"Our Home Is a Muddy Structure": Perceptions of Housing and Health Risks Among Older Adults in Contrasting Neighborhoods in Ghana.

Aging occurs in a variety of social and physical environmental settings that affect health. However, despite their rapidly growing populations, public health research in sub-Saharan Africa has yet to address the role of residential environments in the health and well-being of older adults. In this study, we utilized an ethnographic research methodology to explore barriers and facilitators to health among older adults residing in two contrasting neighborhoods in Accra, Ghana. Our specific objective was to identify patterns of health risks among older adults in the two neighborhoods. Data were collected through qualitative interviews with a purposive sample of health workers (n = 5), community leaders (n = 2), and older adults residing in a slum and non-slum neighborhood (n = 30). Our thematic data analysis revealed that, despite different underlying drivers, health barriers across the slum and non-slum were largely similar. The harmful effects of these health barriers - poor built environments, housing precariousness, unsanitary living conditions, defective public services, and social incivilities - were mitigated by several facilitators to health, including affordable housing and social supports in the slum and better housing and appealing doors in the non-slum. Our study contributes to a more nuanced understanding of the ways in which aging and urban environments intersect to influence population health in resource poor settings. In particular, rather than the commonly referenced dichotomy of poor and non-poor settlements in discourses of neighborhood health, our findings point to convergence of health vulnerabilities that are broadly linked to urban poverty and governmental neglect of the elderly.

Successful Community Participation in Climate Change Adaptation Programs: on Whose Terms?

Community participation in climate change adaptation (CCA) programs has been advocated for long, but its implementation remains uncertain. There is also very little understanding and consensus on how and to what extent local communities can and should be involved in these projects. Arguably, both the concept and practice of community participation remain equivocal and contentious due to a lack of systematic effort to define the participatory framework in CCA. While the framework for community participation can be adopted from other planning and management discourses, yet they are typically expert-driven. The local communities hardly play a role in designing the framework. This study, therefore, took an alternative approach to define the meaning and implication of community participation from local communities' perspectives. To this end, we used the grounded theory qualitative research methods to survey 50 respondents across five rural communities in climate change impacted Northern Ghana. To evaluate the communities' meaningful participation in the adaptation projects, respondents suggested three critical parameters-First, community participation in a CCA project can be considered successful if the project contributes towards the livelihood security of the community. Second, the project outcome should be tangible. Third, the project should enhance the community's skills and training such that the community can run a similar project in the future without much dependence on external agencies. This study provides an alternative methodological insight on how to design and operationalize meaningful community participation in CCA that will have universal application irrespective of the geographical and socio-cultural boundaries.

Following the footsteps: Urbanisation of Wa Municipality and its synergism in risk accumulation, uncertainties and complexities in urban Ghana.

Global demographic characteristics have witnessed a significant shift with more than half of the world's population crossing the rural-urban threshold in 2008. In Ghana, the 2010 census report revealed 50.9% urban population. While the many benefits of organised and efficient cities are well understood, it must be recognised that rapid, often unplanned urbanisation brings risk of profound social instability, risk to critical infrastructure, potential water crises and the potential for devastating spread of disease. These risks can only be further exacerbated as this unprecedented transition from rural to urban areas continues. This also means stakes are high for public and private interventions to ensure that urbanisation reinforces rather than retards prosperity. In spite of these past experiences, urban governance policies in emerging smaller cities are frequently ambivalent and piecemeal, exhibiting similar negative tendencies, a development that has received less academic attention. This study adopted multiple research techniques and the data were generated through a structured questionnaire survey, personal interviews and discussions. Based on our conviction that the development trajectory of any city hinges on the quality of its physical foundation, we seek to fill the knowledge gap using the Wa Municipality, the least urbanised but one of the fastest urbanising cities in Ghana today, as a case study. The results reveal emerging tendencies that indicate that Wa appears to be following in the footsteps of its predecessors - experiencing an inefficient potable water supply system and chronic sanitation situation, making diarrhoea one of many challenges for residents. It is ultimately suggested that a collaborative partnership with all key stakeholders is a better option to reap the potential for urbanisation to strengthen economic growth and development.

Fire risk reduction through a community-based risk assessment: reflections from Makola Market, Accra, Ghana.

This paper explores the level of vulnerability to the hazard of fire that exists in Makola Market in Accra, Ghana, and assesses how this threat can be reduced through a community-based risk assessment. It examines the perceptions of both market-stall occupants and primary stakeholders regarding the hazard of fire, and analyses the availability of local assets (coping strategies) with which to address the challenge. Through an evaluation of past instances of fire, as well as in-depth key stakeholder interviews, field visits, and observations, the study produces a detailed hazard map of the market. It goes on to recommend that policymakers consider short-to-long-term interventions to reduce the degree of risk. By foregrounding the essence of holistic and integrated planning, the paper calls for the incorporation of disaster mitigation measures in the overall urban planning process and for the strict enforcement of relevant building and fire safety codes by responsible public agencies.

Perceptions of health and environmental impacts of e-waste management in Ghana.

This paper explores the perception of health and environmental concerns of workers and residents living close to e-waste recycling sites in Ghana using both qualitative and quantitative research techniques. The social constructionist approach and a logit regression model were adopted to examine the rationale of their claims and concerns which have hitherto been unknown and unexplored. We find that workers' environmental and health perceptions were seriously downplayed and do not match those of epidemiological studies, revealing a lack of convergence between lay and expert knowledge. This study further shows a respondent-specificity rationale; the perception of those directly involved in the processes was mainly influenced by economic considerations, while some at best displayed "genuine" ignorance. We recommend that all policy interventions incorporate approaches that have a better chance of arriving at conclusions economically meaningful to participants and that facilitate greater understanding of health and environmental issues.

Private sector involvement in solid waste management in the Greater Accra Metropolitan Area in Ghana.

Solid waste management (SWM) is becoming a major issue in most cities where the provision of such public service had hitherto been the sole responsibility of central government. However, the costs involved and the rate of waste generation have virtually forced city authorities to seek new arrangements with the private sector. This paper reviews public-private partnership (PPP) in SWM in the Greater Accra Metropolitan Area (GAMA) and reveals that the policy worked well until one of the stakeholders failed to deliver. It maintains that harnessing the social support, acceptability and participation is key to sustainable PPP. The paper calls for institutional and private sector collaboration.