Browsing by Author "Tawiah, E.O."
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Item Female Adolescent Sexuality, Contraceptive Use and Reproductive Health In The Central Region of Ghana: A Case Study Of Cape Coast And Mankrong(University of Ghana, 2003-04) Kwankye, S.O.; Tawiah, E.O.; Amarfi, J.K.; Nabila, J.S.; University of Ghana, College of Humanities, Regional Institute for Population StudiesThe study on Adolescent Sexuality, Contraceptive Use and Reproductive Health was undertaken as part of the ongoing effort at understanding some of the problems that confront adolescents in Ghana, With a general objective of examining the magnitude of reproductive health-related problems pertaining to adolescent sexuality and contraceptive use, the study used a sample of 1,828 female adolescents aged 12-24 years (1,503 from Cape Coast and 325 from Mankrong) in the Central Region of Ghana as a case study. This was with the primary purpose of comparing the situation in an urban vis-a-vis a rural area. The two study areas are far apart: Cape Coast at the coast while Mankrong is located in the interior of the Central Region. It uses simple techniques including cross-tabulations as well as multiple regression analysis to examine quantitative and qualitative data collected from structured questionnaire and focus group discussions held separately among male and female adolescents and adults in Cape Coast and Mankrong. Among other things, the study found that the proportion of adolescents ever having sex increased with higher age of the adolescent with higher proportion having sex in Mankrong compared to Cape Coast. The mean age at first sex was, however, almost the same at 16.9 years in Cape Coast and 17 years in Mankrong. Mean age at first sex also increased with higher age of adolescents, implying plausibly of a declining age at first sex at the two study areas. Furthermore, there were suggestions to indicate that females become sexually active earlier than their male counterparts on account of the fact that at first sex most females were much younger than their male partners at the time. However, it was deduced that due to the fact that first sex usually may occur with persons who may be sexually more experienced and older, it may not always be easy to determine whether or not it is the female who enters into sex earlier if one depended on responses exclusively from the male or female. Generally, the adolescents did not approve of pre-marital sex but gave the indication of the possibility to indulge in it for financial reasons. What people approve of may thus, be different from what they may practise depending on the issues at stake. Peer pressure and lack of knowledge were the main reasons that provided grounds for a large proportion of the adolescents entering into sex for the first time. Again, although most of the adolescents did not approve of abortion, the report on abortion among them showed a possibility of an underestimation, suggesting a situation of a much higher abortion rate among the sexually active adolescents than was reported. Abortion rates were found to be higher in Cape Coast relative to Mankrong. Also important was the finding that adolescents who used contraception at first sex had a higher age at pregnancy. Similarly, adolescents who practised contraception had a relatively lower number of children ever bom in contrast with those who did not practise contraception at first sex. There was also a lower number of children ever bom with higher education of the woman. Results from the multiple regression analysis confirmed most of the observations made in the cross-tabulations. These included a declining age at first sex at 100 per cent level of confidence. Besides, financial considerations were found to contribute more to the reduction of an adolescent’s age at first sexual activity. The study confirmed at 95 per cent level of confidence, four of the five hypotheses, namely, that: i) There is an inverse relationship between age at first sexual intercourse and childbearing among adolescents; ii) There is an inverse relationship between adolescent childbearing and contraceptive use at first sex; iii) There is an inverse relationship between education and childbearing among adolescent females; and iv) There is a direct relationship between contraceptive use at first sex and age at first sexual activity among adolescent females. However, the hypothesis that contraceptive use is directly related to the level of education of the adolescent could not be analysed due to the very small sample of adolescents who were reported to be contracepting at the time of the survey. It is therefore, recommended that future research should consider a much larger sample of adolescents to facilitate such an analysis. In addition, future research should probe into the educational level of adolescents as at the time of their first sexual act for incorporation into the analysis. Similarly, future research should consider collecting information on the educational aspirations of adolescents as a proxy in analysing the timing of first sex among adolescents. The study further recommends intensive and sustained public education against criminal abortion, highlighting the short and long-term health implications to the adolescents while underscoring the fact that abortion is not a family planning method. It also calls for a review of the educational policy in Ghana with a possibility of making Family Life Education (FLE) a completely separate subject from Social Studies and be taught at earlier stages of the primary school education possibly at Primary Class Four. Besides, to ensure that teachers who are well trained in FLE teach pupils, FLE should be a compulsory component of the curricula of teacher training colleges in the country. A call is also made for the establishment of District Youth Centres throughout the country to offer education and counselling on all issues pertaining to the adolescents, especially their sexual and reproductive health. The study concludes by calling on government and civil society to put adolescent sexuality and reproductive health as a national development priority and to show the maximum commitment in addressing the various dimensions of the problem principally as critical components of the efforts at addressing the HIV/AIDS epidemic in Ghana. This is borne out of the realisation that the adolescents offer a window of opportunity and hope in the fight against HIV/AIDS among the entire population of Ghana.Item Infant and child health: Evidence from 2003 Ghana demographic and health survey(Population, Health and Development in Ghana: Attaining the Millennium Development Goals, 2007) Tawiah, E.O.3 Chapter Infant and Child Health: Evidence from 2003 Ghana Demographic and Health Survey Emmanuel O. Tawiah Introduction The unacceptably high levels of infant, child and under-five mortality in Ghana result in excessive and sheer waste of human lives. The recent increase in the under-five mortality rate from 107.6 per 1,000 live births during 1994-1998 to 111 per 1,000 live births in the period 1998-2003 makes the achievement of the Millennium Development Goal (MDG) of reducing underfive mortality by two-thirds between 1990 and 2015 quite difficult to attain. Most of these deaths are preventable through the adoption of relatively simple and inexpensive strategies such as breastfeeding promotion, childhood vaccination, provision of basic hygiene and health education. The factors associated with high infant and child mortality include poverty, malnutrition, poor sanitation and inadequacy of health facilities. In addition, human immunodeficiency virus (HIV) can be transmitted from mother to child before or during child birth and young children whose mothers die are at a very high risk of dying themselves at young age (United Nations, 1994). The health of infants and children is of crucial importance , both as a reflection of current health status of a large segment of the population and as a predictor of the health of the next generation. In 2000, persons aged less than five years comprised 14.7 % of the total population of Ghana. Protecting the health of this large population of infants and children today is an investment in the labour force of tomorrow. Good infant and child health is synonymous with wealth of the future. This chapter attempts to describe infant and child health inequalities as well as examine some of the factors that affect treatment of two common causes of illhealth among children namely; fever/cough and diarrhoea . Methodology The data are derived from the 2003 Ghana Demographic and Health Survey (GDHS), a nationally representative sample of women aged 15-49. The GDHS was designed to, among other things, collect information from female respondents, who were asked questions on topics such as respondent’s background, reproduction, antenatal and delivery care, breastfeeding, immunization, health and nutrition. The analysis is restricted to women aged 15-49 and their births in the five years preceding the survey. A total of 3,340 births comprising 1,114 or 33.4% and 2,226 or 66.6% respectively in the urban and rural areas were recorded in the five years prior to the survey. The indicators of infant and child health include breastfeeding practices, vaccination coverage, nutritional status, receipt of vitamin A supplement, prevalence of anaemia, prevalence and treatment of common childhood illnesses such as acute respiratory infection (AR1), fever and diarrhoea. The analysis does not include antenatal , delivery and postnatal care although these activities promote positive infant and child health outcomes. Two separate analyses are done. Bivariate analyses are used to examine relationships between selected demo30 POPULATION, HEALTH AND DEVELOPMENT graphic and socio-economic variables and childhood immunization coverage, breastfeeding practices, nutritional status, prevalence of anaemia, receipt of vitamin A supplement , prevalence and treatment-seeking for AR1, fever and diarrhoea. For the logistic regression analysis, all variables are categorical or grouped and for each variable, one category is selected as the reference category (RC). The two dependent variables used in the logistic regression analysis are receipt of medical treatment for fever/cough and receipt of medical treatment for diarrhoea. The results of logistic regression analysis are given as regression coefficients , odds ratio (if greater than unity, the probability of receiving medical treatment is higher than that of nonreceipt ), and p values, to assess the relative statistical significance of the selected variables. Results Childhood Mortality Poor infant and child health tends to result in high infant and child mortality levels. Table 1 provides information on early childhood mortality in Ghana to serve as a backdrop to examination of infant and child health inequalities by sex, type of place of residence and region. Under-five mortality is relatively high in Ghana. One out of nine children dies before attaining age five. Rural areas have considerably and consistently higher mortality levels than urban areas. For instance, under-five mortality in rural areas is 27% higher than it is in urban areas. There are wide regional differentials in under-five mortality. Under-five mortality varies from 75 per 1,000 live births in the Greater Accra Region to 208 per 1,000 live births in the Upper West Region. The rate for the Upper...Item Maternal health care in five sub-Saharan African countries(African Population Studies, 2011-12) Tawiah, E.O.This paper examines inequalities in access to maternal health care services and identifies demographic and socio-economic factors associated with poor maternal health outcomes using data from five Demographic and Health Surveys conducted in Ghana (2003), Kenya (2003), Nigeria (2003), Uganda (2000-2001) and Zambia (2001-2002). The six maternal health care indicators show that rural women are more disadvantaged than urban women. Home deliveries comprise more than half of total births. Getting money for treatment stands out as the most important problem women have in accessing health care. In general, Nigerian women experience poorer maternal health outcomes than women in the other four countries. Maternal educational attainment, urban/rural residence and partner's occupation emerge as the most important predictors of inadequate antenatal care, institutional delivery and current use of any contraceptive method. Female education beyond secondary school level coupled with strenuous efforts to reduce poverty holds the key to keep women off the road to death.Item Population ageing in Ghana: A profile and emerging issues(African Population Studies, 2011-12) Tawiah, E.O.Population ageing in Ghana is a consequence of a gradual fertility decline which is also occurring in many sub-Saharan African countries. Data from the 2005/2006 Ghana Living Standards Survey show that the percentage of the elderly (persons aged 60 years and above) has increased from 4.9 in 1960 to 5.3 in 1970, 5.8 in 1984 and 7.2 in 2000. Median age has increased from 17 years in 1970 to 18.1 years in 1984 and 19.4 years in 2000, implying a 14.1 percentage increase in 30 years. Socio-economic indicators show that elderly females are more vulnerable and disadvantaged than their male counterparts due in part to low educational attainment resulting in low female participation in the formal sector with its attendant low remuneration and inadequate retirement package. One important emerging issue is the branding of elderly females as witches and subjecting them to abuse and torture in certain parts of the country. This harmful practice infringes upon the human rights of these women and the government of Ghana should do well to abolish the witches' camps. A large proportion of workers engaged in the informal sector of the economy do not contribute to the Social Security Scheme and this makes it extremely difficult for them to cater for their needs in old age particularly when the extended family is unable to provide support and care. The government of Ghana should make strenuous efforts to bridge the gap between producing a concise National Ageing Policy and its implementation.Item Sociodemographic correlates of obesity among Ghanaian women(Public Health Nutrition, 2011-07) Dake, F.A.A.; Tawiah, E.O.; Badasu, D.M.Objective To examine the sociodemographic correlates of obesity among Ghanaian women.Design The 2003 and 2008 Ghana Demographic and Health Survey data sets were used to examine the sociodemographic characteristics and the BMI of women aged 15-49 years using descriptive statistics, bivariate and multivariate analyses.Setting Ghana is a West African country which is divided into ten administrative regions. The country is further divided into the northern and southern sectors. The northern sector includes the three northern regions (Northern, Upper East and Upper Westen regions) and the seven remaining regions form the southern sector.Subjects Women aged 15-49 years whose BMI values were available.Results The overall prevalence of obesity and overweight increased from 25·5 % in 2003 to 30·5 % in 2008. Obesity varied directly with age from 20 to 44 years. Women with higher education had the highest rate of obesity. Obesity was more common among women from wealthy households compared to women from poor households.Conclusions Obesity and overweight were found to be more common among older women, urban women, married women, women with higher education and women from rich households. Adoption of healthy lifestyles and the implementation of policies that promote healthy living can help reduce the prevalence of overweight and obesity. © 2010 The Authors.Item Why some women deliver in health institutions and others do not: a cross sectional study of married women in Ghana, 2008.(African journal of reproductive health, 2012-09) Smith, M.E.; Tawiah, E.O.; Badasu, D.M.Existing inequalities in an environment where men wield so much authority can have negative implications for women's reproductive health outcomes. Using a quantitative approach, the study explores the relationship between some selected socioeconomic variables, women's status and choice of place of delivery. All three indicators of status employed by the study were significantly associated with whether a woman had an institutional delivery or not. This association however diminished after controlling for other confounding socio-economic variables. The findings indicate that a woman's status does not act independently to affect her choice of place of delivery but these effects are channelled through some socio-economic variables. Wealth and educational status of the women and their partners emerged predictors of choice of place of delivery. Expansion of economic opportunities for women, as well as female education must be encouraged. In addition, these should not be done in neglect of male education.