ghanaopendata/ghanaian-research-english huggingface dataset:
Path analyses of risk factors for linear growth faltering in four prospective cohorts of young children in Ghana, Malawi and Burkina Faso

Stunting prevalence is an indicator of a country’s progress towards United Nations’ Sustainable Development Goal 2, which is to end hunger and achieve improved nutrition. Accelerating progress towards reducing stunting requires a deeper understanding of the factors that contribute to linear growth faltering. We conducted path analyses of factors associated with 18-month length-for-age z-score (LAZ) in four prospective cohorts of children who participated in trials conducted as part of the International Lipid-Based Nutrient Supplements Project in Ghana (n=1039), Malawi (n=684 and 1504) and Burkina Faso (n=2619). In two cohorts, women were enrolled during pregnancy. In two other cohorts, infants were enrolled at 6 or 9 months. We examined the association of 42 indicators of environmental, maternal, caregiving and child factors with 18-month LAZ. Using structural equation modelling, we examined direct and indirect associations through hypothesised mediators in each cohort. Out of 42 indicators, 2 were associated with 18-month LAZ in three or four cohorts: maternal height and body mass index (BMI). Six factors were associated with 18-month LAZ in two cohorts: length for gestational age z-score (LGAZ) at birth, pregnancy duration, improved household water, child dietary diversity, diarrhoea incidence and 6-month or 9-month haemoglobin concentration. Direct associations were more prevalent than indirect associations, but 30%–62% of the associations of maternal height and BMI with 18-month LAZ were mediated by LGAZ at birth. Factors that were not associated with LAZ were maternal iron status, illness and inflammation during pregnancy, maternal stress and depression, exclusive breast feeding during 6 months post partum, feeding frequency and child fever, malaria and acute respiratory infections. These findings may help in identifying interventions to accelerate progress towards reducing stunting; however, much of the variance in linear growth status remained unaccounted for by these 42 individual-level factors, suggesting that community-level changes may be needed to achieve substantial progress.

Source: UG
The path dependence of district manager decision-space in Ghana

The district health system in Ghana today is characterized by high resource-uncertainty and narrow decision-space. This article builds a theory-driven historical case study to describe the influence of path-dependent administrative, fiscal and political decentralization processes on development of the district health system and district manager decision-space. Methods included a non-exhaustive literature review of democratic governance in Ghana, and key informant interviews with high-level health system officials integral to the development of the district health system. Through our analysis we identified four periods of district health system progression: (1) development of the district health system (1970-85); (2) Strengthening District Health Systems Initiative (1986-93); (3) health sector reform planning and creation of the Ghana Health Service (1994-96) and (4) health sector reform implementation (1997-2007). It was observed that district manager decision-space steadily widened during periods (1) and (2), due to increases in managerial profile, and concerted efforts at managerial capacity strengthening. Periods (3) and (4) saw initial augmentation of district health system financing, further widening managerial decision-space. However, the latter half of period 4 witnessed district manager decision-space contraction. Formalization of Ghana Health Service structures influenced by self-reinforcing tendencies towards centralized decision-making, national and donor shifts in health sector financing, and changes in key policy actors all worked to the detriment of the district health system, reversing early gains from bottom-up development of the district health system. Policy feedback mechanisms have been influenced by historical and contemporary sequencing of local government and health sector decentralization. An initial act of administrative decentralization, followed by incomplete political and fiscal decentralization has ensured that the balance of power has remained at national level, with strong vertical accountabilities and dependence of the district on national level. This study demonstrates that the rhetoric of decentralization does not always mirror actual implementation, nor always result in empowered local actors. © The Author 2015.

Source: UG
Path integral in position-deformed Heisenberg algebra with maximal length uncertainty

In this work, we study the path integral in a position-deformed Heisenberg algebra with quadratic deformation which imple ments both minimal momentum and maximal length uncer tainties. We construct propagators of path integrals within this deformed algebra using the position space representation on the one hand and the Fourier transform and its inverse representa tions on the other. The result is remarkably similar to the one obtained by Pramanik (2022) from the Perivolaropoulos’s de formed algebra (Perivolaropoulos, 2017). Then, the propagators and the corresponding actions of a free particle and a simple harmonic oscillator are discussed as examples. We also show that the actions which describe the classical trajectories of both systems are bounded by the ordinary ones of classical mechanics due to the existence of this maximal length. Consequently, par ticles of these systems travel faster from one point to another with low kinetic and mechanical energies.

Source: UG
Pathfnder elements and indicator minerals of Au from the Kubi Gold ore deposits in Ghana

The Au mineralization in the Kubi Gold Mining Area in the Birimian of Ghana is associated with garnet (about 85 vol.%), magnetite, pyrrhotite, arsenopyrite, and sulfde minerals, as well as quartz with gold and calcite. These minerals and the included elements can act as indicator minerals or pathfnder elements. For the present work, we collected samples from drill holes at diferent depths, from the alluvial zone (0–45 m) to the ore zone (75–100 m). The distributions of minerals and elements in the rocks that act as indicator minerals and pathfnder elements in the concession area were investigated along the drill hole cross sections. X-ray difraction shows that the samples contain garnet, pyrite, periclase, and quartz as the main indicator minerals. By energy-dispersive X-ray spectroscopy, Fe, Mg, Al, S, O, Mn, Na, Cu, Si, and K are identifed as corresponding pathfnder elements. The results indicate that the Au mineralization in the Kubi Mine area correlates mostly with the occurrence of garnet, pyrite, goethite, and kaolinite in the host rocks, which show towards the surface increasingly hematitic and limonitic alteration in form of Fe(oxy-)hydroxides.

Source: UG
Pathogenesis of bat rabies in a natural reservoir: Comparative susceptibility of the straw-colored fruit bat (Eidolon helvum) to three strains of Lagos bat virus

Rabies is a fatal neurologic disease caused by lyssavirus infection. People are infected through contact with infected animals. The relative increase of human rabies acquired from bats calls for a better understanding of lyssavirus infections in their natural hosts. So far, there is no experimental model that mimics natural lyssavirus infection in the reservoir bat species. Lagos bat virus is a lyssavirus that is endemic in straw-colored fruit bats (Eidolon helvum) in Africa. Here we compared the susceptibility of these bats to three strains of Lagos bat virus (from Senegal, Nigeria, and Ghana) by intracranial inoculation. To allow comparison between strains, we ensured the same titer of virus was inoculated in the same location of the brain of each bat. All bats (n = 3 per strain) were infected, and developed neurological signs, and fatal meningoencephalitis with lyssavirus antigen expression in neurons. There were three main differences among the groups. First, time to death was substantially shorter in the Senegal and Ghana groups (4 to 6 days) than in the Nigeria group (8 days). Second, each virus strain produced a distinct clinical syndrome. Third, the spread of virus to peripheral tissues, tested by hemi-nested reverse transcriptase PCR, was frequent (3 of 3 bats) and widespread (8 to 10 tissues positive of 11 tissues examined) in the Ghana group, was frequent and less widespread in the Senegal group (3/3 bats, 3 to 6 tissues positive), and was rare and restricted in the Nigeria group (1/3 bats, 2 tissues positive). Centrifugal spread of virus from brain to tissue of excretion in the oral cavity is required to enable lyssavirus transmission. Therefore, the Senegal and Ghana strains seem most suitable for further pathogenesis, and for transmission, studies in the straw-colored fruit bat.

Source: UG
Pathogenesis of type 1 and type 2 diabetes mellitus in sub-Saharan Africa: implications for transitional populations

The increasing prevalence and incidence of diabetes and its long-term complications in sub-Saharan Africa (SSA) could have devastating human and economic toll if the trends remain unabated in the future. Approximately 90% or majority of patients with diabetes belongs to the adult onset, type 2 diabetes category while 10% have type 1 diabetes in SSA. However, because of the paucity of metabolic and clinical data, a clear understanding of the natural history of both diseases and the classification of diabetes subtypes has been hampered. Nevertheless, we have attempted to provide a concise review of the pathophysiology of both type I and type 2 diabetes as well as phenotypic and clinical variations in patients residing in SSA. The limited metabolic data, (albeit increasing), from high-risk and diabetic individuals in the SSA, have contributed significantly to the understanding of the pathogenetic mechanisms of diabetes and the variations in the presentation of the disease. Sub-Saharan African patients with type I diabetes have essentially absolute insulin deficiency. In addition, patients with type 2 diabetes in SSA region also manifest severe insulin deficiency with varying degrees of insulin resistance. Although the exact genetic markers of both diseases are unknown, we believe studies in patients of SSA origin who reside in diverse geographic environments (African diaspora) could potentially contribute to our understanding of the genetic and environmental mediators of both diseases. However, many intrinsic, individual and societal obstacles such as poor education and illiteracy, low socio-economic status and lack of access to health care make uncertain the translation of diabetes research in SSA. In this regard, effective management and/or prevention of diabetes in SSA individuals should adopt multidisciplinary approaches. Finally, innovative health care delivery and educational models will be needed to manage diabetes and its long-term complications in SSA.

Source: UG
The pathologist in Ghana and potential for research

One of the neglected areas of clinical medical practice in developing countries is the field of Laboratory Medicine. As a result, the important role of the laboratory physician in diagnosis of disease and subsequent management of patients is not much appreciated. Even more worrying is lack of appreciation of the research potential of laboratory medicine, considering that it provides a repository of confirmatory data on many human disorders; data that have been usefully employed for the study of various diseases in developed parts of the world. It is perhaps, the reason that many diseases peculiar to developing countries still remain untamed. My experience in the practice of anatomical pathology in several countries has taught me that the specialty, as with other specialties of laboratory medicine in Ghana needs more attention, with regards to its development to the level where it can meet its clinical functions satisfactorily. When this is ensured, it would also provide the necessary vital contribution to research that has characterised its practice in more advanced countries. More exposure of the specialty to undergraduate medical students must be encouraged in order to attract trainees into the specialty. Along with this exposure must go an increase in infrastructure and the necessary facilities to permit growth of the specialty. Research potential of the specialty must be harnessed and fully supported financially to help in unravelling peculiar disease problems of our locality. To achieve this, I have re-emphasised the need for a special fund to drive scientific research in Ghana

Source: UG
Paths to attaining food security: The case of Cameroon

This paper sets out to develop a framework for characterizing agricultural growth orientations. We identify four main components in the global food system (technology, institutions, people, and natural resources). Based on the extent to which any two of these components are important in driving the growth of agriculture, we distinguish four main orientations of agricultural growth: local food, high resource-technology driven, guided technology driven, and right-to-food growth orientations. Given the social and environmental challenges that agricultural growth has to meet in Cameroon, we argue that the local food orientation and guided technology-driven orientation offer better opportunities for meeting the problem of food security in this country.

Source: UG
Pathways for the economic empowerment of female entrepreneurs in emerging economies: Implications for social work

In many emerging economies, owning and operating a small/medium-scale business is essential in the creation of wealth, empowering business owners and helping to address the developmental challenges of the society. Although many women are venturing into family businesses in Ghana, there are still some challenges that hinder their economic empowerment. Interviewing 15 women in small, family businesses in Accra, this article identifies three main concerns of the women which are identified as critical pathways that social workers interested in the economic empowerment of female entrepreneurs could follow. The implications of the findings for social work practice are discussed.

Source: UG
Pathways of change: qualitative evaluations of intimate partner violence prevention programmes in Ghana, Rwanda, South Africa and Tajikistan

A critical component of evaluations of the effectiveness of intimate partner violence prevention programmes involves understanding pathways of change among individuals who participate in such programmes, and the intervention or contextual elements that support or hinder these. This paper draws on qualitative evaluations of four intimate partner violence prevention programmes in Ghana, Rwanda, South Africa and Tajikistan conducted as part of the What Works to Prevent Violence against Women and Girls Programme. Using a comparative case study approach, a secondary analysis was applied to thematically analysed data to explore how and why men and women change in response to different types of programmes across diverse contexts. Similar pathways of change were identified including the value of learning and applying relationship skills to support equitable, non-violent relation ships; the importance of participatory approaches to challenge harmful gender norms and allow for group rapport; and the integration of economic empowerment activities to reduce drivers of intimate partner violence and conflict, and promote participants’ self-confidence and status. These findings provide insights regarding intervention design and implementation factors pertinent to bring about changes in intimate partner violence.

Source: UG
Pathways to care: Factors predicting women’s access to clinic versus pharmacy-based medication abortion in Ghana

Background: Women’s decision to access medication abortion (MA) in clinics or pharmacies may be shaped by several factors, but is an area that has not been adequately researched. Little is also known about the primary predictors of choice of MA provider. Objectives: Our study examined the factors associated with choice of MA provider and identified the primary predictors. Design: A non-inferiority and prospective design. Methods: We utilized data from a non-inferiority and prospective study that recruited women who had MA from selected clinics and pharmacies in Ghana. Our sample comprises 1045 and 929 women from clinics and pharmacies, respectively. We used a multivariate binary logistic model to examine the factors associated with MA providers. Following this, a decision tree model was utilized to shed light on the main predictors. Results: Our results show that women were more likely to spend more on accessing MA in clinics than in pharmacies (adjusted odds ratio (AOR) = 1.0, p < 0.01). Notably, results from the decision tree model indicate that MA cost has the strongest effect on provider selection (χ2 = 937, p < 0.01). Additionally, women over 24 years old (AOR = 0.7, p < 0.05), those with secondary education (AOR = 0.5, p < 0.01), those who learned about MA from friends or close relatives (AOR = 0.5, p < 0.01), and those who previously had MA before their recent MA (AOR = 0.6, p < 0.01) were less likely to access MA in clinics. Conclusion: We found that cost has the strongest effect on women’s choice of MA provider in Ghana. In addition, sociodemographic and abortion-related factors play a role. These factors should be considered in developing strategies to enhance equal opportunity in accessing high-quality and safe MA. For instance, developing strategies to reduce MA costs in clinical settings could reduce the burden on vulnerable women, including those younger who may prefer clinic providers.

Source: UG
Pathways to Global versus Local Brand Preferences: The Roles of Cultural Identity and Brand Perceptions in Emerging African Markets

The effects of cultural identity on perceptions about and preference for global and local brands remain less understood. Using consumer cultural identity theory, this study tests assumptions that cultural identity drives perceived brand globalness and localness. It also examines how such perceptions shape brand value assessments and preference formation. The study draws on consumer data from two prominent emerging African markets, South Africa and Ghana, to test the hypothesized relations through structural equation modelling. The findings support predictions that individuals’ cultural identity drives their perceptions of brands as local/global. Specifically, global identity drives global brand preference in both countries, but local identity was a weak driver of local brand preference in Ghana. The perceived value of local brands impacts local brand preference more than foreign brand preference. The study highlights several contributions on the pathways to global or local brand preferences that should benefit international marketing scholars and branding professionals.

Source: UG
Pathways to unsafe abortion in Ghana: The role of male partners, women and health care providers

Background Despite abortion being legal, complications from induced abortion are the second leading cause of maternal mortality in Ghana. The objective of this study was to understand the decision-making process associated with induced abortion in Ghana. Study Design Data were collected from female postabortion patients, male partners, family planning nurses and obstetricians/gynecologists at two teaching hospitals in Ghana using in-depth interviews and focus group discussions. Results While experiences differ for married and single women, men are involved in abortion decision making directly, through "orders" to abort, or indirectly, through denying responsibility for the pregnancy. Health care providers can be barriers to seeking safe abortions in this setting. Conclusions Women who choose to terminate a pregnancy without their male partners' knowledge should have the means (both financial and social) to do so safely. Interventions with health care providers should discourage judgemental attitudes and emphasize individually focused patient care. © 2013 Elsevier Inc.

Source: UG
Pathways Utilized for Antenatal Health Seeking Among Women in the Ga East District, Ghana

BACKGROUND: Ghana's maternal mortality ratio has been declining over the last two decades but at a rather slow pace. Poor access to effective maternity care is identified as one of the key challenges of maternity care. The current study mapped out the pathways to pregnancy care seeking among urban-dwelling adult women in a peri-urban district located in the Greater Accra region of Ghana.METHODS: A total of 300 women who had a live birth in the last 12 months participated in a community-based survey. They answered questions on care seeking behavior related to their last pregnancy. A multivariate Logistic regression model was used to identify factors associated with multiple care seeking behavior.RESULTS: Almost all women in the survey (98%) reported accessing skilled antenatal care (ANC) from a biomedical provider, although 35% begun ANC later than the first trimester. About 45% of women simultaneously utilized both ANC and alternative care providers (ACP) including traditional birth attendants, herbalists, and spiritualists. A complex pathway to antenatal care seeking behavior involving shuttling between providers was observed. Controlling for household wealth, household size, and age, seeking care from multiple providers concurrently was associated with residence in Kwabenya sub-district OR=2.13 (95% CI: 1.28, 3.55) and previous abortion OR=2.08 (95% CI: 1.11, 3.91).CONCLUSIONS: Urban-dwelling women in Ga East District seek antenatal care concurrently from multiple sources. Health system interventions must seek ways to integrate alternative care providers into the existing biomedical health care system.

Source: UG
Pathways Utilized For Antenatal Health Seeking Among Women In The Ga East District, Ghana

Background: Ghana’s maternal mortality ratio has been declining over the last two decades but at a rather slow pace. Poor access to effective maternity care is identified as one of the key challenges of maternity care. The current study mapped out the pathways to pregnancy care seeking among urban-dwelling adult women in a peri-urban district located in the Greater Accra region of Ghana. Methods: A total of 300 women who had a live birth in the last 12 months participated in a community-based survey. They answered questions on care-seeking behavior related to their last pregnancy. A multivariate A logistic regression model was used to identify factors associated with multiple care-seeking behavior. Results: Almost all women in the survey (98%) reported accessing skilled antenatal care (ANC) from a bio-medical provider, although 35% began ANC later than the first trimester. About 45% of women simultaneously utilized both ANC and alternative care providers (ACP) including traditional birth attendants, herbalists, and spiritualists. A complex pathway to antenatal care seeking behavior involving shuttling between providers was observed. Controlling for household wealth, household size, and age, seeking care from multiple providers concurrently were associated with residence in Kwabenya sub-district OR=2.13 (95% CI: 1.28, 3.55) and previous abortion OR=2.08 (95% CI: 1.11, 3.91) Conclusions: Urban-dwelling women in Ga East Dis trict seek antenatal care concurrently from multiple sources. Health system interventions must seek ways to integrate alternative care providers into the existing biomedical health care system.

Source: UG