Browsing by Author "Atiglo, D.Y."
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Item Coastal vulnerability and migration in Ghana(University of Ghana, 2015-04-17) Atiglo, D.Y.; Quashigah, J.; Neri, P.; Appeaning, A.K.; Codjoe, S.N.A.Coastal vulnerability to sea level rise and other hazards is expected to push migration due to loss of land, habitat and livelihood security. The migration literature on Ghana rarely links coastal environmental systems with migration. This study aimed (i) to assess the vulnerability of Ghana's coasts to inundation and erosion (ii) to explore the relation between coastal vulnerability and population change through migration. We used data from Ghana's 2000 and 2010 Population and Housing Censuses and remotely sensed data to develop a coastal vulnerability index (CVI) comprising physical and socioeconomic vulnerability. The physical vulnerability index (PVI) was based on coastal elevation, geomorphology, geology, local subsidence,. shoreline change, tidal range and wave height. The socioeconomic vulnerability index (SVI) was based on economic activity, socio-demographic characteristics and housing conditions. Due to unavailability of explicit out-migration data at the district level, we estimated net migration using the Census Survival Ratio method. The results of the PVI revealed that districts in the farthest western and eastern coasts are highly vulnerable. The SVI showed the eastern coastal districts as the most vulnerable. Consequently, three districts in the eastern coast of Ghana with the highest combined CVI also tend to have very high deficit migration. Simple linear regression models show a negative correlation between coastal vulnerability and net migration. The technique employed in this study provides an improved assessment of coastal vulnerability and contributes to evaluating the environment-migration nexusItem Correlates of sexual inactivity and met need for contraceptives among young women in Ghana(BMC Women's Health, 2018-08) Atiglo, D.Y.; Biney, A.A.E.Background Young women in sub-Saharan Africa continue to experience unintended pregnancies despite effective contraceptive methods being more readily available than ever. This study sought to determine the correlates of met need for contraceptives and sexual inactivity among young women in Ghana who want to postpone childbearing. We examine this among all women and then separately by marital status. Methods Using data from 1532 females aged 15–24 years from the 2014 Ghana Demographic and Health Survey, we conducted descriptive and multinomial logistic regression analyses to assess sociodemographic, economic and obstetric determinants of the type of family planning method (current abstinence, modern contraceptive method) used by married and unmarried young women. Results A higher proportion (~ 44%) of the respondents was currently abstinent compared to those with met need (~ 25%). Abstinence was higher among single young women while unmet and met need were higher among the married. Having at least senior high school education was significantly associated with the likelihood of current abstinence (especially among single women) and with met need. Being in the middle and rich categories, on the other hand, was associated with lower likelihood of current abstinence and a met need. Compared with multiparous women, those with one or no surviving child had a lower likelihood of being abstinent and having a met need. Other correlates of both current abstinence and met need are region of residence and ethnicity, while previous pregnancy termination and age were associated with abstinence and contraceptive use, respectively. Conclusions Unmet need is high among young women but abstinence is an option they are using. As reproductive health programmes target the at-risk groups, the secondary and higher educational levels must be attained by most women as this is associated with use of abstinence and met need.Item Does financial autonomy imply reproductive and sexual autonomy? Evidence from urban poor women in Accra, Ghana(African Studies, 2019-03) Dodoo, N.D.; Atiglo, D.Y.; Biney, A.A.E.; Alhassan, N.; Peterson, M.B.; Dodoo, F.N.A.This article investigates the association between financial autonomy and three other measures of autonomy – sexual autonomy, perceived reproductive autonomy and actual reproductive autonomy in Ga-Mashie, Accra, Ghana. From anthropological accounts, the financial independence of women from this community, coupled with unique living arrangements, have resulted in them being independent and autonomous. The analytical sample consists of 172 women who were in union at the time of the survey. Binary logistic and ordered logistic regression models ran between financial autonomy and the other measures of autonomy, and controlling for relevant socioeconomic and demographic characteristics of the women, reveal that in this context, financial autonomy does not have the perceived effect of increasing autonomy in the three other spheres. Rather, measures that hint at egalitarianism and close marital relationships – namely, marital power, agreement with partners about reproductive issues and marital duration – are more significantly associated with sexual and reproductive autonomy. We conclude that, coupled with schemes to increase the financial autonomy of women, in this context, other measures aimed at improving marital relationships should be explored and encouraged.Item Examining the association between motivations for induced abortion and method safety among women in Ghana(2017) Biney, A.A.E.; Atiglo, D.Y.This article draws on data from 552 women interviewed in the 2007 Ghana Maternal Health Survey to examine the association between motivations for women's pregnancy terminations and the safety of methods used. Women's reasons for induced abortions represented their vulnerability types at the critical time of decision making. Different motivations can result in taking various forms of action with the most vulnerable potentially resorting to the most harmful behaviors. Analysis of survey data pointed to spacing/delaying births as the main reason for abortion. Furthermore, women were more likely to terminate pregnancies unsafely if their main motivation for abortion was financial constraints. Especially among rural women, abortions for any reason were more likely associated with safe methods than if for financial reasons. These findings suggest a theme of vulnerability, resulting from poverty, as the motivations for women to resort to harmful abortion methods. Therefore, interventions formulated to reduce instances of unsafe pregnancy terminations should target reducing poverty and capacity building with the aim of economic advancement, in addition to curbing the root of the problem: unintended pregnancy.Item Gender, Vulnerability to Environmental Change and Migration in the Volta Delta, Ghana(University Of Ghana, 2017-12) Atiglo, D.Y.Migration has long been a response to unfavourable environmental conditions, and an engine for population redistribution. Studies acknowledge that gender influences vulnerability to environmental change and migration. However, there is a paucity of empirical research on the interconnectedness between vulnerability to environmental change and migration from a gendered perspective. Further, studies rarely migration intentions, actual migration and immobility migration in a holistic manner. This thesis examines the interrelationships among gender, vulnerability to environmental change and migration in the Volta Delta of Ghana. Three aspects of migration behaviour comprising are investigated in relation to household vulnerability, measured as economic and environmental sensitivity to flooding and drought. I considered the household as a gendered unit to investigate household vulnerability and migration behaviour. Household gender was categorised based on both the sex of household head and the presence of an adult of alternative sex than the head’s. Thus, there are four household gender categories: male-headed households with female adults, male-adult only households, female-headed households with male adults, and female-adult only households. This quantitative study data from the 2016 DEltas, vulnerability to Climate Change: Migration and Adaptation (DECCMA) Ghana Survey. The first stage of analyses included univariate descriptions of the variables in the study. The second stage assessed relationship between household gender category and vulnerability while controlling for geophysical, demographic and socioeconomic characteristics. The final stage examined the interrelationship among household gender, economic and environmental vulnerability to drought and flooding, and migration. Univariate analyses indicate that the highest proportion of household type was the male-headed households with female adults while the least were the female-headed households with male adults. Generally, vulnerability to drought was higher than vulnerability to flooding while environmental vulnerability was higher than economic vulnerability. About half the households had migrants living out; about two-fifths had members who aspired to migrate and less than a fifth were involuntarily immobile. Results of multivariate analyses indicate that household gender category is significantly associated with economic vulnerability to droughts. Female-adult only households are less vulnerable to economic impacts of droughts than male-headed households with female adults. Female-adults only households are also less likely to have members aspiring to migrate and to be involuntarily immobile. Yet, these households are more likely to have members who have migrated. Male-adult only households have higher propensities for migration aspiration and to be involuntarily immobile. Also, households that are vulnerable to economic impacts of droughts are more likely than non-vulnerable households to have out-migrants, but are less likely to have migration aspiration, and to be involuntarily immobile. A synthesis of results reveals an interrelationship through household gender category, vulnerability and migration. Household gender category is influenced by out- migration of a member and this affects household vulnerability to environmental change. Gender structure determines the levels of aspirations and involuntary immobility. The study cautions against the blanket feminisation of vulnerability, as results indicate that female-adult only households have lowest economic vulnerability to drought while male-adults only households tend to not have the capacity to move even if they intend to. Finally, this study recommends that to fully comprehend the environment-migration nexus, studies need to look at different dimensions of vulnerability in relation to different aspects of migration.Item Household food sources and diarrhoea incidence in poor urban communities, Accra Ghana(PLOS, 2021) Larbi, R.T.; Atiglo, D.Y.; Peterson, M.B.; Biney, A.A.E.; Dodoo, N.D.; Dodoo, F.N.Diarrhoeal diseases remain a significant cause of morbidity and mortality, particularly in poor urban communities in the Global South. Studies on food access and safety have however not considered the sources of discrete food categories and their propensity to harbour and transmit diarrhoeal disease pathogens in poor urban settings. We sought to contribute to knowledge on urban food environment and enteric infections by interrogating the sources and categories of common foods and their tendency to transmit diarrhoea in low-income communities in Accra. We modelled the likelihood of diarrhoea transmission through specific food categories sourced from home or out of home after controlling for alternate transmission pathways and barriers. We used structured interviews where households that participated in the study were selected through a multi-stage systematic sampling approach. We utilized data on 506 households from 3 low-income settlements in Accra. These settlements have socio-economic characteristics mimicking typical low-income communities in the Global South. The results showed that the incidence of diarrhoea in a household is explained by type and source of food, source of drinking water, wealth and the presence of children below five years in the household. Rice-based staples which were consumed by 94.5% of respondents in the week preceding the survey had a higher likelihood of transmitting diarrhoeal diseases when consumed out of home than when eaten at home. Sources of hand-served dumpling-type foods categorized as “staple balls” had a nuanced relationship with incidence of diarrhoea. These findings reinforce the need for due diligence in addressing peculiar needs of people in vulnerable conditions of food environment in poor urban settlements in order to reap a co-benefit of reduced incidence of diarrhoea while striving to achieve the global development goal on ending hunger.Item Impact of extreme weather conditions on healthcare provision in urban Ghana(Social Science & Medicine, 2020-05-22) Codjoe, S.N.A.; Gough, K.V.; Wilby, R.L; Kasei, R.; Yankson, P.W.K.; Amankwaa, E.F.; Abarike, M.A.; Atiglo, D.Y.; Kayaga, S.; Mensah, P.; Nabilse, C.K.; Griffiths, P.LExtreme weather events pose significant threats to urban health in low- and middle-income countries, particularly in sub-Saharan Africa where there are systemic health challenges. This paper investigates health system vulnerabilities associated with flooding and extreme heat, along with strategies for resilience building by service providers and community members, in Accra and Tamale, Ghana. We employed field observations, rainfall records, temperature measurements, and semi-structured interviews in health facilities within selected areas of both cities. Results indicate that poor building conditions, unstable power supply, poor sanitation and hygiene, and the built environment reduce access to healthcare for residents of poor urban areas. Health facilities are sited in low-lying areas with poor drainage systems and can be 6 °C warmer at night than reported by official records from nearby weather stations. This is due to a combination of greater thermal inertia of the buildings and the urban heat island effect. Flooding and extreme heat interact with socioeconomic conditions to impact physical infrastructure and disrupt community health as well as health facility operations. Community members and health facilities make infrastructural and operational adjustments to reduce extreme weather stress and improve healthcare provision to clients. These measures include: mobilisation of residents to clear rubbish and unclog drains; elevating equipment to protect it from floods; improving ventilation during extreme heat; and using alternative power sources for emergency surgery and storage during outages. Stakeholders recommend additional actions to manage flood and heat impacts on health in their cities, such as, improving the capacity of drainage systems to carry floodwaters, and routine temperature monitoring to better manage heat in health facilities. Finally, more timely and targeted information systems and emergency response plans are required to ensure preparedness for extreme weather events in urban areas.Item Meeting women's demand for contraceptives in Ghana: Does autonomy matter?(Women and Health, 2019-04) Atiglo, D.Y.; Codjoe, S.N.A.This study addressed a basic conceptual gap in research on the relationship between women's autonomy and contraceptive behavior and included intention to use while measuring the unmet demand for family planning. The study used data from the 2014 Ghana Demographic and Health Survey. The weighted sample included 2,017 sexually active, non-pregnant, fecund women in unions, aged 15-49 years, who wanted to delay conception for at least 2 years. The relation of household decision-making autonomy to current contraceptive use and intention was assessed, adjusting for women's socio-demographic, partner, and couple characteristics. About half of the women studied had a met demand for contraception, and over a third had no intention to use a contraceptive method in the future. In adjusted multinomial logistic regression models, household decision-making autonomy was not significantly associated with met contraceptive demand for contraceptives, but was associated with their intentions to use contraception (p = .05). Formal education, age, wealth, and region of residence were significantly associated with having a met demand. In Ghana, women's household decision-making autonomy appears to have modest relation to contraceptive uptake. Programs to improve meeting contraceptive demand should consider contextual factors and place differences in contraceptive uptake.Item Misperception of drivers of risk alters willingness to adapt in the case of sargassum influxes in West Africa(Global Environmental Change, 2024) Atiglo, D.Y.; Jayson-Quashigah, P-N.; Sowah, W.; Tompkins, E.L.; Addo, K.A.Since 2011, large influxes of a brown macroalgae (pelagic sargassum seaweed) have proliferated across the Tropical Atlantic basin, its dispersal and seasonality theorized to be driven by localized and large scale winds and currents, in combination with changes in the Atlantic Meridional Mode and ocean upwelling. These influxes seasonally affect coastal populations across the breadth of the Tropical Atlantic (from central America to West Africa), causing damage to: economies, marine-based and non-marine coastal livelihoods, social functioning, health, ecology, and the aesthetics of the local environment. We use the ongoing sargassum influx in West Africa as a case study of adaptation to an emergent (and compound) risk in progress that also contributes to the empirical gap in sargassum adaptation research in West Africa. The research, in four sites in the Western Region of Ghana employs data from 16 focus group discussions, six key informant interviews, and participant obser vation. We finds that due to a series of coincidences, participant communities perceive that sargassum influxes were seeded by and then annually driven by oil and gas exploration in Western Ghana. This is in contrast to scientific research that indicates that pelagic sargassum was initially seeded in the tropical Atlantic basin (from the Sargasso Sea) in 2010 following an anomalous weather event in winter 2009–2010. Following Rogers’ Protection Motivation Theory, we explore the sources of information and the processing of that information to understand the divergence between scientific and community perceptions of the physical drivers. We find that community perceptions of oil and gas company responsibility for causing the sargassum problem leads the communities to perceive that the oil and gas companies should be responsible for the clean-up activities. Communities are further constrained by a perceived lack of capacity to act. Solutions to address this adaptation impasse could involve the government working with communities and the oil and gas industry to clarify the actual drivers of sargassum. Such guidance may open opportunities for the government and industry to work with communities to address misperceptions of the scientific nature of the influxes. Collaborative approaches, while addressing extant tensions, may also change the narrative about the problem, support affected commu nities to engage with adaptive measures, including re-use opportunities, and enhance community capacity to act. As a present-day emergent risk, pelagic sargassum provides an unusual yet contemporary empirical study of real time adaptation and the central role of perceptions in shaping proactive adaptation and seeking exploitable opportunities from new environmental risks.Item Multinomial logistic regression analysis of the determinants of anaemia severity among children aged 6–59 months in Ghana: new evidence from the 2019 Malaria Indicator Survey(BMC Pediatrics, 2023) Klu, D.; Atiglo, D.Y.; Christian, A.K.Background Anaemia among children under age fve 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 determi nants 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 char acteristics. SPSS version. At the multivariate level, three diferent multinomial logistic models were run with selected predictor variables. All tests were conducted at the 95% confdence level. Results The overall anaemia prevalence among children under age fve 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 signifcantly 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 fndings show the importance of understanding the interrelation among diferent factors that infuence anaemia severity among children under age fve as critical in developing strategies and programmes aimed at addressing childhood anaemia.Item Sense of community and willingness to support malaria intervention programme in urban poor Accra, Ghana(Malaria Journal, 2018-08) Atiglo, D.Y.; Larbi, R.T.; Kushitor, M.K.; Biney, A.A.E.; Asante, P.Y.; Dodoo, N.D.; Dodoo, F.N.A.Background The extensive research on community members’ willingness to support malaria interventions ignores the role of psychosocial determinants. This study assesses the impact of individuals’ sense of community (perceptions of community cohesion, altruism, seeking help from neighbours and migrant status) on their willingness to participate in a mosquito control programme using data on 768 individuals from the 2013 RIPS Urban Health and Poverty Survey in poor coastal communities in Accra, Ghana. A contingent valuation experiment was employed to elicit individuals’ willingness to support the programme by contributing nothing, labour time/money only or both. Results Findings show that different dimensions of sense of community related differently with willingness to support the programme. Perceived community cohesion was associated with lower odds while help-seeking from neighbours and being a migrant were associated with higher odds of supporting the programme. Altruism was the only dimension not linked to willingness to participate. Conclusions Different dimensions of sense of community are associated with community members’ willingness to provide labour, time or both to support the malaria eradication programme. The findings of this study have implications for targeting social relational aspects, in addition to geographical aspects, of communities with malaria-resilient policy and intervention. They also warrant further research on psychosocial factors that predict willingness to support health programmes in urban poor settings.Item Sociodemographic and geophysical determinants of household vulnerability to coastal hazards in the Volta Delta, Ghana(International Journal of Disaster Risk Reduction, 2022) Atiglo, D.Y.; Abu, M.; Jayson-Quashigah, P.; et al.Theoretical emphasis on combining geophysical and socioeconomic characteristics in assessing vulnerability is growing but with little empirical support. Similarly, there is increasing consideration of cumulative vulnerability to multiple stressors, yet empirical studies are scant. This study seeks to assess the geophysical and socioeconomic determinants of households’ vulnerability to the cumulative impacts of three coastal hazards—flooding, erosion and salinity—using evidence from the Volta Delta in Ghana. The study employed multiple linear regression and binary logistic regression functions to assess cumulative vulnerability and exposure to individual hazards, respectively. Results indicate that while exposure to hazards is determined largely by geophysical factors and the socioeconomic and demographic characteristics of households determine the extent of vulnerability to their impacts. In addition, socioeconomic and demographic characteristics of households, particularly higher wealth levels, non-agricultural occupation, and improved drinking water sources are associated with lower levels of vulnerability to the cumulative impacts of coastal hazards. In developing contexts, resilience to coastal hazards requires improved access to social amenities as well as alternative livelihood options.Item Women's Autonomy and Reproductive Health Behaviour in Ghana(University of Ghana, 2013-07) Atiglo, D.Y.; Codjoe, S.N.A.Ensuring optimum reproductive health through universal access to family planning services is key to human development. Though knowledge of contraception is high in Ghana its use among married women is very low, a phenomenon attributed to women’s lack of power or autonomy in sexual relationships. This study primarily sought to examine the levels of women’s autonomy in Ghana and determine the extent to which women’s contraceptive use is precipitated by their autonomy in relationships. The study also assessed other socio-economic and demographic characteristics of women that are associated with their contraceptive use. The study used data from the 2008 Ghana Demographic and Health Survey. Guided by previous studies women’s autonomy was measured by two indices, decision-making autonomy and autonomy from violence which were computed. Univariate analysis measured the distribution of respondents and their characteristics and showed that a majority of the respondents reported some decision-making autonomy and autonomy from violence. The relationship between autonomy, the control variables and contraceptive use was analysed using bivariate techniques. At the multivariate level, the relationship between contraceptive use and these indices were analysed while controlling for socio-economic and demographic characteristics using binary logistic regression. Neither dimension of women’s autonomy was found to be a significant predictor of contraceptive use. Woman’s age, wealth status, region of residence, educational attainment and number of living children showed significant associations with contraceptive use. . Findings from the study inform recommendations to improve contraceptive use. There is also need for further research into the standardisation and dynamics of women’s autonomy and its effect on reproductive health behaviourItem Women's empowerment, children's nutritional status, and the mediating role of household headship structure: Evidence from sub‐Saharan Africa(Maternal Child Nutrition, 2023) Christian, A.K.; Atiglo, D.Y.; Okyere, M.A.; et al.We aimed to examine the association between women's empowerment and childhood nutritional status while accounting for the mediating role of household headship structure. Cross‐country, cross‐sectional quantitative data from the most recent Demographic and Health Surveys (2015–2018) were used. Women's empowerment was measured as a composite index of participation in household decision‐making, attitude towards domestic violence, and asset ownership. Childhood nutrition status was measure as anaemia (haemoglobin concentration < 110g/L), stunting (height‐for‐age z‐scorescore <−2) and the co‐occurrence of anaemia and stunting. Applying the Lewbel two‐stage least squares, women's migration status was used as an instrumental variable. We used data on 25,665 woman‐child dyads from eight sub‐Saharan African countries: Burundi (2016), Ethiopia (2016), Guinea (2018), Malawi (2016), Mali (2018), Zimbabwe (2015), Uganda (2016), and Tanzania (2015). The women were in their reproductive ages (15–49 years) and children were under 5 years old. The findings showed that an increase in women's empowerment index reduces children's likelihood of being anaemic and having a co‐occurrence of anaemia and stunting [coeff (SE), −0.114 (0.025) and −0.072 (0.032), respectively]. Specifically, an increase in asset ownership or decision‐making dimensions of empowerment significantly reduces the likelihood of anaemia and the co‐occurrence of anaemia and stunting among children. Children of empowered women from male‐headed households were more likely to be anaemic and be concurrently anaemic and stunted compared to their counterparts whose mothers were from female‐headed households. Interventions designed to improve childhood nutrition through women's empowerment approaches need to consider asset ownership and instrumental agency of women while acknowledging the mediating effect of household headship typology.