Predictors of maternal mortality in Ghana: evidence from the 2017 GMHS Verbal Autopsy data.

BACKGROUND: Maternal mortality remains a significant public health challenge in many low and middle-income countries, including Ghana. From Ghana's 2017 Maternal Health Survey verbal autopsy data, we examined the predictors of maternal mortality in Ghana. METHODS: A total of 1240 deaths of women aged 15-49 were involved in the survey across all regions in Ghana. Binary and multivariate logistic regression analyses were employed; confidence level was set at 95%. RESULTS: The results show that the prevalence of maternal death was 13.2% (164/1240). After adjusting for potential covariates, women aged 20-29 years (aOR = 4.270, 95%CI= 1.864 - 9.781, p=0.001), bled during labour/delivery (aOR= 0.241, 95%CI = 0.059 - 0.992, p=0.049), and those who used traditional/herbal medicines during pregnancy were more likely to die compared to non-users (aOR= 3.461, 95%CI = 1.651 - 7.258, p=0.001). CONCLUSION: Our findings highlight the need to intensify maternal education regarding the value to be gained by increasing skilled healthcare during complications in pregnancy to allow effective management of complications during labour/delivery. Also, education for pregnant women and their families on possible adverse effects of using unapproved traditional/herbal medicines during pregnancy as well as a need to seek timely care before the onset of labour to allow healthcare providers ample opportunity to address labour and birth complications, is urgently required.

Mapping the vulnerability of indigenous fruit trees to environmental change in the fragile savannah ecological zone of Northern Ghana.

Following the incidence of environmental change globally and its negative consequences on livelihoods of local populations, vulnerability assessment has become central to mitigation and adaptation response in the global south. However, researches on vulnerability to climate change in the African continent have seldom focused on Indigenous Fruit Trees (IFTs) although they are an essential part of the strategic forest resources and livelihood systems of local communities. This paper explores the vulnerability of two IFTs, shea (Vitellaria paradoxa) and dawadawa (Parkia biglobosa) to climatic and other stressors that are not directly linked to climate change in rural Ghana and the implications for planning. The paper analyzed vulnerability from farmer perspectives elicited through a mixed study design involving the use of Participatory Rural Appraisal (PRA) methods and a household survey. The results reveal that IFTs are highly vulnerable to drought, rainstorms, bushfires and charcoal production and less vulnerable to heavy precipitation, flash floods and sand mining. Such vulnerability arising from the combined effects of multiple stressors has led to a decreasing trend in production and yields of IFTS over the past few decades, adversely affecting livelihoods of rural women and households. To reduce vulnerability, it is an imperative to promote Environmental Change Adaptation Planning (ECAP) that prioritizes conservation and propagation of IFTs, and diversification of rural livelihoods.

The double tragedy of agriculture vulnerability to climate variability in Africa: How vulnerable is smallholder agriculture to rainfall variability in Ghana?

This article analysed vulnerability of smallholder agriculture to climate variability, particularly the alternating incidences of drought and heavy precipitation events in Ghana. Although there is an unmet need for understanding the linkages between climate change and livelihoods, the urgent need for climate change adaptation planning (CCAP) in response to climate change makes vulnerability assessment even more compelling in development research. The data for analysis were collected from two complementary studies. These included a regional survey in the Upper West Region and an in-depth study in three selected communities in the Sissala East District. The results showed that smallholder agriculture is significantly vulnerable to climate variability in the region and that three layers of vulnerability can be identified in a ladder of vulnerability. Firstly, farmers are confronted with the double tragedy of droughts and heavy precipitation events, which adversely affect both crops and livestock. Secondly, farmers have to decide on crops for adaptation, but each option - whether indigenous crops, new early-maturing crops or genetically modified crops - predisposes farmers to a different set of risks. Finally, the overall impact is a higher-level vulnerability, namely the risk of total livelihood failure and food insecurity. The article recommended CCAP and an endogenous development (ED) approach to addressing agriculture vulnerability to climate variability within the framework of decentralisation and local governance in Ghana.