Browsing by Author "Ahiadeke, C."

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Adolescents and parents' perceptions of best time for sex and sexual communications from two communities in the Eastern and Volta Regions of Ghana: Implications for HIV and AIDS education
(BMC International Health and Human Rights, 2013-09) Asampong, E.; Osafo, J.; Bingenheimer, J.B.; Ahiadeke, C.
Background: Adolescents and parents' differ in their perceptions regarding engaging in sexual activity and protecting themselves from pregnancy and sexually transmitted infections (STIs). The views of adolescents and parents from two south-eastern communities in Ghana regarding best time for sex and sexual communications were examined. Methods. Focus Group interviews were conducted with parents and adolescents (both In-school and Out-of school) from two communities (Somanya and Adidome) in the Eastern and Volta regions of Ghana with epidemiological differentials in HIV infection. Results: Findings showed parents and adolescents agree that the best timing for sexual activity amongst adolescents is determined by socioeconomic viability. In practice however, there were tensions between adolescents and parents crystallized by spoilt generation and physiological drive ideologies. Whilst one community relied on a more communal approach in controlling their children; the other relied on a confrontational approach. Sex-talk is examined as a measure to reduce these tensions, and children in both communities were ambivalent over sexual communication between their parents and themselves. Parents from the two communities however differed in their perceptions. Whilst parents in one community attributed reduced teenage pregnancies to sex education, those in the other community indicated a generalized adolescents' sexual activeness manifested in the perceived widespread delinquency in the community. Conclusion: Parents in both communities reported significant barriers to parents-adolescents sexual communication. Parents in both communities should be educated to discuss the broader issues on sexuality that affects adolescents and their reproductive health needs. © 2013 Asampong et al.; licensee BioMed Central Ltd.
Adolescents and parents¿ perceptions of best time for sex and sexual communications from two communities in the Eastern and Volta Regions of Ghana: implications for HIV and AIDS education
(2013-09-26) Asampong, E.; Osafo, J.; Bingenheimer, J.B.; Ahiadeke, C.
Abstract Background Adolescents and parents’ differ in their perceptions regarding engaging in sexual activity and protecting themselves from pregnancy and sexually transmitted infections (STIs). The views of adolescents and parents from two south-eastern communities in Ghana regarding best time for sex and sexual communications were examined. Methods Focus Group interviews were conducted with parents and adolescents (both In-school and Out-of school) from two communities (Somanya and Adidome) in the Eastern and Volta regions of Ghana with epidemiological differentials in HIV infection. Results Findings showed parents and adolescents agree that the best timing for sexual activity amongst adolescents is determined by socioeconomic viability. In practice however, there were tensions between adolescents and parents crystallized by spoilt generation and physiological drive ideologies. Whilst one community relied on a more communal approach in controlling their children; the other relied on a confrontational approach. Sex-talk is examined as a measure to reduce these tensions, and children in both communities were ambivalent over sexual communication between their parents and themselves. Parents from the two communities however differed in their perceptions. Whilst parents in one community attributed reduced teenage pregnancies to sex education, those in the other community indicated a generalized adolescents’ sexual activeness manifested in the perceived widespread delinquency in the community. Conclusion Parents in both communities reported significant barriers to parents-adolescents sexual communication. Parents in both communities should be educated to discuss the broader issues on sexuality that affects adolescents and their reproductive health needs.
Assessing the Effects of Uncollected Waste Generated by Households in Tema Newtown
(University of Ghana, 2013-07) Addy, N.N.A.; Ahiadeke, C.; University of Ghana, College of Humanities, Institute of Statistical, Social and Economic Research
The problem of waste collection and disposal has been a canker to the development of cities and towns across Ghana. Day in day out, there are reports of piles of waste left uncollected around city centres and residences. Huge tonnes of waste are seen scattered in streets and gutters and the effects are enormous especially in the face of rapid urbanization. Some of the effects include flooding, the spread of diseases as a result of cross contaminations, the aesthetic value of the community among others. The city of Tema is one fast urbanizing area with such challenges associated with waste generation. This study therefore sought to ascertain the effects of uncollected household waste generated in Tema Newtown – a community within the Tema Metropolitan Area. The study used a survey of 120 households, key informant interviews of officials within the administrative and traditional jurisdiction of Tema and observations to achieve its objectives. Additionally, the Contingent Valuation Method was used to elicit and analyze respondents’ willingness to pay. The results of the study showed that out of 11.64 tonnes of waste generated per day in Tema Newtown, 3.8 tonnes remains uncollected. The study also revealed that the respondents were aware of the problem of uncollected yet were unconcerned. However, they were aware of the effects of the waste generated and what was left uncollected which included the widespread of diseases, flooding, contamination of water bodies and devaluation of the town due to the odour in some communities within the town. According to the result of the valuation, majority of the respondents are willing to pay a fee for better and improved waste management system. The study therefore encourages the adoption of the Public Private Partnership and the various recycling of waste materials to reduce the rate of uncollected waste and efficient waste management.
Attitude of Parents and Adolescents towards Contraceptive Use by Adolescents in Alajo, Ayawaso Central Submetro of Accra
(University of Ghana, 2009-08) Maya, E.T.; Ahiadeke, C.; Adanu, R.; University of Ghana, College of Health Sciences, School of Public Health
Introduction Despite high knowledge about contraceptives among adolescents its use is low. Parental attitude towards adolescent contraceptive can adversely affect contraceptive use by adolescents. Objectives: 1. To describe the general knowledge of parents and adolescents on contraceptives 2. To determine the proportion of parents and adolescents who are in favour of contraceptive use among adolescents 3. To determine the proportion of parents and adolescents who discuss contraception 4. To describe how selected sociodemographic factors affect the attitude of parents and adolescents towards contraceptive use among adolescents. Methods A cross-sectional survey was done employing both quantitative and qualitative methods. A face-to-face interview using a structured questionnaire was conducted with a simple randomly selected sample of adolescents and parents. Focus group discussions were held with some parents. The quantitative data was analysed using SPSS 16.0. The qualitative data was analysed in themes according to study objectives. Results Two hundred and seventy seven adolescents and 264 parents were interviewed. More than 99% knew about modern contraceptives. Over 95% of them knew sexually transmitted infections can be prevented by using condoms. About 60% approve of contraceptive use by adolescents. However, only about 12 - 18% of parents who agreed to adolescent contraceptive use will encourage this when faced with the reality. Less than 10% of the adolescents had on their own initiated a discussion that involved contraception with their parents. About 30 – 40% of parents indicated that they have on their own discussed contraception with adolescents but the qualitative study indicated that such discussions were rare. Both parents and adolescents had misconceptions about contraceptive use among adolescents. For the adolescents, being sexually active, and for the parents, belief that contraceptive use has advantages for adolescent users and their own prior contraceptive use were significantly associated with agreeing that sexually active adolescents should use contraceptives. Conclusion and recommendations Both parents and adolescents have high knowledge about modern contraceptive use in preventing both sexually transmitted infections and pregnancy. However, misconceptions and fear of side effects is preventing parents from discussing contraception with adolescents. Parents do not have the will to also encourage adolescents to use contraceptives. There is the need to educate both parents and adolescents to dispel the misconceptions about contraceptives. Contraceptive use among adults should be encouraged as adults on contraceptives are more likely to encourage adolescent contraceptive use.
Breast-feeding, diarrhoea and sanitation as components of infant and child health: A study of large scale survey data from Ghana and Nigeria
(Journal of Biosocial Science, 2000-01) Ahiadeke, C.
Using Demographic and Health Survey datasets from Ghana and Nigeria, this study examined whether the protective effects of breast-feeding are greatest where the poorest sanitation conditions prevail. It was found that mixed-fed infants aged between 0 and 11 months tend to have a higher risk of diarrhoea than fully breast-fed children, while the risk of diarrhoea among weaned infants is twice that of mixed-fed infants. The probit regression models employed in the analysis were used to predict the probability of diarrhoea associated with each breast-feeding pattern for both 'poor' and 'good' sanitation areas. It was found that the risk of diarrhoea among mixed-fed infants in the poor sanitation areas tends to be high while the same risk among fully breast-fed infants tends to be minimal. In essence, the health risks of mixed feeding are real, particularly for infants aged less than 7 months, and are even worse for those weaned before 6 months of age.This paper studies the interactions between breast-feeding practices, household environmental sanitation and diarrhea-related diseases in Ghana and Nigeria, employing the data collected from the Demographic and Health Surveys conducted in Ghana in 1993 and Nigeria in 1990. Results showed that mixed-fed infants aged between 0 and 11 months tend to have a higher risk of diarrhea than fully breast-fed children, while the risk of diarrhea among the weaned infants is twice that of mixed-fed infants. The probit regression models employed in the analysis were used to predict the probability of diarrhea associated with each breast-feeding pattern for both ¿poor¿ and ¿good¿ sanitation areas. Furthermore, it was found that the risk of diarrhea among mixed-fed infants in the poor sanitation areas tends to be high, while the same risk among fully breast-fed infants tends to be minimal. In conclusion, health risks of mixed feeding are substantial, particularly for infants aged under 7 months, and are even worse for those weaned before 6 months of age.
Causes of Teenage Pregnancy in Senya Bereku Community of Awutu- Efutu- Senya District
(University of Ghana, 2005-07) Asamoah, J.; Ahiadeke, C.; Asante, F.; University of Ghana, College of Humanities, Institute of Statistical, Social and Economic Research
The main objective of the study was to investigate intofactors contributing to teenage pregnancy in the Senya- Bereku community of the Awutu-Effutu-Senya District, which has a high dropout rate of girls in the educational facilities make recommendations to the District Health Management Team and District Assembly of Awutu-Effutu-Senya District. The dissertation is based on data collected from the field between June 2004 and June 2005. Data on 200 adolescents of which 82 was male, 10 teenage mothers, 5 mothers of adolescent mothers and ten opinion leaders. Distribution of respondents was presented in tables, pie charts, bar charts and cross tabulations. The chi-square test was used to establish the association between independent variables stated in the hypothesis and teenage pregnancy. The finding of the study showed that coercion, career aspirations, parental control, knowledge and usage of contraceptives and involvement in extracurricular activities were significantly related to adolescent sexuality. The median age of sexual debut was 16 years for males and females, and there was poor usage of conventional family planning methods despite education on teenage pregnancy and HIV/AIDS. Programmes to help reduce the incidence of teenage pregnancy will need the combined efforts of all stakeholders. Health services and counselling centres should be established for the youth with emphasis on reproductive behaviour and sexuality. Early onset of education on teenage pregnancy and contraceptives are recommended for the youth in the early teenage years prior to the median age of sexual debut. Channeling of sexual energy into asexual activity such as athletics and clubs will be helpful for the youth. Teenage mothers can be helped and supported by the community to continue their education.
Clinic-based surveillance of adverse pregnancy outcomes to identify induced abortions in Accra, Ghana.
(Studies in Family Planning, 2008-06) Oliveras, E.; Ahiadeke, C.; Adanu, R.M.; Hill, A.G.
Reliable measures of induced abortion remain elusive, especially when the public perception is that the procedure is immoral or improper. This study draws on interviews using a modified preceding birth technique (PBT) with women attending antenatal and maternity clinics in Accra to compare rates of adverse pregnancy outcomes (stillbirths, miscarriages, and induced abortions) with rates from a household maternity history and the Ghana Demographic and Health Survey. The reports from the antenatal clinics produced some of the highest rates for adverse outcomes of pregnancy. In light of the generally high coverage of antenatal services found even in developing countries, the method based on the PBT holds promise for the improvement of reports of miscarriage and abortion worldwide. © 2008 The Population Council, Inc.
Common mental disorders, economic growth and development: Economic consequences and measurement issues
(2016) Asante, F.A.; Dzator, J.; Dzator, M.; Ahiadeke, C.
A large number of studies have attempted to discern the causes of low productivity and slow growth in developing countries especially in Sub-Saharan Africa (SSA). The effects of global economic integration, corruption, geography, financial aid and human capital indicators such as education have been widely explored. Despite the significant contribution of common mental disorders (CMDs) to poverty and to the burden of disease, mainstream growth analyses have not yet integrated the body of scholarship that identifies the linkages between CMDs and growth. There are potential benefits of prioritising CMDs in development strategies but there are several challenges. Among the greatest challenges is patchy mental health record. Poor data hinders the conceptualisation and the analyses of the effect of common mental disorders on economic growth and development. This paper explores the theoretical and empirical macro-growth effects of CMDs in sub-Saharan Africa. Preliminary theorizing and evidence suggest that improvement in CMDs is likely to be a stimulus to growth in SSA. We explore further the performance of a non-psychometric instrument known as the K-6 as a cost-effective instrument with which to measure community mental health in household surveys across populations that have various levels of infrastructure and literacy. The K-6 instrument which is a semi-structured questionnaire includes six non-specific psychometric items measuring negative affective states or psychological distress. We also collect socioeconomic data during the survey which enabled us to study the determinants of common mental health conditions among urban and rural households in Ghana. Urban and rural communities were analysed separately because they may demonstrate different determinants of CMDs. We report the outcome of the simple non-psychometric survey as well as the results from logistic regressions showing the factors that affect common mental disorders among the survey respondents. The results show that both urban and rural groups experienced diminished mental health during the food and fuel price hikes of 2008 and 2009, and from the global financial crises over the same period, compared with those who reported no mental distress. The coefficients from the logistic regression estimated by the maximum likelihood show spatial variations in mental health indicators by age, education, and per capita income. For this study, gender did not appear to be a good predictor of any of the specific psychological distress measures assessed.
Community Perceptions on Induced Abortions and Contraceptives in the Manhyia and Asawase Sub Metros of Kumasi
(University of Ghana, 2008-08) Ghartey, E.; Ahiadeke, C.; Asante, R.O.; University of Ghana, College of Health Sciences, School of Public Health
Improving maternal health is a key concern of the international community due to the unacceptably high maternal mortality rate. Invariably several studies have identified induced unsafe abortions as a major contributory factor to these maternal deaths. Contraceptive use, a cheap and effective preventive method of unplanned pregnancies is rather low. Ghana and for that matter Kumasi is no exception to the rule of high incidence of induced abortions and its attendant public health problems. This cross-sectional study combines both qualitative and quantitative methods to explore the community’s perceptions of induced abortions and contraceptives in the Manhyia and Asawase sub metros of Kumasi. The members of the reproductive age group for women and men 15 to 49 and 15 to 59 respectively were, identified as the main respondents. Methods of data collection included interviews with semi-structured questionnaires, focus group discussion, and in-depth interview of opinion leaders and health workers in the community. The results indicate a widespread knowledge of the complications associated with induced abortions in the communities. For e.g., 261 (65.5%) of respondents stated rightly three conditions that may arise from terminating a pregnancy. Recourse to induced abortions was nonetheless widespread and cuts across social and religious classes. There is high level of male involvement and participation in abortion related-decision making There was a high level of knowledge of both the traditional and modern methods of contraceptives among both sexes. Three hundred and eighty nine respondents representing 97.25% of the total respondents knew at least one method of contraceptive. This knowledge however, has been overshadowed by a general, perceived fear of health effects associated with contraceptive use and a belief of ―not being at risk of pregnancy‖. In view of these, practice of contraception especially the modern methods among the communities is poor resulting in a relatively high unmet need for family planning Interventions must be prompt and in collaboration with the media, must focus on these three: The physical and socio-economic complications of induced abortions Disabuse the minds of the community of the beliefs and misconceptions about contraceptives through vigorous mass education Make contraceptives attractive by highlighting its enormous contraceptive and other non contraceptive benefits. It is believed that the views from different members of the community have provided insight into the context of unwanted pregnancies, induced abortions and knowledge of contraceptive. It again expected that the information gathered will serve as a guideline in the formulation of effective, practical, preventive policies and programmes for reducing induced abortions and its effects in the Kumasi metropolis as well as the nation.
Constraints of Maternity Health Care Delivery in Government Hospitals: The Case of Korle-Bu Teaching Hospital
(University of Ghana, 2003-07) Bentsil-Quaye, R.; Ahiadeke, C.; Nsowah-Nuamah, N.N.N.; University of Ghana, College of Humanities, Institute of Statistical, Social and Economic Research
A study was conducted at the Korle-bu Teaching Hospital to determine the constraints of maternity healthcare delivery. Sixty-two patients as well as professional and non-professional staff were interviewed. The results indicate that 90.3% of patients who access maternity care at the hospital come from within Accra while 9.7% come from the immediate suburbs. An average of 167 patients attend antenatal clinic daily and most prefer KBTH to other hospitals because of the presence of expert medical personnel, 24 hours emergency service and lower charges. The majority of 53.0% of patients first attend antenatal clinic in the second trimester. An average of 40 admissions and 33 deliveries are made daily. Out of this. 33.2% are referred cases from other government and private health institutions. Referred and emergency cases often have to be treated on credit as patients come to the hospital with no money or luggage. The maternity department has 254 beds which are constantly occupied with extra patients lying on the floor. The length of stay at the hospital has been shortened to make bed space available to incoming patients. Some patients are not able to settle their bills after discharge. Some of these patients run away while others have their bills paid for them by Non-Governmental Organizations or individuals through the Social Welfare. The major constraints identified are shortage of nurses and doctors, lack of equipment and non-drug consumables, lack of storage space for files and a lack of bed space. The hospital has these limitations because it mainly depends on government funds which are not sufficient and are released late. To assist itself, the hospital generates funds internally through drugs and service charges.
Determinants of maternal mortality in Ghana: A Focus on neighbourhood characteristics and socio-demographic status,
(School of Social Sciences, University of Ghana, 2014) Adamba, C.; Osei-Akoto, I.; Owusu, A.Y.; Ahiadeke, C.
The widening disparity in the risk of maternal mortality between developed and developing countries is of considerable concern. In Ghana, there are crucial disparities in the risk of maternal mortality across different regions and communities. This forms the focus of this study: to understand the influence of place of living on the risk of maternal mortality. The analysis showed that the level of deprivation of the neighbourhood within which women lived was very important in explaining the probability of maternal deaths after adjusting for individual factors. The level of deprivation of the neighbourhood had an engulfing effect on residents and suppressed the expected positive effect of educational attainment. The increasing effect of deprivation however reduces when the proportion of women with senior high school education in a neighbourhood increases. Policies that promote educational attainment up to at least the senior high school level for women would be influential in reducing the risk of maternal mortality. Further research on the effect of vulnerable locations on health status is recommended.
“Does Prolonged Breast-Feeding Enhance Nutritional Status; Evidence From Ghana”
(University of Ghana, 2001-09) Sawudatu, Z.; Ahiadeke, C.; Armar-Klemesu, M.; University of Ghana, College of Humanities, Institute of Statistical, Social and Economic Research
This study set out to investigate the relationship between breastfeeding and the nutritional status of children in Ghana. This stems from the fact that in spite of conflicting research findings on the benefits of prolonged breastfeeding, there is intensive breastfeeding compaign going on in the country. The 1998 GDHS data set was used in this study. Specifically, data on breastfeeding and other child feeding practices, childhood illnesses and anthropometry as well as some background information on mothers were utilised in this study. In all, data on a total of 2108 children aged 0-3 years were analysed. Bivariate analysis and linear regression models were used in analysing the data. Findings of the study show that almost 100% of Ghanaian children are breastfed for some time of their lives. The mean duration of breastfeeding was 19 months with mothers from urban areas and mothers with higher education breastfeeding for shorter periods than their counterparts. Other factors that significantly influenced the duration of breastfeeding included the age, educational level and employment status of mother, place of residence and type of toilet facility, morbidity especially diarrhoea and sex of household head. The study further revealed that breastfeeding beyond 18 months of age is associated with increased risk of malnutrition. (This finding is consistent with other studies from Ghana(Brakohiapa et al., 1988 and Nube and Asenso- Okyere, 1996) and other countries). The negative association between prolonged breastfeeding and nutritional status may be partially explained by the fact that children who continue to breastfeed beyond 18 months of age may be deprived of adequate qualities and quantities of supplementary foods either because of their impoverished situation or simply because their mothers are ignorant of the need to enrich and give adequate meals to supplement breastfeeding. It is also possible that such children may not have developed good appetite for other meals owing to delayed introduction of supplementary foods. In conclusion, the results of the find ings presented in this study show that, there is some evidence to suggest that prolonged breastfeeding beyond 18 months of age in Ghana is negatively associated with increased risk of malnutrition even after controlling for confounding variables. The policy implication from this study is that even though the promotion of breastfeeding is in the right direction, there is the urgent need for health workers to emphasis the need for mothers to give their children adequate qualities and quantities of supplementary foods in addition to breast-milk. Mothers should also be made to consider breastfeeding a secondary source of food (energy) for their children after the first six months of age. This will encourage the children to develop better appetite for supplementary foods from which they derive their daily energy requirement. These findings were however, limited by the fact that the GDHS data was inadequate in investigating the relationship between breastfeeding and nutritional status. Secondly, the findings are also limited by methodological errors in the study. In view of these limitations, it is suggested that further research be carried out using different methodological approaches. Further studies can also be carried out to assess the impact of prolonged breastfeeding on maternal health and nutritional status so as to ensure that extended breastfeeding is not done at the expense of mothers’ health.
Evaluation of the Role of Community Health Officers in the Community Health and Family Planning Project in the Kassena Nakana District
(University of Ghana, 2002-08) Blantari, M.J.; Binka, F.N.; Ahiadeke, C.; University of Ghana, College of Health Sciences, School of Public Health
The success or otherwise of most health related programs in most developing countries are judged using many indicators, among which is the beneficiary communities’ perception of the program. This study examined or probed into the perceptions of the communities with regard to the services rendered by Community Health Officers (CHOs) as front liners in the Community Health and Family Planning (CHFP) project being executed by the Navrongo Health Research Center (NHRC) in the Kassena- Nankana District of Northern Ghana. The subjects of the study were adult males and females who were in three age categories; below thirty years, between thirty-one and forty-nine years and those who were fifty years and above. This was done in order to provide information that would help improve upon CHO services in the treatment cells to project implementers. Qualitative methods i.e. Focus Group Discussions, Key Informant Interviews and In-depth Interviews were mainly used to capture information related to the communities’ access to health information, health services, the nature of the referral system, treatment and preventive care, family planning services and general acceptability of the CHO services. The study also used Focus Group Discussions and structured questionnaire to examine the work, social and welfare concerns of the CHOs. Most discussants believed that the CHO services have brought a drastic improvement in their lives and have resulted in the elimination of most childhood killer diseases in the community. Family planning services have also improved lifestyles and they now have healthier mothers and children. However it is their wish that the CHOs spent more time with them in the community, make drugs available to them; put a good referral system in place and provide diversified family planning methods. The CHOs also expressed varying degrees of concerns that militated against their effectiveness. These concerns include their inability to have many basic tools to work with; the deplorable conditions of the Community Health Compounds; non-availability of drugs; marital insecurity and the lack of motivation in terms of letting them attend refresher courses. The conclusions drawn from this study are that communities in the project area recognize the immense contribution CHO services have brought to their lives. But there are certain basic issues that need to be tackled to ensure the desired results of the project. It is recommended that for the program to have its desired impact, the issue of payment for services has to be addressed, more efficient referral system should be put in place, the CHOs need to be given more training and their welfare concerns need to be adequately tackled.
Factors influencing the use of adequately iodated salt in Ghana
(African Journal of Food Science, 2012) Ahiadeke, C.; Ackah, C.; Aryeetey, R.; Acquah, A.
Ghana is one of the largest producers of salt in the West African region yet, access to and the use of adequately iodized salt is not widespread. Using the Ghana Multiple Indicator Cluster Survey (MICS) 2006, this paper examined the factors influencing the use of adequately iodized salt in Ghana. Factors that influence the use of adequately iodized salt include knowledge, access to information, and wealth status. Where access to formal education opportunities was not available, access to information through media still served as an important instrument to educate the public and increase the community’s knowledge on the nutritional value of consuming adequately iodized salt. Based on these findings, it was recommended that the cost of iodized salt should be reduced to make it more affordable particularly for the poor since wealth is an important factor influencing the use of adequately iodized salt. Furthermore, monitoring and ensuring enforcement of the law of salt fortification with iodine would help Ghana achieve universal salt iodization.
The impact of Ghana's R3M programme on the provision of safe abortions and postabortion care
(Health Policy and Planning, 2014-09) Sundaram, A.; Juarez, F.; Ahiadeke, C.; Bankole, A.; Blades, N.
In 2006, in response to the high maternal mortality, driven largely by unsafe abortions, the government of Ghana, in partnership with other organizations, launched the reducing maternal mortality and morbidity (R3M) programme in seven districts in Greater Accra, Ashanti and Eastern, to improve comprehensive abortion care services. This article examines whether this intervention made a difference to the provision of safe abortion services and postabortion care (PAC). We also examine the role played by provider attitudes and knowledge of the abortion law, on providers with clinical training in service provision. Primary data on health care providers in Ghana, collected using a quasi-experimental design, were analysed using propensity score weighting. Apart from the treatment group, the sample included two controls: (1) Districts in Accra, Ashanti and Eastern, not exposed to the treatment; and (2) Districts from distant Brong Ahafo, also not exposed to the treatment. The findings show that providers in the treatment group are nearly 16 times as likely to provide safe abortions compared with their peers in Brong Ahafo, and ∼2.5 times as likely compared with providers in the other control group. R3M providers were also different from their peers in providing PAC. Associations between provider attitudes and knowledge of the law on both outcomes were either non-significant or inconsistent including for providers with clinical knowledge of abortion provision. Provider confidence however is strongly associated with service provision. We conclude that the R3M programme is helping safe abortion provision, with the differences being greater with control groups that are geographically distant, perhaps owing to lower contamination from movement of providers between facilities. Increasing provider confidence is key to improving both safe abortion provision and PAC. © 2014 Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.
Incidence of Induced Abortion in Southern Ghana
(International Family Planning Perspectives, 2001-06) Ahiadeke, C.
Context: In countries such as Ghana, where the law restricts elective induced abortion, data to quantify the incidence of abortion are scarce. Existing data on induced abortions in Ghana come mainly from hospital records, which are unreliable because record-keeping is poor and induced abortions often are classified inaccurately. Methods: A multistage random sampling design was used to identify 18,301 women aged 15-49 from eight communities in four of the 10 regions in Ghana between January and March 1997. Of the identified women, 1,689 were pregnant. From March 1997 to March 1998, fieldworkers living in the pregnant women's communities monitored their health and pregnancy outcomes, including self-induced abortions. Results: During the study period, the rate of abortion in the study areas was 17 induced abortions per 1,000 women of childbearing age. There were 19 abortions per 100 pregnancies (or 27 abortions for every 100 live births). The majority (60%) of women who had an abortion were younger than 30, and 36% were nulliparous. Forty-five percent had obtained their abortions before the seventh week of gestation, and 90% had done so before the 10th week. Only 12% of the women said they had obtained their abortion from a physician. Muslim women had decreased odds of obtaining an abortion. Women who lived in urban areas, who were educated or who had four or more children had increased odds of obtaining an abortion. Women who were self-employed had greater odds of obtaining an abortion than those who were employed by someone else. Conclusion: Ghana's abortion law does nothing to prevent many induced abortions from occurring. However, few Ghanaian women who seek abortions obtain them from physicians, and most appear to induce abortions themselves, often in collaboration with pharmacists.
Methods of Self-Induced Abortion. A Community Based Study in the Ga-East District of Greater Accra Region
(University of Ghana, 2010-04) Duah, F.Y.; Norgbe, G.K.; Ahiadeke, C.
Purpose: In Ghana the available statistics on unsafe abortions could only be gathered from the hospitals and the clinics especially in the major cities, leaving out the numerous cases of self –induced abortions in the rural communities where the women privately indulged in induced abortion without it being recorded in any hospital records. The purpose of this study was to investigate methods of self –induced abortion, one of the causes of maternal mortality in Ghana. This study seeks to provide information on sources of substances used, mode of application of these substances as well as the reasons why some women resort to self- induced abortion. Design/methodology: The study design was cross-sectional involving the use of quantitative and qualitative methods for data collection, conducted at Ga-East district of Greater Accra region. A simple random sampling was used to identify and select 200 women in their reproductive age (between the ages of 15- 49 years) selected from six communities of Danfa –Abokobi sub district. Qualitatively, two focus group (FGD) discussions sessions were conducted and two in-depth interview (IDI) were also done. Findings: The study found that 50% of the women having self- induced abortion are single, below 34years with middle levels of education (junior/senior secondary and vocational/technical schools), though significant numbers have no formal education. Those who practice self- induced abortion are mostly artisans, apprentices, traders and unemployed. The main reasons why women obtained self –induced abortion were financial difficulty (i.e. money to maintain the pregnancy), partner denial of responsibility, to enable them pursue education and apprenticeship, contraceptive failure, fear of parent, stigmatization and not ready for a child. Modes of inducing abortion included drinking of concoctions from local herbs such as grounded ablototor leaves with paracetamol and akpeteshie, mixtures of grounded Guinness bottles in high concentration of sugar solution, concentrated laundry blue with camphor and sugar. Swallowing and insertion of cytotec tablets and insertion of local plants like leaves of nkradedua into vagina and stem of gbukagba into the cervix. These women obtained these substances mostly from quack doctors, pharmaceutical shops, and friends, got it themselves, and drug peddlers. Conclusion : There is every indication that self- induced abortion rate in the rural communities are high and calls for intervention from the district health administration, district assembly, social groups, health professionals and policy makers aimed at reducing the incidence of unsafe abortion. The evidence suggested that health service providers should intensify awareness about family planning and highlight the dangers of induced /unsafe abortion. District assembly should take steps to improve the socio- economic status of women in the district. Bye- laws should be made by the district assembly to punish those who connive and abet with the women to obtain induced abortion illegally.
Peer influences on sexual activity among adolescents in Ghana
(Studies in Family Planning, 2015-03) Bingenheimer, J.B.; Asante, E.; Ahiadeke, C.
Little is known about the influences of peers on the sexual activity of adolescents in sub-Saharan Africa. Better understanding of these issues could lead to more effective sexual and reproductive health interventions. Using two waves of survey data from 1,275 adolescents in two southeastern Ghanaian towns, we examine age, sex, and community differences in peer group characteristics. We also examine prospective associations between peer group characteristics and self-reported sexual initiation and multiple partnerships during a 20-month follow-up period. Sex differences in peer-context variables were small. Affiliation with antisocial peers and perceived peer norms favoring sex increased the odds of transition to first sex. Having more friends increased the odds among younger respondents of acquiring multiple new sexual partners. Among males, perceived peer norms favoring sex increased the odds of acquiring multiple partners. We discuss the implications of these findings for adolescent sexual and reproductive health intervention strategies in sub-Saharan Africa, and conclude that peer-based interventions may be best suited to the needs of at-risk adolescent boys. © 2015 The Population Council, Inc.
Population Density and Fertility in Farm Households: A Study of the Millennium Development Authority Zones in Ghana
(Environment, Development and Sustainability, 2013-08) Ahiadeke, C.; Der, D.D.
Agriculture is mainly a rural preoccupation, and about three quarters of the population growth in developing countries emanate from agricultural households. Some demographers posit that the agricultural system affects birth rates; in addition, population pressures might put stress on agricultural land in farming communities. This paper focuses on the population to land ratio in the Millennium Development Authority (MiDA) Enumeration Areas (EAs) in Ghana and tackles the important question: Do households adjust to an increasing population/land ratio by having fewer children? The authors explore this theme in the context of rural population density and fertility in the three MiDA zones, drawing on data collected in 23 EAs in Ghana in 2008. The results suggest that fertility in the MiDA zones can be affected by density if nothing is done to regulate population density. The regression estimates for the pooled data show that all the coefficients are negative and statistically significant at the 0.05 level or better. Thus, children ever born is inversely correlated with density, agricultural production, female literacy and the trend variable (year). The estimates from the cross-sectional data as well as the spatial coefficient were consistent with those of the pooled data. The results under various model specifications are stable. We find from the Cox model that areas with higher education levels and a lower share of individuals working in agriculture, both correlated with land use. Agricultural production has at most a modest independent effect on fertility. Our findings suggest that population density has a reasonable inhibiting effect on fertility in the MiDA Zones. © 2012 Springer Science+Business Media Dordrecht.
Prevalence of anemia among under-5 children in the Ghanaian population: Estimates from the Ghana demographic and health survey
(BMC Public Health, 2014-06) Ewusie, J.E.; Ahiadeke, C.; Beyene, J.; Hamid, J.S.
Anemia in children continues to be a major public health challenge in most developing countries, particularly in Africa. Anemia in the early stages of life leads to severe negative consequences on the cognitive as well as the growth and development of children, which may persist even after treatment. We examine the prevalence of anemia in under-five children in the Ghanaian population to help inform and serve as a guide to health policies and possible interventions. Methods. Data from the 2008 Ghana Demographic and Health Survey (GDHS) was used. Data consists of health, demographic and socio-economic factors. Anemia status was determined using hemoglobin level, and prevalence of childhood anemia along with 95% confidence intervals was provided. We also examined the distribution of prevalence across different age and socio-demographic groups as well as the different regions and sub-regions in Ghana. Results: The overall prevalence of anemia in under-five children in Ghana was 78.4% (N = 2168, 95% CI: 76.7-80.2), where 7.8% (N = 2168, 95% CI: 6.6-8.9) of the children had severe anemia, 48.0% (N = 2168, 95% CI: 45.9-50.2) moderate anemia and 22.6% (N = 2168, 95% CI: 20.8-24.4) had mild anemia. The highest prevalence regions were the Upper East, 88.9% (N = 158, 95% CI: 80.9-94.0), and Upper West 88.1% (N = 220, 95% CI: 76.4-94.6). The prevalence was also higher among children under 2 years of age, 85.1% (N = 781, 95% CI: 82.6-87.7) than children 2-5 years of age, 74.8% (N = 1387, 95% CI: 72.5-77.1). No significant difference in prevalence between boys and girls was observed. Conclusions: Given the high prevalence of childhood anemia observed in Ghana, particularly among those less than 2 years old, and given the negative consequences on their cognitive and behavioral development even in later years, there is an urgent need for effective and efficient public health interventions. © 2014Ewusie et al.; licensee BioMed Central Ltd.