Impact of extreme weather conditions on healthcare provision in urban Ghana.

Extreme weather events pose significant threats to urban health in low- and middle-income countries, particularly in sub-Saharan Africa where there are systemic health challenges. This paper investigates health system vulnerabilities associated with flooding and extreme heat, along with strategies for resilience building by service providers and community members, in Accra and Tamale, Ghana. We employed field observations, rainfall records, temperature measurements, and semi-structured interviews in health facilities within selected areas of both cities. Results indicate that poor building conditions, unstable power supply, poor sanitation and hygiene, and the built environment reduce access to healthcare for residents of poor urban areas. Health facilities are sited in low-lying areas with poor drainage systems and can be 6 °C warmer at night than reported by official records from nearby weather stations. This is due to a combination of greater thermal inertia of the buildings and the urban heat island effect. Flooding and extreme heat interact with socioeconomic conditions to impact physical infrastructure and disrupt community health as well as health facility operations. Community members and health facilities make infrastructural and operational adjustments to reduce extreme weather stress and improve healthcare provision to clients. These measures include: mobilisation of residents to clear rubbish and unclog drains; elevating equipment to protect it from floods; improving ventilation during extreme heat; and using alternative power sources for emergency surgery and storage during outages. Stakeholders recommend additional actions to manage flood and heat impacts on health in their cities, such as, improving the capacity of drainage systems to carry floodwaters, and routine temperature monitoring to better manage heat in health facilities. Finally, more timely and targeted information systems and emergency response plans are required to ensure preparedness for extreme weather events in urban areas.

Hydro-climatic stress, shallow groundwater wells and coping in Ghana's White Volta basin.

Debates of the nexus between water-related stresses and water availability for groundwater-dependent irrigation which comprises of non-conventional groundwater abstraction schemes is only recently emerging. The interaction between Seasonal Shallow Wells (SSWs), one of such indigenous abstractions scheme and groundwater recharge remains new to groundwater science and development. The SSWs supplement formal irrigation (e.g. reservoirs) and surface water for dry season agriculture in Ghana's White Volta Basin, yet links with the overall gradient of groundwater is unknown. Therefore, using the Water Evaluation And Planning (WEAP) model and qualitative techniques, the implications of groundwater recharge and surface runoff in their orientation to shallow wells is explored. Standardized precipitation index (SPI) from a regional downscale model for droughts and floods showed increased drought and flood influence on groundwater recharge and irrigation. Enhanced surface runoff water and climate change continuously reduced groundwater recharge by 2030, with decreased stream and water inflows. Irrigation water requirements of reservoirs were computed to be between 173% and 327% of normal reservoir water requirements, yet majority of dams did not meet these requirements especially during the dry season. The basin has history of dryness and exhibited uneven distribution of groundwater, yet recharged water of unsaturated soil moisture zones made water available to the SSWs. The SSWs were patronised mostly by women and farming households based on perceptions of limited cost, less sophistication and no formal regulatory measures. The paper therefore provides framework for establishing links between the mechanics of SSWs, and existing climatic and hydrologic conditions for informed groundwater development.