ghanaopendata/ghanaian-research-english huggingface dataset:
Is home management of fevers a cost-effective way of reducing under-five mortality in Africa? the case of a rural Ghanaian district

OBJECTIVE: To assess the cost-effectiveness of two strategies of home management of under-five fevers in Ghana - treatment using antimalarials only (artesunate-amodiaquine - AAQ) and combined treatment using antimalarials and antibiotics (artesunate-amodiaquine plus amoxicillin - AAQ + AMX). METHODS: We assessed the costs and cost-effectiveness of AAQ and AAQ + AMX compared with a control receiving standard care. Data were collected as part of a cluster randomised controlled trial with a step-wedged design. Approximately, 12,000 children aged 2-59 months in Dangme West District in southern Ghana were covered. Community health workers delivered the interventions. Costs were analysed from societal perspective, using anaemia cases averted, under-five deaths averted and disability-adjusted life years (DALYs) averted as effectiveness measures. RESULTS: Total economic costs for the interventions were US$ 204,394.72 (AAQ) and US$ 260,931.49 (AAQ + AMX). Recurrent costs constituted 89% and 90% of the total direct costs of AAQ and AAQ + AMX, respectively. Deaths averted were 79.1 (AAQ) and 79.9 (AAQ + AMX), with DALYs averted being 2264.79 (AAQ) and 2284.57 (AAQ + AMX). The results show that cost per anaemia case averted were US$ 150.18 (AAQ) and US$ 227.49 (AAQ + AMX) and cost per death averted was US$ 2585.58 for AAQ and US$ 3272.20 for AAQ + AMX. Cost per DALY averted were US$ 90.25 (AAQ) and US$ 114.21 (AAQ + AMX). CONCLUSION: Both AAQ and AAQ + AMX approaches were cost-effective, each averting one DALY at less than the standard US$ 150 threshold recommended by the World Health Organisation. However, AAQ was more cost-effective. Home management of under-five fevers in rural settings is cost-effective in reducing under-five mortality.

Source: UG
Is increased mortality by multiple exposures to COVID-19 an overseen factor when aiming for herd immunity?

Governments across the globe responded with different strategies to the COVID-19 pan demic. While some countries adopted measures, which have been perceived controversial, others pursued a strategy aiming for herd immunity. The latter is even more controversial and has been called unethical by the WHO Director-General. Inevitably, without proper con trol measures, viral diversity increases and multiple infectious exposures become common, when the pandemic reaches its maximum. This harbors not only a potential threat overseen by simplified theoretical arguments in support of herd immunity, but also deserves attention when assessing response measures to increasing numbers of infection. Methods and findings We extend the simulation model underlying the pandemic preparedness web interface CovidSim 1.1 (http://covidsim.eu/) to study the hypothetical effect of increased morbidity and mortality due to ‘multi-infections’, either acquired at by successive infective contacts during the course of one infection or by a single infective contact with a multi-infected individual. The simulations are adjusted to reflect roughly the situation in the USA. We assume a phase of general contact reduction (“lockdown”) at the beginning of the epidemic and additional case-isolation measures. We study the hypothetical effects of varying enhancements in morbidity and mortality, different likelihoods of multi-infected individuals to spread multi-infections and different susceptibility to multi-infections in different disease phases. It is demonstrated that multi-infections lead to a slight reduction in the number of infections, as these are more likely to get isolated due to their higher morbidity. However, the latter substantially increases the number of deaths. Furthermore, simulations indicate that a potential second lockdown can substantially decrease the epidemic peak, the number of multi-infections and deaths. Enhanced morbidity and mortality due to multiple disease exposure is a potential threat in the COVID-19 pandemic that deserves more attention. Particularly it underlines another facet questioning disease management strategies aiming for herd immunity.

Source: UG
Is Inheritance System a Factor in the Care of AIDS Orphans? The Asante and Krobo of Ghana Scenario

Background Almost three decades after the discovery of HIV and AIDS in Ghana, the most obvious impact of the disease is the growing orphan crisis affecting most families and communities, especially in areas that the prevalence of HIV has exceeded the epidemic’s threshold of 5%. Studies have indicated that these orphans usually experience a wide range of problems which include education, nutrition, physical and sexual abuse, emotional and psychological distress, stigma and discrimination, among others The aim of the study was to examine the social, cultural, and traditional norms and practices that influence the care of children orphaned by AIDS in Ghana. Methods The study employed focus group discussions, in-depth interviews and key informant interviews to generate information on the socio-cultural factors that impact orphan care in the Ashanti and Eastern regions of Ghana. Results The findings indicated that the cultural practices that influence how well an AIDS orphan is taken care of by their caregivers include traditional rituals, ceremonies, and norms like funeral rites, marriage and naming ceremonies, festivals, inheritance, polygyny, and puberty rites. The social factors mentioned to affect orphan care significantly were: excessive alcohol drinking, and tobacco and drug use, dressing with fashion, night club attendance, market days, stigma and discrimination, among others. Conclusion It is recommended that though some cultural and traditional practices are deeply rooted in communities and cannot be done away completely, orphan care policies on interventions should take into account these factors to mitigate their effects on the care of orphans.

Source: UG
Is It the Timing? Short‑Term Mobility and Coital Frequency in Agbogbloshie, Ghana

Short-term mobility is often associated with increased sexual risk behavior. Mobile individuals often have higher rates of sexual risk behavior compared to non-mobile individuals, but the reasons why are not clear. Using monthly retrospective panel data from 202 men and 282 women in Agbogbloshie, Ghana, we tested whether short-term mobility was associated with changes in coital frequency, and whether the association was due to the act of travel in the given month (e.g., enabling higher risk behavior), the reason for travel, or an individual’s travel propensity at other times in the year. Overnight travel specifcally to visit family or friends, or for education, health, or other reasons, was associated with increased coital frequency for men. However, men with higher travel propensities had lower overall coital frequency and the act of traveling enabled more sex only for the most frequent male travelers. Men who seldom traveled had much higher coital frequency, but the act of traveling was not associated with additional sex acts. For women, travel for education, health, or other reasons increased coital frequency. Occasional female travelers had slightly more sex acts compared to non-mobile women, and the act of traveling for these women was associated with slight increases in coital frequency, supporting the enabling hypothesis. Highly mobile women had fewer sex acts per month on average. Our fndings suggest that mobility characteristics measured on a broad temporal scale, as well as the reason for mobility, are important to understand the relationship between short-term mobility and sexual behavior.

Source: UG
Is knowledge that powerful? Financial literacy and access to finance: An analysis of enterprises in the UK

Purpose The purpose of this paper is to examine the relationship between financial literacy, access to finance and growth among small- and medium-sized enterprises (SMEs) within the Midlands region of the UK. It assesses whether financial literacy assists SMEs to overcome information asymmetry, mitigates the need for collateral, optimizes capital structure and improves access to finance. Design/methodology/approach To gain a deeper insight into the complex relationship between financial literacy, access to finance and growth, a qualitative research is carried out among SMEs that have operated for over five years or longer. Using the purposive sampling technique, 37 firms were selected based on size, location and characteristics, mainly from the city of Birmingham and the joining conurbations. Open-ended and a combination of dichotomous questions were used for the survey. Interviews were recorded, transcribed and thematically analyzed. Findings Financial literacy is an interconnecting resource that mitigates information asymmetry and collateral deficit when evaluating loan applications, therefore financial literacy should be part of school curriculum. The analysis suggests enhanced financial literacy, reduces monitoring cost and serves to optimize firms’ capital structure that positively impacts on SMEs growth. Financial management knowledge is recognized as the core resource that aids an effective decision making by owners of SMEs. Research limitations/implications The limitation of this research is the small sample that limits its generalization. Its findings could be enhanced by a larger sample and by conducting comparative studies in other regions or economies. SMEs growth is seen as a strategic policy to stimulate enterprise but the finance gap tends to constrain that objective. The UK Government’s effort to improve access to finance and to mitigate excessive collateral demands by lenders has proved elusive. This empirical research provides evidence that financial literacy enhances access to finance and, in turn, promotes growth potentials. Practical implications The results of this study advocate the provision of financial literacy at schools and target support for SMEs to acquire financial management skills in order to mitigate information asymmetry between lenders and borrowers. Social implications Findings suggest that financial literacy mediates access to finance, enables enterprises to use optimal financial structure to mitigate business failure, creates employment and reduces public sector support for social benefits. Originality/value This study is novel in that it examines financial literacy and its implications for access to finance and firm growth in the UK. The study is an effort to highlight the role of financial information in mitigating barriers to finance for SMEs.

Source: UG
Is land grabbing an opportunity or a menace to development in developing countries? Evidence from Ghana

This study examined the developmental effects of land grabbing on farming households’ livelihoods and their adaptation strategies. Primary data was collected from 560 randomly selected farming households in seven regions of Ghana using questionnaire and was complemented with key informant interviews and focused group discussions. The Spearman rank correlation was used to determine the relationship between land grabbing and livelihood outcomes while the adaptation strategies of households were analysed qualitatively using descriptive and content analysis. The results revealed that land grabbing has a significant negative relationship with food production, income, social cohesion, health and nutrition of farming households, but had a significant positive relationship with education and employment of farming households. Based on the empirical findings, this study concludes that land grabbing in Ghana is to some extent a threat to development, as the disadvantages outweigh the advantages of the livelihood outcomes of the households that have been affected by these land deals, although it may yield some development opportunities that would yield benefits to the households in the long term. The policy recommendations are presented.

Source: UG
Is mass drug administration against lymphatic filariasis required in urban settings? The experience in Kano, Nigeria

The Department of Parasitology conducts research into parasitic diseases of public health importance with the overall goal of reducing their transmission and the heavy disease burden that they impose on affected populations. The Department maintains focus on parasitic diseases in general. These include major diseases such as malaria, and others listed under the Neglected Tropical Diseases (NTD) control initiative such as, lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiasis, trypanosomiasis and leishmaniasis.

Source: UG
Is Personhood Lost After Mental Illness? Exploring The Dynamic Interface Between Personhood And Mental Illness In Ghana.

Understanding of local conceptions of personhood and mental illness is central for developing therapeutic alliance and treatment regimens for persons living with mental illness. Such persons are exposed to several discriminatory behaviours yet factors that seem to encourage these behaviours are still not entirely understood. Personhood as construed from an emic perspective could potentially guide an understanding of societal attitudes toward individuals suffering from mental illness. This study explored Akan and Ewe conceptions of personhood in relation to mental illness. Using a semi-struc tured interview guide, seven Focused Group Discussions (FGDs) were conducted in the Tutu and Taviefe communities of the Eastern and Volta Regions of Ghana. A thematic analysis of interviews brought out three main themes: loss of sense of personhood during mental illness; liminality of personhood status after mental illness; and restoration of personhood sta tus. Within these conceptions, activities such as restoring routines and occupational therapy could be utilized to “restore personhood” at least at the performative level. This demonstrates the dynamic interface between notions of personhood and mental illness with implications for stigma reduction.

Source: UG
Is political business cycle an enemy to human development? Empirical evidence from Africa

Extant literature has argued that, with major extension of democracy since the 1990s, political business cycle has become more intense and has made African political systems more fragile. In light of this, this paper examines both the existence of African political business cycles and their impact on human development. It confirms the existence of political business cycles in Africa. Estimates of a panel fixed effects and system-GMM regression techniques for 38 African countries from 1990 to 2015 also suggest that such cycles worsen human development in African countries. This finding is consistent if we limit our analysis to various sub-regions of Africa, and also at two different income levels.

Source: UG
Is resilience socially constructed? Empirical evidence from Fiji, Ghana, Sri Lanka, and Vietnam

The objective of this paper is to better understand the various individual and household factors that influence resilience, that is, people's ability to respond adequately to shocks and stressors. One of our hypotheses is that resilience does not simply reflect the expected effects of quantifiable factors such as level of assets, or even less quantifiable social processes such as people's experience, but is also determined by more subjective dimensions related to people's perceptions of their ability to cope, adapt or transform in the face of adverse events. Data collected over two years in Fiji, Ghana, Sri Lanka and Vietnam confirms the importance of wealth in the recovery process of households affected by shocks and stressors. However our results challenge the idea that within communities, assets are a systematic differentiator in people's response to adverse events. The findings regarding social capital are mixed and call for more research: social capital had a strong positive influence on resilience at the community level, yet our analysis failed to demonstrate any tangible positive correlation at the household level. Finally, the data confirm that, like vulnerability, resilience is at least in part socially constructed, endogenous to individual and groups, and hence contingent on knowledge, attitudes to risk, culture and subjectivity. © 2016 The Authors.

Source: UG
Is Ride-Hailing a Step Closer to Personal Car Use? Exploring Associations between Car-Based Ride-Hailing and Car Ownership and Use Aspirations among Young Adults

New and emerging ICT-mediated mobility services, such as ride-hailing, are shaping travel behaviours with profound implications for sustainable urban transport and mobility. Despite the growing literature on ride-hailing’s impact on travel behaviour, there is a dearth of evidence on the possible influence of this relatively new form of car-based transport on car ownership and use aspirations, and future travel behaviour. We address this gap in the literature by answering the question: does car-based ride-hailing explain aspirations for private car-based transport among young adults? We mobilise a conceptual model that accounts for the possible influences on car ownership and use aspirations of individuals’ perceived similarities between ride-hailing and private car use; perceived benefits of ride-hailing; attitude toward car ownership and use; attitude toward the environment; as well as socio-demographic attributes. We test this model empirically in a developing country context where there is a growing use of car-based ride-hailing services, especially among young demographics. We found that individuals perceived close similarities between car-based ride-hailing and private car use, and that attitude toward car use (instrumental aspects) and perceived benefits of ride-hailing had a direct positive influence on their perceptions. Car ownership and use aspirations were strongly underpinned by individuals’ experience using carbased ride-hailing as well as the social-symbolic meaning of the private car. We also found a dissonance between individuals’ pro-environmental attitude and their desire for car ownership and use. We conclude that ride-hailing is fulfilling an immediate preference for car-based transport among our study participants. Car-based ride-hailing could therefore be a step closer to realizing personal car ownership and use aspirations. We reflect on the implications for creating sustainable urban transport and mobility futures.

Source: UG
Is rural contribution to aggregate poverty reduction substantial? New Evidence.

Using the recent estimates of rural, urban and aggregate poverty rates for 31 developing countries, the present study statistically examines the extent to which the rural sector contributes to aggregate poverty reduction. After adjusting for the effect of rural-urban migration, our results suggest that the rural sector makes a substantial contribution to aggregate poverty reduction across all five regions, consistent with earlier studies arguing for the importance of rural sector growth in poverty reduction. Recent studies giving greater priority to urbanisation-especially small and secondary towns-are thus mistaken.

Source: UG
Is single-dose NVP relevant in the era of more efficacious PMTCT regimens? Lessons from Zambia

For almost a decade, single-dose nevirapine (sdNVP) has been proven to be a safe and effective drug for the prevention of mother-to-child transmission (PMTCT) of HIV. With the advent of the use of more efficacious combination therapy strategy in reducing mother-to-child transmission, sdNVP has been relegated as a lower tier intervention. Availability of infrastructural capacity coupled with the practical reality that very few women attend an antenatal clinic more than once makes universal implementation of combination therapy a challenge. This retrospective review examined PMTCT programmatic indicators following the introduction of sdNVP at first contact in selected sites. Data from79 PMTCT sites was reviewed fromApril 2006 to March 2007 (when sdNVP was offered only after 32 weeks) and compared to the period of April 2007 March 2008. In the pre-intervention period (April 2006 March 2007), the monthly average of pregnant women who received sdNVP per site was 5.02. Post-intervention (April 2007 March 2008), the monthly average increased by 59% to 7.97 (p-valueB0.05). In pre-intervention period when sdNVP was dispensed at 32 weeks, the average proportion of pregnant women who received antiretroviral prophylaxis was 59%. This increased to 82% after the intervention. Current systems for dispensing sdNVP may be used as a foundation for implementation of more efficacious PMTCT regimens. The sdNVP administered at first contact should be a safety net for women who are unable to receive more efficacious regimen

Source: UG
Is social protection in Ghana a right?

Through an analysis of Ghana’s Livelihood Empowerment Against Poverty (LEAP) programme, this article examines the extent to which national governments have embraced the rights-based approach to social assistance. Based on interviews with beneficiary households and policymakers at national and sub-national levels, it finds that although official policy documents depict the LEAP in rights-based terms, beneficiaries see it as a charitable programme. The article concludes that if the LEAP is to play a stronger role in promoting citizenship rights in Ghana, it is important to strengthen district level structures to investigate and redress beneficiaries’ complaints in a timely manner.

Source: UG
Is social support associated with hypertension control among Ghanaian migrants in Europe and non-migrants in Ghana? The RODAM study

Hypertension (HTN) control is crucial in preventing HTN-related complications such as stroke and coronary heart disease. Yet, HTN control remains suboptimal particularly among sub-Saharan African (SSA) populations partly due to poor selfmanagement. Self-management of HTN is influenced by social support, but the evidence on the role of social support on HTN control particularly among SSA populations is limited. This study assessed the association between multiple proxies for social support and HTN control among Ghanaians resident in Ghana and Europe. The Research on Obesity and Diabetes among African Migrants (RODAM) study participants with HTN and who self-reported HTN (n = 1327) were included in this analysis. Logistic regression was used to assess the association between proxies of social support and HTN control (SBP < 140 mmHg and DBP < 90 mmHg) with adjustments for age and socioeconomic status (SES). Among Ghanaian males in both Europe and Ghana, cohabiting with more than two persons was associated with increased odds of having HTN controlled. Male hypertensive patients cohabiting with ≥ 5 persons had the highest odds of having HTN controlled after adjustment for age and SES (OR 0.30; 95% CI 0.16–0.57; 0.60; 0.34–1.04, respectively). This association was not observed among females. Relationship status, frequency of religious activity attendance and satisfaction with social support did not show any significant association with HTN control. Our study shows that cohabitation is significantly associated with HTN control but in males only. The other proxies for social support appeared not to be associated with HTN control. Involving persons living with Ghanaian men with HTN in the treatment process may help to improve adherence to HTN treatment. Further research is needed to explore in-depth, how these social support proxies could contribute to improved HTN control among SSA populations.

Source: UG