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AbstractThis study explored the perspectives of community members on the management and ownership of freshwater resources. A mixed-method study was conducted targeting household heads, traditional leaders, and assembly members in communities surrounding the lake. Household heads (309), and 14 focus group discussions were used in the study. There were 46.9% and 29.4% of the respondents who perceived that the lake was owned by the government and the community (chiefs and the indigene) respectively. While 48.2% and 28.8% perceived the traditional authority and the government separately as the managers of the lake. The study found out that, the community perceives the Lake as their resource and hence their traditional leaders should have control over it with support from the government and other NGOs. This implies that activities carried out concerning the Lake should have the approval of people to avoid conflict and power struggles.

AbstractTo effectively shape healthcare outcomes and delivery, patient engagement has become increasingly important. It also has a significant impact on customer satisfaction and service quality. This study offers an introspective analysis of healthcare providers’ experiences and perceptions as it explores the relationship between patient engagement, service quality, and customer well-being. The study used a quantitative approach, and data were collected from a sample of 320 healthcare professionals working in different healthcare settings. The study adopted the snowball sampling technique to obtain the needed data for processing and analysis through PLS-SEM. The participants used in this study were Doctors and Nurses in public hospitals in Ghana. This study adds insights from the viewpoint of healthcare providers to the expanding body of literature on patient engagement, service quality, and customer well-being. The results highlight the significance of patient involvement in determining healthcare experiences and results, underscoring the necessity for healthcare institutions to adopt patient-centered care tenets and foster cooperative and empowered cultures. According to the findings, patient engagement fosters open communication, shared decision-making, and collaborative care, all of which are critical components of improving the service quality. To improve treatment adherence, improve health outcomes, and increase patient satisfaction, healthcare providers stress the value of giving patients the freedom to actively participate in their healthcare journey. Additionally, it has been shown that patient engagement enhances customer well-being by encouraging a sense of empowerment, independence, and control over one’s health.

AbstractThis study investigates the impact of social media on tourists’ destination decisions in a less digitalized economy through the lens of the uses and gratification theory. Data was collected from 428 local tourists sampled across various tourist destinations in Ghana (a sub-Sahara Africa) using a structured questionnaire. Analysis was carried out using variance-based PLS-SEM (Partial Least Square Structural Equation Modelling). The results show that tourist contentment, destination image, behavioral goals, and the availability of tourism information are driving forces of social media usage toward tourism destination decisions. The findings imply that tourism service providers should revise and incorporate the trending social media strategies to enhance their interaction with prospective visitors (customers) to increase their market share and become more competitive. This paper not only broadens the social media marketing literature but offers a comprehensive assessment of the integration of social media given the myriad of challenges besetting users and tourism service providers and discusses its impact in shaping tourist destination decisions in emerging and developing economies. Limitations and avenues for future research are discussed.

AbstractSocial media plays a crucial role in modern healthcare by promoting patient engagement, facilitating communication among professionals, and serving as a platform for health education and outreach. Its significance in healthcare delivery continues to grow as digital communication becomes increasingly integral to the industry’s efforts to improve healthcare outcomes. Nonetheless, existing studies have not adequately and empirically explored its impact in less digitalized economies. Thus, this study seeks to investigate the impact of social media on healthcare delivery systems in a less digitalized economic context. Leveraging the social media engagement theory, the study employs a partial least squares (PLS-SEM) approach to explore the impact of social media in Ghana’s healthcare system. Based on a purposely selected sample of 457 healthcare professionals from Ghana, the study found that using social media for crisis management, patient-doctor relationships, and information dissemination positively impacts healthcare systems. On the contrary, social media use for public relations activities did not have any significant impact on healthcare delivery. This study contributes to the growing literature on the affordances of social media in the circular economy towards improved healthcare delivery in emerging economies. The study offers a strategy for optimizing the use of social media within healthcare settings to foster enhanced healthcare outcomes, particularly a less digitalized economies.

AbstractWhile there is sufficient evidence from empirical studies that digital technologies are strategic resources for value creation, existing literature on the theme lacks general concepts that explore an organization’s strategic resources concerning digital orientations and transformation initiatives. This study hence builds on a resource-based view with digital orientation literature to conceptualize a novel strategic orientation concept to understand the attitude toward digital innovation integration among firms in an emerging and developing country. This study tests a new conceptual framework using survey data from 472 employees of small-to-medium-sized service-based firms and employing structural equation model analysis with a variance-based SEM approach. Our empirical results showed that IT infrastructural availability and digital innovation investment are significant organizational drivers that have a direct relationship with attitude toward digital innovation integration among firms whereas IT competencies, digital innovation management, and knowledge of digital innovation are not significant with attitude toward digital innovation integration. More importantly, our findings advance the literature on a firm’s strategic resources and bring the realms of strategy and digital orientation closer together. The study provides valuable insights for management and shareholders regarding the specific drivers that affect the adoption of digital technologies among service-based SMEs in emerging economies.

Small and medium enterprises (SMEs) are vital to the economic development of emerging economies, significantly contributing to employment, innovation, and GDP growth. This study investigates the influence of market competition on SME performance in emerging economies, specifically examining the moderating role of process innovation. Using a sample of 365 SMEs in the western region of Ghana, the research employed a convenience sampling technique to gather data. The analysis utilized partial least square structural equation modeling (PLS-SEM) to explore the relationships between market competition, process innovation, and SME performance. The findings revealed that three direct hypotheses were supported, indicating a positive relationship between market competition and SME performance, while the moderated hypotheses were not supported. These insights provide valuable implications for SME owners, managers, and policymakers.

This paper deals with the stability and occurrence of Hopf bifurcation of a distributed delay differential cobweb model using the chain trick technique. This is a generalized form of the fixed delay cobweb model to which it is compared using the same parameter values. The results from the delay distribution showed that whenever less weight (γ=0.146) is put on past prices, the current equilibrium price is adjusted upwards while the reverse is observed when a higher weight (γ=0.186) is put on the previous price. It is also observed that if the initial price is set below/above the equilibrium price, the price adjustment either affects the consumers or benefits the suppliers. However, the fixed delay cobweb model does not display the consumers or suppliers benefits of the price dynamics in either direction. These are unique, underlying patterns in price dynamics discovered when using a distributed delay model compared to traditional fixed delay cobweb models. Furthermore, our model challenges the traditional cobweb model’s requirement for divergence, as it is based on the weight assigned to past prices rather than the relationship between the elasticities of supply and demand, which is the determining factor in the classical model. Based on these insights, we recommend that future price adjustment models incorporate distributed delays, as they reveal more intricate price dynamics and provide a more comprehensive understanding of market behavior than fixed delay models.

Background: Individuals living with hypertension are at an increased risk of cardiovascular- and cerebrovascular-related outcomes. Interventions implemented at the community level to improve hypertension control are considered useful to prevent cardiovascular and cerebrovascular events; however, systematic evaluation of such community level interventions among patients living in low- and middle-income countries (LMICs) is scarce. Methods: Nine databases were searched for randomized controlled trials (RCTs) and cluster randomized control trials (cRCTs) implementing community level interventions in adults with hypertension in LMICs. Studies were included based on explicit focus on blood pressure control. Quality assessment was done using the Revised Cochrane Risk of Bias tool for randomized trials (ROBS 2). Results were presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Fixed-effect meta-analyses were conducted for studies that reported continuous outcome measures. Results: We identified and screened 7125 articles. Eighteen studies, 7 RCTs and 11 cRCTs were included in the analysis. The overall summary effect of blood pressure control was significant, risk ratio = 1.48 (95%CI = 1.40–1.57, n = 12). Risk ratio for RCTs was 1.68 (95%CI = 1.40–2.01, n = 5), for cRCTs risk ratio = 1.46 (95%CI = 1.32–1.61, n = 7). For studies that reported individual data for the multicomponent interventions, the risk ratio was 1.27 (95% CI = 1.04–1.54, n = 3). Discussion: Community-based strategies are relevant in addressing the burden of hypertension in LMICs. Community-based interventions can help decentralize hypertension care in LMIC and address the access to care gap without diminishing the quality of hypertension control. Prospero: CRD42020194081

ABSTRACTWalking is a fundamental mode of transport for many people globally, with immense health and environmental benefits. However, increased walking is associated with an increased risk of road traffic crashes and injuries, especially where traffic enforcement is poor, and pedestrians could easily be distracted. Despite this, a plethora of evidence exists on driver distraction; however, there is a dread of evidence of pedestrian distraction (i.e. distracted walking), particularly in Africa. This paper uses a quantitative methodology to examine the predictors of distractive activities to walking in Accra, Ghana. The study surveyed 400 pedestrians within Accra’s Central Business District (CBD). A questionnaire was deployed via Kobo Toolkit and Jamovi was used in analysing the data. The study observed that three of the top four distractive activities to walking were digital devices-related (e.g. the use of mobile phones). We found that listening to music, making, receiving phone calls, and conversing with other people while walking are the main distractive activities. The binary logistic regression model found sex, age, level of education, occupation, reasons for walking, weekly time for walking and time for common trips as significant predictors of distractive activities to walking.

AbstractDespite collaborative efforts by the government and the private sector in the provision of health facilities in Ghana, a substantial proportion of communities in rural Ghana still have poor access to primary health care. Employing a case study research design, this study presents an overview of the geographic distribution of healthcare facilities in Kpandai District and access to primary health care. Focus group discussions and interviews were conducted with randomly selected households, opinion leaders, healthcare and in-charges of health facilities to ascertain their perception of accessibility to health services. Geographic Information System (GIS) (ArcMap) was used to model the spatial distribution of health facilities. Spatially, 139 communities representing 50.5% of the communities are not accessible health facilities per World Health Organization and Ghana Health Service Survive distance threshold to health centers and Community-based Health Planning and Services (CHPS), and hospitals, respectively. Ideally, this implies that the majority of the population have to travel for more than 5 km to access health care services. This study found that the poor spatial distribution of health facilities has negative implications on access to primary health care in the district. Poor conditions of roads were a major barrier to the household’s accessibility to district hospitals. In addition to this, the availability, affordability, adequacy and acceptability which are major determinants of access to primary health care delivery were found to be fairly good. These findings have implications for the realization of the United Nations’ health-related Sustainable Development Goals.

AbstractThe changing trend in the circular economy has pushed most firms to be competitive in their business activities using emerging technology. SMEs in recent times are increasingly leveraging technologies such as social media to enhance their interactions with their customers, increase their reach and become competitive. Despite this, SMEs in the manufacturing sector in developing economies are often underexplored in literature in their resolve to leverage social media to improve their performance and sustainability. This research explores the integration of social media in SME manufacturing firms’ activities toward their performance and sustainability in developing countries. Drawing on relevant literature and the social media engagement theory, we employed a questionnaire survey to collect data from 417 managers/staff of SME manufacturing firms in Ghana, using PLS-SEM techniques for the analysis. Research findings revealed that social media integration proved a direct positive correlation with SME manufacturing firms’ performance. Additionally, it was revealed that social media utilization has a positive and significant effect on SME manufacturing firms’ performance. The findings further show that social media usage assists SME firms’ performance and fosters their sustainability. It is concluded that SMEs should incorporate social media marketing strategies for firms’-customer relationships and internal and external collaboration. By implication, this study offers practitioners and researchers knowledge regarding social media integration among SMEs in emerging economies.

AbstractSocial media is constantly changing the business landscape across all economic sectors. Given this, small and medium enterprises (SMEs) are leveraging this to give their businesses a new trend. In emerging economies, however, the rate of adoption and integration of social media among small and medium enterprises appears to have lagged due to a multitude of factors. Drawing on the technology organization and environment (TOE) framework, the purpose of this study was to investigate the factors affecting social media application adoption and their impact on SMEs’ sustainability in Ghana’s context. Data was collected from 430 managers of SMEs in Ghana using a structured questionnaire and analyzed using a PLS-SEM. Findings revealed that cost-effectiveness, customer pressure, employees’ competence, financial resource availability, and leaders’ support positively influence social media adoption, while social media adoption also impacts SME firms’ sustainability. A negative effect was, however, observed for factors like industry pressure, perceived complexity, relative advantage, and perceived compatibility. This study contributes to the rising deployment of social media by businesses to improve their competitiveness. The implications of the research are also discussed.

AbstractThe services sector continues to play a major role in the transformation of economies. For instance, the tourism sub-sector, which is a key segment of the service sector has become one of the major contributors to economic transformation in developing economies. Given this prospect, stern competition has been created among tourism firms across the globe. However, the tourism sectors in most developing countries continue to grapple with competitive pressure challenging their competitive sustainability. Drawing on the theory of change, the purpose of this paper is to investigate factors that drive the competitive sustainability of small and medium enterprises in the tourism sector in Ghana. Data was collected from 310 SMEs in the tourism sector through the administration of a structured questionnaire and analyzed using Partial Least Square Structural Equation Modelling. The results show that price sensitivity, site maintenance, and entrepreneurial competency have a positive and significant effect on the competitive sustainability of small and medium enterprises in the tourism sector. By implications, the paper provides managers of tourism facilities with an encompassing mechanism aimed at improving tourism sites, enhancing the entrepreneurial competencies of staff, and adopting pricing strategies to enhance the competitive sustainability of the tourism sector from a developing country’s perspective. The study advances theories on tourism competitive sustainability.

AbstractDigital technologies are essential tools that Service-based firms can integrate into their business to transform their operations. However, in the emerging countries’ perspective, research on the application of digital orientation among Service-based firms is less researched. This poses questions to scholars why the adoption of digital orientation is quite low among developing economies. The purpose of this article is to examine the impediments to digital orientation among Service-based firms in emerging and developing countries. Inspired by a resource-based view, a survey using a structured questionnaire was administered to 466 respondents (management and employees) of Service-based firms via a convenience sampling method in Ghana. Findings revealed that the knowledge gap, cost burden, and upgrading of technology positively and significantly create the gap in digital orientation among Service-based firms. The authors admonished that Service-based firms should 'be orient' on the use of digital technologies through appropriate training programs to enhance its adoption. The study again recommends practitioners of Service-based firms cultivate the habit of investing in human and technical capacities to optimize the benefits of the evolution of digital technologies. Limitations and future research directions are discussed.

Despite the extensive literature on flood-related depression, depression severity for individual damaged household items is unclear. Furthermore, the effect of depression levels on the time taken to replace damaged household items is equivocal. To resolve these research gaps, this study employed a questionnaire to collect data from slum dwellers in Old Fadama and analysed using a Wilcoxon signed-rank test and stepwise multinomial regression techniques. The findings revealed that flood-affected persons ranked depression levels associated with damaged furniture/chairs/tables/sofa more severe than other household items such as Electronic: Fan/Iron, Electronic: Fridges/deep freezers/coolers/food storage, Beds/ Mattresses/other sleeping mats. Damaged items considered to have moderate cost generated mild depression levels while affordable items were less likely to generate severe depression. Concerning the replacement of damaged items, younger respondents, with lower income, in rent-free apartments and with low depression levels replaced damaged items after a year and more. The study recommends that National Disaster Management Organisation [NAMDO] should include the provision of psychological assistance to flood victims and spearhead the establishment of a national flood insurance policy, while insurers support with packages for slum areas in Ghana.

Guidance on contextually tailored implementation strategies for the prevention, treatment, and control of hypertension is limited in lower-middle income countries (Lower-MIC). To address this limitation, we compiled implementation strategies and accompanying outcomes of evidence-based hypertension interventions currently being implemented in five Lower-MIC. The Global Research on Implementation and Translation Science (GRIT) Coordinating Center (CC) (GRIT-CC) engaged its global network sites at Ghana, Guatemala, India, Kenya, and Vietnam. Purposively sampled implementation science experts completed an electronic survey assessing implementation outcomes, in addition to implementation strategies used in their ongoing hypertension interventions from among 73 strategies within the Expert Recommendations for Implementing Change (ERIC). Experts rated the strategies based on highest priority to their interventions. We analyzed the data by sorting implementation strategies utilized by sites into one of the nine domains in ERIC and summarized the data using frequencies, proportions, and means. Seventeen implementation experts (52.9% men) participated in the exercise. Of Proctor's implementation outcomes identified across sites, all outcomes except for appropriateness were broadly assessed by three or more countries. Overall, 59 out of 73 (81%) strategies were being utilized in the five countries. The highest priority implementation strategies utilized across all five countries focused on evaluative and iterative strategies (e.g., identification of context specific barriers and facilitators) to delivery of patient- and community-level interventions, while the lowest priority was use of financial and infrastructure change strategies. More capacity building strategies (developing stakeholder interrelationships, training and educating stakeholders, and supporting clinicians) were incorporated into interventions implemented in India and Vietnam than Ghana, Kenya, and Guatemala. Although robust implementation strategies are being used in Lower -MICs, there is minimum use of financial and infrastructure change strategies. Our study contributes to the growing literature that demonstrates the use of Expert Recommendations for Implementing Change (ERIC) implementation strategies to deliver evidence-based hypertension interventions in Lower-MICs and will inform future cross-country data harmonization activities in resource-constrained settings.

The paper uses a new technique to find a unique solution to a delay differential cobweb model (formulated from a joint supply-demand function of price) with real model parameters via the Lambert W-function without considering any complex branches. The dynamics of the model are demonstrated with simulations and found to complement previous studies using literature values. However, the condition for instability δ/β>1 in the previous studies was defied by our model due to the time delay associated with the supply function. The practical application and advantage of this model over the existing models are that the stability of this model is not limited to only the ratio of price elasticity of demand and supply but also the time-delay parameter (i.e., a missing link in the previous models). Our model, on the other hand, loses its stability when the time delay associated with the supply function is fixed at τ=1.8. Since most of the physical systems, including economical systems, are time-delay inherent and such stability conditionalities should not limit their performance, it is recommended that such systems be modelled using delay differential functions. The novelty of this research is that there has not been a definite general solution to the cobweb model with a time delay whose price dynamics mimic the behaviour of the existing cobweb models in the literature. An illustrative example in a delayed fractional-order differential equation also buttressed the importance of the time delay in the model, aside from the impact of the ratio of the price elasticity of supply and demand.

To ensure effective and efficient relationship marketing, brand management has become an asset (pre-requisite) for quality service marketing to thrive. Brands have gone viral to develop communities to interact with existing and novice consumers. However, the relationships between these online communities and brand trust are less explored in the literature, given the fact that consumers and users of information are core beneficiaries of these communities. The study, hence, adopted a referral (snowball) method of sampling technique to identify and gather data from social media users who are mainly millennials from the Czech Republic. Five hypotheses were tested using PLS-SEM with 534 valid respondents. The results show that online brand community has a direct significant effect on consumer’s brand trust, and indirect significant via the mediating role of peer-to-peer interaction and consumer brand engagement. Hence, the research provides managers (brand practitioners) with new insights regarding the motivations (brand promise and trust) as consequence of interacting in online brand communities. Again, this study enhances social media marketing and branding literature for researchers and practitioners to leverage on the relevance of online brand community for a firm’s competitive edge. Limitation and future research directions are considered.

The paper examines entrepreneurs’ attitudes towards chosen problems of managing financial risk in the V4 countries’ small and medium-sized enterprises. Financial risk has a significant effect on SMEs’ operations and their sustainability in the market. Entrepreneurs’ attitudes were quantified in terms of the defined aim, and a comparison of the differences in the intensity of these perceptions was made. An empirical investigation was accomplished in the V4 countries via an online questionnaire in 2020 (before the onset of the corona-crisis). A total of 1,585 valid questionnaires were obtained. The results were compared using Chi-squared and Z-score. Entrepreneurs in all V4 countries perceive financial risk correctly as an everyday part of their business activities. Their perceptions are very similar in all V4 countries. SMEs in the V4 countries evaluated the financial performance of their companies quite positively. Entrepreneurs in this research have a relatively high opinion of their financial risk management knowledge, which they presented accordingly. The research also revealed that Hungarian entrepreneurs, instead of those from the other three V4 countries, have a higher opinion of their financial risk capabilities. They highly evaluated their financial risk management knowledge and showed a higher self-confidence in managing financial risk.

Innovative marketing has given rise to practitioners’ and scholars’ attention in the 21st-century market. Given this, social media marketing has become the order of the day when accessing modern tools for marketing communication. However, the adoption of this innovation comes with its associated challenges, particularly, from a developing country perspective. Against this background, this study sought to examine the inhibitors characterized in the application of social media channels as an innovative tool for advertising and communication among SMEs (small and medium enterprises) in Ghana. For study results to be achieved, a quantitative research approach with a questionnaire of 650 was distributed among managerial staff of the fashion industry in the central part of Ghana of which 512 respondents were duly received and correctly filled for data processing and analysis. Results from the partial least square structural equation method (PLS-SEM), showed that despite the importance of innovation, lack of managerial skills/marketing expertise, perceived cost, regular systems/links upgrade, and financial constraints are significant inhibiting factors affecting the application of social media as advertising and communication tools among SMEs in developing economy. Interestingly, the findings further showed that ’company’s size’ as well as ’availability of social media channel/tool’ significantly control for the outcome variable (internet/social media) as a marketing communication tool. AcknowledgmentThis work is supported by Tomas Bata University in Zlin through; IGA/FaME/2019/002: The role of the institutional environment in fostering entrepreneurship, and further supported by IGA/FaME/2020/002 and IGA/FaME/2019/008. The authors are thankful to Prof. Jaroslav Belás, Prof. Boris Popesko, and Prof. Miloslava Chovancová for their guidance towards developing this manuscript.

Background Cardiovascular diseases (CVDs) are the number cause of death worldwide. In Ghana CVD has been the leading cause of death since 2001. The prevalence of CVD risk factors among adolescents in Ghana has been increasing. This study seeks to develop, implement and evaluate the effects of a behavioral modification intervention program to reduce CVD risk factors among secondary school students in Brong Ahafo, Ghana. Methods A cluster-randomized controlled trial was conducted with schools as clusters over a period of six-months with pre and post intervention evaluations. Participants were public secondary school students (14–19 years) from four schools in Brong Ahafo, Ghana. Students in the intervention group were trained by the researchers whereas those of the control group received no intervention. The intervention included health education and physical activity modules. Follow-up data using same questionnaire were collected within two weeks after the intervention was completed. Intention-to-treat analysis was performed after replacing missing values using the multiple imputation method. The generalized linear mixed model (GLMM) was used to assess the effects of the intervention study. Results The GLMM analyses showed the intervention was effective in attaining 0.77(pConclusion There is an urgent need for the intervention program to be integrated into the existing curriculum structure of secondary school schools. Implementing the intervention will allow for longer and more consistent impact on the reduction of CVD risk factors among secondary school students.

The notable contribution of small and medium enterprises (SMEs) in the development of socio-economics has been very encouraging in terms of its GDP contribution and employment creation. Both developed and developing countries are living testimonies of the contributions by SMEs. The primary aim of this paper is to assess the use of social media as a promotional tool for SME development. To achieve this objective, a total of 800 structured questionnaires were developed through an intercept and online survey to obtain data for the exercise. A non-probability sampling technique was employed for the collection of the data of which 648 respondents were dully accurate for the data processing/analysis. Using PLS-SEM with the help of ADANCO software v 2.2.1, findings revealed that the use of social media as an advertising tool has a significant effect on a firm’s financial performance, business motivation, customers’ perspective/attraction, and an increase in market share, thus, a key in reflecting a positive change in their marketing and promotional activities in the consumer market. The findings of the study are both beneficial to practitioners/owners of SMEs and the social media marketing literature in general. This study further strengthens the need for businesses to invest in digital marketing tools and employ them effectively to stay competitive in the long term for the firm’s growth and survival.

Abstract The purpose of the paper is to examine the type of environmental-related information firms disclose mostly in Ghana, the trend of such disclosures and investigate the determinants of environmental disclosures by firms in Ghana. Using the Global Reporting Initiative (GRI) index as a benchmark, a content analysis of the corporate annual report of 17 firms listed on the Ghana Stock Exchange (GSE) was conducted over a 10-year period (2003 to 2012) to determine the total environmental disclosure scores of the sampled firms. The determinants of environmental disclosure practices of the firms were ascertained by means of a regression analysis. Results of this study indicate that listed firms in Ghana disclose some amount of environmentally-related information espoused by GRI though the level of disclosure is low. Also, the level of disclosure by environmentally-sensitive firms is higher than the less sensitive firms similar to existing studies. Moreover, the study finds firm size, auditor type, age of the firm and industry type to be significant predictors of firms’ environmental disclosure practices.