Soil quality and heavy metal contamination in an open dumpsite in Navrongo, Ghana.

The increasing proximity of the Dudumbia dumpsite, an open dumpsite in Navrongo, Ghana, to human settlements necessitates an investigation of the soil quality to safeguard the environment from heavy metal toxicity. This study examined the impact of waste dumping activities on the physicochemical properties of the soil, as well as the level of heavy metal (Pb, Cd, Ni, Cr, As, Hg, Cu, Mn, and Zn) contamination and associated risks. Various contamination and risk assessment tools were used, including the geoaccumulation index (Igeo), pollution load index (PLI), potential ecological risk (Er), and potential ecological risk index (PERI). The study found significant improvements in notable soil attributes such as phosphorus (P), organic carbon (C), total nitrogen (N), calcium (Ca), magnesium (Mg), potassium (K), sodium (Na), and effective cation exchange capacity, with percentage increases ranging from 50.8 to 2078.3%. Igeo values ranged from 2.07 to 6.20, indicating contamination levels from moderate to extreme. The PLI and PERI values were 16.241 and 1810, respectively. The Er values for the heavy metals ranged from 36 to 607, indicating ecological risk levels from low to very high, with Cd and Hg posing very high risks. These results suggest that while the dumpsite soil shows improvements in some characteristics favourable for plant cultivation, waste dumping significantly contributes to heavy metal contamination. The soil at the dumpsite is deteriorated and poses significant health risks, particularly due to Cd and Hg. Therefore, remediation efforts should prioritise mitigating the risks posed by Cd and Hg.

Adolescent girls' and young mothers' knowledge and use of antenatal care in the Ahafo Region, Ghana: A cross-sectional study.

BACKGROUND:  Antenatal care (ANC) is crucial to reducing maternal and neonatal deaths, but few studies examined adolescent girls' and young women's ANC utilisation and knowledge in Ghana. AIM:  To assess adolescents' and young mothers' knowledge of ANC, utilisation and factors influencing its use in Ghana. SETTING:  Tano North Municipality, Ahafo Region. METHODS:  This community-based, cross-sectional study involved 440 adolescent and young mothers (between 10 and 24 years). A structured questionnaire was employed to collect data face-to-face. Descriptive and statistical analyses were performed, and p  0.05 was considered statistically significant. RESULTS:  Of the 440 respondents, most were aged 20-24 years (61.2%), married (30.0%), Christians (78.2%), completed junior high school (JHS) (47.8%) and traders (38.9%). Postnatal mothers were 71.6% (315), and all had utilised ANC services. Antenatal care knowledge was good among 75% (330) respondents, with no significant variation by age. Religion influenced knowledge, with Muslims having lower knowledge. Antenatal care utilisation was high ( 50%) among those aged 15-19 years, married, Christians, JHS graduates and traders. Age, marital status and employment type significantly influenced ANC utilisation. Individuals in the age group 15-19 years and married women demonstrated higher odds of utilising ANC services. Casual workers and unemployed respondents were found to have lower odds of utilising ANC services compared to traders. CONCLUSION:  Age, marital status, and employment type influenced ANC utilisation in the Ahafo Region. Adolescent mothers under 15 years had lower rates, requiring targeted interventions to improve pregnancy outcomes.Contribution: This study highlights the knowledge and factors influencing ANC use in Ahafo Region and adds to the existing research evidence on ANC.

Ownership and usage of insecticide-treated nets in Ghana: a scoping review of facilitators and barriers.

BACKGROUND: Insecticide-treated nets (ITNs) are pivotal tools for malaria prevention in endemic regions like Ghana. Understanding the protective factors and barriers influencing ITN ownership and usage is crucial for designing effective interventions. A scoping review was conducted to identify studies exploring protective factors and barriers related to ITN ownership and usage. METHODS: This review followed the guidelines by Askey and O'Malley. Search was done in four major databases including PubMed, Science Direct, PubMed CENTRAL, and JSTOR. Additional searches were done in Google Scholar and Google. Peer-reviewed and grey literature were included. RESULTS: A total of 24 papers met the eligibility criteria and were included in the review. Included studies found regional disparities in ITN ownership and usage. Furthermore, included studies reported ownership rates between 97.8 and 28% and usage rates between 94 and 20%. Protective factors facilitating ITN ownership were marital status, higher educational attainment, higher income levels, and being aged 25 years or older. In contrast, the factors for its use included community-level campaigns advocating for ITN use and awareness, individuals with secondary education or higher and those residing in urban areas. Missed opportunities in free distribution exercises and the unavailability of subsidized ITNs at health facilities were barriers to ownership. CONCLUSION: Understanding and addressing protective factors and barriers influencing ITN ownership and usage are crucial for enhancing malaria prevention strategies and achieving sustainable progress in combating malaria in endemic areas. Collaborative and evidence-based interventions are essential for addressing these challenges effectively.

Nasal Anthropometry: An Assessment Among the Akan and Ewe Ethnic Groups in Ghana.

The distribution of nasal types has been reported to be influenced by climatic adaptation as the nose is involved in conditioning inhaled air. Previous studies have reported differential nasal types and dimensions among varying populations which is very beneficial in planning for rhinoplasty and in forensic identification. However, there is inadequate data on nasal types and dimensions of the various ethnic groups in the Ghanaian population. Since it is inappropriate to apply nasal dimensions of one ethnic group to another, the current study sought to assess the nasal types and dimensions of Akans and Ewes in the Ghanaian population. Nasal height, nasal length, nasal tip protrusion, morphological nose width, and anatomical nose width were measured from 202 participants (116 Akans and 86 Ewes) aged 18-27 years belonging to the Akan and Ewe ethnic groups. Nasal index was calculated, and the frequencies of the nasal types among the two ethnic groups were determined. Ewe significantly had greater nasal length and nasal tip protrusion than the Akans. For both ethnic groups, sexual dimorphism was observed in morphological nose width and anatomical nose width, with males having greater values than females. The platyrrhine (broad nose) nasal type was predominant among the Akan and Ewe ethnic groups. The average nasal dimensions of the Akan and Ewe ethnic groups for the Ghanaian population have been reported in the present study, which will be useful in rhinoplasty intended for individuals belonging to these ethnic groups and in identification.

Collective Intelligence-Based Participatory COVID-19 Surveillance in Accra, Ghana: Pilot Mixed Methods Study.

BACKGROUND: Infectious disease surveillance is difficult in many low- and middle-income countries. Information market (IM)-based participatory surveillance is a crowdsourcing method that encourages individuals to actively report health symptoms and observed trends by trading web-based virtual "stocks" with payoffs tied to a future event. OBJECTIVE: This study aims to assess the feasibility and acceptability of a tailored IM surveillance system to monitor population-level COVID-19 outcomes in Accra, Ghana. METHODS: We designed and evaluated a prediction markets IM system from October to December 2021 using a mixed methods study approach. Health care workers and community volunteers aged ≥18 years living in Accra participated in the pilot trading. Participants received 10,000 virtual credits to trade on 12 questions on COVID-19-related outcomes. Payoffs were tied to the cost estimation of new and cumulative cases in the region (Greater Accra) and nationwide (Ghana) at specified future time points. Questions included the number of new COVID-19 cases, the number of people likely to get the COVID-19 vaccination, and the total number of COVID-19 cases in Ghana by the end of the year. Phone credits were awarded based on the tally of virtual credits left and the participant's percentile ranking. Data collected included age, occupation, and trading frequency. In-depth interviews explored the reasons and factors associated with participants' user journey experience, barriers to system use, and willingness to use IM systems in the future. Trading frequency was assessed using trend analysis, and ordinary least squares regression analysis was conducted to determine the factors associated with trading at least once. RESULTS: Of the 105 eligible participants invited, 21 (84%) traded at least once on the platform. Questions estimating the national-level number of COVID-19 cases received 13 to 19 trades, and obtaining COVID-19-related information mainly from television and radio was associated with less likelihood of trading (marginal effect: -0.184). Individuals aged <30 years traded 7.5 times more and earned GH ¢134.1 (US $11.7) more in rewards than those aged >30 years (marginal effect: 0.0135). Implementing the IM surveillance was feasible; all 21 participants who traded found using IM for COVID-19 surveillance acceptable. Active trading by friends with communal discussion and a strong onboarding process facilitated participation. The lack of bidirectional communication on social media and technical difficulties were key barriers. CONCLUSIONS: Using an IM system for disease surveillance is feasible and acceptable in Ghana. This approach shows promise as a cost-effective source of information on disease trends in low- and middle-income countries where surveillance is underdeveloped, but further studies are needed to optimize its use.

Assessment of expanded programme on immunization routine data quality in the upper east region of Ghana.

BACKGROUND: Data quality is a major challenge for most health institutions and organizations across the globe. The Ghana Health Service, supported by other non-governmental organizations, has instituted various strategies to address and improve data quality issues in regional and district health facilities in Ghana. This study sought to assess routine data quality of Expanded Programme on Immunization, specifically for Penta 1 and Penta 3 vaccines. METHODS: A descriptive cross-sectional study design was used for the study. A simple random sampling method was used to select thirty-four health facilities across seven sub-municipalities. Records from the Expanded Programme on Immunization (EPI) Tally Books and Monthly Vaccination Summary Report were reviewed and compared with data entered into the District Health Information Management System 2 (DHIMS2) software for the period of January to December 2020. The World Health Organization Data quality self-assessment (DQS) tool was used to compare data recorded in the EPI tally books with monthly data from summary reports and DHIMS2. Data accuracy ratio was determined by the data quality assessment tools and STATA version 14.2 was used to run additional analysis. A data discrepancy is when two corresponding data sets don't match. RESULTS: The results showed discrepancies between recounted tallies in EPI tally books and summary reports submitted as well as DHIMS2. Verification factor of 97.4% and 99.3% and a discrepancy rate of 2.6 and 0.7 for Penta 1 and Penta 3 respectively were recorded for tallied data and summary reports. A verification factor of 100.5% and 99.9% and a discrepancy of -0.5 and 0.1 respectively for the same antigens were obtained for the summary reports and DHIMS2. Data timeliness was 90.7% and completeness was 100% for both antigens. CONCLUSION: The accuracy of Penta 1 and Penta 3 data on EPI in the Upper East Region of Ghana was high. The data availability, timeliness and completeness were also high.

Patient socio-demographics and clinical factors associated with malaria mortality: a case control study in the northern region of Ghana.

BACKGROUND: Ghana is a malaria-endemic country with the entire population at risk. The Northern region of the country recorded the highest malaria case fatality rate (CFR) for two consecutive years: 1.11% in 2013 and 1.07% in 2014. Even though the National Malaria Elimination Programme (NMEP) has achieved a reduction in malaria mortality, the existence of high case fatality in the Northern region was alarming. This study, therefore, aimed to determine the factors associated with malaria mortality in the northern region of Ghana to institute control measures. METHODS: An unmatched case control study was conducted from July 2015 to August 2015. The study population consisted of patients admitted to health facilities for severe malaria in the Northern region of Ghana. A case was defined as a patient diagnosed with severe malaria at an eligible health facility who died as a result of malaria. A control was a patient diagnosed with severe malaria admitted to an eligible health facility who did not die. Health facilities that recorded CFRs of 1.0% and above were randomly sampled for this study, after which, 10 cases and 20 controls were recruited from each health facility. Information on cases and controls was then abstracted from hospital records using an electronically deployed abstraction tool. Continuous variables were expressed as means and medians, and categorical variables as frequencies and proportions. Multivariable logistic regression was used to assess the strength of the association between malaria mortality and factors predictive of malaria mortality. A p-value of < 0.05 was considered statistically significant. RESULTS: In all, a total of 95 cases and 190 controls participated in this study. The median ages of cases and controls were 4.1 years (IQR = 21.6) and 5.7 years (IQR = 18.2), respectively. Fifty-four (56.8%) cases were females, while 93 (49.0%) of the controls were females. Factors associated with malaria mortality included: duration of hospital stay less than 24 h [aOR: 12.0, 95% CI (5.9-24.6)], severe pallor [aOR: 2.3, 95% CI (1.1-4.6)], children under 5 years [aOR: 2.8, 95% CI (1.4-5.6)], oral Artesunate/Amodiaquine administration [aOR: 0.4, 95% CI (0.2-0.9)] and sepsis as an additional diagnosis [aOR: 4.1, 95% CI (1.8-9.5)]. CONCLUSION: Predictors of malaria mortality in the Northern region include children under 5 years, severe pallor, sepsis as an additional diagnosis, and use of oral anti-malarial. Patients with severe pallor and sepsis as co-morbidities should receive proactive management. The NMEP and its partners should implement measures to strengthen the referral system, anaemia prevention and management, and retrain health workers on malaria case management. Malaria control interventions targeted at under five children in the region should be reviewed and enhanced.

Spatial analysis and factors associated with low birth weight in Ghana using data from the 2017 Ghana Maternal Health Survey: spatial and multilevel analysis.

OBJECTIVE: Low birth weight (LBW) is an important indicator of newborn health and can have long-term implications for a child's development. Spatial exploratory analysis provides a toolkit to gain insight into inequalities in LBW. Few studies in Ghana have explored the spatial distribution of LBW to understand the extent of the problem geographically. This study explores individual and cluster-level distributions of LBW using spatial exploration components for common determinants from nationally representative survey data. DESIGN: We used data from the 2017 Ghana Maternal Health Survey and conducted individual-level and cluster-level analyses of LBW with place and zone of residence in both bivariate and multivariate analyses. By incorporating spatial and survey designs methodology, logistic and Poisson regression models were used to model LBW. SETTING: Ghana. PARTICIPANTS: A total of 4127 women aged between 15 and 49 years were included in the individual-level analysis and 864 clusters corresponding to birth weight. PRIMARY AND SECONDARY OUTCOME MEASURES: Individual and cluster-level distribution for LBW using spatial components for common determinants. RESULTS: In the individual-level analysis, place and zone of residence were significantly associated with LBW in the bivariate model but not in a multivariate model. Hotspot analysis indicated the presence of LBW clusters in the middle and northern zones of Ghana. Compared with rural areas, clusters in urban areas had significantly lower LBW (p=0.017). Clusters in the northern zone were significantly associated with higher LBW (p=0.018) compared with the coastal zones. CONCLUSION: Our findings from choropleth hotspot maps suggest LBW clusters in Ghana's northern and middle zones. Disparities between the rural and urban continuum require specific attention to bridge the healthcare system gap for Ghana's northern and middle zones.

Sustainability of pneumococcal conjugate vaccination in Ghana: a cost-effectiveness analysis in the context of donor transition.

Background: Streptococcus pneumonia is responsible for 18% of infant deaths in Ghana. With co-financing from Gavi in 2012, Ghana introduced the PCV13 into the childhood immunization programme to reduce the burden of Streptococcus pneumonia. However, Ghana will graduate to the Gavi fully self-financing phase in 2026, when the nation assumes full responsibility of paying for the PCV13. This research aims to evaluate the health impact and cost-effectiveness of PCV13 immunization in Ghana since its implementation and after the cessation of support from Gavi. Methods: We used the UNIVAC tool to evaluate two main scenarios of cost-effectiveness, from vaccine introduction (2012-2025) and after Gavi transition (2026-2031) in comparison with no vaccination. The sources of data include national data, international estimates and expert opinion. Cost was considered from both the government and societal perspectives. We discounted health outcomes at 3%. Currency values were stated in US Dollars. We tested the robustness of the base case results by performing scenario and sensitivity analyses. Results: PCV13 will reduce the pneumococcal disease burden by 48% from 2012 to 2031. The vaccination programme costs are USD 130 million and USD 275 million in 2012-2025 and 2026-2031 respectively. It also has a budget impact of USD 280 million for the 2026-2031 period from the perspective of government. The incremental cost-effectiveness ratios are USD 89 and USD 73 respectively from the perspectives of government and society in 2012-2025. The incremental cost-effectiveness ratios are USD 530 and USD 510 respectively from the perspectives of government and society in 2026-2031. Conclusion: The PCV13 vaccination programme in Ghana is cost-effective at 50% GDP per capita threshold even when Gavi withdraws co-financing support from 2026 onwards.

Prevalence and Associated Factors of Adolescent (15-19 Years) Childbearing in Ghana.

Background: Adolescent pregnancies continue to be a global issue that affects more high-income, middle-income, and then low-income countries, with the latter experiencing the majority of cases. Aim: The current study looked into the prevalence and variables predicting adolescent childbearing in Ghana. Methodology: Data from the Ghana Multiple Indicator Cluster Survey (MICS) 2017-2018 was used to conduct an analytical cross-sectional study. The results were examined with SPSS Version 20 (IBM Corp., 2011, and NY). Pearson's chi-square and binary logistics analyses were done for associations. A p value of 0.05 was used to determine the analysis's statistical significance. Results: The total number of adolescents isolated from the 2017 Ghana MICS dataset for this study analysis was 2974. The mean age of the study participants was 16.9 ± 1.4 years with a modal age of 15 years. The prevalence of adolescent childbearing according to this study analysis was 12.3%. The predictive factors for adolescent childbearing were increasing age, decreasing educational level, Volta regional originality, ethnic originality of the study participants, and low economic status. Conclusion: The prevalence of adolescent childbearing in this study was significant and needs the attention of all. Programs to improve adolescent reproductive health must take into account multiple levels of elements, such as the individual, family, community, institutions, national, and international challenges that have an impact on such programs.

KNUST aging and human immunodeficiency virus outcomes-Study protocol.

INTRODUCTION: Globally, 7 million people with HIV (PWH) aged over 50 years exist. 5 million of them live in sub-Saharan Africa, the epicenter of the HIV epidemic. In Ghana, every 1 in 6 PWH is aged over 50 years. However, access to geriatric health care is grossly limited in Ghana and the sub-Saharan Africa region. This has resulted in a lack of focus on geriatric syndromes, a multi-factorial clinical condition common in older PWH, that do not fit discrete disease categories. Consequently, this gap threatens the life expectancy for aging PWH, necessitating the need to promptly fill it. The KNUST Aging and HIV Outcomes (KAHO) study will help identify priorities and opportunities for developing an effective integrated model of HIV and geriatric healthcare in Ghana. METHODS AND ANALYSIS: The KAHO study will recruit 151 PWH aged 50 years and older at the Infectious Disease Unit (IDU) of the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST). The study will be conducted over a 2-year period and participants will be seen at months 0, 6 and 12. Participants at each visit will be taken through assessments and questionnaires on geriatric health, cognition, social vulnerability, HIV-related conditions and they will provide biospecimens for laboratory testing. We will also conduct semi-structured qualitative interviews of PWH, healthcare providers, policy makers and study research assistants. Quantitative data will be analyzed using one sample proportion test and linear regression models appropriately. The Levesque's framework will be used as a guide to analyze qualitative data.

Snakebites and Antisnake Venom Utilization in Ghana's Oti Region: A 6-Year Retrospective Study.

Background: Snakebite is a global environmental and occupational hazard and a significant public health threat. In rural areas, snakebite cases often go unreported and undocumented due to the lack of access to well-structured healthcare facilities/infrastructure. In some cases, the need for antisnake venom (ASV) far outstrips supply, negatively affecting treatment outcomes. This study, therefore, assessed the epidemiological characteristics of snakebite cases, their management, and how antivenoms are utilised at the selected hospital in the Jasikan District Hospital. Methods: A 6-year retrospective study using secondary data from antivenom return forms (pharmacy records), clinical records (patient folders), the District Health Information Management System-2 (DHIMS-2) database, and consulting room registers was carried out in selected hospitals in the Jasikan District, Oti, Ghana. Results: The predominant symptom of snakebite was localised pain (71.4%). The snakebite commonly occurred at home (19%) and on farms (18%). Of the 98 snakebite cases, ASV was administered to 73 (74.5%) cases. Supportive treatment applied included prophylactic antitetanus immunoglobulin (ATS) (80.6%), prophylactic antibiotics (63%), corticosteroids (80.6%), and analgesics (63%). 95% (n = 94) of complete recoveries were recorded; three were discharged against medical advice, and one was mortality. The supply and use of antivenom were erratic throughout the months of high incidence, partly due to inconsistent availability at the Regional Medical Stores. The average ASV vials and hospital stay duration were 1.23 ± 0.86 vials and 2.67 ± 1.97 days, respectively. Although the peak of snakebites occurs in April, May, and June, the demand for antivenom in April and May exceeded supply. Conclusion: The outcome of most snakebite case management was appropriate, irrespective of inadequate ASV supply in certain months. The erratic antivenom supply should be aligned with seasonal and facility-use patterns to enhance regional snakebite management.

Maternal anaemia and polycythaemia during pregnancy and risk of inappropriate birth weight for gestational age babies: a retrospective cohort study in the northern belt of Ghana.

BACKGROUND: Small for gestational age (SGA) and large for gestational age (LGA) births are topical issues due to their devastating effects on the life course and are also accountable for neonatal mortalities and long-term morbidities. OBJECTIVE: We tested the hypothesis that abnormal haemoglobin levels in each trimester of pregnancy will increase the risk of SGA and LGA deliveries in Northern Ghana. DESIGN: A retrospective cohort study was conducted from April to July 2020. SETTINGS AND PARTICIPANTS: 422 postpartum mothers who had delivered in the last 6-8 weeks before their interview dates were recruited through a systematic random sampling technique from five primary and public health facilities in Northern Ghana. PRIMARY MEASURES: Using the INTERGROWTH-21st standard, SGA and LGA births were obtained. Haemoglobin levels from antenatal records were analysed to determine their effect on SGA and LGA births by employing multinomial logistic regression after adjusting for sociodemographic and obstetric factors at a significance level of α=0.05. RESULTS: Prevalence of anaemia in the first, second and third trimesters of pregnancy was 63.5%, 71.3% and 45.3%, respectively, and that of polycythaemia in the corresponding trimesters of pregnancy was 5.9%, 3.6% and 1.7%. About 8.8% and 9.2% of the women delivered SGA and LGA babies, respectively. After adjusting for confounders, anaemic mothers in the third trimester of pregnancy had an increased risk of having SGA births (adjusted OR, aOR 5.56; 95% CI 1.65 to 48.1; p<0.001). Mothers with polycythaemia in the first, second and third trimesters of pregnancy were 93% (aOR 0.07; 95% CI 0.01 to 0.46; p=0.040), 85% (aOR 0.15; 95% CI 0.08 to 0.64; p<0.001) and 88% (aOR 0.12; 95% CI 0.07 to 0.15; p=0.001) protected from having SGA births, respectively. Interestingly, anaemia and polycythaemia across all trimesters of pregnancy were not statistically significant with LGA births. CONCLUSION: Anaemia during pregnancy increased from the first to the second trimester and subsequently decreased in the third trimester while polycythaemia consistently decreased from the first to the third trimester. LGA babies were more predominant compared with SGA babies. While anaemia in the third trimester of pregnancy increased the risk of SGA births, polycythaemia across the trimesters offered significant protection. Healthcare providers and stakeholders should target pressing interventions for anaemia reduction throughout pregnancy, especially during the third trimester to achieve healthy birth outcomes.

Management of febrile convulsion in home settings: a qualitative study of multiple caregiver practices in the Cape Coast Metropolis in Ghana.

BACKGROUND: Febrile convulsion (FC) among children is a common emergency concern received in hospitals and clinics. However, in Ghana, FC is commonly perceived as a non-hospital disease and usually managed at home. There is limited research on the home management of FC. This study, therefore, explored the home management of FC. METHODS: The study design was a descriptive and interpretive phenomenology. Data sources were triangulated among 42 participants across 5 communities within 2 km distance from regional hospitals in the Cape Coast Metropolis. Participants were purposively selected and interviewed face to face in their homes and treatment centres using semistructured interview guides. Interviews were transcribed and thematically analysed with QSR NVivo V.14. RESULTS: Three themes were identified from the inductive analysis. These themes were treatment, prevention and case referral. Subthemes on treatment were tepid sponging with lukewarm water, the use of herbal medicine and spiritual approaches. FC was referred to as 'asram suro'. The 'asram' literally means the moon, and 'suro' connotes the skies, indicating possibly that the condition emanates from a god of the moon. Caregivers prevented FC through behavioural approaches, herbal medicine, and mystical approaches including making scarification and tying amulets and beads particularly on the child's face and wrists respectively. FC cases were referred for clinical attention after home care resulted in undesirable treatment outcomes. A conceptual framework depicting the decision-making and practices towards FC management is presented. CONCLUSION: FC is commonly managed at home independent of orthodox care availability. Caregivers employed herbal and ad hoc treatment regimens, usually unwarranted, visually frightening and spiritual approaches which were not the best home management approaches. These findings call for the need to educate caregivers about the best home management of FC.

Dynamics of corporate social responsibility (CSR) during mineral exploration: Evidence from Eastern Region, Ghana.

How are decisions around Corporate Social Responsibility (CSR) arrived at in the mining sector, particularly in Ghana? To date, the literature on mining and development in the region has mostly analysed individual interventions made in the name of CSR and critiqued the case for embracing it. These assessments, however, very crucially overlook exploration, an essential phase of the mine lifecycle, during which inaugural dialogues are initiated with local communities that ultimately have a bearing on CSR strategy over the long term. This paper examines the dynamics of CSR at the exploration phase of mining projects, surveys local communities' perspectives on the subject, and assesses the actions of international mineral exploration companies. It does so using semi-structured interviews and focus group discussions with policymakers, exploration company officials, and inhabitants of and leaders in mining communities in the Eastern Region of Ghana. The findings suggest that while mineral exploration companies use CSR as platform to showcase their commitments to social and environmental standards, they have made little efforts to understand the socio-cultural, economic and political dynamics of their host communities. It was also revealed that host communities are not afforded the opportunity to provide inputs into decisions on how CSR should be operationalised. The paper calls for a revision of policies and regulations governing mining in Ghana by making CSR a key requirement for mineral exploration companies seeking to undertake exploration or prospecting activities in the country.

Factors influencing integrated disease surveillance and response system in selected districts in the Eastern Region of Ghana.

BACKGROUND: Ghana adopted the Integrated Disease Surveillance and Response (IDSR) system, which is an integration of the various programs in the surveillance system and can contain disease outbreaks and pandemics. Implementation of the IDSR is influenced by several factors which can affect its functionality and ability to contain disease outbreaks. This study assessed the factors influencing the IDSR system in selected districts in the Eastern Region of Ghana. METHOD: A cross-sectional study was conducted between February-March, 2022 in Fanteakwa North, Abuakwa South and New Juaben South districts in the Eastern Region of Ghana among health care workers who are involved in IDRS activities. Both primary and secondary data were collected and analyzed using descriptive statistics and regression analysis at 0.05 significant level with 95% confidence interval. RESULTS: Three hundred and forty-seven (347) health care workers participated in the study with 56.2% (195/347) indicating that rumor registers were available at the health facilities. Most of the respondents (64.8%, 225/347) had means of transport for disease surveillance activities while majority (61.9%, 215/347) had case-based forms for case investigation. About half (51.9%, 180/347) of the participants revealed that they did not receive any feedback from the next higher level in the past year. Availability of transport for IDSR activities was almost 3.4 times more likely to contribute positively to IDSR system compared to facilities without transport (AOR = 3.36; 95% CI = 1.44-7.83; p = 0.005). Respondents who have the capacity to apply case definition are 2 times more likely to contribute to an effective IDSR system compared to health workers who cannot apply case definition (AOR = 1.94; 95% CI = 1.17-3.21; p = 0.013). Respondents who did not receive feedback from the next higher level were 52% less likely to have an effective IDSR system compared to respondents who received feedback from the next higher level (AOR = 0.48; 95% CI = 0.23-1.00; p = 0.05). CONCLUSION: Effective operation of IDSR is affected by the application of case definition and means of transport at health facilities. In addition, the capacity of health care workers to provide feedback can influence the smooth operation of the IDSR in the studied area in Ghana.

Perceptions of patients and healthcare providers regarding barriers and enablers of HIV anti-retroviral therapy among women at a regional hospital in Ghana: implications for national HIV/AIDS control.

BACKGROUND: The Acquired Immune Deficiency Syndrome (AIDS) pandemic has created a lot of devastation over the last four decades and continues to be a public health threat. Anti-retroviral treatment (ART), a group of medications that people who have been diagnosed with the Human Immunodeficiency Virus (HIV) infection take, has been shown to be efficacious and has significantly improved the fight against the disease. In Ghana, women carry a higher prevalence and incidence of HIV. The study's objectives were to understand the experiences of women living with HIV/AIDS on ART and determine the barriers and enablers for ART uptake from the perspective of both the females living with HIV and their healthcare providers in the Upper East Regional Hospital of Ghana. METHODS: This was a qualitative study that used interviews to acquire data from women living with HIV on the perceived barriers and enablers for ART. The Upper East Regional Hospital in Ghana was the study site. We used a phenomenological approach to explore the lived experiences, perceptions, and meanings associated with ART among women. We collected data until we reached thematic saturation, interviewing a total of sixteen women living with HIV. We conducted a focus group discussion with nine healthcare workers providing care at the ART clinic. Data were analysed using thematic analysis. RESULTS: Women living with HIV and their healthcare providers viewed an environment that provided encouragement and support from healthcare workers and patients' relatives, the ability to conceal HIV status, peer counselling, and the perceived benefits of therapy as enablers of ART uptake and medication adherence. The following were barriers to ART uptake and adherence: ill health, forgetfulness, long distances to ART clinics, cultural and spiritual beliefs, and fear of stigma. CONCLUSIONS: Enablers of ART uptake should be expanded upon and encouraged so that women living with HIV/AIDS can access drugs in a timely and stress-free manner. On the other hand, the barriers identified can be addressed through education, the expansion of healthcare infrastructure, and the economic empowerment of women.

Association of information technology ability, workplace social engagement, and successful ageing: validation of a short measure with three African samples.

This study examined the association of workplace social engagement (WSE) and information technology ability (ITA) with successful ageing and validated a brief scale measuring WSE. The interaction of WSE and ITA on successful ageing was also assessed. A cross-sectional design was adopted, and the participants were 1186 older adults living in Kenya (n = 350), Nigeria (n = 260), and Ghana (n = 576). Pearson's correlation and factor analyses of two datasets (i.e., waves 1 and 2) from the sample were utilised to validate the WSE scale. Hierarchical linear regression analysis with relevant sensitivity analyses were utilised to assess the associations with wave 2 data. The WSE scale produced satisfactory psychometric properties (i.e., reliability and validity) as a unidimensional measure. WSE and ITA were positively associated with successful ageing in Kenya and Ghana and in the consolidated data. The interaction between WSE and ITA was positively associated with successful ageing and its domains (i.e., illness avoidance, functioning, and engagement with life) in Kenya, Ghana, and consolidated data. At higher ITA or the use of information technologies, WSE is less strongly associated with successful ageing. WSE is more strongly associated with successful ageing only at moderate ITA.

Effect of group antenatal care versus individualized antenatal care on birth preparedness and complication readiness: a cluster randomized controlled study among pregnant women in Eastern Region of Ghana.

BACKGROUND: As utilization of individual antenatal care (I-ANC) has increased throughout sub-Saharan Africa, questions have arisen about whether individual versus group-based care might yield better outcomes. We implemented a trial of group-based antenatal care (G-ANC) to determine its impact on birth preparedness and complication readiness (BPCR) among pregnant women in Ghana. METHODS: We conducted a cluster randomized controlled trial comparing G-ANC to routine antenatal care in 14 health facilities in the Eastern Region of Ghana. We recruited women in their first trimester to participate in eight two-hour interactive group sessions throughout their pregnancies. Meetings were facilitated by midwives trained in G-ANC methods, and clinical assessments were conducted in addition to group discussions and activities. Data were collected at five timepoints, and results are presented comparing baseline (T0) to 34 weeks' gestation to 3 weeks post-delivery (T1) for danger sign recognition, an 11-point additive scale of BPCR, as well as individual items comprising the scale. RESULTS: 1285 participants completed T0 and T1 assessments (N = 668 I-ANC, N = 617, G-ANC). At T1, G-ANC participants were able to identify significantly more pregnancy danger signs than I-ANC participants (mean increase from 1.8 to 3.4 in G-ANC vs. 1.7 to 2.2 in I-ANC, p < 0.0001). Overall BPCR scores were significantly greater in the G-ANC group than the I-ANC group. The elements of BPCR that showed the greatest increases included arranging for emergency transport (I-ANC increased from 1.5 to 11.5% vs. G-ANC increasing from 2 to 41% (p < 0.0001)) and saving money for transportation (19-32% in the I-ANC group vs. 19-73% in the G-ANC group (p < 0.0001)). Identifying someone to accompany the woman to the facility rose from 1 to 3% in the I-ANC group vs. 2-20% in the G-ANC group (p < 0.001). CONCLUSIONS: G-ANC significantly increased BPCR among women in rural Eastern Region of Ghana when compared to routine antenatal care. Given the success of this intervention, future efforts that prioritize the implementation of G-ANC are warranted. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04033003 (25/07/2019). PROTOCOL AVAILABLE: Protocol Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9508671/ .