Assessment of Neonatal Mortality and Associated Hospital-Related Factors in Healthcare Facilities Within Sunyani and Sunyani West Municipal Assemblies in Bono Region, Ghana.

Objectives: Ghana's quest to reduce neonatal mortality, in hospital facilities and communities, continues to be a nightmare. The pursuit of achieving healthy lives and well-being for neonates as enshrined in Sustainable Development Goal three lingered in challenging hospital facilities and communities. Notwithstanding that, there have been increasing efforts in that direction. This study examines the contributing factors that hinder the fight against neonatal mortality in all hospital facilities in the Sunyani and Sunyani West Municipal Assemblies in Bono Region, Ghana. Methods: The study utilized neonatal mortality data consisting of neonatal deaths, structural facility related variables, medical human resources, types of hospital facilities and natal care. The data was collected longitudinally from 2014 to 2019. These variables were analysed using the negative binomial hurdle regression (NBH) model to determine factors that contribute to this menace at the facility level. Cause-specific deaths were obtained to determine the leading causes of neonatal deaths within health facilities in the two municipal assemblies. Results: The study established that the leading causes of neonatal mortality in these districts are birth asphyxia (46%), premature birth (33%), neonatal sepsis (11%) and neonatal jaundice (7%). The NBH showed that neonatal mortality in hospital facilities depend on the number of incubators, monitoring equipment, hand washing facilities, CPAPb machines, radiant warmers, physiotherapy machines, midwives, paediatric doctors and paediatric nurses in the hospital facility. Conclusions: Early management of neonatal sepsis, birth asphyxia, premature birth and neonatal infections is required to reduce neonatal deaths. The government and all stakeholders in the health sector should provide all hospital facilities with the essential equipment and the medical human resources necessary to eradicate the menace. This will make the realization of Sustainable Development Goal three, which calls for healthy lives and well-being for all, a reality.

An autoregressive distributed lag approach for estimating the nexus between CO2 emissions and economic determinants in Pakistan.

Carbon dioxide (CO2) emissions have become a critical aspect of the economic and sustainable development indicators of every country. In Pakistan, where there is a substantial increase in the population, industrialization, and demand for electricity production from different resources, the fear of an increase in CO2 emissions cannot be ignored. This study explores the link that betwixt CO2 emissions with different significant economic indicators in Pakistan from 1960 to 2018 using the autoregressive distributed lag (ARDL) modelling technique. We implemented the covariance proportion, coefficient of determination, the Durbin Watson D statistics, analysis of variance (ANOVA), variance inflating factor (VIF), the Breusch-Pagan test, the Theil's inequality, the root mean quare error (RMSE), the mean absolute percentage error (MAPE), and the mean absolute error (MAE) for the diagnostics, efficiency, and validity of our model. Our results showed a significant association between increased CO2 emissions and increased electricity production from oil, gas, and other sources. An increase in electricity production from coal resources was seen to have resulted in a decrease in CO2 emissions. We observed that an increase in the gross domestic product (GDP) and population growth significantly contributed to the increased CO2 emissions. The increment in CO2 emissions resulting from industrial growth was not significant. The increment in CO2 emissions in the contemporary year is significantly associated with the preceding year's increase. The rate of increase was very alarming, a sign that no serious efforts have been channelled in this regard to reduce this phenomenon. We call for policy dialogue to devise energy-saving and CO2 emission reduction strategies to minimize the impact of climate change on industrialization, population growth, and GDP growth without deterring economic and human growth. Electricity production from different sources with no or minimal CO2 emissions should be adopted. We also recommend rigorous tree planting nationwide to help reduce the concentration of CO2 in the atmosphere as well as environmental pollution.

Examining the risk factors for overweight and obesity among women in Ghana: A multilevel perspective.

Overweight/obesity prevalence is on the increase in epidemic proportions across Low- and Middle-Income countries (LMICs). The public health burden associated with obesity/overweight cannot be underestimated due to its association with chronic health outcomes. This study investigated the individual- and community level risk factors for obesity/overweight among reproductive women. The data used consist of 4393 reproductive women and form part of the 2014 Ghana Demographic and Health Survey (GDHS). Information on these women are clustered within 427 communities. A 2-tier random intercept multilevel logistic model was used to assess the effect of individual- and community level factors on the likelihood of a woman to be obese/overweight. The obesity/overweight prevalence among reproductive women was estimated to be 35.5% (95% CI: 34.04, 36.90%), which significantly differed across clusters. Most at risk were women from middle-income households (aOR = 2.85; 95% CI: 2.28, 3.56), upper-income households (aOR = 5.019, 95% CI: 3.85, 6.55), attaining secondary education (aOR = 1.74; 95% CI: 1.41, 2.16), and higher (aOR = 1.63; 95% CI: 1.14, 2.33), old age (20-29 years (aOR = 4.26; 95% CI: 3.142,5.78); 30-39 years (aOR = 8.59; 95% CI: 6.15, 12.00); 40-49 years (aOR = 12.81; 95% CI: 9.10, 18.16)). Significant differences in the probability of being overweight/obese between different communities were observed (MOR = 1.39). The high prevalence of overweight/obesity requires urgent public health interventions to prevent future public health crises. Efforts to strengthen the healthcare system, encourage lifestyle modification, and public health education are needed to solidify the gains of ensuring a healthy population by 2030 (SDG 3).

Spatial analysis of the prevalence of obesity and overweight among women in Ghana.

OBJECTIVE: Identifying hot spots for the overweight aids in effective public health interventions due to the associated public health burden and morbidities. This study, therefore aimed to explore and determine the spatial disparities in the overweight/obesity prevalence among women in Ghana. The study also aims at modelling the average body mass index (BMI) values using the spatial regression and the performance compared with the standard regression model. DESIGN: This is a cross-sectional study using data from the 2014 Ghana Demographic and Health Survey (GDHS). SETTING: The study was set in Ghana. PARTICIPANTS AND METHODS: Data on 4393 non-pregnant women aged 15-49 years from the 2014 GDHS. Both global (Moran's I) and the local indicators for spatial dependence were examined through the mapped BMI values across the country by clusters. An estimated spatial lag model was used to explain the spatial differences in the average body sizes of women. RESULTS: The overall prevalence of overweight/obesity among reproductive women in Ghana was 35.4%, and this was highly prevalent among educated women (p<0.001), those from wealthy households (p<0.001) and dwelling in an urban setting (p<0.001). Significant clustering (Moran's I=0.3145, p<0.01) of overweight/obesity was observed with hot spots (clustering) in Greater Accra, Central, Western and Ashanti regions. The spatial lag model was the best fit based on the Likelihood ratio test and the Akaike information criterion and Bayesian information criterion values. The mean age of women and household wealth were significant factors accounting for the increase in the average cluster body size (BMI) of women and the spatial differences. CONCLUSION: The prevalence of overweight/obesity was high and spatially clustered in the southern, middle and coastal regions. Geographic specific and effective public health interventions and strategies are needed to address the growing morbidity burden associated with the rise in the average body sizes of reproductive women.