emotions such as happiness. The findings of this paper call for broad-based multi-sectoral approach to managing green spaces in urban Ghana. [ABSTRACT FROM AUTHOR]

The advent and development of technologies such as artificial intelligence have created benefits and challenges for educational stakeholders. Artificial intelligence, such as OpenAI's Chat Generative Pre-trained Transformer (ChatGPT), has brought new benefits, challenges and pressures for higher educational institutions. There are relatively few reports of how students perceive and intend to use ChatGPT. Taking cognizance of these, the research explored students' perceptions and intentions to use ChatGPT in their higher education. Guided by two hypotheses and a mixed-method approach, the analysis revealed no statistical relationship between perception and intention to use ChatGPT. Despite this statistical relationship, the study reported students' positive perceptions towards ChatGPT, and intentions to use ChatGPT and advocated its adoption in education. Based on these findings, the study offers implications for educational practices and further research. [ABSTRACT FROM AUTHOR]

Overweight/obesity (OW/OB) rates are increasing in Ghana. This study aims to identify the predictors of OW/OB in women, men, and at the household level (having at least one person as OW/OB in the household) in rural Ghana and examine local perceptions of the consequences of having an OW/OB person in the household. This was a cross-sectional mixed methods study. The quantitative data was a secondary analysis of the baseline data from the LinkINg Up (LU) project; a nutrition-sensitive agriculture intervention in eight rural communities in the Eastern Region of Ghana (ClinicalTrials.gov NCT03869853). The sample included 331 women and 205 men, 19-90 years old; there were 196 households that had both a participating woman and man (spouse, son, brother, or father). Logistic regression was used to assess variables associated with OW/OB in women (n=322), men (n=205), and households (n=196). Exposure variables included age, social support, mental health, self-efficacy, food security, the other family members' OW/OB status, and others. Qualitative data included six focus group discussions (FGDs) (three with women and three with men, aged 22-69 years and recruited from the comparison arm of the LU project) were conducted in February-March 2022 in three of the eight project communities. A structured guide and a body figure instrument were used. The FGD recordings were translated and transcribed from Krobo to English. The analysis used an inductive thematic approach. Both women and men's OW/OB were positively associated with age and wealth. Women's OW/OB was negatively associated with age squared, and the score for mental health symptoms. Men's OW/OB was negatively associated with being Krobo compared to other ethnicities. Households in the highest wealth tertile were 2.5-fold more likely to have at least one person who is OW/OB as compared to households in a lower wealth tertile. Participants expressed positive social consequences of having an OW/OB person for their families (for example respect). A person's size was concerning only when it affected one's ability to farm or make money, which would harm the household unit (for example lead to food insecurity, children dropping out of school). Having money was seen as a modifier for the negative effects. No negative consequences were perceived for OW people. The implications of the interruption of an OB person's work on their family are worrisome and call for interventions that address poverty and food insecurity along with nutrition. [ABSTRACT FROM AUTHOR]

Improving productivity of cocoa farms while ensuring forests sustainability through cocoa agroforestry is increasingly gaining the attention of policy makers. Using data from cocoa farmers in rural areas of Southern Ghana, the present study analyzes farmer perceptions on economic and ecological benefits of cocoa agroforestry shade levels with non-parametric tests, and economic performance of cocoa agroforestry shade levels with a cost-benefit modeling approach. The results from the study show that apart from market forces, farmers' ecological perceptions play a crucial role in the establishment of agroforestry shade levels. There is also evidence to suggest that the medium shade cocoa agroforestry has a higher economic performance. Policies that promote awareness creation and increase knowledge on cocoa agroforestry shade levels are essential ingredients for forest sustainability in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

China features significantly in the Covid-19 narrative for good and bad reasons. The purpose of this paper is to test, empirically, the assumption that Covid-19 would negatively influence perceptions of China in Ghana, due to its perceived relationship with the pandemic. We characterise Chinese manufactured products as soft power resources and analyse the role they play in addressing the personal needs and interests of Ghanaians and how they affect positive and negative perceptions of China amid the Covid-19 pandemic. We used a mixed research method and collected data from a sample size of 1,020 for analysis. We found that Ghanaians are rational actors who maximise the perceived gains of their actions in pursuit of their objectives. Thus, the self-interest and personal satisfaction Ghanaians gain through China's manufactured products outweigh the negative representation of China in the Covid-19 narrative, shaping a positive attitude in Ghana towards China. We situate the argument within rational choice theory. [ABSTRACT FROM AUTHOR]

In the housing industry in Ghana, wood treatment is often done using water-borne preservatives. Common examples of preservatives include Acid Copper Chromate (ACC), Chromated Copper Arsenate (CCA), and Chlorpyrifos (Dursban). It is important to know that good wood preservatives must be available on the market to ensure the quality of wood products in the Ghanaian housing industry. It is not enough that the preservative is efficient; it ought to be popular on the market. However, the popularity of a preservative may not necessarily portray its popularity. The main purpose of this study was to identify the most and least popular water-borne wood preservatives (Dursban, CCA, and ACC) in use and also determine any possible associations between woodworkers' views concerning the most and least popular water-borne wood preservatives used in the housing industries and demographic status. An analytic sample of 199 participants was included in our study using a cross-sectional descriptive survey design. The results suggest that woodworkers rated Dursban as the most popular (65 %), CCA least popular (52 %), and ACC unsure (37 %). More specifically, young adults (74 %), secondary educated (84 %), carpentry speciality (86 %), and over two years experienced (88 %) woodworkers rated Dursban the most popular water-borne wood preservative used in the housing industry. However, young adults (56 %), secondary educated (59 %), carpentry specialists (59 %), and over two years experienced woodworkers (60 %) rated CCA the least popular water-borne wood preservative use in the housing industry. Further, we observed significant associations between participants' education, profession, and experience with their perceptions of widespread water-borne wood preservatives used in the Ghanaian housing industry. Our study has implications for research, practice, and policy. [ABSTRACT FROM AUTHOR]

One of the fast-growing major non-communicable diseases (NCD) that poses a danger to global public health is Diabetes mellitus (DM). Trends in the incidence of DM indicate a disproportionate increase in developing countries due to current rapid demographic transitions from traditional to more westernized and urbanized lifestyles. Knowledge of DM is vital for curbing or control. The objectives of this study were to evaluate the level of knowledge and awareness of DM among the Ho municipality general population, identify areas of deficiency for targeted health education efforts, and identify respondent characteristics that may be associated with knowledge of diabetes. A survey involving 132 respondents (age over 18 years) was conducted in the Ho municipality of the Volta region of Ghana. A 42-item pre-tested questionnaire was administered to participants to evaluate general and specific knowledge and awareness of DM. The Pairwise Multiple Comparison and Fisher's Exact tests were used to test the hypotheses and associations between the respondents' knowledge level and groups respectively. Of the 132 respondents, 22% were in the age range of 40-46 years; 72.7% were female. Mean over all diabetes knowledge composite score was poor: 32.99% (CI; 27.5, 38.5). Respondents performed best in the symptoms section: mean score was 36.247% (CI; 29.0, 43.4); and worst in the section on complications: mean score was 30.909% (CI; 23.6, 38.2). In multiple linear regression analyses, education level, older age, own self having diabetes, and having a family member/relative/friend with diabetes were significantly associated with knowledge of diabetes. Knowledge of diabetes among the inhabitants of Ho municipality respondents was interpreted as being inadequate 32.99% (CI; 27.5, 38.5). Some deficient portions and factors associated with knowledge of diabetes were identified. Relevant information for targeted health education programs in Ghana and beyond may be considered as one of such benefits of these findings. [ABSTRACT FROM AUTHOR]

Aim: To assess the perception of nursing students on medical errors. Design: A descriptive cross‐sectional survey. Method: Data were collected from March–April 2019 in a university in Ghana from two hundred (200) students using simple random sampling and analysed with SPSS version 21. Results: Mean age of respondents was 22.64 years. Medication error was perceived as the most common medical errors (MEs; 76%). Negligence was perceived as the most common cause of MEs (80.5%); nurses and doctors (84.5%–89.5%) were considered as staff who make most MEs. Respondents perceived that students commit MEs due to less knowledge about procedures (79%) and inadequate supervision (77%) in the clinical setting. Conclusion: Medication errors were observed as the most common of MEs that can affect patients' safety. Taking prudent measures in addressing this can reduce MEs in health facilities. Enhanced supervision and effective ways of teaching drug administration are recommended. [ABSTRACT FROM AUTHOR]

Background: This study explored cultural and community perceptions of optimal diet for maternal and child health in northern Ghana. Methods: This was an exploratory cross-sectional study using qualitative methods for data collection. Data were collected between March and April 2019 consisting of 10 focus group discussions with men and women community members between 18 and 50 years in the Kassena-Nankana districts of Ghana. Data were organised using QSR NVivo 12 qualitative software to facilitate thematic analysis. Results: All study participants recognised the importance of an optimal diet for mother, child and better pregnancy and breastfeeding outcomes. However, there were different cultural beliefs and taboos about what foods are healthy and non-healthy for women at different stages of the reproductive period. Foods perceived to be unhealthy for pregnant women were fatty foods and fresh meat (uncooked or unprocessed meat) due to the belief that they can lead to delivery complications, which many women feared. In addition, some participants relayed the cultural belief that pregnant woman should not eat eggs because it would make the child a thief. Lactating mothers are not to eat foods such as vigna subterranean known locally as bambara bean and "gari" (local meal made from cassava) because it is believed to inhibit breastmilk production. Participants emphasised that food insecurity and economic constraints meant women could not achieve optimal diet and could not afford to be selective in food choices. Conclusion: Community members recognized the importance of optimal nutrition but were constrained by poverty and cultural barriers. A dual approach which targets improvements of local food production and economic empowerment in combination with community-based discussion and education of the impacts of food taboos on health, should facilitate improvement in the diets of women and future generations. [ABSTRACT FROM AUTHOR]

Background With increasing orientation towards including pregnant women in clinical trials, investigators must conduct culturally acceptable research to aid recruitment and retention. There is limited information on experiences and meanings that pregnant women make of trial participation in Africa. This study reports experiences and perceptions of Ghanaian pregnant women regarding their participation in a clinical trial. Methods From October to December 2012, 45 in-depth interviews were conducted among pregnant women and their male partners regarding their experiences and perceptions of clinical trial processes as part of an antimalarial drug safety and efficacy trial in pregnant women in the Ashanti region of Ghana. Analysis was by predetermined themes and inductive analysis. Results Familiarity with the disease studied in the trial and trust in health workers favoured participation with the latter underlying acceptance of study drugs in the absence of symptoms. Adverse drug events were perceived as intrinsic sickness exhibited on the path to wellness. There were no cultural barriers to blood sampling during home visits but hospital-based sampling was preferred. Home visits were linked to participants having HIV infection. Conclusion This study contributes knowledge on sociocultural matters underpinning pregnant women's decisions regarding trial participation in an era of increasing drug trials involving pregnant women. [ABSTRACT FROM AUTHOR]

This study investigated students' perception of plagiarism, sources of information on plagiarism, attitude towards plagiarism, reasons for acts of plagiarism and knowledge of the consequences of plagiarism. A quantitative approach was used. Data was gathered using survey from a sample size of 319 graduate students of University of Ghana, selected using the stratified sampling technique. The main data collection instrument was the questionnaire and the data were analysed descriptively. Findings showed a universal awareness of plagiarism with lecturers as their major source of information. Students generally had a basic understanding of the concept of plagiarism but have broadened the concept of plagiarism to encompass other forms of academic dishonesty. Although they believed they have control over plagiarism, they still plagiarized. Reasons for plagiarising included poor academic writing skills, laziness, lack of time management skills, poor understanding of plagiarism, ease of downloading other people's work from the Internet and pressure to succeed. The study creates awareness of plagiarism and its consequences, and facilitates increased knowledge, and understanding of the subject among students. It also adds to knowledge and serves as an additional source of reference to researchers and students in this area of study. [ABSTRACT FROM AUTHOR]

This paper seeks to measure farmers' perceptions on climate variations, and examine the effects of such variations on cassava production in Ghana. Using a three-stage sampling technique involving cluster, stratified, and simple random sampling techniques, structured questionnaires were administered to 252 smallholder cassava farmers in the Awutu Senya District of the Central Region, Ghana. This was supplemented with focus group discussion sessions with male and female cassava farmers for the purpose of triangulating the quantitative and qualitative data. The study showed an overwhelming 98% of respondents, comprising 57% males, and 43% females, acknowledging to have noticed changes in the weather patterns over the last 30 years. While 85% of respondents said rainfall was decreasing, 75% said the rains did not come at the expected time, with 58% of them saying reduced rainy periods were the noticeable changes. Respondents attributed the changes in weather patterns to environmental degradation (72%), natural phenomenon (15%), and punishment by God (1%). Majority of them (97%) said they had suffered from decreasing yields in cassava as a result of seasonal variations in temperature and rainfall. The paper makes a strong case for activities that will bridge the knowledge-and-skill gap between male and female farmers. [ABSTRACT FROM AUTHOR]

The importance of cassava in the food system of Ghanaians cannot be underestimated. Research and development systems have released 25 new cassava varieties. The adoptions of these varieties have been low. The study explores factors that induce farmers to use improved cassava varieties in Ghana. The study used data from 450 cassava farmers and employed multinomial logistic model. The results revealed that apart from the farm and farmer characteristics such as farm size, distance, age and gender, perception of cassava characteristics had strong influence on the use of improved cassava varieties. Perception of disease resistance, perception of longevity in-soil and high yielding had effect on adoption of improved cassava varieties. Institutional factors including awareness, field demonstrations and extension visit significantly affected adoption. The importance of strengthening and resourcing research institutions and extension services to promote and create awareness about the existing improved cassava varieties is vital. [ABSTRACT FROM AUTHOR]

Climate change has diverse physical and socio-economic implications for communities in semi-arid areas. While several studies have sought to understand the underlying power relations that shape adaptive capacities of rural farmers, fewer studies have focused on unpacking the differences within the different social groups. In this paper, we present a case study based on women smallholder farmers from semi-arid Ghana. It explores their nuanced perceptions of climate variability and highlights how gender intersects with other identities, roles and responsibilities to influence adaptation strategies and barriers to adaptation in the semi-arid context. Farm-level data was collected from 103 women farmers using semi-structured interviews, focus group discussions and key informant interviews. Rainfall patterns were perceived by the women farmers to be increasingly erratic and perceptions of average temperatures were that they are increasing. Adoption of adaptation strategies were influenced by socio-demographic factors such as age, marital and residential status, which also influenced decision-making and power dynamics within the household. The paper highlighted the complex relationships that mediate women farmers' access to resources and influence their vulnerability to climate variability and change. Highlighting the intra-gender differences that shaped the adaptation options and adaptive capacity is a prerequisite for proper adaptation policy planning and targeting. [ABSTRACT FROM AUTHOR]

Introduction: kaolin is a type of clay consumed mostly by women especially pregnant women of which the act of clay eating is termed geophagy. Different people use this type of clay for diverse purposes. Notwithstanding, most Ghanaians consume this clay out of cravings, taste and smell. There have been some attendant problems with the consumption of clay especially by pregnant women. This research sought to assess the mineral and microbial contents of kaolin and address the perceptions of pregnant women on geophagy. Methods: this study employed a cross-sectional convenient sampling method to sample 217 pregnant women and sellers of clay (Ayilo). A face-to-face interview was conducted to administer a structured questionnaire to respondents. Mineral and microbial analyses were also conducted on the ore of the kaolin mined from Anfoega in the Volta Region of Ghana using standardized procedures. Results: results from this study suggests geophagy prevalence of 48.4% (n=217) among pregnant women in the Ho municipality of Ghana. Results obtained also suggest smell and taste of the clay, influenced the consumption by these pregnant women to a large extent. Strikingly, majority of the respondents had no knowledge on the adverse health implications clay consumption had on the human body. The physiological state of pregnancy also cause many to use it to treat nausea, other accompanying discomfort and in some instances to quench their hunger. Traces of Lead, Nickel and Arsenic were found in the clay. Common microorganisms ident ified were Bacillus, Pseudomonas, Mucor and Aspergillus spp. Conclusion: geophagy is a common practice among pregnant women living in the Ho municipality in the Volta region, Ghana. Most of them consumed it for varied reasons. Although there are beneficial minerals, accumulated effects of these heavy metals can lead to various complications in pregnancy. The clay also contained pathogenic microorganisms. These pathogens have a whole range of deleterious effects on the human body ranging from gastrointestinal infections to cancer and so may not be safe to consume clay products from Anfoega, Ghana. [ABSTRACT FROM AUTHOR]

• Gold mining has been pivotal to Ghana's development. • There is lack of empirical attention on environmental policymaking. • We employ the use of Q-sort methodology to quantitatively analyze qualitative perspectives. • We find three shared perspectives among stakeholders. • We provide the implications of the results for future research in developing countries. Gold mining might have contributed to socio-economic development in Ghana, but it has also exacerbated incidences of environmental degradation and fostered associated human rights violations within local communities. As a result, the government of Ghana has sought to address the incidences of environmental degradation related to mining by formulating and implementing a wide range of environmental policies. However, the extent to which these environmental policies have been effective remains debatable. This problem has been attributed to the fact that the views of critical stakeholders were either neglected or received inadequate attention in the design and implementation of environmental policies. Consequently, drawing on empirical evidence from fieldwork in Ghana, and based on Q-methodology, this paper seeks to understand areas of agreements and disagreements among critical stakeholders as a way to improve environmental policy development and implementation. The paper identifies the politics of blaming, regulatory disjuncture and stakeholder expectation dissonance as areas of disagreements within stakeholder views that might also explain the ineffectiveness of environmental policy development and implementation within Ghana's gold mining industry. Similarly, based on the Q-sort factor analysis, the paper synthesizes three perspectives that critical stakeholders believe, if adhered to, could enhance the effectiveness of environmental policies within Ghana's gold mining sector. The paper concludes by considering the implications of its findings for environmental policy development and implementation in developing countries. [ABSTRACT FROM AUTHOR]

Background: One of the maternal health care strategies identified by the World Health Organization as being crucial for saving lives of pregnant women, which also serves as an indicator for progress in reducing maternal mortality, is the provision and utilization of skilled birth care. Despite the importance of skilled birth care in preventing maternal morbidity and mortality, many women continue to give birth at home without the assistance of skilled birth attendants in rural communities of Ghana. Purpose: The purpose of this study was to explore the cultural beliefs that potentially influenced the choice of home births among rural women in Ghana. Methods: A qualitative approach was utilized to conduct this study. Twenty participants who delivered at home were purposefully selected and interviewed individually. Semistructured interviews were used to explore the cultural belief patterns that potentially influenced the choice of home births among women in rural Ghana. Thematic analysis approach was used to analyze the data. Results: Four major themes emerging from the data analysis which influenced rural women's decision to give birth at home are namely: opportunity to access psychological support through family members, opportunity to access culturally acceptable food, opportunity to adopt a birthing position of choice, and opportunity for safe and culturally accepted disposal of placenta. Conclusion: This study concluded that the cultural beliefs held by these women greatly affected their decision to deliver at home. Hence, there is a need for health care managers to facilitate collaborative practices between the skilled birth attendants and traditional birth attendants. This is because this approach could enhance the integration of the cultural beliefs and practices of women in the orthodox health care delivery system to facilitate the utilization of skilled birth care. [ABSTRACT FROM AUTHOR]

Abstract: Small‐quantity lipid‐based nutrient supplements (SQ‐LNS) have been studied in efficacy and effectiveness trials, but little is known about how parents perceive the products and their effects. In a randomised trial in Ghana, efficacy of SQ‐LNS provided to women during pregnancy and the first 6 months postpartum and to their children from 6 to 18 months of age was assessed by comparison with iron‐folic acid (IFA) capsules and multiple micronutrient (MMN) capsules provided to women. In a follow‐up study conducted when the index children from the original trial were between 4 and 6 years of age, we used survey‐based methods to assess retrospective and current parental perceptions of nutrient supplements generally and of SQ‐LNS and their effects compared with perceptions IFA and MMN capsules. Most parents perceived that the assigned supplements (SQ‐LNS, IFA, or MMN) positively impacted the mother during pregnancy (approximately 89% of both mothers and fathers) and during lactation (84% of mothers and 86% of fathers). Almost all (≥90%) of mothers and fathers perceived that the assigned supplement positively impacted the index child and expected continued positive impacts on the child's health and human capital into the future. A smaller percentage of parents perceived negative impacts of the supplements (7%–17% of mothers and 4%–12% of fathers). Perceptions of positive impacts and of negative impacts did not differ by intervention group. The results suggest that similar populations would likely be receptive to programs to deliver SQ‐LNS or micronutrient capsules. [ABSTRACT FROM AUTHOR]

Abstract Considering the inherently hazardous nature of some artisanal fishing and farm work in Ghana, there is sometimes a thin line between what is considered child work and child labour. I drew on literature exploring cultural relativism and human rights and the concept of the margin of appreciation in considering whether child labour violates human rights. I aimed to establish parental perceptions of child labour and human rights in rural and urban Ghana amongst 60 government officials, NGO representatives, and both parents whose children were/were not involved in child labour. The average age of participants was 31 years. Semistructured interviews were conducted with parents (10), stakeholders (10), focus groups (30); and participant observation techniques (10) utilised to gather the needed data and purposively sampled across rural areas (Ankaase, Anwiankwanta and Kensere), and urban areas (Jamestown, Korle Gonno and Chorkor) in Ghana. Interviews were recorded, transcribed utilising a framework approach as the main data analysis method. The paper finds that children are engaged in work to teach them work ethics as most parents consider work socialisation as beneficial for children and society. The paper also finds that knowledge of human rights makes parents more committed to children's welfare. Overall, the paper finds that sensitivity to the economic and cultural context is important in understanding the issue of child labour and, more generally, in applying the United Nations Convention on the Rights of the Child (UNCRC) and working out the parenting policies and practices that are in the best interests of the child. [ABSTRACT FROM AUTHOR]

Wa, a fast growing municipality in Ghana, is at the first stage of the urban environmental transition where most of the environmental problems tend to occur within or close to the home, including the management of human faecal matter. This study examined the state of faecal matter management in Wa. A stratified sample of residential areas and a systematic sampling of households were employed for the selection of respondents and data was collected using questionnaire survey and key informant interviews. The results indicate that 52% of households in the municipality do not have their own toilet facilities and open defecation appears to be an acceptable practice for them. Surprisingly, public perception about faecal matter handling generally indicates that there are no dangers posed by exposure to humans. The finding suggests a considerable demand for improvements in the management of faecal matter but efforts to improve the situation might be thwarted by misconceptions of the risks posed by exposure to humans. Local government authorities need to re-engineer their efforts of providing a liveable environment by developing a regulatory framework that incorporates subsidies for the construction of household toilets and enforcement of sanitation bye-laws. [ABSTRACT FROM AUTHOR]

This study assesses the extent to which employee perceptions of organisational politics influence their commitment in the public sector of Ghana. Three standard scales were adopted for generating data for the study namely; perceptions of organisational politics scale, employee commitment questionnaire and the political behaviour scale. Data were processed using the IBM Statistical Product and Service Solution's Version 19.0. The partial least squares structural equation modeling was used to measure the relationship between organisational politics and employee commitment. The mediating effect of political behaviour on this relationship was also measured using the same partial least squares structural equation modeling. A sample of 120 employees was selected from the Wenchi Municipal Assembly for the study. The results of the study indicate that employee perceptions of organisational politics have a positively significant relationship with their commitment in the public sector in Ghana. It was therefore recommended for management to reconsider the individual, group and organisational circumstances that generate perceived organisational politics in order to curtail any unwanted political behaviour in the Assembly. [ABSTRACT FROM AUTHOR]

There are less favourable attitudes towards inclusion of children with disabilities in Ghana as a result of historical assumptions concerning Persons With Disabilities (PWDs). These assumptions are cultural beliefs which look down upon persons with disabilities, leading to either the exclusion of PWDs from mainstream schools or including them adversely; for instance, when they are provided with separate facilities which sometimes are not conducive for learning. Using Ghana as an example, the study examined challenges children with disabilities face in mainstream schools as well as perspectives on disability. The study utilised qualitative method of research mainly in-depth interviews and social model of disability, advanced by Mike Oliver as an underpinning research technique theory. The study found that children with disabilities mostly face challenges such as discrimination from their colleagues, teachers, and non-teaching staff in the school. Also, government does not adequately plan for children with disabilities by way of policies and programmes. The number of special education teachers in the mainstream educational facilities are inadequate, and the few available teachers seem to lack the competence to properly impart knowledge to them to ensure the development of their potentials. Besides, findings indicated that, the understanding of the word “disabled” and its explanation associated with cultural beliefs cause and worsen disability in these group of children denying them their rights. These challenges indicate that, children with disabilities educational needs were not properly taken care of and the system does not help them to benefit from education. The study therefore recommends the need to re-orient people’s thoughts and their beliefs towards children with disabilities to reduce or eliminate the challenge they encounter in schools and in the larger society. [ABSTRACT FROM AUTHOR]

This study examines university students’ perceptions of the Ghana police service in contrast with general population studies that explain citizens’ attitudes toward the police. Two research questions guided this study: (1) What are university students’ perceptions of the police? and (2) What factors influence university students’ perceptions of the police? Using data collected from one large university in Ghana between the months of December 2012 and February 2013, the study found several intriguing findings. First, students have moderate trust in the Ghana police. Second, students critically evaluated police procedural fairness and effectiveness. Multivariate regression models revealed that vicarious experiences of police corruption, marital status, level of education, and ethnicity predicted students’ trust in the police as well as influenced their perceptions of fairness and effectiveness. Policy implications of the findings are discussed. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization recommends community case management of malaria and pneumonia for reduction of under-five mortality in developing countries. Caregivers' perception and understanding of the illness influences the care a sick child receives. Studies in Ghana and elsewhere have routinely shown adequate recognition of malaria by caregivers. Similarly, evidence from Asia and some African countries have shown adequate knowledge on pneumonia. However, in Ghana, little has been documented about community awareness, knowledge, perceptions and management of childhood pneumonia particularly in the Dangme West district. Therefore this formative study was conducted to determine community perceptions of pneumonia for the purpose of informing the design and implementation of context specific health communication strategies to promote early and appropriate care seeking behaviour for childhood pneumonia.Methods: A mixed method approach was adopted. Data were obtained from structured interviews (N = 501) and eight focus group discussions made up of 56 caregivers of under-fives and eight community Key Informants. Descriptive and inference statistics were used for the quantitative data and grounded theory to guide the analysis of the qualitative data.Results: Two-thirds of the respondents had never heard the name pneumonia. Most respondents did not know about the signs and symptoms of pneumonia. For the few who have heard about pneumonia, causes were largely attributed to coming into contact with cold temperature in various forms. Management practices mostly were self-treatment with home remedies and allopathic care.Conclusion: The low awareness and inadequate recognition of pneumonia implies that affected children may not receive prompt and appropriate treatment as their caregivers may misdiagnose the illness. Adequate measures need to be taken to create the needed awareness to improve care seeking behaviour. [ABSTRACT FROM AUTHOR]

Objective: This study assessed the perception of risk of cervical cancer and existence of risk factors for cervical cancer based on five known risk factors among women attending the Tamale Teaching Hospital in Tamale, Ghana. Methods A consecutive sample of 300 women was interviewed using a semi-structured questionnaire to inquire about risk factors and perception of risk of cervical cancer. Specific risk factors that were explored included early coitarche, multiple sexual partners, polygamous relationships, history of smoking, and having a current partner who had multiple sexual partners. Results: Sixty-one per cent of women reported that they had no personal risk for cervical cancer. 27% of respondents were in polygamous relationships, and of those, more than half didn't think they were at an increased risk of cervical cancer. 2 women had a total of ≥ 5 sexual partners in their lifetime and neither believed they were at any risk for cervical cancer. 23% said their current partner had had at least 2 sexual partners in his lifetime, and of those, (61%) thought they were at no risk for cervical cancer. 46% of respondents reported not having any of the risk factors listed in the study. 23% of respondents reported having one risk factor while 21% had two risk factors and 11% had three or more risk factors. Conclusion: Women's perception of personal risk for cervical cancer is lower than their actual risk based on the five behavioural risk factors assessed and a lack of knowledge of the personal factors for the disease. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to examine how misconceptions affect the ability of people with disability to find and maintain jobs, and the coping strategies they adopt to manage their economic conditions. Methods: A qualitative study was conducted with special focus on the Kumasi Metro. Purposive sampling enabled the researchers to select participants on the basis of their own set of inclusion criteria. Data was collected through Focus group discussions and interviews that were conducted in the local language, Twi. The raw data was transcribed from Twi to English, using the notes taken during the discussions and comparing it with information recorded on tapes and audio recorders. Corrected and transcribed data was grouped under the various themes of the discussions. Data was analysed through the question-led approach. The most identified themes have been presented as the major findings with related headings. Some responses have been quoted to support the findings. Results: People with disability who participated in the study experienced unemployment, job-seeking problems, the desire to maintain jobs, inability to retain jobs as a result of negative attitudes from co-workers and members of the larger community, and faced difficulty in paying personal bills. To manage their problems, the tendency was to avoid and withdraw from normal societal interaction, and while some begged for alms on the street, others relied on government policies and financial interventions. Conclusion and Implications: It is recommended that stakeholders should intensify public education on disability. Public education should be custommade to suit the community's needs and understanding of the condition, taking into account local culture and belief systems. People with disability should be encouraged to form groups for self-help programmes, especially at the community level. [ABSTRACT FROM AUTHOR]

Most studies on climate change and schistosomiasis transmission have mainly been on the development of models to understand the nature of the relationship. Globally, no attempt has been made to understand the relationship from the point of view of community members through public perception studies. In addition, there is no study on the nexus between climate change and schistosomiasis transmission in Ghana, albeit the disease is endemic in some parts of the country. This article attempts to fill both knowledge gaps. It uses four climate variables, hospital reported schistosomiasis cases, and data from focus group discussions undertaken in Ga District. Results show an increasing trend in total annual rainfall, maximum and minimum temperatures, and a decline in the number of rainy days between 1970 and 2010, during which time there was an increase in reported schistosomiasis cases. A Pearson correlation analysis shows negative and positive significant associations, respectively, between temperature and total rainfall and schistosomiasis cases. However, maximum temperature granger causes reported schistosomiasis cases. Community members perceive that extreme warm temperatures in recent times encourage people to swim in rivers, which increases infection rates. Rainfall is associated with water-based activities including swimming, washing, and bathing. Some control and prevention interventions and treatment-seeking behaviours are discussed, and some recommendations provided. [ABSTRACT FROM AUTHOR]

This methodological paper systematically describes the steps towards exploring client-perceived barriers to enroll in the National Health Insurance Scheme in Ghana. To respond to the stagnating enrollment rate and to provide evidence-based information for developing policy and practice, the request for this study was made by the insurance authority. We adopted a Participatory Action Approach (PAA) and employed a linked trajectory of qualitative and quantitative methods to inquire deeply into clients’ motives and assumptions, and the root causes of these barriers, while transferring learning among multiple stakeholders in the system: the client, the healthcare provider, and the insurer. Data were collected in 2011 and 2012 among clients in their local communities in two regions in Ghana. Clients were participants in the research, expressing and sharing their emic perspectives and commonly shared opinions with the other stakeholders. This paper explores the contribution of the PAA to healthcare and health insurance studies. We claim that the PAA is a necessary approach for the study of a complex situation such as the health insurance context in Ghana as well as for the facilitation of learning and democratic decision-making. Making multidisciplinary stakeholders, including clients, part of the research contributes to finding solutions that are acceptable to different stakeholders. Our study contributes to PAA methodology knowledge and provides new insights on combining qualitative and quantitative research methods. We propose this as a model to be used within action research that can also be applied in other contexts outside of Africa. [ABSTRACT FROM AUTHOR]

Background: Timely and appropriate management of febrile illness among children under five years of age will contribute to achieving Millennium Development Goal-4. The revised World Health Organization-Global Malaria Programme's policy on test-based management of malaria must integrate effectively into the Integrated Management of Childhood Illness (IMCI). This study reports on perceptions of health workers on the health system factors influencing effective delivery of test-based diagnosis of malaria with IMCI. Methods: A qualitative study was conducted among a range of health workers at different levels of the health system in the Brong Ahafo Region of Ghana. Interview transcripts were transferred into Nvivo 8 software for data management and analysis. A frame-work approach at two levels was used in the analysis, which included the processes required for implementation of test-based management of malaria and the health systems context. Results: Forty-nine in-depth interviews were conducted. The National Health Insurance Scheme (NHIS) was perceived to have led to an increase in health facility attendance, thereby increasing the workload of health workers. Workload was reported as the main reason that health workers were not able to complete all of the examinations included in the IMCI algorithm. The NHIS financing guidelines were seen to be determining diagnosis and treatment practices by health-care givers. Concern was expressed about the erratic supply of malaria rapid diagnostic test kits (RDTs), the quality of RDTs related to potential false negative results when clinical symptoms were consistent with malaria. IMCI was seen as important but practically impossible to fully implement due to workload. Conclusions: Implementation of the WHO-revised IMCI guideline is confronted with a myriad of health systems challenges. The perceptions of front-line health workers on the accuracy and need for RDTs together with the capacity of health systems to support implementation plays a crucial role. The NHIS financing guidelines of diagnostics and treatments are influencing clinical decision-making in this setting. Further study is needed to understand the impact of the NHIS on the feasibility of integrating test-based management for malaria into the IMCI guidelines. [ABSTRACT FROM AUTHOR]

This paper examines community perceptions on the provision of quality health care in the Kassena-Nankana District in Ghana. The paper examines the relationship between Ghana's National Health Insurance Scheme (NHIS) and the provision of quality health care, given that quality health care is an important determinant of access to health. Using a mixed methods research design, the researchers compared the perceptions of the insured and the uninsured people with respect to their perceived quality of health care received at health facilities. While the results of the household survey suggest that there is no statistically significant difference between the quality of health care received by either the insured or the uninsured, the focus group discussions indicate that the uninsured are attended to more quickly and are given more respect. The results highlight the perception that quality drugs are unavailable. The researchers recommend adequate supplies of good quality drugs to encourage utilisation of health services. [ABSTRACT FROM AUTHOR]

To understand the role of religion in the sexual behaviours of adolescents, the views of parents who are key agents of socialization were examined from two south-eastern communities in Ghana. Focus Group interviews were conducted with mothers (and female caregivers) of adolescents and one with fathers (and male caregivers) of adolescents. Thematic analysis was used to analyse the data. Findings indicated that parents from one community perceived religion as playing a double-edged role in adolescents' sexual behaviours as on one hand it played a protective role by restraining adolescents from risky sexual behaviours; on the other hand it disparaged the existing traditional measures that regulated adolescents' sexual behaviour. However, parents from the other community found a collaborative interface between the existing social control measures-communal socialization and proscriptive morality with religious ethics. Religious socialization, social capital theory and the concept of social suffering are used to explain some of the findings of this study. Implications for HIV and AIDS education and prevention are also discussed. [ABSTRACT FROM AUTHOR]

This article examines the interrelationships between rainfall variability, livelihood/food security and migration in rural Savannah communities in Northern Ghana. It addresses the question of how strong dry season migration is pronounced and whether the recent dominant migration type is a coping or adaptation mechanism. The analysis is based on empirical research conducted in four communities of the Nadowli District (Upper West Region), using a mixed methods approach. It was found that the households are highly dependent on rain-fed subsistence agriculture and livestock rearing, showing a low degree of economic diversification. Study participants in general complained about the unpredictability of the weather and linked changes in rainfall to declining crop yields and livestock possession as well as to increasing food prices. A common livelihood strategy used by households is dry-season migration to more suitable farming areas and to mining sites. Research in 2011 revealed that the majority of migrants were forced to migrate during the rainy season in order to feed the household members. This observation may indicate a shift in seasonal migration patterns with potentially harmful consequences for household livelihood security in the future. [ABSTRACT FROM AUTHOR]

Effective adaptation to climate change and variability is contingent on the perceptions of farmers and the ability of policy makers to merge these with scientific knowledge systems. The study examined the differentiated knowledge, experiences and perceptions of small traditional farmers and modern commercial farmers and their adaptation influences using qualitative interviews. Farmers generally have very clear ideas of the trends in the parameters of climate change as they relate to farm productivity and other livelihoods. Commercial farmers had a better understanding of the science of climate change, but small farmers presented a localised explanation of observed climate changes. Non-climate factors influenced adaptation of both groups of farmers. The capacities of small farmers are lower than their commercial counterparts, but the risks associated with commercial farming are much higher owing to higher investments in uncertain physical and economic conditions. Differentiated policies are needed at climate proofing the investments and efforts of farmers. [ABSTRACT FROM AUTHOR]

Abstract: Stigma associated with any chronic disease is one of the greatest challenges to the treatment of the disease. Stigma in health is a complex concept, and it causes people with a stigmatizing disease to conceal their disorder. Epilepsy is one such condition with numerous outdated, sometimes inhumane, and sometimes absurd perceptions that tend to fuel its stigma. Health-care workers who participated in an epilepsy training program as part of a World Health Organization/Ghana Health Service collaboration were asked to compile the perceptions associated with epilepsy in their communities. The comments they gathered are presented here. [Copyright &y& Elsevier]

In 2007, a collaborative project was initiated between Kwame Nkrumah University of Science and Technology’s (KNUST’s) Department of Sociology and Social Work (DSSW) and the University of Utah (U of U) College of Social Work (CSW) to establish a Bachelors of Social Work (BSW) Program in Kumasi, Ghana. As part of this initiative, there was a specific need to develop a field education component in the emerging BSW. To assist in establishment of an effective field education program, a research team from the U of U CSW returned to Kumasi, Ghana in 2008 to conduct a qualitative exploratory case study. This article presents initial research findings regarding perceptions of key community stakeholders about the role of social work in this developing country; and their perceptions regarding the necessity of practica for preparing students to practice social work. From evidence sources, themes about professionalism, gender/role of women and community structures emerged concerning perceptions of the role of social work. Themes specific to exposure to vulnerable populations, skill development, understanding the roles and perceptions of social workers in Ghana, and the importance of field education will be presented and implications for future international collaborations will be examined. [ABSTRACT FROM AUTHOR]

Background: Malaria remains the leading cause of morbidity and mortality in sub-Saharan Africa despite tools currently available for its control. Making malaria vaccine available for routine use will be a major hallmark, but its acceptance by community members and health professionals within the health system could pose considerable challenge as has been found with the introduction of polio vaccinations in parts of West Africa. Some of these challenges may not be expected since decisions people make are many a time driven by a complex myriad of perceptions. This paper reports knowledge and perceptions of community members in the Kintampo area of Ghana where malaria vaccine trials have been ongoing as part of the drive for the first-ever licensed malaria vaccine in the near future. Methods: Both qualitative and quantitative methods were used in the data collection processes. Women and men whose children were or were not involved in the malaria vaccine trial were invited to participate in focus group discussions (FGDs). Respondents, made up of heads of religious groupings in the study area, health care providers, traditional healers and traditional birth attendants, were also invited to participate in in-depth interviews (IDIs). A cross-sectional survey was conducted in communities where the malaria vaccine trial (Mal 047RTS,S) was carried out. In total, 12 FGDs, 15 IDIs and 466 household head interviews were conducted. Results: Knowledge about vaccines was widespread among participants. Respondents would like their children to be vaccinated against all childhood illnesses including malaria. Knowledge of the long existing routine vaccines was relatively high among respondents compared to hepatitis B and Haemophilus influenza type B vaccines that were introduced more recently in 2002. There was no clear religious belief or sociocultural practice that will serve as a possible barrier to the acceptance of a malaria vaccine. Conclusion: With the assumption that a malaria vaccine will be as efficacious as other EPI vaccines, community members in Central Ghana will accept and prefer malaria vaccine to malaria drugs as a malaria control tool. Beliefs and cultural practices as barriers to the acceptance of malaria vaccine were virtually unknown in the communities surveyed. [ABSTRACT FROM AUTHOR]

Background: Ghana's National Health Insurance Scheme (NHIS), established into law in 2003 and implemented in 2005 as a 'pro-poor' method of health financing, has made great progress in enrolling members of the general population. While many studies have focused on predictors of enrolment this study offers a novel analysis of NHIS members' perceptions of service provision at the national level. Methods: Using data from the 2008 Ghana Demographic Health Survey we analyzed the perceptions of service provision as indicated by members enrolled in the NHIS at the time of the survey (n = 3468; m= 1422; f = 2046). Ordinal Logistic Regression was applied to examine the relationship between perceptions of service provision and theoretically relevant socioeconomic and demographic variables. Results: Results demonstrate that wealth, gender and ethnicity all play a role in influencing members' perceptions of NHIS service provision, distinctive from its influence on enrolment. Notably, although wealth predicted enrolment in other studies, our study found that compared to the poorest men and uneducated women, wealthy men and educated women were less likely to perceive their service provision as better/same (more likely to report it was worse). Wealth was not an important factor for women, suggesting that household gender dynamics supersede household wealth status in influencing perceptions. As well, when compared to Akan women, women from all other ethnic groups were about half as likely to perceive the service provision to be better/same. Conclusions: Findings of this study suggest there is an important difference between originally enrolling in the NHIS because one believes it is potentially beneficial, and using the NHIS and perceiving it to be of benefit. We conclude that understanding the nature of this relationship is essential for Ghana's NHIS to ensure its longevity and meet its pro-poor mandate. As national health insurance systems are a relatively new phenomenon in sub-Saharan Africa little is known about their long term viability; understanding user perceptions of service provision is an important piece of that puzzle. [ABSTRACT FROM AUTHOR]

Background: The Ghana Neglected Tropical Diseases control program aimed to raise population awareness on soil-transmitted helminth (STH) infections and achieve a 100% coverage of preventive chemotherapy (PCT) by 2020. This study aims at determining the factors associated with the knowledge of school-age children and describing their perceptions at Krachi East Municipal in Ghana., Patients and Methods: It was a cross-sectional study. Children and their caregivers were selected from 8 communities following a two-stage stratified sampling. Descriptive statistics and binary logistic regression were performed at a 5% significance level., Results: 352 children and their caregivers were surveyed, mainly from Dambai (66.48%). The median age was 11 (IQR: 9-12) years and the children aged 7-14 years. About half of the children were males (53.13%) and most caregivers were females (66.48%). Most children perceived a benefit associated with PCT (94.89%). The proportion of children perceiving a health risk did not differ significantly from those not perceiving a risk (49.72% vs 50.28%; p=0.8802). In general, children had poor knowledge (91.19% vs 8.81%; p<0.0001). Good knowledge was associated with ethnic group [Guan: aOR=3.96 95%CI 1.11-14.12; p=0.034], child age [(11-12 years: aOR=6.05 95%CI 1.21-30.22; p=0.026); (13-14 years: aOR=8.19 95%CI 1.64-40.89; p=0.010)] and caregivers' sex (Female: aOR=2.97 95%CI 1.02-8.66; p=0.046) in the adjusted model., Conclusion: Younger children and male caregivers seem to have low knowledge of intestinal worms and PCT. Therefore, they must get more attention regarding health education., (Copyright © 2022 SFMTSI.)

Objective This paper identifies, ranks and compares perceptions of insured and uninsured households in Ghana on health care providers (quality of care, service delivery adequacy, staff attitudes), health insurance schemes (price, benefits and convenience) and community attributes (health ‘beliefs and attitudes’ and peer pressure). In addition, it explores the association of these perceptions with household decisions to voluntarily enrol and remain in insurance schemes.Methods First, data from a household survey of 3301 households and 13 865 individuals were analysed using principal component analysis to evaluate respondents’ perceptions. Second, percentages of maximum attainable scores were computed for each cluster of perception factors to rank them according to their relative importance. Third, a multinomial logistic regression was run to determine the association of identified perceptions on enrolment.Results Our study demonstrates that scheme factors have the strongest association with voluntary enrolment and retention decisions in the National Health Insurance Scheme (NHIS). Specifically these relate to benefits, convenience and price of NHIS. At the same time, while households had positive perceptions with regards to technical quality of care, benefits of NHIS, convenience of NHIS administration and had appropriate community health beliefs and attitudes, they were negative about the price of NHIS, provider attitudes and peer pressure. The uninsured were more negative than the insured about benefits, convenience and price of NHIS.Conclusions Perceptions related to providers, schemes and community attributes play an important role, albeit to a varying extent in household decisions to voluntarily enrol and remain enrolled in insurance schemes. Scheme factors are of key importance. Policy makers need to recognize household perceptions as potential barriers or enablers to enrolment and invest in understanding them in their design of interventions to stimulate enrolment. [ABSTRACT FROM AUTHOR]

Although human excreta contain the necessary nutrients for plant growth, local authorities in Ghana spend huge sums of money to dispose them as waste. Reusing excreta for agricultural purposes saves expenditure for chemical fertilizers, improves soil fertility, reduces poverty and ensures food security. People’s attitudes and perceptions about excreta vary between cultures and even within specific cultures. This study aimed to explore attitudes and perceptions among a peri-urban agricultural community towards sanitized human excreta and its use. The study adopted an exploratory design and collected data from 154 randomly selected households using questionnaires and focus group discussions. It was found that there is a general negative attitude to fresh excreta and the handling of it. However, the residents accept that excreta can be used as fertilizer, but they are not willing to use it on their own crops or consume crops fertilized with excreta. The study recommends open discussions in the community for a successful implementation of ecological sanitation. [ABSTRACT FROM AUTHOR]

This paper examines Ghana's evolving tourism policies with special reference to its spatial and pro-poor impacts. Using a sample of 182 respondents around the Kakum National Park in Ghana's Central Region, an area which is rich in tourism assets but economically poor, it examines residents' expectations, experiences and perceptions about tourism development in the area. While some expectations were too much, others had been met, if only somewhat. Residents' experiences in terms of direct socio-economic benefits were modest. But largely on account of indirect gains from a range of pro-poor interventions, the majority had a fairly positive perception of tourism in the area. Respondents of communities beyond the Park's reception area had gained more from associated interventions rather than from tourism. Age and place of birth were also found to be key variables that influenced residents' perspectives on tourism development in the area. Nevertheless, residents' overall perception suggests that sustainable tourism development requires an approach that simultaneously improves the tourism product and enhances residents' livelihood options. The need for residents to be involved in decision-making if pro-poor tourism is to be successful was underlined. [ABSTRACT FROM AUTHOR]