Dam-mediated flooding impact on outpatient attendance and diarrhoea cases in northern Ghana: a mixed methods study.

BACKGROUND: Floods are the most frequently occurring natural disaster and constitute a significant public health risk. Several operational satellite-based flood detection systems quantify flooding extent, but it is unclear how far the choice of satellite-based flood product affects the findings of epidemiological studies of associated public health risks. Few studies of flooding's health impacts have used mixed methods to enrich understanding of these impacts. This study therefore aims to evaluate the relationship between two satellite-derived flood products with outpatient attendance and diarrhoeal disease in northern Ghana, identifying plausible reasons for observed relationships via qualitative interviews. METHODS: A convergent parallel mixed methods design combined an ecological time series with focus group discussions and key informant interviews. Through an ecological time series component, monthly outpatient attendance and diarrhoea case counts from health facilities in two flood-prone districts for 2016-2020 were integrated with monthly flooding map layers classified via the Moderate Resolution Imaging Spectroradiometer (MODIS) and Landsat satellite sensors. The relationship between reported diarrhoea and outpatient attendance with flooding was examined using Poisson regression, controlling for seasonality and facility catchment population. Four focus group discussions with affected community members and four key informant interviews with health professionals explored flooding's impact on healthcare delivery and access. RESULTS: Flooding detected via Landsat better predicted outpatient attendance and diarrhoea than flooding via MODIS. Outpatient attendance significantly reduced as LandSat-derived flood area per facility catchment increased (adjusted Incidence Rate Ratio = 0.78, 95% CI: 0.61-0.99, p < 0.05), whilst reported diarrhoea significantly increased with flood area per facility catchment (adjusted Incidence Rate Ratio = 4.27, 95% CI: 2.74-6.63, p < 0.001). Key informants noted how flooding affected access to health services as patients and health professionals could not reach the health facility and emergency referrals were unable to travel. CONCLUSIONS: The significant reduction in outpatient attendance during flooding suggests that flooding impairs healthcare delivery. The relationship is sensitive to the choice of satellite-derived flood product, so future studies should consider integrating multiple sources of satellite imagery for more robust exposure assessment. Health teams and communities should plan spatially targeted flood mitigation and health system adaptation strategies that explicitly address population and workforce mobility issues.

Reviewing the Common Barriers to the Mental Healthcare Delivery in Africa.

The current paper sought to thematically present common challenges associated with mental healthcare services in Africa. We largely limited our search for literature materials to studies published from 2003 to 2019 in African countries from which the findings showed that there are common challenges confronting mental healthcare services in Africa. The challenges include: inadequate mental healthcare facilities, funding constraints, shortage of professional healthcare workers, inadequate training and development scheme for mental health workers and weak mental healthcare policies. Implications for policy and practice are disclosed and recommendations are stated to trigger actions to remedy the situation. This information is beneficial for researchers, policymakers, mental healthcare providers and community members who are interested in mental healthcare issues. It was concluded that in order for Africa to enjoy successful mental healthcare service, critical and enduring attention must focus on sound and enforceable government policy on mental healthcare service, provision of adequate and regular funding, availability of adequate mental healthcare facilities, provision of training and development facilities for the mental health professionals and collaboration of mental healthcare providers.

The Role of the Penteco/Charismatic Clergy in the Political Health Development in Ghana.

Several countries in Africa are perpetually linked to an inexpungable history of cyclical ethnic conflicts, violence and coup d'état which culminated in the untimely death of many, others severely wounded and many left in a hopeless situation. The paper discusses in-depth, the role and functions of the clergy (ministers of religion) in the political health development in Ghana. The rationale is that the clergy's esteemed status among the church members and the society as a whole could impact positively on the lives of the people in the society, and for that matter, they are expected to speak to national issues. Twenty-one clergy participated in one-on-one in-depth interviews for this study. It was found out that a number of the ministers of religion were not interested in political health development issues, and therefore, their roles in politics were woefully inadequate. It is recommended that the clergy boldly take up their leadership responsibilities and provide a framework for collaboration and reconciliation in the peace-building process and also be models of a peaceful disposition. The clergy are to continue to pray fervently, advise politicians and educate their church members for a sound political health development in Ghana.

Leveraging the Deliverance Phenomenon: Penteco/Charismatic Vista.

This article reflects on the deliverance concept within Classical Pentecostalism and Neo-Pentecostalism against historical and contemporary considerations. The research design combined ethnography and case study. Participant observation and in-depth interviews were used for data collection. Findings include: overstretched demonic mentality; the notion that the Penteco/Charismatic believer cannot be possessed but could be harassed by demons; and dehumanizing situations inherent in deliverance practice. It is recommended that sanity, care and collaboration be established amongst deliverance practitioners, psychologists, psychiatrists, professional counsellors as well as other business experts to ensure a holistic deliverance practice and also to enhance the dignity and value of the deliverance ministry in Ghana and Africa at large.

Child survival: the role of a mother's education.

In developing countries, children are considered as social and human capital needed for growth and development. However, the ability of uneducated parents to provide basic services to keep a child alive has always been in doubt. This has resulted in the avoidable deaths of children. This study seeks to examine the role of a mother's education in keeping a child alive. This is achieved by using the Ghana Demographic and Health Survey (DHS) Dataset (1988-2014) with 33,896 observations. This study uses the negative binomial model and finds an inverse and statistically highly significant relationship between a mother's education and the survival of her child in Ghana. Further robustness checks confirm that the result is consistent across gender of child and years of data collection. In line with the finding, this study recommends women's education from the basic education level as it drives the probability of saving a life. Globally, we suggest that education, especially at the basic level, should include health education to address numerous health concerns.

Increased flooded area and exposure in the White Volta river basin in Western Africa, identified from multi-source remote sensing data.

Accurate information on flood extent and exposure is critical for disaster management in data-scarce, vulnerable regions, such as Sub-Saharan Africa (SSA). However, uncertainties in flood extent affect flood exposure estimates. This study developed a framework to examine the spatiotemporal pattern of floods and to assess flood exposure through utilization of satellite images, ground-based participatory mapping of flood extent, and socio-economic data. Drawing on a case study in the White Volta basin in Western Africa, our results showed that synergetic use of multi-temporal radar and optical satellite data improved flood mapping accuracy (77% overall agreement compared with participatory mapping outputs), in comparison with existing global flood datasets (43% overall agreement for the moderate-resolution imaging spectroradiometer (MODIS) Near Real-Time (NRT) Global Flood Product). Increases in flood extent were observed according to our classified product, as well as two existing global flood products. Similarly, increased flood exposure was also observed, however its estimation remains highly uncertain and sensitive to the input dataset used. Population exposure varied greatly depending on the population dataset used, while the greatest farmland and infrastructure exposure was estimated using a composite flood map derived from three products, with lower exposure estimated from each flood product individually. The study shows that there is considerable scope to develop an accurate flood mapping system in SSA and thereby improve flood exposure assessment and develop mitigation and intervention plans.