Spatial heterogeneity in drinking water sources in the Greater Accra Metropolitan Area (GAMA), Ghana.

Universal access to safe drinking water is essential to population health and well-being, as recognized in the Sustainable Development Goals (SDG). To develop targeted policies which improve urban access to improved water and ensure equity, there is the need to understand the spatial heterogeneity in drinking water sources and the factors underlying these patterns. Using the Shannon Entropy Index and the Index of Concentration at the Extremes at the enumeration area level, we analyzed census data to examine the spatial heterogeneity in drinking water sources and neighborhood income in the Greater Accra Metropolitan Area (GAMA), the largest urban agglomeration in Ghana. GAMA has been a laboratory for studying urban growth, economic security, and other concomitant socio-environmental and demographic issues in the recent past. The current study adds to this literature by telling a different story about the spatial heterogeneity of GAMA's water landscape at the enumeration area level. The findings of the study reveal considerable geographical heterogeneity and inequality in drinking water sources not evidenced in previous studies. We conclude that heterogeneity is neither good nor bad in GAMA judging by the dominance of both piped water sources and sachet water (machine-sealed 500-ml plastic bag of drinking water). The lessons from this study can be used to inform the planning of appropriate localized solutions targeted at providing piped water sources in neighborhoods lacking these services and to monitor progress in achieving universal access to improved drinking water as recognized in the SDG 6 and improving population health and well-being.

Socioeconomic determinants of birth registration in Ghana.

BACKGROUND: Identity registration is not only a matter of human rights but it also serves as an important instrument for planning about health, education and overall development. This paper examines the chances of a child born in Ghana between 2001 and 2006 obtaining legal status of identity. METHODS: Data for this paper were extracted from the 2006 Ghana Multiple Indicator Cluster Survey (MICS). We used discrete choice modelling in estimating the likelihood of child registration in Ghana. RESULTS: Mother's education and household wealth are identified to be positively associated with the likelihood of a child being registered. In the context of structural factors, being a resident in the Eastern region of Ghana and rural areas were found to be risk factors for children not being registered. Besides, children who were resident in households where the head is affiliated to Traditional Religion were found to be at significant risk of being unregistered. CONCLUSION: Overall, our findings give an impression of birth registration being a privilege for children whose parents are educated, wealthy and resident in urban communities. Policies meant to increase uptake have to be broad-based, targeting the less privileged particularly with practical interventions such as transport vouchers to registration centres. This may help appropriate meaning to international protocols on birth registration as a human right issue to which Ghana affirms.

HOUSEHOLD NUCLEATION, DEPENDENCY AND CHILD HEALTH OUTCOMES IN GHANA.

This study uses three key anthropometric measures of nutritional status among children (stunting, wasting and underweight) to explore the dual effects of household composition and dependency on nutritional outcomes of under-five children in Ghana. The objective is to examine changes in household living arrangements of under-five children to explore the interaction of dependency and nucleation on child health outcomes. The concept of nucleation refers to the changing structure and composition of household living arrangements, from highly extended with its associated socioeconomic system of production and reproduction, social behaviour and values, towards single-family households - especially the nuclear family, containing a husband and wife and their children alone. A negative relationship between levels of dependency, as measured by the number of children in the household, and child health outcomes is premised on the grounds that high dependency depletes resources, both tangible and intangible, to the disadvantage of young children. Data were drawn from the last four rounds of the Ghana Demographic and Health Surveys (GDHSs), from 1993 to 2008, for the first objective - to explore changes in household composition. For the second objective, the study used data from the 2008 GDHS. The results show that, over time, households in Ghana have been changing towards nucleation. The main finding is that in households with the same number of dependent children, in nucleated households children under age 5 have better health outcomes compared with children under age 5 in non-nucleated households. The results also indicate that the effect of dependency on child health outcomes is mediated by household nucleation and wealth status and that, as such, high levels of dependency do not necessarily translate into negative health outcomes for children under age 5, based on anthropometric measures.

Neighbourhood mothers' education and its differential impact on stunting: Evidence from 30 Sub-Saharan African countries.

The study used data from Demographic and Health Surveys for 30 Sub-Saharan African countries to investigate differences in the residential effects of mothers' education on stunting. Multilevel logistic regressions were employed to examine the neighbourhood effects of mothers' education on stunting. The study found that although a higher proportion of mothers with secondary education in a neighbourhood, irrespective of the residence type (rural or urban), reduces a child's probability of being stunted, this effect is stronger for children residing in rural areas than those in the urban. Achieving a target of at least 75 per cent of mothers obtaining secondary education and higher will bridge the rural-urban gap in stunting in Sub-Saharan Africa.

Reproducibility of statistical data, academic publications and policy implications: Evidence from Ghana.

This paper examines the accuracy, validity and presentation of statistical evidence and also assesses the implications of irreproducibility associated with variations in sample size for academic research work and policy-making. The 2012/13 Ghana Living Standards Survey (GLSS), 10 academic publications and the Free Senior High School policy in Ghana are used to address the objectives of the paper. The data show that about 20 per cent of the tables in the Main Report of the GLSS Six is irreproducible, 10 per cent of the tables have outcomes worth re-examining, and in terms of completeness in the presentation of statistical evidence, only 3 out of the 27 sampled tables report the sample size that was used. Again, nine out of the 10 academic publications use half of the original sample size, two-fifths of the publications do not report the sample size for the descriptive statistics, a couple of the papers show varying sample size between the descriptive statistics and the regression analysis.

Dietary diversity and child malnutrition in Ghana.

The health of children in Ghana has improved in recent years. However, the current prevalence rates of malnutrition remain above internationally acceptable levels. This study, therefore, revisits the determinants of child health by using Ghana's Multiple Indicator Cluster Survey to investigate the effect of infant feeding practices on child health. We used the World Health Organization's Infant and Young Children Feeding guidelines to measure dietary quality. The econometric analyses show that dietary diversity may cause improvement in children's health in Ghana. This suggests that educational campaigns on proper infant feeding and complementary dieting could be an effective means of improving the health of children in Ghana.