Browsing by Author "Dodoo, F.N.A."
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Item Cohabitation, marriage, and 'sexual monogamy' in Nairobi's slums(Social Science and Medicine, 2007-04) Hattori, M.K.; Dodoo, F.N.A.The current study investigates the extent to which sexual exclusivity-the restriction of one's sexual engagements to a single partner-prevails across various marital status, union type, and co-residence categories among Nairobi's poorest residents, slum dwellers. This question is central to the spread of HIV in the increasingly urban and poor, high prevalence countries of sub-Saharan Africa, where transmission is primarily via heterosexual sex. In many circles, sexual exclusivity is considered a prominent feature of the marriage institution. Yet, marriage and cohabitation are often not easily distinguishable in sub-Saharan Africa, meaning that the frequent use, as a proxy, of the "in union" category, which includes married as well as cohabiting persons can, at best, be considered tenuous. Using the 2000 Nairobi Cross-Sectional Slum Survey (NCSS), this paper confirms that marriage is associated with higher reports of sexual exclusivity even in settings where poverty provokes risky behavior. The finding, here, is of lower risk of HIV infection for married respondents, with a smaller effect observed among non-married cohabiters. Converse to the implied benefits of marriage, though, women with co-wives are more likely to report multiple partners. The implications of these findings are discussed. © 2006 Elsevier Ltd. All rights reserved.Item Community and individual sense of trust and psychological distress among the urban poor in Accra, Ghana(PLoS ONE, 2018-09) Kushitor, M.K.; Peterson, M.B.; Asante, P.Y.; Dodoo, N.D.; Boatemaa, S.; Awuah, R.B.; Agyei, F.; Sakyi, L.; Dodoo, F.N.A.; De-Graft Aikins, A.Background Mental health disorders present significant health challenges in populations in sub Saharan Africa especially in deprived urban poor contexts. Some studies have suggested that in collectivistic societies such as most African societies people can draw on social capital to attenuate the effect of community stressors on their mental health. Global studies suggest the effect of social capital on mental disorders such as psychological distress is mixed, and emerging studies on the psychosocial characteristics of collectivistic societies suggest that mistrust and suspicion sometimes deprive people of the benefit of social capital. In this study, we argue that trust which is often measured as a component of social capital has a more direct effect on reducing community stressors in such deprived communities. Methods Data from the Urban Health and Poverty Survey (EDULINK Wave III) survey were used. The survey was conducted in 2013 in three urban poor communities in Accra: Agbogbloshie, James Town and Ussher Town. Psychological distress was measured with a symptomatic wellbeing scale. Participants’ perceptions of their neighbours’ willingness to trust, protect and assist others was used to measure community sense of trust. Participants’ willingness to ask for and receive help from neighbours was used to measure personal sense of trust. Demographic factors were controlled for. The data were analyzed using descriptive and multivariate regressions. Results The mean level of psychological distress among the residents was 25.5 (SD 5.5). Personal sense of trust was 8.2 (SD 2.0), and that of community sense of trust was 7.5 (SD 2.8). While community level trust was not significant, personal sense of trust significantly reduced psychological distress (B = -.2016728, t = -2.59, p < 0.010). The other factors associated with psychological distress in this model were perceived economic standing, education and locality of residence. Conclusion This study presents evidence that more trusting individuals are significantly less likely to be psychologically distressed within deprived urban communities in Accra. Positive intra and inter individual level variables such as personal level trust and perceived relative economic standing significantly attenuated the effect of psychological distress in communities with high level neighbourhood disorder in Accra.Item The Conditionality of Norms: The Case of Bridewealth(Social Psychology Quarterly, 2018-12) Horne, C.; Dodoo, N.D.; Dodoo, F.N.A.Social norms are rules that prescribe and proscribe behavior. The application of norms is conditional. But scholars have little systematic understanding of the factors that affect conditionality. The authors argue that understanding norms requires assessing the costs and benefits of focal and nonfocal behaviors for norm targets, beneficiaries, and enforcers. The authors develop hypotheses about two combinations of these factors; they hypothesize that 1) costs to the norm target of complying with the norm, and 2) behavior by the norm beneficiary that hurts the norm target, weaken the norm. The authors use a vignette experiment to test these hypotheses in the context of bridewealth norms in Africa. The results are consistent with the predictions. The study contributes to the literature on norms by suggesting a systematic approach to understanding norm conditionality.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 Explanatory models of stroke in Ghana: perspectives of stroke survivors and their caregivers(Ethnicity and Health, 2019-03) Sanuade, O.A.; Dodoo, F.N.A.; Koram, K.; De-Graft Aikins, A.Objective: This study examines explanatory models (EMs) of stroke and its complications among people living with stroke, and their caregivers, in two urban poor communities in Accra (Ga Mashie) and Korle Bu Teaching Hospital (KBTH), Accra. Methods: Twenty-two stroke survivors and 29 caregivers were recruited from 2 urban poor communities in Accra and KBTH. Qualitative data were obtained using semi-structured interviews that lasted between 45 minutes and 2 hours. The interviews were audiotaped, transcribed and analysed thematically, informed by the concept of EMs of illness. Results: Participants referred to stroke as a sudden event and they expressed different emotional responses after the stroke onset. Stroke survivors and their caregivers attributed stroke with poor lifestyle practices, high blood pressure, unhealthy diet and dietary practices, supernatural causes, stress, family history, other chronic diseases, and delay in treatment of symptoms. While the stroke survivors associated stroke complications with physical disability and stigmatisation, the caregivers associated these with physical disability, behavioural and psychological changes, cognitive disability and death. These associations were mostly influenced by the biomedical model of stroke. Conclusion: The biomedical model of stroke is important for developing interventions that will be accepted by the stroke survivors and the caregivers. Nevertheless, sociocultural explanations of stroke need to be taken into consideration during delivery of medical information to the participants. This study proposes an integrated biopsychosociocultural approach for stroke intervention among the study participants.Item Gender in African population research: The fertility/ reproductive health example(Annual Review of Sociology, 2008-08) Dodoo, F.N.A.; Frost, A.E.We survey the literature on sub-Saharan Africa to identify how gender has factored into explaining fertility levels and behavior. Tracing the development of male role theory, we argue that despite increasing awareness of men's authority, fertility research continues to focus almost exclusively on women and treats gender as a property of individuals instead of as a system of inequality. The mainstream fertility literature generally overlooks the decision-making nexus wherein men's authority seemingly overrides women's preferences. Positing that male authority in the reproductive and sexual arenas is predicated on cultural rights negotiated at marriage - and undergirded by bridewealth payments - we contend that attempts to understand (and change) reproductive behavior will hardly be sustainable without attention to this contextual realm. In that vein, we speculate that efforts to empower women (via increased education, occupational opportunities, microcredit schemes, etc.) may hardly yield sustainable outcomes without concurrent efforts to alter cultural distributions of gendered power. Copyright © 2008 by Annual Reviews.Item Geographic mobility and potential bridging for sexually transmitted infections in Agbogbloshie, Ghana.(2017) Cassels, S.; Jenness, S.M.; Biney, A.A.; Dodoo, F.N.A.Short-term mobility can significantly influence the spread of infectious disease. In order for mobile individuals to geographically spread sexually transmitted infections (STIs), individuals must engage in sexual acts with different partners in two places within a short time. In this study, we considered the potential of mobile individuals as bridge populations - individuals who link otherwise disconnected sexual networks and contributed to ongoing STI transmission. Using monthly retrospective panel data, we examined associations between short-term mobility and sexual partner concurrency in Agbogbloshie, Ghana. We also examined bridging by the location of sex acts and the location of sexual partners in concurrent triads, and whether mobile individuals from our sample were more likely to be members of geographic bridging triads. Although reported rates of sexual partnership concurrency were much higher for men compared to women, mobility was only associated with increased concurrency for women. Additionally, this association held for middle-distance mobility and short-duration trips for women. Taking into account the location of sex acts and the location of sexual partners, about 22% of men (21.7% and 22.4% for mobile and non-mobile men, respectively) and only 3% of women (1.4% and 3.3% for mobile and non-mobile women, respectively) were potential bridges for STIs over the last year. Our results highlight the gendered nature of mobility and sexual risk behavior, reflecting the normative social context that encourages women to conceal certain types of sexual behavior.Item "The man comes to marry the woman": Exploring adolescent boys' gendered expectations for bridewealth and marriage among the akwapim of Southern Ghana(Marriage and Family Review, 2010-02) Frost, A.E.; Dodoo, F.N.A.A qualitative analysis of 28 in-depth interviews with adolescent boys aged between 12 and 15 years in the Akwapim highlands of Ghana reveals that the traditional practice of bridewealth exchange-called the customary rites among the Akwapim-fuels adolescent boys' expectations of increased male authority in marriage. Although the available literature on bridewealth argues that the traditional marriage practice of bridewealth exchange in sub-Saharan Africa gives men rights over women's sexual and reproductive capacities, as well as their household labor (Fortes, 1962), the findings of this article suggest that bridewealth payments influence not only these areas but male expectations for broader control over, and obedience from, their wives. © Taylor & Francis Group, LLC.Item Minimal coital dilution in Accra, Ghana(Journal of Acquired Immune Deficiency Syndromes, 2015-05) Jenness, S.M.; Biney, A.A.E.; Ampofo, W.K.; Dodoo, F.N.A.; Cassels, S.Background: Coital dilution, the reduction in the coital frequency per partner when an additional ongoing partner is added, may reduce the transmission potential of partnership concurrency for HIV and other sexually transmitted infections. Empirical estimates of dilution, especially dilution of sexual acts unprotected by condoms, are needed to inform prevention research. Methods: Sexually active adults in Accra, Ghana were recruited in a multistage household probability sample. Degree (number of ongoing partners), total acts, and unprotected acts were measured retrospectively for each month in the past year through an event history calendar. Random-effects negative binomial models estimated the association between degree and coital frequency. Results: Compared with person-months with a single partner (monogamy), 2.06 times as many total acts and 1.94 times as many unprotected acts occurred in months with 2 partners. In months with 3 partners, 2.90 times as many total acts and 2.39 times as many unprotected acts occurred compared with monogamous months. Total acts but not unprotected acts also declined with partnership duration. Conclusions: No dilution was observed for total acts with up to 3 concurrent partners, but a small amount of dilution was observed for unprotected acts for months with multiple concurrencies. This suggests moderate selective condom use in months with multiple concurrencies. The implications of the observed dilution for future HIV transmission must be investigated with mathematical models. Copyright © 2015 Wolters Kluwer Health, Inc.Item On the brain drain of Africans to America: Some methodological observations(Perspectives on Global Development and Technology, 2006-09) Dodoo, F.N.A.; Takyi, B.K.; Mann, J.R.Recurring debates about the impact of the brain drain - The developing world's loss of human capital to more developed countries - Has motivated estimation of the magnitude of the phenomenon, most recently by the World Bank. Although frequently cited as a key contributor to Africa's wanting development record, what constitutes the "brain-drain" is not always clearly defined. Today, in the absence of an accounting system, resolution of the definitional and measurement question depends on relative comparisons of measurement variants, which will identify definitional shortcomings by clarifying the merits and demerits of these variants, and thereby suggest corrective imputations. This paper compares the World Bank's approach to a chronological precedent (Dodoo 1997) to clarify the value of variant comparisons. The resultant implications for corrections are also discussed. © Koninklijke Brill NV 2006.Item Prevalence and correlates of stroke among older adults in Ghana: Evidence from the Study on Global AGEing and adult health (SAGE)(PLoS ONE, 2019-03) Sanuade, O.A.; Dodoo, F.N.A.; Koram, K.; De-Graft Aikins, A.This study examines the prevalence and correlates of stroke among older adults in Ghana. This cross-sectional study retrieved data from Wave 1 of the World Health Organization (WHO) Survey on Global Ageing and Adult Health (SAGE) conducted between 2007 and 2008. The sample, comprising 4,279 respondents aged 50 years and above, was analysed using descriptive statistics, cross tabulations and Chi-Square tests, and a multivariable binary logistic regression. Respondents ranged in age from 50 to 114 years, with a median age of 62 years. Stroke prevalence was 2.6%, with the correlates being marital status, level of education, employment status, and living with hypertension or diabetes. The results showed that being separated/divorced, having primary and secondary education, being unemployed and living with hypertension and diabetes, significantly increased the odds of stroke prevalence in this population. The results suggest that interventions to reduce stroke prevalence and impact must be developed alongside interventions for hypertension, diabetes and sociodemographic/economic factors such as marital status, level of education, and employment statusItem 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 Urban-rural differences in the socioeconomic deprivation-Sexual behavior link in Kenya(Social Science and Medicine, 2007-03) Dodoo, F.N.A.; Zulu, E.M.; Ezeh, A.C.We compare the impact of socioeconomic deprivation on risky sexual outcomes in rural and urban Kenya. Quantitative data are drawn from the Demographic & Health Surveys (DHS) and qualitative data from the Sexual Networking and Associated Reproductive and Social Health Concerns study. Using two separate indicators of deprivation we show that, although poverty is significantly associated with the examined sexual outcomes in all settings, the urban poor are significantly more likely than their rural counterparts to have an early sexual debut and a greater incidence of multiple sexual partnerships. The disadvantage of the urban poor is accentuated for married women; those in Nairobi's slums are at least three times as likely to have multiple sexual partners as their rural counterparts. The implications of these findings are discussed. © 2006 Elsevier Ltd. All rights reserved.Item What are the characteristics of 'sexually ready' adolescents? Exploring the sexual readiness of youth in urban poor Accra(BioMed Central Ltd., 2016) Biney, A.A.E.; Dodoo, F.N.A.Background: Adolescent sexual activity, especially among the urban poor, remains a challenge. Despite numerous interventions and programs to address the negative consequences arising from early and frequent sexual activity among youth in sub-Saharan Africa, including Ghana, only slight progress has been made. A plausible explanation is that our understanding of what adolescents think about sex and about their own sexuality is poor. In that sense, examining how adolescents in urban poor communities think about their sexual readiness, and identifying characteristics associated with that sexual self-concept dimension, should deepen our understanding of this topical issue. Methods: A total of 196 male and female adolescents, ages 12 to 19, were surveyed in the 2011 RIPS Urban Health and Poverty Project in Accra, Ghana. The youth responded to three statements which determined their levels of sexual readiness. Other background characteristics were also obtained enabling the assessment of the correlates of their preparedness to engage in sex. The data were analyzed using ordered logistic regression models. Results: Overall, the majority of respondents did not consider themselves ready for sex. Multivariate analyses indicated that sexual experience, exposure to pornographic movies, gender, ethnicity and household wealth were significantly linked to their readiness for sex. Conclusion: Sexual readiness is related to sexual activity as well as other characteristics of the adolescents, suggesting the need to consider these factors in the design of programs and interventions to curb early sex. The subject of sexual readiness has to be investigated further to ensure adolescents do not identify with any negative effects of this sexual self-view.Item What are the characteristics of ‘sexually ready’ adolescents? Exploring the sexual readiness of youth in urban poor Accra(BioMed Central, 2016) Biney, A.A.E.; Dodoo, F.N.A.Background Adolescent sexual activity, especially among the urban poor, remains a challenge. Despite numerous interventions and programs to address the negative consequences arising from early and frequent sexual activity among youth in sub-Saharan Africa, including Ghana, only slight progress has been made. A plausible explanation is that our understanding of what adolescents think about sex and about their own sexuality is poor. In that sense, examining how adolescents in urban poor communities think about their sexual readiness, and identifying characteristics associated with that sexual self-concept dimension, should deepen our understanding of this topical issue. Methods A total of 196 male and female adolescents, ages 12 to 19, were surveyed in the 2011 RIPS Urban Health and Poverty Project in Accra, Ghana. The youth responded to three statements which determined their levels of sexual readiness. Other background characteristics were also obtained enabling the assessment of the correlates of their preparedness to engage in sex. The data were analyzed using ordered logistic regression models. Results Overall, the majority of respondents did not consider themselves ready for sex. Multivariate analyses indicated that sexual experience, exposure to pornographic movies, gender, ethnicity and household wealth were significantly linked to their readiness for sex. Conclusion Sexual readiness is related to sexual activity as well as other characteristics of the adolescents, suggesting the need to consider these factors in the design of programs and interventions to curb early sex. The subject of sexual readiness has to be investigated further to ensure adolescents do not identify with any negative effects of this sexual self-view.