Global response to climate-sensitive infectious diseases has been uncertain and slow. The understanding of the underlying vulnerabilities which forms part of changes created by forces within the Earth system has never before been critical until the coronavirus disease 2019, "COVID-19" pandemic with the initial developmental phase linked to weather elements and climate change. Hence, the heightened interest in climate-sensitive infectious diseases and GeoHealth, evident in the renewed calls for "One Health" approach to disease management. "One Health" explains the commonality of human and animal medicine, and links to the bio-geophysical environment, yet are at crossroads with how forces within the Earth system shape etiologies, incidences, and transmission dynamics of infectious diseases. Hence, the paper explores how these forces, which are multistage and driven by climate change impacts on ecosystems affect emerging infectious diseases, leading to the question "what drive the drivers of diseases?" Three questions that challenge broad theories of Earth system science on boundaries and connectivity emerged to guide study designs to further interrogating disease surveillance and health early warning systems. This is because, climate change (a) drives prevailing biological health hazards as part of forces within the Earth system, (b) shifts disease control services of ecosystems and functioning to effectively regulate disease incidence, and (c) modifies pathogen-species hosts relationships. Hence, the need to rethink pluralistic concepts of climate-sensitive diseases in their infection and management from a GeoHealth perspective, which "One Health" potentially conveys, and to also maintain ecosystem health.
Purpose: Sub-Saharan African countries are experiencing rapid population growth. This is essential in achieving the Demographic Dividend. Age structure, fertility and education play a key role in the achievement of the Demographic Dividend. Although gains from age structure are crucial, its gains are not automatic. However, the inter-relatedness of fertility and education makes a reduction in fertility a cause and effect on investments in education.
Methodology: This narrative review looks at studies discussing the Demographic Dividend from a development theory point of view. It is an attempt to explain how different countries within Sub-Saharan Africa are faring due to the inter-play between fertility and education.
Findings: The results highlight how the Demographic Dividend is really an Educational Dividend. It also shows a negative correlation between education and fertility across regions and time. The political environment with emphasis on good governance plays a key role in harnessing the Demographic Dividend. Aside this, a fertility decline alone could worsen the existing economic conditions if it is not in tandem with higher education rates among young adults. This is in line with Ester Boserup’s view of seeing population as a resource.
Unique contribution to theory, practice and policy (recommendation): A conducive political environment attracts investments and creates room for entrepreneurship and job creation which are necessary to be able to harness the Demographic Dividend. There’s the need to however, look at the definition of working age group and conditions necessary to promote entrepreneurship.
Enhancing Child Nutrition through Animal Source Food Management (ENAM)
project provided financial and technical support for caregivers' Income
Generation Activities (IGA) with the aim of increasing their access to
Animal Source Foods (ASF) for improved child nutrition. Using baseline
data from the ENAM project, this study assessed the relationship
between the type of caregivers' IGA -whether it is related to ASF
[ASF-R] or unrelated [ASF-U] - and the quantity and diversity of ASF
consumed by their children. Structured questionnaire was used to obtain
data on household socioeconomic and demographic characteristics and
children's ASF consumption in the past week from 530 caregivers of
children 2-to5 years old in 12 communities in three agro-ecological
zones of Ghana. A weighed food record of children's dietary intakes was
also completed during two 12-hour home observations on a randomly
selected sample of 117 children. Approximately 6% (n=32) of caregivers
were not engaged in any IGA. Of the caregivers who were involved in an
IGA (n=498), approximately one-third of them were engaged in an ASF-R
IGA, such as selling smoked fish, selling eggs and the selling cooked
food that included ASF. Caregivers (67%) were engaged in ASF-U IGA,
such as crop farming, petty trading in non ASF items and artisanal
work. The quantity and diversity of ASF consumed by the children did
not differ (p=0.988 and p=0.593, respectively) by the type of caregiver
IGA. However, after accounting for agro-ecological zone, being involved
in an ASF-R IGA positively predicted children's ASF diversity
(p<0.001). The number of children in the household negatively
predicted children's ASF diversity (p=0.011) whereas high/medium
household wealth status tended to be positively associated with ASF
diversity (p=0.064).The study suggested that there is need to promote
ASF-R IGA among caregivers to increase the ability to purchase more
varied and nutritious food items for improving children's growth.
Food-related beliefs and attitudes influence dietary behaviors and are important drivers of nutrition outcomes. Understanding beliefs and attitudes that drive dietary behaviors, as part of the process for developing Food-based Dietary Guidelines is critical for targeting messages to motivate healthy dietary diets. This rapid review was undertaken to summarize readily available local evidence on food-related beliefs, attitudes, and associated practices in Ghana. A rapid review of 39 peer-reviewed publications and graduate-level theses on the dietary behaviors of Ghanaians was conducted between November and December 2020. The study only included articles published between 1990 and 2020 involving apparently healthy populations living in Ghana. Documents were identified through a systematic literature search of Google Scholar and PubMed. Data on food-related knowledge, beliefs, attitudes, and practices were extracted into an excel template and analyzed using thematic content analysis. The sampled research included primarily cross-sectional studies of urban, rural, peri-urban and mixed localities throughout Ghana: one was a prospective research. A range of food-related taboos were identified and classified as taboos for the general population, pregnancy-related, or child-related. Although awareness of food-related taboos was common, they were not extensively practiced. Energy-giving and nutrient-dense foods are commonly promoted during pregnancy. Culturally prescribed pre-lacteal feeds and other infant and young child feeding (IYCF) behaviors reported in the studies were not aligned with IYCF recommendations. A 3-meals-a-day pattern was observed, commonly, across all age groups; most adult meals, particularly supper, was prepared at home. However, ready-to-eat meals were regularly purchased by adults and adolescents. Adolescents frequently reported snacking and skipping meals; breakfast was the most frequently skipped meal. Fruits and vegetables were the least consumed food groups across all age groups. Muslim faith was associated with consuming more diverse diets and greater fruit and vegetable consumption. The findings of this review provide an overview of food-related beliefs and practices of Ghanaians and can inform decisions on areas to emphasize in food-based dietary guidelines and associated nutrition education messages to promote healthy diets in the Ghanaian population. Effective nutrition education is needed to dispel harmful food beliefs and practices and promote healthy food choices across the life cycle. Dietary patterns in Ghana are linked with cultural and religious practices that are often unique to particular subgroups, although there are common strands of beliefs across ethnic groups. These beliefs can result in either adverse or beneficial outcomes, depending on what eating patterns it determines. Key words: food prohibitions, dietary practices, dietary pattern, Nutrition, Ghana
Galamsey, a popular name for small-scale mining in Ghana, is an important livelihood for many rural Ghanaians. Although concerns have been raised in the popular media about the adverse effects of galamsey on the environment, human health, and livelihoods, there is a representational paucity of evidence regarding its links with local food systems, particularly, from the perspective of affected mining communities. The current study explored community perceptions and experiences of galamsey and its perceived effects on food security and livelihoods in the East Akim Municipality in the Eastern region of Ghana. Primary data was collected in the East Akim Municipality of Ghana, using a photovoice method. Thirty-six male and female adults were purposively selected with the help of a community focal persons and advertisements in the study communities. Respondents participated in a one-day photography training and thereafter, were deployed to take at least fifteen photos that portray the effect of galamsey on food security and health. Subsequently, each participant was asked to select five of the photographs they have taken and explain why they captured that image. A photo exhibition was held to facilitate community conversation and perspectives on the effects of galamsey on food and nutrition security. Galamsey has resulted in degradation of, otherwise, fertile agricultural land, and contamination of freshwater sources. As a consequence, there is reduced cultivable land, reduced crop production, shortage of essential staple foods, increase in food price, and increased consumption of ultra-processed foods. There is also perception of increased exposure to heavy metals like mercury in locally-produced food. Given the adverse health consequences of both food and nutrition insecurity, and increased consumption of processed foods, it is important that public and policy discussions to minimize the effects of galamsey in Ghana should include considerations about food and nutrition insecurity in mining communities. Key words: mining, galamsey, food security, health, agriculture, land degradation, food system
Abstract Background Anaemia among children under age five is a major public health issue. Although anaemia prevalence is declining in Ghana, the severity among anaemic children is worsening. This study aims to investigate the determinants of anaemia severity among children aged 6 to 59 months in Ghana. Method The study utilized a weighted sample of 1,258 children with anaemia with data obtained from the 2019 Ghana Malaria Indicator Survey. The predictor variables included maternal, household child and health system characteristics. SPSS version. At the multivariate level, three different multinomial logistic models were run with selected predictor variables. All tests were conducted at the 95% confidence level. Results The overall anaemia prevalence among children under age five was 43.5%. Of these, 2.6% were severely anaemic, 48.5% were moderately anaemic, and 48.9% had mild anaemia. The multinomial analysis showed that maternal, household, child and health system factors significantly predicted anaemia levels among anaemic children. The results indicate that a lower likelihood of anaemia severity is likely to be found among children whose mothers belong to Pentecostal/Charismatic faith (AOR = 0.18-model I; AOR = 0.15-model III) and children who tested negative for malaria (AOR = 0.28-model II and III). Again, a higher probability of anaemia severity was found among anaemic children whose mothers were not aware of NHIS coverage of malaria (AOR = 2.41-model II, AOR = 2.60-model III). With regard to moderate anaemia level, children who belong to the poorest, poorer and middle household wealth index had a higher likelihood of being moderately anaemic compared to those in rich households. Similarly, anaemic children who were less than 12 months old (AOR = 2.21-model II, AOR = 2.29-model III) and those between the ages of 1–2 years (AOR = 1.84-model II, AOR = 1.83-model III) were more likely to have moderate anaemia levels. Conclusion The study findings show the importance of understanding the interrelation among different factors that influence anaemia severity among children under age five as critical in developing strategies and programmes aimed at addressing childhood anaemia.
The mechanisms through which livestock ownership is associated with childhood anaemia are contested. Using a cross-sectional, community-based survey of 300 households in southern Ghana, we determined the associations of household livestock ownership with anaemia among children aged 2–5 years. Potential mediating effects of animal-source food (ASF) consumption, microbial infections, and household food security were investigated. Data on each child's anaemia, malaria, and intestinal infections were collected for a subset of 221 households. Anaemia was defined as a haemoglobin (Hb) concentration <110 g/L. ASF consumption was measured as a count of the number of different ASF types consumed by each child in the week prior to the interview. Household food security was measured with a 15-item, pre-tested tool adapted from the USDA Household Food Security Core Module. The number of sheep and goats in aggregate was associated with higher odds of a child being anaemic (aOR (95% CI) = 1.10 (1.03, 1.17)). Households owning more free-range poultry had greater diversity of consumed ASFs among children (Coef. (95% C) = 0.02 (0.01, 0.03)). Owning more pigs was associated with higher odds that a household was food secure (1.05 (0.99, 1.12). We found no evidence that the child's ASF consumption mediated the association of livestock ownership with child anaemia, however,household food security mediated the association between household pig ownership and child anaemia. Overall, household ownership of livestock was associated with higher ASF consumption among children and improved household-level food security, yet also a higher odd of anaemia among those young children. The mechanisms leading to these seemingly counterintuitive relationships require further investigation.
Food security and human migration are both major developmental issues for governments, particularly in sub-Saharan Africa. However, scholarship on the links between rural out-migration and food insecurity remains ambiguous about migrants in their destination and lacks ample comparison with the place of origin. Using data from the nationally representative Ghana Living Standards Survey (Round 7), we employed multinomial logit functions to examine the food security status of migrants relative to their non-migrant counterparts in their rural origins across Ghana’s three development zones i.e. Coastal, Middle Belt and Northern. The results showed that compared to their respective non-migrants, whereas rural out-migrants from the Coastal and Middle Belt development zones to urban areas were significantly more likely to be severely food insecure, rural out-migrants from the Northern Development Zone were less likely to be food insecure. Increase in household size and decrease in household expenditure were both associated with an increased likelihood of being food insecure across all development zones. These empirical findings highlight the importance of the unique characteristics of different migration flows in current food security and migration discourse globally. This study shows that rural out-migration to urban centers might not necessarily ensure relatively better food security as largely anticipated if the origin of migrants is overlooked.
Abstract Background Despite the importance of contraceptives in reducing unwanted pregnancy and other related maternal morbidity and mortality, contraceptive usage is very low among women in their reproductive ages. In Ghana, there is an increase in contraceptive use for traditional and modern methods in rural areas. However, there is a paucity of studies examining the factors associated with any contraceptive method in the rural Eastern region of Ghana. Therefore, this study seeks to examine the prevalence and determinants of current use of any contraceptive method among women of reproductive age in the rural Eastern Region of Ghana. Methods A community-based cross-sectional study was conducted among women of reproductive age in the rural Eastern region of Ghana. A structured questionnaire was used to interview rural women in Lower Manya and Upper Manya Krobo districts of Eastern region who were selected using a simple random sampling technique. The data were analysed using Stata version 16. A Binary logistic regression was used to examine the determinants of current use of any contraceptive use (traditional and modern methods). Results The prevalence of contraceptive use was 27.8%. From the unadjusted analyses, age (p = 0.001), marital status (p = 0.087), desire for another child (p = 0.089) and head of household (p = 0.013) were independently associated with contraceptive use. In the adjusted analysis, contraceptive use was significantly higher among respondents aged 18–35 years (aOR:3.27; 95%CI:1.46–7.34;p = 0.004) or 36–40 years (aOR:2.14;95%CI:0.97–4.71;p = 0.049), husbands/partners who were head of households (aOR:3.40; 95%CI: 0.96–12.10; p = 0.028) compared with those aged 41–49 years and respondents who were head of households respectively. Contraceptive use was significantly lower among migrants (aOR:0.59; 95%CI:0.31–1.09; p = 0.036) compared with non-migrant. Conclusion This study highlights the factors associated with contraceptive use and the need to improve campaigns and educate rural women on contraceptives to prevent unwanted pregnancy and space birth. Family planning programs should target young women, non-migrants and male-headed households to design an intervention to increase contraceptive use in rural areas.
Engagement in income generation activities (IGA) that involve animal source foods (ASF) may influence children’s intake of animal products through increased availability of ASF in the home and increased income that can be used to purchase ASF. This study compared the diversity of ASF in the diet of children whose caregivers’ engaged in ASF-related IGA and those engaged in an IGA unrelated to ASF. Data on household income and sociodemographics, and diets of 2- to 5-y-old children were collected through interviews with 251 caregivers in 6 rural and semi-rural communities in 3 regions of Ghana. About 34% (n= 83) of caregivers were engaged in an ASF-related IGA. Rural caregivers with ASF-related IGA had a significantly higher weekly income than those in ASF-unrelated IGA (p<0.05); however, a similar difference was not noted among semi-rural caregivers. Rural children tended to have higher dietary ASF diversity than semi-rural children (P=0.05). Children’s ASF diversity was not predicted by type of IGA. Weekly income of at least US$10.90, caregiver formal education, and rural location predicted children’s ASF diversity (P<0.001). Ability to purchase ASF in the market rather than its accessibility in the home through an IGA may be a more important determinant of ASF in children’s diets in rural and semi-rural communities in Ghana. Support was through GL-CRSP, funded in part by US-AID, Grant # PCE-G-00-98-00036-00 and J Ellis fellowship to Christian.
