ghanaopendata/ghanaian-research-english huggingface dataset:
Refusal to enrol in Ghana's National Health Insurance Scheme: Is affordability the problem?

Background: Access to health insurance is expected to have positive effect in improving access to healthcare and offer financial risk protection to households. Ghana began the implementation of a National Health Insurance Scheme (NHIS) in 2004 as a way to ensure equitable access to basic healthcare for all residents. After a decade of its implementation, national coverage is just about 34% of the national population. Affordability of the NHIS contribution is often cited by households as a major barrier to enrolment in the NHIS without any rigorous analysis of this claim. In light of the global interest in achieving universal health insurance coverage, this study seeks to examine the extent to which affordability of the NHIS contribution is a barrier to full insurance for households and a burden on their resources. Methods: The study uses data from a cross-sectional household survey involving 2,430 households from three districts in Ghana conducted between January-April, 2011. Affordability of the NHIS contribution is analysed using the household budget-based approach based on the normative definition of affordability. The burden of the NHIS contributions to households is assessed by relating the expected annual NHIS contribution to household non-food expenditure and total consumption expenditure. Households which cannot afford full insurance were identified. Results: Results show that 66% of uninsured households and 70% of partially insured households could afford full insurance for their members. Enroling all household members in the NHIS would account for 5.9% of household non-food expenditure or 2.0% of total expenditure but higher for households in the first (11.4%) and second (7.0%) socio-economic quintiles. All the households (29%) identified as unable to afford full insurance were in the two lower socio-economic quintiles and had large household sizes. Non-financial factors relating to attributes of the insurer and health system problems also affect enrolment in the NHIS. Conclusion: Affordability of full insurance would be a burden on households with low socio-economic status and large household size. Innovative measures are needed to encourage abled households to enrol. Policy should aim at abolishing the registration fee for children, pricing insurance according to socio-economic status of households and addressing the inimical non-financial factors to increase NHIS coverage. © 2015 Kusi et al.; licensee BioMed Central.

Source: UG
Refusal to enrol in Ghana¿s National Health Insurance Scheme: is affordability the problem?

Abstract Background Access to health insurance is expected to have positive effect in improving access to healthcare and offer financial risk protection to households. Ghana began the implementation of a National Health Insurance Scheme (NHIS) in 2004 as a way to ensure equitable access to basic healthcare for all residents. After a decade of its implementation, national coverage is just about 34% of the national population. Affordability of the NHIS contribution is often cited by households as a major barrier to enrolment in the NHIS without any rigorous analysis of this claim. In light of the global interest in achieving universal health insurance coverage, this study seeks to examine the extent to which affordability of the NHIS contribution is a barrier to full insurance for households and a burden on their resources. Methods The study uses data from a cross-sectional household survey involving 2,430 households from three districts in Ghana conducted between January-April, 2011. Affordability of the NHIS contribution is analysed using the household budget-based approach based on the normative definition of affordability. The burden of the NHIS contributions to households is assessed by relating the expected annual NHIS contribution to household non-food expenditure and total consumption expenditure. Households which cannot afford full insurance were identified. Results Results show that 66% of uninsured households and 70% of partially insured households could afford full insurance for their members. Enroling all household members in the NHIS would account for 5.9% of household non-food expenditure or 2.0% of total expenditure but higher for households in the first (11.4%) and second (7.0%) socio-economic quintiles. All the households (29%) identified as unable to afford full insurance were in the two lower socio-economic quintiles and had large household sizes. Non-financial factors relating to attributes of the insurer and health system problems also affect enrolment in the NHIS. Conclusion Affordability of full insurance would be a burden on households with low socio-economic status and large household size. Innovative measures are needed to encourage abled households to enrol. Policy should aim at abolishing the registration fee for children, pricing insurance according to socio-economic status of households and addressing the inimical non-financial factors to increase NHIS coverage.

Source: UG
Regenerative edible insects for food, feed, and sustainable livelihoods in Nigeria: Consumption, potential and prospects

Edible insects are imperative as food, feed, and other products for industries, but commercial farming and utilization of insects as food, feed and industries is rare in Nigeria. However, consumption of insects in Nigeria is longstanding and increasingly becoming popular and receiving more attention because of their potential as alternatives to animal protein and a means of livelihood to mitigate hunger and poverty. We harnessed academic and grey literature and personal communications to obtain a wholesome and concise review of the edible insects in Nigeria. This process revealed 13 edible insect species consumed amongst various tribes and indigenous people in the country. We found that the consumption of insects in Nigeria is ubiquitous but more popular and generally accepted in southern Nigeria than in the northern part of the country. However, farming insects for food and feed is seldom because edible insects are harvested from wild populations. Insights into the challenges of farming edible insects in Nigeria revealed that funding, seasonality, technical know-how or expertise are at the forefront. while poor extension services, inadequate processing technologies, and not having in place strategies for their upscaling is also implicated. We recommend mutualistic cooperation between key stakeholders along the agricultural value chain in Nigeria, such as the government, investors, and others that will foster partnerships with established industries in East Africa, especially Kenya and Uganda, where farming insects for food, feed, and livelihoods are thriving.

Source: UG
Regional brain volume changes in alcohol-dependent individuals during early abstinence: associations with relapse following treatment

Cross-sectional structural magnetic resonance (MR) imaging studies of individuals with an alcohol use disorder (AUD) report that those who relapse after treatment, relative to individuals who maintain a period of extended abstinence, show greater morphological abnormalities in multiple brain regions near the inception of treatment, particularly in the frontal lobe. However, given the cross-sectional design of previous studies, it is unclear if the baseline morphological differences between future abstainers and relapsers were maintained over the course of early recovery. The primary goal of this study was to determine if frontal lobe tissue volume recovery during early abstinence is associated with long-term abstinence from alcohol. We compared frontal, parietal, temporal and occipital grey matter (GM) and white matter (WM) volumes, at 1 and 4 weeks of abstinence, among individuals who resumed alcohol consumption within 12 months of treatment (Relapsers) and those who showed sustained abstinence over 12 months following treatment (Abstainers). At 1 and 4 weeks of sobriety, both Abstainers and Relapsers demonstrated significantly smaller GM volumes than Controls in the majority of ROIs, but Relapsers exhibited significantly smaller bilateral frontal GM volumes than Abstainers. No significant group differences were observed for any WM region of interest. The persistent bilateral frontal GM volume deficits in Relapsers over 4 weeks from last alcohol use may represent an endophenotype that differentiates those who respond more favorably to the typical psychosocial and pharmacological interventions provided for AUD. © 2016 Society for the Study of Addiction

Source: UG
: Regional Conflict Resolution Mechanisms: A comparative analysis of two African Security Complexes

The need for regional organizations to take up the resolution of the conflicts in their region or security complex has become important especially following the end of the cold war. Two regional security complexes in Africa, namely ECOWAS and SADC are examined in the light of conflicts erupting in their regions - Liberia and Sierra Leone in the ECOWAS and Lesotho and DR Congo in the SADC sub regions. The paper examines the efforts of the two regional bodies to resolve the conflicts and concludes that intervention in conflicts succeed or fail depending on the level of regionness or the existence of structures for conflict resolution in the regional security complex. In the case of the conflicts in the ECOWAS security complex the organization’s conflict resolution efforts were ad hoc, even though they were bold and innovative, the efforts were not set within an effective conflict resolution mechanism and they were not very successful. In the case of SADC its conflict resolution effort in Lesotho was botched and in the DR Congo it did not make any meaningful effort at helping to resolve the conflict save some mediation efforts by South African leaders

Source: UG
Regional dissemination of a trimethoprim-resistance gene cassette via a successful transposable element.

Background: Antimicrobial resistance is a growing international problem. We observed a 50% increase in the prevalence of trimethoprim resistance among fecal Escherichia coli from healthy Nigerian students between 1998 and 2005, a trend to increase that continued in 2009. Methods and Findings: A PCR-based screen revealed that 131 (43.1%) of isolates obtained in Nigeria in 2005 and 2009 carried integron-borne dfrA cassettes. In the case of 67 (51.1%) of these isolates, the cassette was a class 1-integron-borne dfrA7 gene, which has been reported at high prevalence from E. coli isolates from other parts of Africa. Complete sequencing of a 27 Kb dfrA7-bearing plasmid from one isolate located the dfrA7 gene within a Tn21-type transposon. The transposon also contained an IS26-derived bla/sul/str element, encoding resistance to b-lactams, sulphonamides and streptomycin, and mercury resistance genes. Although the plasmid backbone was only found in 12 (5.8%) of trimethoprim resistant isolates, dfrA7 and other transposon-borne genes were detected in 14 (16.3%) and 32 (26.3%) of trimethoprim resistant isolates collected in Nigeria in 2005 and 2009, respectively. Additionally, 37 (19.3%) of trimethoprim-resistant E. coli isolates collected between 2006 and 2008 from Ghana were positive for the dfrA7 and a transposon marker, but only 4 (2.1%) harbored the plasmid backbone. Conclusions: Our data point to transposition as a principal mechanism for disseminating dfrA7 among E. coli from Nigeria and Ghana. On-going intensive use of the affordable broad-spectrum antibacterials is likely to promote selective success of a highly prevalent transposable element in West Africa.

Source: UG
Regional integration and non-tariff barriers to Intra-Sub-Saharan Africa trade

The paper assesses the ex-post trade effect of sub-regional trade agreements (RTAs), financial integration and other non-tariff barriers on intra-regional trade involving 43 Sub-Saharan Africa (SSA) countries. The objective is to find out if RTAs within SSA had increased trade flows to inform current efforts of establishing a successful continental free trade area in SSA. Estimating a gravity model augmented with measures of trade agreements and financial integration, the paper made use of bilateral trade flows and key gravity covariates from CEPII database over the period 1960–2015. After controlling for the endogeneity of the trade agreement dummy, multilateral price resistance and zero-valued trade flows, we find RTAs within SSA and especially among Economic Community of West Afri can States and Southern Africa Development Community members to have had a positive and significant impact on bilateral trade. Financially integrated trading partners also traded more, while we also found distance, landlocked-ness, common currency and colonial link to have an impact on trade costs and bilateral trade flows within SSA. The results indicate the need to focus on policies to expand and integrate regional markets in SSA by removing impediments to trade and improving on trade facilitation measures to significantly improve trade performance under the newly established African Continental Free Trade Area.

Source: UG
Registered or unregistered? Levels and differentials in registration and certification of births in Ghana

Background: The birth of a child is a vital event that needs to be registered but this is not always the case as an estimated 40 million births go unregistered annually. Birth registration safeguards the basic rights of children and gives them an identity, citizenship/nationality and legal protection against violence, abuse and human rights violations. It is therefore necessary that all births are registered and even more critical that the registration of a birth is followed by the issuance of a birth certificate. But sadly, birth registration in many African countries continues to remain below acceptable international standards and not all registered births are certified. This paper examined birth registration and certification in Ghana. Differentials in the characteristics of children and mothers of children whose births are registered and certified, children whose births are registered but not certified and children whose births are not registered were examined. Methods: This paper analysed data from the 2014 Ghana Demographic and Health Survey drawing on variables from the household and children's data files. Descriptive analytical tools (frequencies, percentage and cross tabulations) and multinomial logistic regression analysis were used to examine differentials in birth registration status among an analytical sample of 3880 (weighted) children aged 0-4 years. Results: The birth of about every 1 in 4 (28.89%) children in Ghana have never been registered. Birth registration and certification was lowest among children born to young mothers (15-19 years), children whose mothers have no formal education, mothers who reside in rural areas and mothers in the poorest wealth quintile. Additionally, home births and births that were not assisted by a medical professional were observed to have the lowest proportion of registered and certified births. Furthermore, the birth of children who are less than a year old was significantly more likely not to be registered or issued with a birth certificate. Conclusion: Efforts aimed at improving birth registration and certification in Ghana need to target groups of children and mothers with low levels of registration and certification particularly children who are born at home, children born to young mothers and children whose mothers are poor and or reside in rural areas. © 2018 The Author(s).

Source: UG
Regolith mapping of deeply weathered terrain in savannah regions of the Birimian Lawra Greenstone Belt, Ghana

A regolith map for the Lawra Belt has been developed by categorising the regolith-landform units by processing and interpreting remote sensing data. Regolith landform units were extracted from Landsat band ratios 3/1 and 5/4 to map ferruginous saprolite and lags; band ratio 5/7 was used to identify residual regolith and band ratio 4/2 was employed to separate ferruginous units from non-ferruginous regolith. Additional regolith landform units' discrimination was provided by compiling and interpolating radiometric data particularly for Landsat TM poorly defined areas. SRTM images were used to mark out the extent of the alluvial plains. High topographical terrains were marked from DEM image to represent the residual areas. Regolith landform unit (RLU) map that showed residual (relict and erosional), ferruginous, and depositional domains of the Lawra Belt was developed by superimposing the extractions made from the remote sensed data. Interpretive map generated from the remote sensed image analysis was validated by first creating a non-genetic regolith map through ground truth survey. The non-genetic map based on spatial distributions of the different regolith mapping units were classified on genetic classes or regimes based on regolith-landform similarities to develop a genetic map. The interpretive and the genetic map were superimposed to develop the regolith map for the Lawra Belt. The inliers and outliers presenting compositional overlaps within broad regolith classes were rectified from the field mapping information. The combined approach of image analysis and the ground truth mapping grouped the regolith of Lawra Belt into ferruginous (F), relict (R), erosional (E) and depositional (D) regimes. © 2015 Elsevier B.V.

Source: UG
Regular and irregular international migration of parent(s): the experiences of left-behind Children in Accra and Sunyani

This study sought to examine the extent to which international migration of parent(s) impacts on children left-behind, with specific reference to their educational performance. The study adopted a mix of both quantitative and qualitative approaches through the use of questionnaire and in-depth interviews as the main instruments of data gathering. This study involved 227 participants and respondents comprising 213 basic school children from both migrant and non-migrant households, 8 basic school teachers and 6 caregivers of children left behind in Accra and Sunyani. The ages of the children involved in the study ranged from 10 to 16 years. The findings of the study revealed that, in the Ghanaian context, the effects of parental migration on children, whether desirable or undesirable depended on other factors such as living arrangement, care and support that the children receive, the migration status of the parent(s) other than the mere parental separation.

Source: UG
Regulated expression of the Ras effector Rin1 in forebrain neurons

The Ras effector Rin1 is induced concomitant with synaptogenesis in forebrain neurons, where it inhibits fear conditioning and amygdala LTP. In epithelial cells, lower levels of Rin1 orchestrate receptor endocytosis. A 945 bp Rin1 promoter fragment was active in hippocampal neurons and directed accurate tissue-specific and temporal expression in transgenic mice. Regulated expression in neurons and epithelial cells was mediated in part by Snail transcriptional repressors: mutation of a conserved Snail site increased expression and endogenous Snai1 was detected at the Rin1 promoter. We also describe an element closely related to, but distinct from, the consensus site for REST, a master repressor of neuronal genes. Conversion to a consensus REST sequence reduced expression in both cell types. These results provide insight into regulated expression of a neuronal Ras effector, define a promoter useful in telencephalic neuron studies, and describe a novel REST site variant directing expression to mature neurons.

Source: UG
Regulation and performance of Ghana’s multi-tiered rural and microfinance industry

The World Bank’s ‘Comparative Review of Microfinance Regulatory Framework Issues’ concludes that ‘recognizing different tiers of both regulated and unregulated institutions in a financial structure facilitates financial deepening and outreach’, yet warns that ‘legislation intended to promote microfinance may impose untenable supervisory burdens, while an excessively restrictive approach may constrict innovation and expansion’ (Gallardo et al., 2005, p. iii). Ghana represents a regulatory framework that has evolved to permit several tiers of both regulated and unregulated institutions engaged in microfinance, sometimes facilitating new institutional forms and sometimes responding to evolution of the market. Indeed, Ghana has been an innovator since the introduction of the first African credit union in 1955 and the first rural bank in 1976. It offers a contrast to countries that have only in the last decade created regulated tiers suitable for microfinance (for example, Uganda, Kenya), sometimes severely restricting their form (West African Monetary Union, Ethiopia), or that leave regulation to apex bodies (Bangladesh, Philippines; Meagher, 2002). © Palgrave Macmillan, a division of Macmillan Publishers Limited 2013.

Source: UG
Regulation of gambling in Sub-Saharan Africa: findings from a comparative policy analysis

Objectives: Commercial gambling markets have undergone unprecedented expansion and diversification in territories across Sub-Saharan Africa (SSA). This gambling boom has popularised the uptake of gambling products in existing circuits of popular culture, sport and leisure and raised concerns about the extent to which state legislation is equipped to regulate the differentiated impacts of gambling on public health. Study design: Comparative policy analysis. Methods: This article provides a systematic mapping of the regulatory environment pertaining to gambling across SSA. The review was conducted by obtaining and triangulating data from a desk review of online materials, consultation with regulatory bodies in each territory and the VIXIO Gambling Compliance database. Results: Gambling is legally regulated in 41 of 49 (83.6%) SSA countries, prohibited in 7 (14.3%) and is not legislated for in 1 (2.0%). Of those countries that regulate gambling, 25 (61.0%) countries had dedicated regulators and 16 (39.0%) countries regulated via a government department. Only 2 of 41 (4.9%) countries have published annual reports continuously since the formation of regulatory bodies, and 3 (7.3%) countries have published an incomplete series of reports since the formation. In 36 (87.8%) countries, no reports were published. Enforcement activities were documented by all five regulators that published reports. Conclusion: The review uncovered a lack of coherence in regulatory measures and the need for more transparent public reporting across SSA territories. There are also variations in regulating online products and marketing, with most countries lacking apt guidelines for the digital age. Our findings suggest an urgent need to address the regulatory void surrounding online forms of gambling and the promotion of gambling products. This underlines the importance of a public health approach to protect against an increase in gambling-related harms

Source: UG