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Background and Objectives: This study aims to investigate the strength of the association between socio-economic, maternal and environmental determinants and under-five mortality in Ghana. Methods: We utilized data from the 2014 Ghana Demographic and Health Survey, a population-based cross-sectional study, which included 4151 children born alive to women aged 15-49 years. The primary outcome variable was under-five mortality. Descriptive statistics and multivariate logistic regression were applied to assess the relationship and relative association of the independent variables with the outcome variable. Results: Children of women with secondary education and above and women within the middle wealth status were 0.593 and 0.886 less likely to experience under five deaths compared to women with no education and women of low wealth status (OR=0.593; 95% CI 1.690 to 2.063; p< 0.01) (OR =0.886; 95% CI 1.48 to 1.63; p

Introduction In spite of the countless initiatives of the Ghana government to improve the quality of maternal healthcare, Upper West Region still records poor childbirth outcomes. This study, therefore, explored women’s perception of the quality of maternal healthcare they receive in the Wa Municipality of the Upper West Region of Ghana. Materials and methods This is a qualitative cross-sectional study of 62 women who accessed maternal healthcare in the Wa Municipality of Ghana. We analysed the transcripts using the analytic inductive technique. An inter-coding technique (testing for inter-coding agreement) was employed. The iterative coding process resulted in a coding scheme with four main themes. We used peer-debriefing technique in ensuring credibility and trustworthiness. Results Logistics and equipment; referral service; empathic service delivery; inadequacy of care providers; affordability of service; satisfaction with services received; as well as experience and service delivery were the parameters used by the women in assessing quality maternity care. A number of gaps were reported in the healthcare system including limited healthcare providers, limited beds and inefficient referral system. Conversely, some of them reported that some healthcare providers offered empathetic healthcare. Contrary views were expressed with respect to satisfaction with maternity care. Conclusion Government and all stakeholders seeking to enhance quality of maternal health and accelerate the attainment of the third Sustainable Development Goal need to reconsider the financing of service delivery at health institutions. Indeed, our findings have illustrated that routine workshops on empathetic healthcare are required in efforts to increase the rate of facility-based childbirth, and thereby subside maternal mortality and all adverse pregnancy outcomes.

While literature on migrants’ associations is well documented in Europe, North America and South America, little is done on Africa’s internal migrant associations in spite of their proliferation and role in dealing with migration and urban precarity. We ask how do migrant association facilitate the integration processes of their members in the host area and how has their role in the process changed over the years? Through a concurrent (convergent) triangulation research design, we survey 120 participants, interviewed 14 and content analyse (media) reports. We conclude that migrant associations are still relevant in engendering adaptive and supportive environment for migrants’ integration. Even though these core objectives have not changed per se, the changing socio-cultural, economic and political surroundings of host communities and the needs of migrants requires that migrant association shift in their approaches to remain relevant.

Intra- and inter-regional migration is widely described. Prior studies have attribute varied reasons for this development including the quest for greener pastures and unequal development in northern Ghana. What has escaped critical scrutiny is some migrants’ ability to escape extreme rural poverty, albeit in harsh urban environment. Such a missing gap can potentiate high policy failures, hence the need for academic attention. Using a mixed method, we focus on two informal daily livelihoods as exemplars – exceptionalism – in Accra. We see their embedded organisational vitality and dynamic networks as illuminating for good livelihood practices, proper city governance and fostering economic empowerment. We call on city authorities to take cognisance of such complexities and heterogeneity of production–labour relations, failure of which can spell doom for policies ostensibly initiated to curb migration, as they are likely to be underpinned by factual inaccuracies and may result in ill-fated interventions.

There is a long history of migration among low-income families in sub-Saharan Africa, in which (usually young, often male) members leave home to seek their fortune in what are perceived to be more favourable locations. While the physical and virtual mobility practices of such stretched families are often complex and contingent, maintaining contact with distantly located close kin is frequently of crucial importance for the maintenance of emotional (and possibly material) well-being, both for those who have left home and for those who remain. This article explores the ways in which these connections are being reshaped by increasing access to mobile phones in three sub-Saharan countries – Ghana, Malawi and South Africa – drawing on interdisciplinary, mixed-methods research from twenty-four sites, ranging from poor urban neighbourhoods to remote rural hamlets. Stories collected from both ends of stretched families present a world in which the connectivities now offered by the mobile phone bring a different kind of closeness and knowing, as instant sociality introduces a potential substitute for letters, cassettes and face-to-face visits, while the rapid resource mobilization opportunities identified by those still at home impose increasing pressures on migrant kin.

Issues surrounding youth employment and unemployment are central to the next development decade. Understanding how youth use mobile phones as a means of communicating and exchanging information about employment and livelihoods is particularly important given the prominence of mobile phone use in young lives. This paper explores and reflects on youth phone usage in Ghana, Malawi and South Africa, drawing on mixed-methods research with young people aged approximately 9-25 years, in 12 (high density) urban and peri-urban sites. Comparative work across these sites offers evidence of both positive and negative impacts. The final section of the paper considers policy implications.

In sub-Saharan Africa, protracted refugee situations have become common within the last three decades. Although voluntary repatriation is mostly recommended as the more lasting solution to refugee problems, some refugees think otherwise. This paper explores the views of Liberian refugees on local integration in Ghana. Using an in-depth interview guide, a total of 25 Liberian refugees were interviewed through the snowball sampling procedure at the Buduburam refugee camp. Guided by both the theory of national identity and an adapted framework on domains of local integration, the results show that the refugees are prepared for local integration. Most of them are already engaged in informal sector businesses as their sources of livelihood; almost all of them have established some social networks which facilitate interactions between them and the indigenes; and moreover they have been granted residence and work permits as well as registered for the National Health Insurance Scheme (NHIS) as part of the integration package. It can be concluded that the Liberian refugees who opted for local integration are positively disposed for local integration in Ghana. There is the need for government to adopt the most appropriate local approach to facilitate the full intergration of the Liberian refugees into the country.

In sub-Saharan Africa, the past two decades have witnessed a phenomenal increase in the use of mobile phones which has attracted diverse research. This paper explores mobile phone use and livelihood activities in some urban and rural areas of Ghana. Qualitative data were extracted from a larger study that covered 24 sites ranging from urban to remote rural locations in Ghana, Malawi and South Africa. The Sustainable Livelihood Framework provided guidance for the study. The main findings of the study indicate that mobile phones provide direct phone-related employment and indirectly enable some others to secure jobs through contact with friends/relations and also facilitate marketing of farm produce in terms of reduction in transaction cost, access to ready market and contacts for better prices for produce. Additionally, phone use enhances job organization through communication between apprentices and their bosses and also facilitates the migration process of some irregular migrants. As a livelihood capital, mobile phone has the potential to reduce vulnerability and improve upon people’s livelihood outcomes. There is therefore the need to make mobile phones more affordable, expand mobile phone network coverage and improve upon service quality to facilitate livelihood activities, particularly in rural areas of the country.

Data from qualitative and survey research with young people in 24 locations (urban and rural) across Ghana, Malawi, and South Africa expose the complex interplay between phone ownership and usage, female empowerment, and chronic poverty in Africa. We consider gendered patterns of phone ownership and use before examining practices of use in educational settings, in business and in romantic and sexual relationships. While some reshaping of everyday routines is evident, in the specific context of female empowerment we find little support within our sites for the concept of the mobile phone as an instrument of positive transformative change. The phone's application in romantic and sexual relationships demonstrates particularly strongly the way phones are complicit in constraining women's empowerment and points to potential wider repercussions, including for educational and entrepreneurship trajectories. Women's agency is still mired within wider structures of patriarchy and chronic poverty: existing inequalities are being re-inscribed and reinforced.

In Ghana, three regions (Upper West, Upper East and Northern) have the highest proportion of voluntary out-migrants but the percentage share of the population of these regions together has been less than 20.0% since 1970. This phenomenon is due to north-south migration which has been widely attributed to low socio-economic development and unfavourable physical characteristics in these regions. The study examines the main drivers of out-migration from the Wa West District (WWD). Using mixed method approach, 120 respondents were surveyed while 12 key informants were interviewed in six selected communities. The results showed that both economic returns and migrants’ sub-culture were the factors that determine out-migration of young people from the WWD. In particular, sub-cultural values/attributes such as quest for modern lifestyles, improved physical appearances, adoption of day/popular southern names and enhanced family/self status were the key factors shaping out-migration in the study area. The study further revealed that job availability and modern lifestyles were the main factors that influenced migrants’ choice of destinations in southern Ghana. The government, through the Wa West District Assembly, the Savanna Accelerated Development Authority (SADA) and other development partners should rigorously promote socio-economic development in the north to reduce out-migration in the WWD. Key words: Economic returns, migrants’ sub-culture, north-south migration, Ghana.

In West Africa, studies on migration and livelihoods are mostly limited to internal migrants. This study analyzed the livelihood activities of itinerant West African migrant traders in the Accra Metropolitan Area, using mixed methods approach. The study which was guided by the framework for migration and itinerant migrant trade surveyed 779 itinerant immigrant traders and interviewed 12 key informants. Descriptive statistics and binary logistic regression were the main analytical techniques used. The results showed that most of the immigrant traders were young, unmarried males with no formal education and their main trading activity was itinerant retailing of foot wears/leather belts/bags and herbal medicines. As regards their livelihood status, female immigrant traders and those who were younger (

Delivering in health facility under the supervision of skilled birth attendant is an important way of mitigating impacts of delivery complications. Empirical evidence suggests that decision-making autonomy is aligned with holistic wellbeing especially in the aspect of maternal and child health. The objective of this paper was to examine the relationship between women’s health decision-making autonomy and place of delivery in Ghana. We extracted data from the 2014 Ghana Demographic and Health Survey. Descriptive and logistic regression techniques were applied. The results indicated that women with health decision-making autonomy have higher tendency of health facility delivery as compared to those who are not autonomous [OR = 1.27, CI = 1.09–1.48]. However, those who have final say on household large purchases [OR = 0.71, CI = 0.59–0.84] and those having final say on visits [OR = 0.86, CI = 0.73–1.01] were less probable to deliver in health facility than those without such decision-making autonomy. Consistent with existing evidence, wealthier, urban, and highly educated women had higher inclination of health facility delivery. This study has stressed the need for interventions aimed at enhancing health facility delivery to target women without health decision-making autonomy and women with low education and wealth status, as this can play essential role in enhancing health facility delivery.

Tanle, A. 2015. Towards an integrated framework for analysing the links between migration and livelihoods. Norsk Geografisk Tidsskrift–Norwegian Journal of Geography. Vol. 69, 257–264. ISSN 0029–1951.Although migration is often perceived as a livelihood strategy for both poor and non-poor households in developing countries such as Ghana, most livelihood frameworks overlook the links between migration and livelihoods. The author therefore reviews literature on livelihood approaches and compares the differences between some livelihood frameworks. The findings show that although all of the studied livelihood frameworks focus on sustainable development they differ in terms of their core mandates, which range from integrated rural development through the environment to sustainable human development. The contexts in which livelihoods are practised are influenced by institutional structures, processes and elements of vulnerability, which could be both internal and external. In conclusion, the author proposes an ...

In Ghana, studies on migration and livelihoods are mostly limited to migrants’ places of origin. This paper therefore assesses livelihood status of permanent migrants resident in the Obuasi Municipality who hail from the northern parts of Ghana. The instrument used was a survey questionnaire and the respondents were both migrants and indigenes aged 18 years and above. The findings showed no significant differences between migrants and indigenes in ownership of assets and consumer durable goods and housing quality. However, the indigenes earned relatively higher than the migrants due to access to various forms of capital and the influence of institutional structures and processes. But to the migrants, their livelihood status has improved since they have built houses, educated their children, remitted relations at home and have acquired some consumer durable goods. Improvement in the livelihood status of migrants could induce further north–south migration. There is therefore the need for government and other stakeholders to bridge the gap of unequal socio-economic development between the northern and southern parts of the country.

Since the 1990s, Ghana has been hosting refugees from neighbouring West African countries and other parts of Africa but not much information is available on their experiences in the country. The main objective of this paper therefore is to examine the experiences of the refugees using the Liberian refugees in the Buduburam Refugee Camp as a case study. Using an in-depth interview guide, 44 refugees of both sexes were interviewed through a convenient sampling procedure based on their consent and willingness to participate in the study. The study employed the structuration theory of migration to examine their experiences and the Kunz’s (Int Migr Rev 15:42–51, 1981) typology of refugees to classify the refugees. Through their own capabilities and opportunities offered by both structure and institution, some refugees were able to sustain themselves through petty trading and artisanship while others were unemployed and had to depend occasionally on their social networks for economic support. Cultural shocks, acculturation, tension and occasional quarrels with the indigenes, stigma and discrimination against refugees in schools and at health centres, inaccessibility to formal sector employment, poor security and inadequate infrastructural facilities were some of their experiences in and outside the camp. The need for proper identification of refugees for security reasons, provision of better security and adequate infrastructural facilities and skills training for refugees to engage in livelihood activities were some of the recommendations from the refugees themselves.

Summary Children’s load-carrying has been largely invisible in studies of African economies, being commonly subsumed under women’s or family labor. This paper, based on interdisciplinary qualitative and quantitative research in 24 sites, examines the role of child porterage in helping to fill Africa’s transport gap and considers its developmental significance for education, well-being, and health. It provides detailed information regarding the scale, nature, and perceived impacts of children’s load-carrying work in domestic and commercial contexts, indicates the importance of gender and generational analysis, and explores key policy challenges.

In sub-Saharan Africa, studies on young people engaged in the shoe-shine business are scanty and also their future intentions in the business are not known. This paper examines the concerns and intentions among young migrants involved in the shoe-shine business in the Cape Coast Metropolis. Through snowball sampling, 191 responded to a questionnaire while 15 others participated in in-depth interviews. The data were analysed using logistic regression and content analysis. The main concerns were injuries, physical stress, exposure to malaria and thieves. Consequently, some of them intend to quit the job in future due to physical stress, aging, declining earnings, inability to combine the job with farming at their places of origin and the precarious nature of the job. The study concluded that the shoe-shine business could be described as a stepping stone to more lucrative and stable jobs due to the challenges involved. There is the need for the National Board for Small-Scale Industries and other relevant state institutions to build the capacities of young people who have already created their own jobs in the informal sector such as the shoe-shine boys to enable them sustain their businesses. Keywords: Migrants, Shoe-shine Business, Intentions to Remain or Quit, Cape Coast Metropolis, Ghana

In the previous four decades there have been changes in both the structure of, and employment opportunities in, Ghana's economy. Responding to the conditions, women have become involved in various economic activities, including the processing of agricultural products. Using the livelihood concept, the paper examines the conditions of women involved in palm kernel oil processing as they eke a living in the face of poverty. Based on a survey of 185 women in two districts in the Central Region of Ghana, the authors analyse the women's entry into the trade, working conditions and earnings. The labour-intensive activity is characterized by low capital outlay, irregular supply of inputs and long working hours. However, the women earn very little due to poor marketing strategies, lack of linkages with the modern economy, and lack of support. These factors make the women vulnerable to external environmental shocks. Nonetheless, the work provides them with some personal income, which is important for self-esteem. ...

Cell phones present new forms of sociality and new possibilities of encounter for young people across the globe. Nowhere is this more evident than in sub-Saharan Africa where the scale of usage, even among the very poor, is remarkable. In this paper we reflect on the inter-generational encounters which are embedded in young people’s cell phone interactions, and consider the wider societal implications, not least the potential for associated shifts in the generational balance of power. An intriguing feature of this changing generational nexus is that while many young people’s phone-based interactions, from their mid-teens onwards, are shifting away from the older generation towards friendship networks in their own age cohort, at the same time they are repositioning themselves – or becoming repositioned – as family information hubs, as a consequence of their phone expertise. The paper draws on mixed-methods research with young people aged c. 9–25years and in-depth interviews with older age-groups in 24 sites (ranging from high density poor urban to remote rural) across Ghana, Malawi and South Africa.

This paper examines the gendered implications of Africa's transport gap (the lack of cheap, regular and reliable transport) for young people in rural Ghana, with particular reference to the linkages between restricted mobility, household work demands, access to education and livelihood potential. Our aim is to show how mobility constraints, especially as these interact with household labour demands, restrict young people's access to education and livelihood opportunities. Firstly, the paper considers the implications of the direct constraints on young people's mobility potential as they travel to school. Then it examines young people's (mostly unpaid) labour contributions, which are commonly crucial to family household production and reproduction, including those associated with the transport gap. This has especially important implications for girls, on whom the principal onus lies to help adult women carry the heavy burden of water, firewood, and agricultural products required for household use. Such work can impact significantly on their educational attendance and performance in school and thus has potential knock-on impacts for livelihoods. Distance from school, when coupled with a heavy workload at home will affect attendance, punctuality and performance at school: it may ultimately represent the tipping point resulting in a decision to withdraw from formal education. Moreover, the heavy burden of work and restricted mobility contributes to young people's negative attitudes to agriculture and rural life and encourages urban migration. Drawing on research from rural case study sites in two regions of Ghana, we discuss ethnographic material from recent interviews with children and young people, their parents, teachers and other key informants, supported by information from an associated survey with children ca. 9–18 years.

This paper explores young people’s experiences and perceptions of mobility and mobility constraints in poorer urban areas of Ghana, Malawi and South Africa within the specific context of inter-generational relations. Drawing principally on qualitative research findings from a study involving both adult and child researchers, our aim is to chart the diversities and commonalities of urban young people’s mobility experiences in the everyday – how they use and experience the city – developing a comparative perspective across three urban study sites which links young people’s mobility with the power relations that operate to shape their movements in individual locations. In particular, we consider how positive and negative images of young people’s mobility play out in terms of the inter-generational frictions and negotiations generated by their mobility performances. We also reflect on the developmental implications, in terms of young people’s access to services and income and their participation in the social networks and peer culture which may shape their life trajectories. Three themes are explored in detail: mobility as challenge, mobility as temptation and mobility control.

This paper examines connectedness to, communication with and monitoring of unmarried adolescents in Ghana by parents, other adults, friends and key social institutions and the roles these groups play with respect to adolescent sexual activity. The paper draws on 2004 nationally-representative survey data and qualitative evidence from focus group discussions and in-depth interviews with adolescents in 2003. Adolescents show high levels of connectedness to family, adults, friends, school and religious groups. High levels of adult monitoring are also observed, but communication with family about sex-related matters was not as high as with non-family members. The qualitative data highlight gender differences in communication. Multivariate analysis of survey data shows a strong negative relationship between parental monitoring and recent sexual activity for males and females, and limited effects of communication. Creating a supportive environment and showing interest in the welfare of adolescents appear to promote positive sexual and reproductive health outcomes. Influence des liens sociaux, de la communication et de la surveillance sur l\'activité sexuelle de l\'adolescent au Ghana. Cet article étudie les liens et la communication avec les adolescents nonmariés et la surveillance par leurs parents, d\'autres adultes, les amis et les institutions sociales clé et les rôles que jouent ces groupes à l\'égard de l\'activité sexuelle de l\'adolescent. Cet article se fonde sur les donnés des enquêtes à représentation nationale et sur l\'évidence qualitative à partir des discussions à groupe cible et des interviews en profondeur auprès des adolescents en 2003. Les adolescents font preuve d\'un niveau élevé du liaison avec la famille, les adultes, les amis, avec l\'école et les groupes religieux. Nous avons, aussi noté des niveaux élevés de surveillance, mais la communication avec la famille par rapport aux sujets liés au sexe n\'était pas aussi élevé que chez ceux qui ne sont pas membres de famille. Les données qualitatives soulignent les différences de genres en ce qui concerne la communication. L\'analyse multifactorielle des données de l\'enquête montre un rapport négatif fort entre la surveillance parentale et l\'activité sexuelle récente pour mâles et femelles et les effets limités de la communication. La création d\'un milieu de soutien et montrant l\'intérêt à légard du bien-être des adolescents semblent promouvoir des résultats positifs sur le plan de la santé sexuelle et de reproduction. Keywords: Adolescents, Ghana, connectedness, communication, monitoring, reproductive health African Journal of Reproductive Health Vol. 11 (3) 2007: pp. 133-147

This article reports on a study of the gender differences in children's journeys to school in sub-Saharan Africa. The authors draw on empirical data from a three-country study (Ghana, Malawi, South Africa) of young people’s mobility. They note that gender differences in school enrollment and attendance in Africa are well established: education statistics in many countries indicate that girls’ participation in formal education is often substantially lower than boys’, especially at secondary school level. Transport and mobility issues are an important piece of this phenomenon, though the precise patterning of the transportation and mobility constraints experienced by girl schoolchildren, and the ways in which transport factors interact with other constraints, varies from region to region. In some contexts, the journey to school represents a particularly hazardous enterprise for girls because they face a serious threat of rape. In other cases girls’ journeys to school and school attendance are hampered by Africa’s transportation gap and cultural conventions which require females to take on this burden (by pedestrian head loading) before leaving for (or instead of attending) school. The authors draw principally on a survey questionnaire conducted in each country with approximately 1000 children aged 7-18 years across 8 sites. They draw attention to the diversity of gendered travel experiences across geographical locations (paying attention to associated patterns of transport provision) and to explore the implications of these findings for access to education. The article concludes with a section of suggestions regarding areas where policy intervention could be beneficial. They call for a stronger emphasis on gendered transport, mobility and access issues in the development policy and practitioner community.