Inequities in spatial access to health services in Ghanaian cities.

Consideration of health equity is fundamental to enhancing the health of those who are economically/socially disadvantaged. A vital characteristic of health equity and therefore health disparity is the level of spatial access to health services and its distribution among populations. Adequate knowledge of health disparity is critical to enhancing the optimal allocation of resources, identification of underserved populations and improving the efficiency and performance of the health system. The provision of such insight for sub-Saharan African (SSA) cities is a challenge and is severely limited in the literature. Accordingly, this study examined the disparities in potential spatial access to health services for four selected urban areas in Ghana based on: (1) the number of physicians per population; (2) access score based on a weighted sum of access components; (3) travel time to health services and (4) the combined evaluation of linkages between travel distance, settlement area, population and economic status. The overall spatial access to health services is low across all selected cities varying between 3.02 and 1.78 physicians per 10 000 persons, whereas the access score is between 1.70 and 2.54. The current number of physicians needs to be increased by about five times to satisfy the World Health Organization's standard. The low spatial access is not equitable across and within the selected cities, where the economically disadvantaged populations were found to endure longer travel distances to access health services. Inequities were found to be embedded within the selected cities where economically poor populations are also disadvantaged in their physical access to healthcare. The health facilities in all cities have reasonable travel distances separating them but are inadequately resourced with physicians. Thus, increasing the physician numbers and related resources at spatially targeted existing facilities would considerably enhance spatial access to health services.

Did COVID-19 Change the Availability and Use of Clean Energy for Cooking? Evidence From Ghana.

A major part of Ghana's current household energy policy is focused on using a branded cylinder recirculation model (BCRM) to promote the safe use of Liquefied Petroleum Gas (LPG) for primary cooking. The implementation of the BCRM is expected to increase LPG adoption by households to the announced policy goal of 50% of the population by 2030. We investigated the impact of the COVID-19 pandemic on the implementation of the BCRM, availability, and household use of cleaner fuels. This was assessed using existing data on clean fuel use prior to the COVID-19 pandemic. Additional data was collected using questionnaire-based household surveys and qualitative interviews. It was found that the expansion of BCRM was significantly impacted by the COVID-19 pandemic. Planning activities such as baseline data collection and stakeholder engagement were delayed due to the COVID-19 restrictions. Changes in household incomes during the pandemic had the biggest percentage effect on household choice of cooking fuel, causing a regression in some cases, to polluting fuel use. This study provides insights that could be valuable in future understanding of the interactions between pandemic control measures and economic disruptions that may affect household energy choices for cooking.

The feasibility and acceptability of clean fuel use among rural households. A pilot study in Central Ghana.

Background: 76% of the population in Ghana uses solid fuels as their primary source of cooking energy, including 41.3% firewood and 31.5% charcoal. Consequently, household air pollution (HAP) continues to be the leading risk factor for the majority of illness burden in the country. In the past, aggressive LPG distribution and adoption schemes have been implemented to reduce HAP in Ghana. Nevertheless, just 22% of Ghanaian households utilize LPG for cooking. Aims: The purpose of this study was to determine the viability and acceptability of four clean fuels among rural households in central Ghana, both separately and in combination. Methods: Quantitative and qualitative methods were used to conduct this study. The Kintampo Health Demographic Surveillance System was used to randomly pick ten homes who exclusively utilized biomass fuel. For each family (n = 10), we gave four stove and fuel combinations that were both clean. The stoves were utilized for two weeks, and free fuel was supplied. After each two-week trial period, interviews were conducted to gauge stove acceptance, with an emphasis on finding the specific energy requirements that each stove satisfied. Conclusions: LPG and ethanol stoves were the most popular among rural families, according to our data. In comparison to Mimi Moto and electric induction stoves, the two stoves were favoured because they were easier to use and clean, cooked faster, were deemed safer, and enabled a variety of cooking styles. Participants' stove preferences appear to be primarily influenced by two domains: 1) realizing the benefits of clean stove technology and 2) overcoming early anxiety of clean stove use, particularly LPG.

Assessing the economic impact of climate change in the small-scale aquaculture industry of Ghana, West Africa.

Background: Aquaculture in Ghana is very profitable, but faces sustainability challenges. This paper assessed the impact pathways by which climate change affects the production and profitability of small-scale aquaculture in Ghana. The study analyzed and compared the economic value of smallholder fish farms with and without the incidence of climatic parameters. Methods: Simple random sampling and purposive sampling techniques were used to select the study area and farms. A total of 30 farmers were interviewed using a questionnaire-based interview. Additionally, using document analysis, observation, and data on farms' production input and output values, the economic impact of climate change on fish farms was assessed. Results: Extreme temperatures, erratic rainfall, floods, drought, storm and erosion are prevalent in fish farms. Available data shows a decrease of 53.4% of small-scale revenue, a 6.9% reduction in small-scale aquaculture value from GH¢ 83,000 to GH¢ 120,000 reducing fish supply by 25%. The findings indicate that the profitability, economic value, and livelihoods of the small-scale aquaculture industry is greatly affected by changes in climate. The incidence of floods, drought, erratic rainfall, erosion, and extreme temperature synergistically induce poverty. The implication on the livelihoods of fish farming households is very alarming and poses a serious threat to food security in the country. Conclusion: Based on the findings, this study concludes that; floods, rainfall temperature, and drought are the major climatic factors affecting the profitability and sustainability of the pond aquaculture industry. The preliminary recommendation is that there is an urgent need to map out flood-free zones close to perennial water bodies to overcome floods and droughts. Planting trees around ponds to create a micro-ecologies ideal for fish culture and also the construction of water storage facilities and proper dyke design would overcome drought and erosion issues. The adaptive capacity of fish-farmers must be built.