Browsing by Author "Agyei-Mensah, S."

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Accessibility to and Utilization of Primary Health Care in the Ga, Dangme East and Dangme West Districts of the Greater Accra Region
(University of Ghana, 2003-11) Mensah, C.M.; Nabila, J.S.; Ardayfio-Schandorf, E.; Awumbila, M.; Agyei-Mensah, S.; University of Ghana, College of Humanities, School of Social Sciences, Department of Geography and Resource Development
The study examined the accessibility and other socio-economic forces that influence the utilization of primary health care services in the rural parts of the Greater Accra Region of Ghana. Three administrative districts, Ga, Dangme West and Dangme East, were selected for study. Both qualitative and quantitative data were used. Questionnaire and interview schedules reinforced by focus group discussions and observations, were the main research instruments. Descriptive and multivariate techniques are the analytical tools. The main factors that influenced utilization as established by the empirical research, have been income, distance, transport and service costs, waiting and travel times, educational status in the analysis. The researcher establishes that, the main factors that influence utilization of primary health care services in the rural parts of Greater Accra Region are income and distance. The other factors are service costs, transport cost and waiting time. Income shows a positive relationship with utilization, whilst service cost exhibits a negative relationship to validate the hypotheses. Income makes a stronger impact than distance, service cost and waiting time. The impact of education, though statistically significant, is weak. There were differences by place of residence, and also by health status (patient and nonpatient). With regard to income, the impact at the Ga District is stronger than that of the Dangme West and Dangme East Districts, whilst non-patients are more affected than patients. With regard to distance and utilization, the Dangme East and Dangme West Districts show a stronger negative impact than the Ga District, whilst the impact of patients is stronger than non-patients. Waiting time and service costs have a greater impact in the Ga District than in the Dangme West and Dangme East Districts. For health status, patients are more affected by distance than non-patients. Several recommendations have been made to enhance utilization and the quality of health and health care. These include among others the strengthening and upgrading of primary health care facilities in the rural districts, improvement of the quantity and quality of medical and paramedical staff and the introduction of a National Health Insurance Scheme.
Air Pollution in Accra Neighborhoods: Spatial, Socioeconomic, and Temporal Patterns
(Environmental Science and Technology, 2010-03) Dionisio, K.L.; Arku, R.E.; Hughes, A.F.; Jose Vallarin, O.; Carmichael, H.; Spengler, J.D.; Agyei-Mensah, S.; Ezzati, M.
This study examined the spatial, socioeconomic status (SES), and temporal patterns of ambient air pollution in Accra, Ghana. Over 22 months, integrated and continuous rooftop particulate matter (PM) monitors were placed at a total of 11 residential or roadside monitoring sites in four neighborhoods of varying SES and biomass fuel use. PM concentrations were highest in late December and January, due to dust blown from the Sahara. Excluding this period, annual PM2.5 ranged from 39 to 53μg/m3 at roadside sites and 30 to 70 μg/m3 at residential sites; mean annual PM10 ranged from 80 to 108 μg/m3 at roadside sites and 57 to 106 μg/m3 at residential sites. The low-income and densely populated neighborhood of Jamestown/Ushertown had the single highest residential PM concentration. There was less difference across traffic sites. Daily PM increased at all sites at daybreak, followed by a mid-day peak at some sites, and a more spread-out evening peak at all sites. Average carbon monoxide concentrations at different sites and seasons ranged from 7 to 55 ppm, and were generally lower at residential sites than at traffic sites. The results show that PM in these four neighborhoods is substantially higher than the WHO Air Quality Guidelines and in some cases even higher than the WHO Interim Target 1, with the highest pollution in the poorest neighborhood. © 2010 American Chemical Society.
Beyond here and now: Evaluating pollution estimation across space and time from street view images with deep learning
(Science of the Total Environment, 2023) Nathvani, R.; Nimo, J.; Agyei-Mensah, S.; et al.
Advances in computer vision, driven by deep learning, allows for the inference of environmental pollution and its potential sources from images. The spatial and temporal generalisability of image-based pollution models is crucial in their real-world application, but is currently understudied, particularly in low-income countries where infrastructure for measuring the complex patterns of pollution is limited and modelling may therefore provide the most utility. We employed convolutional neural networks (CNNs) for two complementary classification models, in both an end-to-end approach and as an interpretable feature extractor (object detection), to estimate spatially and temporally resolved fine particulate matter (PM2.5) and noise levels in Accra, Ghana. Data used for training the models were from a unique dataset of over 1.6 million images collected over 15 months at 145 representative locations across the city, paired with air and noise measurements. Both end-to-end CNN and object-based approaches surpassed null model benchmarks for predicting PM2.5 and noise at single locations, but performance deteriorated when applied to other locations. Model accuracy diminished when tested on images from locations unseen during training, but improved by sampling a greater number of locations during model training, even if the total quantity of data was reduced. The end-to-end models used characteristics of images associated with atmospheric visibility for predicting PM2.5, and specific objects such as vehicles and people for noise. The results demonstrate the potential and challenges of image-based, spatiotemporal air pollution and noise estimation, and that robust, environmental modelling with images requires integration with traditional sensor networks.
The Built Environment and the Risk of Obesity among the Urban Poor in Accra, Ghana
(University of Ghana, 2014-07) Dake, F. A. A.; Codjoe, S. N. A.; Dodoo, F. N. A.; Agyei-Mensah, S.; University of Ghana, College of Humanities, Regional Institute for Population Studies
BACKGROUND: Obesity has become a major public health problem globally. Once more common in developed countries, the prevalence of obesity has been observed to be increasing in developing countries as well. In the past, obesity was attributed to factors such as individual genetic make-up and lifestyle behaviours. These factors however, do not exclusively explain the global increase in the prevalence of obesity over the last three decades. Rather, a built environment that encourages excess calorie consumption and physical inactivity has been proposed as a more likely explanation. OBJECTIVES: The influence of the built environment on obesity has been extensively documented in developed countries but continues to remain a grey area in developing countries, especially in the sub-Saharan Africa region. This study examines the built environment in an urban poor Ghanaian context and investigates how the built environment influences the risk of obesity for residents of these urban poor settings. METHODOLOGY: This study was conducted in three urban poor communities (James Town, Ussher Town and Agbogbloshie) in Accra, Ghana. The study involved the collection of primary data at two levels: the individual and community levels. At the individual level, data were collected on socio-demographic characteristics, lifestyle behaviours and anthropometric measures including weight, height and waist circumference through a survey. At the community level, Geographic Positioning System (GPS) technology was used to gather data on the features of the built environment including the location and number of out-of-home cooked foods, convenience stores, fruit and vegetable sales points and physical activity spaces. Qualitative data on community norms and perceptions about ideal body size and dietary and physical activity behaviours were also collected through focus group discussions. A mix of spatial, qualitative and quantitative analysis tools were used to analyse the data. The dependent variable for the study was obesity which was measured using body mass index (BMI) and waist-to-height ratio while the features of the built environment were used as the main independent variables. RESULTS: The built environment in the study area is suggestive of one that is “obesogenic”. There were more options for out-of-home cooked foods and convenience stores but fewer options for fruits and vegetables and physical activity spaces. Each additional out-of-home cooked food place located in the community was associated with an approximate 0.1 kg/m2 decrease in BMI while each additional convenience store was associated with a 0.2 kg/m2 increase in BMI after controlling for population density, crime level, social cohesion, trust among community members, perception about community ideal body size and individual socio-demographic characteristics and lifestyle behaviours. Also, the presence of a physical activity space in the community was associated with a 0.4 kg/m2 reduction in BMI although statistical significance was not achieved. The results of sex stratified models show a 0.1 kg/m2 reduction in BMI for each additional out-of-home cooked food place among females (at P<0.10) but not among males. The features of the built environment did not show a significant influence on waist-to-height ratio in the general model and sex stratified models although contributing to the variance. CONCLUSIONS: This study demonstrates the existence of a built environment that influences the risk of obesity in an urban poor Ghanaian context. The influence of the built environment on obesity differs depending on the measure of obesity and also differs for males and females. There is the need to expand the scope of obesity research in the sub-Saharan African region by examining the contribution of the built environment.
Change and continuity in the practice and development of geography in Ghana
(Changing Perspectives on the Social Sciences in Ghana, 2014-05) Agyei-Mensah, S.; Yaro, J.A.; Mensah, J.
Societal change and the conceptualization of knowledge production are key instruments in defining the trajectory of academic disciplines. This chapter discusses the evolution of the discipline of geography and its contribution to knowledge and public policy and practice in Ghana. It examines the writings and portfolios held by key geographers and the content of academic courses in the country. Geography in Ghana reflects both the modernization of Ghanaian society and the philosophical evolution of global knowledge production. These are reflected in the content, nature, and contributions of the discipline from the colonial era to the contemporary society. The thematic orientation of the subject reflects societal dynamics and thereby needs to be accredited for the proliferation of areas of specialization. These specializations and the redefinition of content and focus of thematic areas are responses to both societal needs and wider epistemological changes. Ghanaian geographers have contributed immensely to the generation of knowledge and the dissemination of geographic research for national development. However, physical geography has lagged behind human geography over the years due primarily to the lack of adequate infrastructure and funding. © 2014 Springer Science+Business Media Dordrecht. All rights reserved.
The Changing Medical Geography of Africa
(2013-12-09) Agyei-Mensah, S.; Oppong, J.R.
This chapter provides an overview of the historical and contemporary scholarship on medical geography of Africa with emphasis on Ghana. Medical geography research on Africa has traditionally focused on disease ecology and geography of health care, increasingly linking health with its political and economic context. More recent studies typically apply more sophisticated techniques, including genotyping and spatial analysis, in an effort to model disease control and spread as well geographic access to health. African medical geography has a solid foundation but much more needs to be done. For the future, we argue that advanced analytical approaches such as multi-level modeling are needed to provide a deeper understanding of the pressing health issues confronting the continent.
Characterizing Air Pollution in Two Low-Income Neighborhoods in Accra, Ghana
(Science of the Total Environment 402 (2-3): 217-231, 2008) Arku, R.; Vallarino, J.; Dionisio, K.L.; Wilson, J.G.; Memphill, C.; Agyei-Mensah, S.; Spengler, J.; Ezzati, M.
Sub-Saharan Africa has the highest rate of urban population growth in the world, with a large number of urban residents living in low-income “slum” neighborhoods. We conducted a study for an initial assessment of the levels and spatial and/or temporal patterns of multiple pollutants in the ambient air in two low-income neighborhoods in Accra, Ghana. Over a 3-week period we measured (i) 24-hour integrated PM10 and PM2.5 mass at four roof-top fixed sites, also used for particle speciation; (ii) continuous PM10 and PM2.5 at one fixed site; and (iii) 96-hour integrated concentration of sulfur dioxide (SO2) and nitrogen dioxide (NO2) at 30 fixed sites. We also conducted seven consecutive days of mobile monitoring of PM10 and PM2.5 mass and submicron particle count. PM10 ranged from 57.9 to 93.6 μg/m3 at the four sites, with a weighted average of 71.8 μg/m3 and PM2.5 from 22.3 to 40.2 μg/m3, with an average of 27.4 μg/m3. PM2.5/PM10 ratio at the four fixed sites ranged from 0.33 to 0.43. Elemental carbon (EC) was 10–11% of PM2.5 mass at all four measurement sites; organic matter (OM) formed slightly less than 50% of PM2.5 mass. Cl, K, and S had the largest elemental contributions to PM2.5 mass, and Cl, Si, Ca, Fe, and Al to coarse particles. SO2 and NO2 concentrations were almost universally lower than the US-EPA National Ambient Air Quality Standards (NAAQS), with virtually no variation across sites. There is evidence for the contributions from biomass and traffic sources, and from geological and marine non-combustion sources to particle pollution. The implications of the results for future urban air pollution monitoring and measurement in developing countries are discussed.
Chemical characterization and source apportionment of household fine particulate matter in rural, peri-urban, and urban West Africa
(Environmental Science and Technology, 2014) Zhou, Z.; Dionisio, K.L.; Verissimo, T.G.; Kerr, A.S.; Coull, B.; Howie, S.; Arku, R.E.; Koutrakis, P.; Renner, J.D.; Fornace, K.; Hughes, A.F.; Vallarino, J.; Agyei-Mensah, S.; Ezzati, M.
Household air pollution in sub-Saharan Africa and other developing regions is an important cause of disease burden. Little is known about the chemical composition and sources of household air pollution in sub-Saharan Africa, and how they differ between rural and urban homes. We analyzed the chemical composition and sources of fine particles (PM2.5) in household cooking areas of multiple neighborhoods in Accra, Ghana, and in peri-urban (Banjul) and rural (Basse) areas in The Gambia. In Accra, biomass burning accounted for 39-62% of total PM2.5 mass in the cooking area in different neighborhoods; the absolute contributions were 10-45 μg/m 3. Road dust and vehicle emissions comprised 12-33% of PM 2.5 mass. Solid waste burning was also a significant contributor to household PM2.5 in a low-income neighborhood but not for those living in better-off areas. In Banjul and Basse, biomass burning was the single dominant source of cooking-area PM2.5, accounting for 74-87% of its total mass; the relative and absolute contributions of biomass smoke to PM 2.5 mass were larger in households that used firewood than in those using charcoal, reaching as high as 463 μg/m3 in Basse homes that used firewood for cooking. Our findings demonstrate the need for policies that enhance access to cleaner fuels in both rural and urban areas, and for controlling traffic emissions in cities in sub-Saharan Africa. © 2013 American Chemical Society.
Chemical composition and sources of particle pollution in affluent and poor neighborhoods of Accra, Ghana
(Environmental Research Letters, 2013-12) Zhou, Z.; Dionisio, K.L.; Verissimo, T.G.; Kerr, A.S.; Coull, B.; Arku, R.E.; Koutrakis, P.; Spengler, J.D.; Hughes, A.F.; Vallarino, J.; Agyei-Mensah, S.; Ezzati, M.
The highest levels of air pollution in the world now occur in developing country cities, where air pollution sources differ from high-income countries. We analyzed particulate matter (PM) chemical composition and estimated the contributions of various sources to particle pollution in poor and affluent neighborhoods of Accra, Ghana. Elements from earth's crust were most abundant during the seasonal Harmattan period between late December and late January when Saharan dust is carried to coastal West Africa. During Harmattan, crustal particles accounted for 55 μg m-3 (37%) of fine particle (PM 2.5) mass and 128 μg m-3 (42%) of PM10 mass. Outside Harmattan, biomass combustion, which was associated with higher black carbon, potassium, and sulfur, accounted for between 10.6 and 21.3 μg m -3 of fine particle mass in different neighborhoods, with its contribution largest in the poorest neighborhood. Other sources were sea salt, vehicle emissions, tire and brake wear, road dust, and solid waste burning. Reducing air pollution in African cities requires policies related to energy, transportation and urban planning, and forestry and agriculture, with explicit attention to impacts of each strategy in poor communities. Such cross-sectoral integration requires emphasis on urban environment and urban poverty in the post-2015 Development Agenda. © 2013 IOP Publishing Ltd.
A Comparative Study of Ethnic Residential Segregation in Ghana’s Two Largest Cities, Accra and Kumasi
(Springer, 2011-06) Owusu, G.; Agyei-Mensah, S.
The rate of urbanization is far more rapid in sub-Saharan Africa than in any other major region of the world. However, little is known about patterns of ethnic residential segregation in rapidly urbanizing African cities. This paper is crafted to make an important contribution through its focus on Ghana's two largest cities: Accra and Kumasi. Making use of the most recent population and housing census data of 2000 to generate a Location Quotient index, the analyses explore the cities' degree of ethnic diversity and concentration for comparative purposes. In relative terms, the study reveals that the level of residential ethnic segregation is fairly balanced in Accra compared to Kumasi. However, there are important differences between the findings of this Ghanaian case study and findings from research in the West, where the residential segregation is heavily determined by cultural/racial factors in addition to socio-economic factors. In the absence of institutional and ethnic discrimination, the most fundamental underlying cause of segregation in the Ghanaian case appears to be the socio-economic circumstance of ethnic groups present in the cities. The paper concludes by exploring the implications of the study for urban and national development in Ghana as well as the future patterns of ethnic clustering likely to emerge in Accra and Kumasi.
A Critical Review of ‘Third Termism’ in African Politics from an International Law Perspective
(2017-03-29) Appiagyei-Atua, K.; Agyei-Mensah, S.
The return to democracy in Africa, following the fall of the Berlin Wall, saw most African countries drafting and adopting new constitutions which seek to entrench respect for democracy, human rights and the rule of law in the governance ethos of their countries. In most of these constitutions, a two-term limit was specified for a regime to remain in power. Yet, for the past few years, African citizenry are witnessing a trend where their political leaders have had their constitutions doctored to allow for third or indefinite terms, popularly referred to broadly as 'third termism.' The presentation will seek to explain this phenomenon relying on traditional African political system of life-long monarchical rules on which the one-party state was modeled and implemented in most African states between the time of independence and until coups d'état became a means of regime change on the continent. Another model which will be used to analyse this emerging trend is the agenda of exporting 'instant democracy and instant capitalism' by the US under the Clinton and Bush administrations. The presentation will situate the discussion in the context of international law and examine how the principles of unconstitutional change in government developed by the Organisation of African Unity/African Union (OAU/AU) together with the application of the concept of collective recognition of governments could be applied to deal with the 'third termism' phenomenon
Education and employment outcomes in Ghana through the lens of the capability approach [Scolarisation et emploi au Ghana à travers la lunette de l’approche des capabilités]
(Etude de la Population Africaine / Union for African Population Studies, 2014) Sarkodie, A.O.; Agyei-Mensah, S.; Anarfi, J.K.; Bosiakoh, T.A.
Existing literature on education and employment confirms that in Ghana educational qualification largely influences the type of work. Through the lens of the Capability Approach, which sees human development in terms of the expansion of freedoms and opportunities, this paper identifies, for a cross-section of Ghanaians, the array of employment opportunities between and within education endowments. “Between endowments” refers to differentials in opportunities for individuals with different levels of educational qualifications, while “within endowments” considers the differentials for individuals with the same level of education. The source of data is the 2005/06 Ghana Living Standard Survey (GLSS5). Results show that education is not enough to erase inequalities. Multinomial regression analysis demonstrates that functionings differ according to the individual’s context, household and personal conversion factors. This is explained by inequalities in the requirements for a particular job (between educational endowments) and by job accessibility due to personal characteristics (within educational endowments). © 2014, Union for African Population Studies. All rights reserved.
The effect of neighbourhood mortality shocks on fertility preferences: a spatial econometric approach
(The European Journal of Health Economics, 2015-07) Owoo, N.S.; Agyei-Mensah, S.; Onuoha, E.
According to the demographic transition theory, fertility rates fall in response to declines in child mortality rates. Although national statistics indicate that child mortality rates have been declining over time, Ghana’s fertility rates appear to have stalled. This paper hypothesises that women’s fertility behaviours may be more responsive to child mortality experiences at more localised levels. Using all rounds of the Ghana Demographic and Health Surveys (1988–2008) and employing a variety of spatial and empirical estimation techniques, results indicate that in addition to own-child mortality, neighbourhood child mortality shocks are also a determinant of women’s fertility in Ghana. Women in neighbourhoods with large child mortality shocks may desire more children as an “insurance” against future losses, as a result of their increased perceptions of own-child mortality risks. The effect of neighbourhood mortality shocks on fertility preferences: a spatial econometric approach | Request PDF. Available from: https://www.researchgate.net/publication/263344860_The_effect_of_neighbourhood_mortality_shocks_on_fertility_preferences_a_spatial_econometric_approach [accessed Sep 13 2018].
The effect of neighbourhood mortality shocks on fertility preferences: a spatial econometric approach.
(Springer, 2015-07) Owoo, N.S.; Agyei-Mensah, S.; Onuoha, E.
According to the demographic transition theory, fertility rates fall in response to declines in child mortality rates. Although national statistics indicate that child mortality rates have been declining over time, Ghana’s fertility rates appear to have stalled. This paper hypothesises that women’s fertility behaviours may be more responsive to child mortality experiences at more localised levels. Using all rounds of the Ghana Demographic and Health Surveys (1988–2008) and employing a variety of spatial and empirical estimation techniques, results indicate that in addition to own-child mortality, neighbourhood child mortality shocks are also a determinant of women’s fertility in Ghana. Women in neighbourhoods with large child mortality shocks may desire more children as an “insurance” against future losses, as a result of their increased perceptions of own-child mortality risks.
Effectiveness of the National Malaria Control Programme in Akwapim South Municipality
(University of Ghana, 2013-07) Musah, A.; Nabila, J.S.; Agyei-Mensah, S.
Malaria control has received significant attention in the Akwapim South Municipality yet remains the highest cause of ill-health among the people. Not only must interventions be put in place but they must actually be effective in ensuring that malaria morbidity and mortality are eliminated. There have been series of strategies that have been implemented under the malaria control programme to control and prevent malaria. Despite the fact that interventions have been introduced, their effectiveness is in doubt since malaria still remains a major public health problem in the Akwapim South Municipality. The study attempts to evaluate the effectiveness of this programme in terms of its outcomes on access to these interventions, knowledge on malaria and the overall impact of the strategies on trends of malaria prevalence among households in Akwapim South Municipality. The study used the cluster based sampling technique to solicit the views of 200 households using a questionnaire. Also, interviews with 20 health workers provided crucial qualitative data as well as the review of secondary data from the district and regional health offices. Other qualitative methods employed were in-depth interviews and focus group discussions with programme stakeholders and households who were the beneficiaries. The results show a significant increase in terms of coverage of most of the strategies. There is increased possession of insecticides treated nets (74%) of the 100% target by 2015. Despite the increases on access to the ITNs, their utilization remains low among households. All pregnant women who visited health facility were put on Intermittent Preventive Treatment for pregnant women as targeted to achieve by 2015. There was evidence of limited coverage of indoor residual spraying and likewise there was low access to prompt treatment of malaria. Overall, the malaria situation remains high with a prevalence of 67% of households reporting of malaria in the past two weeks. The study indicates a decrease in terms of malaria mortality. Against the target of achieving a 100% for all malaria cases confirmed before treatment by 2015, the findings showed that only 50% of malaria cases were confirmed before treatment. There was also an over concentration on the curative aspect of malaria cases than measures for prevention which are more likely to ensure sustainable malaria control. The key challenges of the programme included inadequate funding, low staffing and low involvement of the people. Poor involvement of the people led to low levels of acceptability. The study concludes by recommending that interventions of the malaria control programme in Akwapim South Municipality be repositioned in a way that increases the performance and effectiveness of the programme.
Epidemiological transition and the double burden of disease in Accra
(Journal of Urban Health:Bulletin of the New York Academy of Medicine. Springer, 87 (5): 879-897, 2010) Agyei-Mensah, S.; de Graft Aikins, A.
It has long been recognized that as societies modernize, they experience significant changes in their patterns of health and disease. Despite rapid modernization across the globe, there are relatively few detailed case studies of changes in health and disease within specific countries especially for sub-Saharan African countries. This paper presents evidence to illustrate the nature and speed of the epidemiological transition in Accra, Ghana’s capital city. As the most urbanized and modernized Ghanaian city, and as the national center of multidisciplinary research since becoming state capital in 1877, Accra constitutes an important case study for understanding the epidemiological transition in African cities. We review multidisciplinary research on culture, development, health, and disease in Accra since the late nineteenth century, as well as relevant work on Ghana’s socio-economic and demographic changes and burden of chronic disease. Our review indicates that the epidemiological transition in Accra reflects a protracted polarized model. A “protracted” double burden of infectious and chronic disease constitutes major causes of morbidity and mortality. This double burden is polarized across social class. While wealthy communities experience higher risk of chronic diseases, poor communities experience higher risk of infectious diseases and a double burden of infectious and chronic diseases. Urbanization, urban poverty and globalization are key factors in the transition. We explore the structures and processes of these factors and consider the implications for the epidemiological transition in other African cities.
Ethnic Residential Clusters in Nima, Ghana
(Springer, 2012-03) Agyei-Mensah, S.; Owusu, G.
The global debate on ethnic residential segregation has focused more on the developed world, and little is known about similar patterns and processes in African cities. This is in spite of the fact that many African cities are now ranked among the world’s most rapidly growing and least regulated urban areas. Indeed, the dynamics of ethnic residential segregation have scarcely been studied in African cities. The little literature available has looked at ethnic segregation between the neighbourhoods of major cities. This paper goes beyond current literature by examining the pattern and processes of ethnic clustering within a multi-ethnic community. Our goal in this paper is to answer the question as to whether within a multi-ethnic urban neighbourhood the major ethnic groups are residentially clustered, isolated or dispersed. The focus is on Nima, a major slum community of Accra, Ghana. The findings of the study show that even though Nima is a multi-ethnic community, some level of ethnic clustering can be discerned. These patterns are linked to the history of settlement formation, religious affiliation and ethnic or place of origin of earlier house owners.
Explaining regional fertility variations in Ghana.
(Journal of Population Research, 2015-12) Agyei-Mensah, S.; Owoo, N.
Ghana's current population is about 24.2 million, and given the current population growth rate of 2.4 %, Ghana's population is expected to double in about 29 years. Although fertility rates in Ghana have declined from 6.4 to 4 children per woman between 1988 and 2008, this transition has not been homogenous across all regions of Ghana. Fertility rates remain higher in the northern regions of the country, compared to the southern regions. This paper examines explanations for the regional fertility variations-particularly the persistently high fertility rates observed in the northern regions-paying particular attention to the contribution of socioeconomic, cultural and religious factors, and fertility attitudes among women in explaining this phenomenon. In order to capture the most recent fertility variations in the country, the paper uses the most recent round (2008) of the Ghana Demographic and Health Survey, and employs a Poisson multivariate estimation technique. Results indicate that regional differences in fertility are largely explained by socioeconomic factors such as urbanization, child mortality, education and household wealth. Cultural and religious factors also explain some of the observed variation between the northern region and the southern regions. The inclusion of the duration of post-partum amenorrhea and other proximate determinants in the model specifications significantly explains residual differences in fertility outcomes, particularly among the three northern regions. Findings therefore indicate a need for more region-specific policy targeting in the effort to reduce high fertility rates and ease the growth in population.
Fertility transition in Ghana: Looking back and looking forward
(Population, Space and Place, 2006-11) Agyei-Mensah, S.
It is widely accepted that while the fertility transition is underway in sub-Saharan Africa, the pattern of change differs widely in both time and space. This paper examines the case of Ghana, regarded as the vanguard in the West African fertility transition. Based largely on analyses of Demographic and Health Survey data as well as localised studies, significant patterns emerge. One puzzling finding is that the increase in modern contraception usage has not kept pace with the declines in fertility. The paper suggests that this mismatch can be explained either by an increase in induced abortions, reduced exposure to sexual relations (perhaps due to HIV), or misreporting of contraceptive use. The paper also highlights the considerable geographical diversity in the ongoing fertility transition. The Northern region is still in the pre-transition stage, with little decline in fertility to date. In contrast, the pace of decline has been very rapid in the Greater Accra region. The factors underlying these patterns and the future trajectory of the fertility transition are discussed. It is argued that the fertility transition may be more leisurely in the near future than in the recent past. Among the factors working against future fertility decline are the stability in the infant mortality rate, the stall in fertility desires, and the low patronage of modern contraceptives especially in rural areas. Copyright © 2006 John Wiley & Sons, Ltd.
Finding Space For African Population Health
(University of Ghana, 2015-11-05) Agyei-Mensah, S.
The concept of space in its multiple forms, is central to the theoretical and methodological foundations of health and population geography. In this lecture, I examine the way space has shaped and continues to shape our understanding of population and health issues in Africa, and explore the unique contribution to be derived from closer linkages between population health and spatial analysis. Methods and models are needed that link individual and aggregate analyses, bridge geographic scales, and couple space and time. These approaches would augment theory, advise policy, and address the existing dearth of knowledge; but call for new methods of data collection and also have implications for population and health training. Illustrations will be drawn from my individual and collaborative work on population and health issues within the Ghanaian and African contexts.