Browsing by Author "Dodoo, N.D."
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Item Age at First Sexual Intercourse and Parity among Women in Urban Poor Communities Accra Ghana.(University of Ghana, 2014-07) Donkor, M.Y.A.; Dodoo, N.D.; University of Ghana, College of Humanities, Regional Institute for Population StudiesThe study of age at first sexual intercourse and parity examined the relationship between age at first sexual intercourse and parity among women in three selected urban poor communities in Accra, Ghana. The study investigated the average age at first sexual intercourse among women aged 15-49 years and their implications on fertility. The unit of analysis was individual women aged 15-49 years and the data set that was used for the analysis was the EDULINK 2011 wave two. Statistical measures such as percentages and means were used to describe the relationship between the background characteristics and the mean parities. Simple linear and multiple regression analyses were also used to analyze the effects of age at first sexual intercourse on parity and the effect of the background characteristics on parity. It was found out through the analyses that the average age at first sexual intercourse among women within the three selected urban poor communities was 17.96 years while the average parity was 2.17 births per woman. The bivariate and multivariate analyses, showed an inverse relationship between age at first sexual intercourse and parity, in that a lower age at first sexual intercourse increased the parity of a woman, hence confirming the hypothesis. Based on the findings, it was recommended that laws in Ghana governing age at first sex should be made stricter by raising the age. Extensive campaign on the knowledge and use of contraception should be embarked on by government and other stakeholders to educate women. Female education should be encouraged, also religious bodies should encourage young women to postpone first sex until they are ready.Item “Cementing” marriages through childbearing in subsequent unions: Insights into fertility differentials among first-time married and remarried women in Ghana(2019-11-14) Dake, F.; Dodoo, N.D.Fertility in Ghana has declined steadily since 1980, however, a slight increase was observed between 2008 and 2014. While several factors may account for this pattern, research on the contribution of type of union is limited. This study examined differentials in the fertility of women in different types of union. Secondary data from 6,285 (weighted) ever-married women aged 15-49 years were analysed using compare means, t-test, analysis of variance, Poisson and binary logistic regression analyses. The findings indicate that, independent of other factors, fertility among remarried women is higher compared to first-time married women but this does not hold true when other factors are controlled for. Additionally, there was no significant difference in the fertility of remarried women who were in union and women who were in union in a first-time marriage. However, compared to remarried women who were currently in a union, fertility was significantly lower among remarried women who were not currently in union and women who have been married only once but were not currently in union. Further analysis revealed that remarried women were significantly more likely to desire more children and less likely to use any method of contraception compared to first-time married women. There is the need for further research to better understand the fertility needs of remarried women.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 The Dynamics of Women’s Autonomy in Household Decision-Making in Ghana, the Role of Religion(2016-04-14) Fuseini, K.; Dodoo, N.D.The present study explored the dynamics of women’s autonomy in household decision-making in Ghana, the role of religion. This study employed a qualitative approach to explore these dynamics among women and men who were in marital unions/living together. The data was collected between December 2014 and January 2015 in two purposively selected towns of Accra (southern Ghana) and Tamale (Northern Ghana), utilising the thematic analysis approach. The results showed no marked religious and regional differences in the dynamics of household decision-making. Religion reinforced the long-standing patriarchal norms of household decision-making. According to these norms and beliefs, men are heads of households and are supposed to lead and be in control of household decision-making. Men insist on maintaining the status quo in household decision-making and justify it using cultural and religious prescriptions. On the other hand, women as subordinates do not contest the power structures of household decision-making, suggesting that they need to be submissive and defer to their husbands in household decision-making as prescribed by culture and especially religion. Nevertheless, women played active roles in the household decision-making process. In some cases, women’s influence may be subtle but very efficient, which men acknowledged. Indeed, ‘men are the heads of households and expected to lead decision-making; however, women are the necks, and when the neck turns the head will follow’. The study showed the importance of cultural and especially religious ideals in the dynamics of household decision-making as well as the influence of women in household decision-making.Item Flux and strain in marriage contraction: The changing face of bridewealth in contemporary Ghana(University of Ghana, 2019-10-03) Dodoo, N.D.: Despite many changes in African societal structures, bridewealth still occupies a central role in contracting marriages. In Ghana, among married women aged 15 to 49, a nationally representative survey in 2014 reported that 82% were in marriages that involved bridewealth. I use semi-structured in-depth interviews with traditional rulers and community leaders in Ghana to examine the current role of bridewealth in marriage and the implications of changes in the practice of bridewealth for unions. The results reveal that social, cultural, and economic changes have led to a breakdown of norms surrounding marriage contraction and the marriage process being more expensive than it was in the past. These have given the leeway for women to contribute to the bridewealth payment, leading to a shift in the power base of marriage, which may lead to marital conflict and instability. It is suggested that the role of love in modern marriages is explored and men are engaged in the process of developing healthy masculinities as avenues to counter the effects of these changes in contracting marriageItem Gender and Perceptions of Personal Security in Ghana(University of Ghana, 2016-09) Sefa-Nyarko, C.; Dodoo, N.D.; University of Ghana, College of Humanities Regional Institute for Population StudiesPeace and security are sine qua non for development; and they are intrinsically linked to demographic change. People are likely to move out en masses where there is extremely low personal security, real or perceived. Even in non-conflict societies, personal security is especially compromised through crime, persecution, domestic violence and public disorder. Perceptions of personal security determine people’s participation in social, economic and political activities, and have an impact on their physiological and psychological wellbeing. Ghana is a typical politically stable country that had a relatively lower score on personal safety in the 2013 Ibrahim Index of African Governance, compared with its own score on other indicators of governance. None of the explanations offered for Ghana’s lower score on personal safety has considered gender as an important demographic indicator. Men and women perceive crime, violence and threats differently based on their socialisation, which makes it imperative that any discourse on personal security takes into account gender dynamics in society. The system of patriarchy which is endemic in almost every society, coupled with cultures of masculinity and femininity, play significant roles in the way men and women perceive their personal security. This study uses a four-item scale from the sixth edition of the Ghana Living Standards Survey to provide gender-sensitive explanations for gender differences in the perception of personal security in Ghana. The results are consistent with existing literature, especially when fear facilitators and fear inhibitors are introduced into the analysis. Residential arrangements and type of place of residence, among others, were found to predict perceptions of personal security significantly. Fear inhibiting factors, like reliable security services and responsive governance, were found to provide positive associations with perceptions of personal security, with women responding more positively. The thesis argues that focusing on improving fear inhibitors can significantly enhance perceptions of personal security of people, and can reduce gender inequality gaps.Item Ghanaian Female Adolescents Perceived Changes in Nutritional Behaviors and Social Environment After Creating Participatory Videos: A Most Significant Change Evaluation(Current Developments in Nutrition, 2023) Ghadirian, M.Z.; Marquis, G.S.; Dodoo, N.D.; Andersson, N.Background: Understanding the influence of participatory video-making on the nutrition-related behavior of video creators may help shape nutrition education interventions. Objectives: This study assessed the perceived value and influence of a participatory video intervention among participants and stakeholders. Methods: A 2018–2019 cluster randomized controlled trial (registered at clinicaltrials.gov as NCT03704649) selected 20 schools (10 intervention, n = 181; 10 control, n = 170) in 1 Ghanaian rural district, enrolled adolescent girls aged 13–16 y, and provided a nutrition curriculum. Each intervention school also participated in 2 series of activities designed to help adolescents plan, film, and screen 2 nutrition-related videos. The Most Significant Change method involved intervention participants and local stakeholders to assess the value and influence of the intervention – a secondary outcome of the trial. Project staff collected 116 stories of change from the adolescents. Stories described shifts in 4 domains: participant, peer, and family behavior, and structural changes in the school. The project team used a selection rubric to identify 14 stories that reflected heightened nutrition literacy. Staff conducted interviews with the 14 adolescents whose stories were selected to elaborate on details and perceived resonance. Finally, local stakeholders assessed the stories to identify the 4 most significant changes of the intervention – 1 per domain. A separate thematic analysis identified emerging patterns of motivation and action across the 14 interviews. Results: The chosen Most Significant Change stories revealed how adolescents found creative solutions to acquire iron-rich foods, encouraged neighbors to eat iron-rich foods, taught their family new agricultural practices, and promoted change in their school canteen. Local stakeholders valued stories that addressed common community nutrition issues in a creative and sustainable way, whereas adolescents prioritized stories that showed a change in health outcomes. Conclusion: Stories of change revealed that the intervention promoted a transformative influence; participants modified their eating habits, lifestyle, and their environment.Item Household Characteristics and Educational Attainment Young People in Poor Urban Communities in Accra(University of Ghana, 2015-07) Basintale, J.N.; Dodoo, N.D.; University of Ghana, College of Humanities Regional Institute for Population StudiesThis study investigates the relationship between household characteristics and educational attainment of young people in poor urban communities in Accra. The study uses the urban health and poverty survey (EDULINK 2011) Round two data, with 326 household heads with young people aged 15-24 years. The objective of the study is to examine household characteristics that determine young people educational attainment in poor urban communities and also the level of education in poor urban communities. The study uses household characteristics as its independent variable and educational attainment as its dependent variable. The Statistical Package for Social Science (SPSS) was used for the analysis of data. The study hypothesized that female household heads are more likely to have their young people attain higher education than male household heads, and older household heads are more likely to have their young people attain higher level of education than younger household heads. At the bivariate stage wealth, religion and locality were found to be significantly associated with the outcome variable. The model tested at the multivariate stage indicated that wealth and religion are significant in predicting the educational attainment.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 Lab experiments in demographic fieldwork: Understanding gender dynamics in africa(Demographic Research, 2014-12) Dodoo, F.N.-A.; Horne, C.; Dodoo, N.D.Background: Anthropological literature has long linked bridewealth payments to decision-making about fertility. Recent research underscores the significance of men's preferences regarding women's reproductive behavior, and suggests that bridewealth payments place constraints on women's reproductive autonomy. Yet because survey data on bridewealth are rare, and the collection of new survey data on bridewealth presents serious challenges, this explanation could not be tested. Objective Our objective in this paper is to highlight the potential utility of lab experiments (in particular, vignette experiments) for improving our understanding of gender relations in Africa, using the hypothesized effect of bridewealth on normative constraints on women's reproductive autonomy as an illustration. Methods: We discuss our reasons for turning to lab experiments, and to vignette experiments in particular. We also summarize a series of studies (Horne, Dodoo, and Dodoo 2013; Dodoo, Horne, and Biney 2014) which have implemented our experimental approach. Results: Our experimental evidence shows that bridewealth payments are associated with greater normative constraints on women's reproductive autonomy. We also find that these negative effects of bridewealth are consistent across participant ages, and do not appear to be ameliorated by female schooling. Conclusions: We conclude that lab experiments in general (and vignette experiments in particular) are underutilized methodological tools that may be useful for helping us gain a better understanding of the cultural context of gender relations in Africa; and that demographic research more generally may benefit from taking advantage of the strengths of experimental methods. © 2014 Dodoo, Horne and Dodoo.Item Marital Transition is Associated with Food Insecurity, Low Dietary Diversity, and Overweight in a Female Population in Rural Ghana(African Journal of Food, Agriculture and Development, 2023) Dallmann, D.; Marquis, G.S.; Colecraft, E.K.; Dodoo, N.D.Research from high-income countries shows that marital transition affects individuals’ nutrition outcomes. Yet, little is known about its effect on women’s food security status and nutrition outcomes in Sub-Saharan Africa. Moreover, most published studies merge cohabitation and marriage into one category, but these statuses might have a distinct effect on nutrition outcomes in different settings. This study examined the association between the marital transition of women living in a rural district in Ghana and their food security status, minimum dietary diversity, and overweight (body mass index (BMI) ≥ 25 kg/m2). This analysis used representative data from women with a child less than 12 months from the Upper Manya Krobo District, which was collected for the 2014 baseline of the Nutrition Links project in 137 villages (clinicaltrials.gov NCT01985243). Women’s marital transition was assessed by merging their current and previous marital status into five categories: i) continuously married; ii) remarried; iii) cohabitating with a previous union; iv) cohabitating with no previous union; v) single (majority never previously married). The adjusted logistic regression showed that, compared to women who were continuously married, those cohabitating—with or without a previous union—and those who were single were more likely to be food insecure (aOR = 2.49; 95% CI [1.31, 4.72], aOR = 2.01; 95% CI [1.13, 3.58], and aOR = 1.85; 95% CI [1.02, 3.38], respectively). Women who were cohabitating—with or without a previous union—were more likely not to meet the minimum dietary diversity than those who were continuously married (aOR = 1.82; 95% CI [0.98, 3.38] and aOR = 1.78; 95% CI [1.01, 3.12], respectively). Finally, compared to the continuously married group, cohabitating women with no previous union were less likely to be overweight (aOR = 0.40; 95% CI [0.22, 0.74]). These results are consistent with previous publications that showed married women were wealthier and more overweight. Moreover, these results indicate that cohabitation affects nutrition-related outcomes differently compared to marriage in a sub-Saharan setting. More attention must be placed on better understanding the social aspects that link women’s marital transition to diet and nutrition outcomesItem The Migration Experience and Differential Risks to Sexual and Reproductive Health in Ghana(Health Education & Behavior, 2020) Sznajder, K.K.; Biney, A.A.E.; Dodoo, N.D.Background. Though internal migration in Ghana has become increasingly common in recent years, research has not focused on the gendered experiences and perceptions of migration and the association with sexual and reproductive health risks for male and female migrants. Method. A qualitative study using semistructured interviews among migrant market workers and market leaders working in Agbogbloshie in Accra, Ghana, was completed in April 2018. Interview domains for the migrant interviews included the following: expectations of migration, current working and living conditions, sexual and reproductive health, access to health care, and self-reported health status. Qualitative data were analyzed using a combination of inductive and deductive coding in MAXQDA. Results. Data indicate that migrant workers have a variety of perceptions surrounding their migration experience. In the urban destination, migrants face a number of challenges that negatively affect their health, including poor accommodation, safety concerns, and low levels of social support. Reported risks to sexual and reproductive health were unsafe sexual encounters, such as low condom use and sexual assault. Discussion. The negative sexual and reproductive health outcomes among migrant populations in urban poor settings are a result of a confluence of factors, including perceptions of destination locations, working and living conditions, social support, and gender norms. A complex systems approach to understanding the sexual health of migrants is warranted. Conclusion. Findings from this research illustrate the complexity of health risks among migrants in Agbogbloshie. Further research is needed to explore the increased vulnerability of migrants compared with nonmigrants in urban poverty and the long-term implications of sexual and reproductive health risks in vulnerable migrant communities.Item Predictors and Consequences of Overweight and Obesity in the Household: A Mixed Methods Study on Rural Ghanaian Women and Men Farmers(African Journal of Food, Agriculture and Development, 2023) Arnouk, M.K.; Marquis, G.S.; Dodoo, N.D.Overweight/obesity (OW/OB) rates are increasing in Ghana. This study aims to identify the predictors of OW/OB in women, men, and at the household level (having at least one person as OW/OB in the household) in rural Ghana and examine local perceptions of the consequences of having an OW/OB person in the household. This was a cross-sectional mixed methods study. The quantitative data was a secondary analysis of the baseline data from the LinkINg Up (LU) project; a nutrition-sensitive agriculture intervention in eight rural communities in the Eastern Region of Ghana (ClinicalTrials.gov NCT03869853). The sample included 331 women and 205 men, 19-90 years old; there were 196 households that had both a participating woman and man (spouse, son, brother, or father). Logistic regression was used to assess variables associated with OW/OB in women (n=322), men (n=205), and households (n=196). Exposure variables included age, social support, mental health, self-efficacy, food security, the other family members’ OW/OB status, and others. Qualitative data included six focus group discussions (FGDs) (three with women and three with men, aged 22-69 years and recruited from the comparison arm of the LU project) were conducted in February-March 2022 in three of the eight project communities. A structured guide and a body figure instrument were used. The FGD recordings were translated and transcribed from Krobo to English. The analysis used an inductive thematic approach. Both women and men’s OW/OB were positively associated with age and wealth. Women’s OW/OB was negatively associated with age squared, and the score for mental health symptoms. Men’s OW/OB was negatively associated with being Krobo compared to other ethnicities. Households in the highest wealth tertile were 2.5-fold more likely to have at least one person who is OW/OB as compared to households in a lower wealth tertile. Participants expressed positive social consequences of having an OW/OB person for their families (for example respect). A person’s size was concerning only when it affected one’s ability to farm or make money, which would harm the household unit (for example lead to food insecurity, children dropping out of school). Having money was seen as a modifier for the negative effects. No negative consequences were perceived for OW people. The implications of the interruption of an OB person’s work on their family are worrisome and call for interventions that address poverty and food insecurity along with nutrition.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.