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Book Chapters: A scholarly introduction of chapter length to an edited volume, where the content of the introduction reports research and makes a substantial contribution to a defined area of knowledge.
On the other hand, Review books or articles provide a critical and constructive analysis of existing published literature in a field, through summary, analysis, and comparison, often identifying specific gaps or problems and providing recommendations for future research. These are considered as secondary literature since they generally do not present new data from the author's experimental work. Review articles can be of three types, broadly speaking: literature reviews, systematic reviews, and meta-analyses.
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Item Some Demographic Characteristics of two rural communities in Southern Ghana(Ghana Medical Journal, 1988-09) Afari, E.A.; Nakano, T.; Owusu-Adjei, S.A study of the demographic characteristics of two rural villages in Southern Ghana in 1987 showed an average rate of natural population increase of 3.8 percent compared to 3.2 per cent recorded nationally (1984 census data). The crude death rates and Infant Mortality rates were far lower than the figures usually quoted, although the birth rate was similar to the national average. It is suggested that if such rates exist in similar villages in Ghana, then official projections are underestimates and will have grave consequences on national development plans. It appears that Primary Health Care (PHC) has succeeded in reducing deaths but has not affected births. Family planning must, therefore, receive more attention.Item Material aspects of Limba, Yalunka and Kuranko ethnicity: Archaeological research in northeastern Sierra Leone(Archaeological Approaches to Cultural Identity, 1989-01) Decorse, C.R.Northeastern Sierra Leone is located within the forest-savanna ecotone; the southern part of the region is characterized by tropical forest and farm bush, whereas the north is more open and savanna grass and baobab trees are common. Physiographically the area lies on the Koinadugu Plateau, an extension of the Guinea Highlands, and is dominated by intr icately dissected plains, hills and mountains. Culturally the area consists largely ofLimba, Yalunka and Kuranko (Fig. 7.1), but smaller numbers of Fulani, Mandinka and other ethnic groups are also present. The three larger groups are swidden agr iculturalists. Chicken, goats and sheep are commonly kept, but cattle, when owned, are often tended by Fulani herdsmen. There is a high degree of cultural similarity throughout the region, but a variety of linguistic, cultural, political and historical factors characterize the individual groups.Item Apprenticeship System of ''Wayside'' Seamstresses From Selected Neighborhoods in Accra.(University of Ghana, 1997-10) Acquaah-Harrison, P.;The purpose of this study was to investigate the apprenticeship system of fifty seamstresses and fifty apprentices from Achimota, Legon and Madina neighbourhoods of Accra. A stratified sampling technique was used to select the respondents from these neighbourhoods. The respondents were interviewed by the researcher, using two separate structured questionnaires: One for the seamstresses and the other for the apprentices. A non-obtrusive observational guide was also used to evaluate teaching/learning interactions at the workshop. Frequency, percentage distribution and cross-tabulation were used to analyze the data. Fathers with low level of education endorsed apprenticeship for their daughters (Ref Appendix VI). The study revealed that the seamstresses were aged between 20 and 40. Their educational attainment ranged from primary six to university. Eighty-two percent had their professional training informally in kiosks while the rest either attended formal vocational training schools or had no formal training in sewing. The apprentices were aged between 15 and 33 years. The educational level of 90% of the apprentices ranged from primary to vocational school. Ten percent had had no formal education. An aspirant apprentice ought to be introduced to a seamstress by a respectable member of her family who would be the guarantor. Apprenticeship fees ranging from 020,000 to 0120,000 were paid for a period of two and a half years apprenticeship, in addition to six months service to sew with the trainer without being paid. The apprenticeship system was devoid of theory work, with an average of seven hours each day spent on some sewing activity. Teaching and learning were through demonstration by the seamstress, observation and practice by the apprentices who most of the time taught one another (peer teaching). Eighty-two percent of the seamstress taught the sewing of slit and kaba and casual wears and eighteen percent taught the sewing of wedding gowns in addition to slit and kaba, using the free hand method of cutting. End of apprenticeship was marked by a final examination. Eighty percent of the apprentices took the Ghana National Tailors/Dressmakers Association (GNTDA) examination. The rest were examined by their trainers who had not registered with the national association. A graduation ceremony was organized in each neighbourhood for the members of GNTDA to cater for an average of two apprentices each from a workshop who completed their service together. Ninety-nine percent of the apprentices aspired to establish their own sewing shop in Accra after training because they were optimistic that business would be better in Accra than in their home towns. It is recommended that, The Ghana National Tailors and Dressmakers Association (GNTDA) in consultation with the National Vocational Training Institute (NVTI) Apprentice Training Board and the Ghana Education Service (GES), develop common syllabus and text books for the Apprenticeship System. Seamstresses should emphasize the importance of fabric grain as well as principles of design as applied in garment design. This would equip the apprentice seamstress with better knowledge in garment design and construction.Item Antiplasmodial Activity of Medicinal Plant Preparations T610 and S076 Using Plasmodium Falciparum in Vitro Culture System(University of Ghana, 2001-08) Appiah-Opong, R.; Gyang, F.N.; Nyarko, A.K.; Dodoo, D.; University of Ghana, College of Humanities, School of Arts, Department of Philosophy and ClassicsSome traditional medical practitioners use decoctions of the plants Tridax procumbens and Phyllanthus amarus, separately, to treat malaria in Ghana. These plants have however, not been investigated scientifically to establish their antimalarial activities. In this study, inhibition of chloroquine-resistant Plasmodium falciparum uptake o f 3H-hypoxanthine was used as an in vitro assay to assess the antiplasmodial activities of aqueous, ethanolic, chloroform and ethyl acetate extracts of Tridax procumbens and Phyllanthus amarus. Chloroquine was used as a reference antimalarial drug. Cytotoxicities of the extracts to red blood cells were also investigated. Furthermore, the aqueous extracts of the plants were evaluated for haem polymerisation inhibitory activity. The results show that high concentrations of chloroquine inhibited the uptake of 3Hhypoxanthine by Plasmodium falciparum, confirming the chloroquine-resistant nature of the parasites used. Both plant extracts also demonstrated antiplasmodial activity against the chloroquine resistant plasmodial parasites. Among the various extracts, the lowest 50% inhibitory concentrations (IC50) of 24.8 and 11.7 |ig/ml corresponded to the aqueous and ethanolic extracts, respectively, of Phyllanthus amarus. For Tridax procumbens, the lowest IC50 values were 225.0 and 143.4 |J.g/ml for the ethanolic and aqueous extracts, respectively. Unlike chloroquine, none of the extracts inhibited haem polymerisation. Within the concentration range used, the least cytotoxicity to RBCs was observed in the aqueous extracts of both plants, the ethanolic extract of Phyllanthus amarus and the ethyl acetate extract of Tridax procumbens. These results suggest that the aqueous and ethanolic extracts of both plants were more effective as antiplasmodial preparations than the other extracts.Item 'Efie' or the meanings of 'home' among female and male Ghanaian migrants in Toronto, Canada and returned migrants to Ghana(New African Diasporas, 2003-09) Manuh, T.The extensive literature relating to the African diaspora has tended to concentrate on the descendants of those who left Africa as part of the slave trade to North America. This important new book gathers together work on more recent waves of African migration from some of the most exciting thinkers on the contemporary diaspora. Concentrating particularly on the last 20 years, the contributions look to the United States and beyond to diaspora settlement in the UK and Northern Europe. New African Diasporas looks at a range of different types of diaspora - legal and illegal, professional and low-skilled, asylum seekers and 'economic migrants' - and includes chapters on diasporic communities originating in Cote d'Ivoire, Democratic Republic of Congo, Eritrea, Ghana, Senegal and Somalia. It also examines often neglected differences based on gender, class and generation in the process. This book will be essential reading for anyone with an interest in the African diaspora and provides the most wide-ranging picture of the new African diaspora yet.Item Ghana(Families Across Cultures: A 30-Nation Psychological Study, 2006-01) Amponsah, B.; Akotia, C.; Olowu, A.A HISTORICAL OUTLINE OF GHANA Ghana derived its name from the ancient Ghana Empire in the Western Sudan, which fell in the eleventh century. Formally known as Gold Coast, Ghana was the first black colony in sub-Saharan Africa to gain independence from the British on March 6, 1957 and became a republic in 1960. The ruins of about 30 castles dotted around the coast of Ghana are evidence of four centuries of the presence of Europeans who traded in ivory, gold, and slaves. The population of Ghana is 18,800,000. Accra is its capital with a population of 1,605,400 inhabitants. The major ethnic groups are the Akan (49 percent), Mole-Dagomba (16.5 percent), Ewe (12.7 percent), and Ga-Adangbe (8 percent) (Ghana Statistical Service, 2000). ECOLOGICAL FEATURES Ghana is located in West Africa on the Gulf of Guinea. It is bordered on the west by Côte d'Ivoire, on the north by Burkina Faso and by Togo on the east. Ghana has an area of 238,533 km2. Ghana is primarily a lowland country. The northern part of the country is grassland showing a dry transitional expanse between the Sahara desert to the north and the southern tropical region. The weather varies by region, but in general it has a tropical climate with annual average temperature between 26 °C and 29 °C. Annual rainfall varies from more than 2,100 mm in the southwest to 1,000 mm in the north. © Cambridge University Press 2006.Item Anatomy and blood supply of the urethra and penis(Urethral Reconstructive Surgery, 2006-01) Quartey, J.K.M.The penis is made up of three cylindrical erectile bodies. The pendulous anterior portion hangs from the lower anterior surface of the symphysis pubis. The two dorsolateral corpora cavernosa are fused together, with an incomplete septum dividing them. The third and smaller corpus spongiosum lies in the ventral groove between the corpora cavernosa, and is traversed by the centrally placed urethra. Its distal end is expanded into a conical glans, which is folded dorsally and proximally to cover the ends of the corpora cavernosa and ends in a prominent ridge, the corona. The corona passes laterally and then curves distally to meet in a V ventrally and anterior to the frenulum, a fold of skin just proximal to the external urethral meatus. The erectile tissue of the corpora cavernosa is made up of blood spaces lined by endothelium enclosed in a tough fibroelastic covering, the tunica albuginea. The corpus spongiosum is smaller with a much thinner tunica albuginea, and its erectile tissue surrounds the urethra. Proximally, at the base of the pendulous penis, the corpora cavernosa separate to become the crura, which are attached to the inferomedial margins of the pubic arch and adjoining inferior surface of the urogenital diaphragm. The corpus spongiosum becomes expanded into the bulb, which is adherent in the midline to the inferior surface of the urogenital diaphragm. This is the fixed part of the penis, and is known as the root of the penis. The urethra runs in the dorsal part of the bulb and makes an almost right-angled bend to pass superiorly through the urogenital diaphragm to become the membranous urethra.Item The absence of social capital and the failure of the Ghanian neoliberal mental model(Neoliberalism: National and Regional Experiments with Global Ideas, 2006-12) Amponsah, N.; Denzau, A.T.; Roy, R.K.In the 1980s, Ghana sought to institute market liberalization reforms based on policy prescriptions outlined by the IMF (International Monetary Fund) and the World Bank known as Structural Adjustment Programs (SAPs). SAPs were designed in accordance with a neoliberal framework known as the Washington Consensus (WC). The WC, a strand of the neoliberal shared mental model that was first coined by John Williamson, articulated a set of market-oriented policy prescriptions and goals that if pursued faithfully, would help encourage countries on the path to greater economic performance and prosperity. Such prescriptions included instructing governments to pursue policies and strategies aimed at promoting fiscal discipline, interest rate liberalization, privatization, deregulation of entrance and exit barriers, and establishing transparent and public-seeking institutions that are established to enforce and abide by a rule of law that would secure property rights and discourage predatory rent-seeking practices.Item History of community psychology in Ghana(International Community Psychology: History and Theories, 2007) Akotia, C.S.; Barimah, K.B.This chapter traces the emergence and practice of community psychology in Ghana. We begin with a discussion of the early stages of the development of community psychology in the country. Having been foreshadowed by the activities of nongovernmental organizations (NGOs), community psychologists mainly use the classroom as a catalyst for promoting the values and principles of the field. The classroom is also used for sensitizing individuals about this field of psychology. The chapter also highlights the fertile psycho-social background that makes the acceptance of community psychology a natural fit in Ghana.We also discuss the challenges in the development and practice of community psychology as a formal discipline in one of the country's universities and conclude with optimism that the field has a promising future in Ghana. © 2007 Springer Science+Business Media, LLC.Item Conclusion(Population, Health and Development in Ghana: Attaining the Millennium Development Goals, 2007) Mba, C.J.; Kwankye, S.O.9 Chapter Conclusion Stephen O. Kwankye and Chuks J. Mba The papers that were presented at the Seminar raised a number of relevant developmental issues and generated a wide range of discussions. A number of recommendations and conclusions were also made. The salient features of these discussions and concomitant recommendations are presented in this chapter. First, it is important to undertake more qualitative studies to investigate the factors that are responsible for the fertility transition in Ghana, considering that the socio-cultural environment plays critical roles in shaping fertility behaviour, choices and decisions not only in Ghana but throughout sub-Saharan Africa. For now however, efforts should be made to develop the large army of youthful population into a useful human resource for nation building. In all the presentations, education has been highlighted as a key factor towards the achievement of almost all the MDGs. In response to this recognition therefore, while ensuring that all children of school going age go to school, equally adequate attention should be paid to adult literacy. This is important considering the high rate of early school drop out especially among females in the rural areas. Formal education alone may not provide us with the full antidote. The analysis of HIV prevalence across sub-Saharan Africa suggests quite plausibly that poor countries are not necessarily those with the highest rates of HIV infection. It is therefore not quite clear the extent to which poverty stands to blame as a major cause of HIV. While this may appear to be a valid argument at the country by country comparison, within each country, the situation may be to the contrary and poverty may be a very important factor or condition in understanding HIV infection and spread although the role of other conditions and factors like education cannot be discounted. The need for more research in this area cannot also be underestimated. There appears to be a conflict between the policy environment and the legal framework regarding sexuality and contraception. While the policy makes it clear that all sexually active adolescents (i.e., 10-19-year-olds) should have access to contraception, the law on defilement rules out sexual consent by persons less than 16 years. By implication, persons less than 16 years cannot and should not be sexually active and are therefore not eligible to have access to, or use any form of contraception in Ghana. This is a clear conflict, which requires resolution to guide institutions and organisations like the Ghana Social Marketing Foundation (GSMF), which are into contraceptive advocacy, provision and sensitisation programmes. Again, there are still concerns about condom educational campaigns as a way of counteracting the upsurge of HIV/AIDS in Ghana and elsewhere in Africa. With reference to young persons however, this practice is clearly in conflict with Ghana’s law on defilement. Consequently, there should be audience segmentation, which should seek to place emphasis on abstinence for young persons to keep them away from early sex and condoms for persons who are sexually active beyond the age at which one could have consent for sex as is enshrined in the laws of the state. From the papers and discussions at the Seminar, one issue on which consensus was again reached is preventive as opposed to curative health. While efforts at encouraging the population to adopt the use of insecticide treated bed nets are ongoing and ought to be intensified , we need to equally intensify public education and attitudinal change regarding environmental sanitation and the sustainability of the eco-system as a critical 184 POPULATION, HEALTH AND DEVELOPMENT component of sustainable development. Garbage collection in our cities and towns should be regular while choked drains ought to be de-silted frequently. As a permanent solution, newly constructed drains should be covered and persons who indiscriminately litter the environment should be prosecuted and heavy fines imposed without delay to serve as deterrent to others. All indicators of the health status of the population appear to be poor in the three northern regions in Ghana, i.e., Northern, Upper East and Upper West. Yet, there are several interventions that are ongoing in these regions by government and several non-governmental organisations (NGOs). In these regions, we have high fertility because among other things, infant mortality is high. The situation in these regions should however, not be misconstrued to indicate a failure of the interventions . This is because demographic phenomena often require long periods of time to register tangible changes.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 Ghana(Beyond Food Production: The Role of Agriculture in Poverty Reduction, 2007) Al-Hassan, R.M.; Jatoe, J.B.D.Item HIV/AIDS and survival challenges in Sub-Saharan Africa: An illustration with Ghana and South Africa(Population, Health and Development in Ghana: Attaining the Millennium Development Goals, 2007) Mba, C.J.6 Chapter HIV/AIDS and Survival Challenges in Sub-Saharan Africa: An Illustration with Ghana and South Africa Chuks J. Mba Introduction and Rationale The acquired immune deficiency syndrome (AIDS), which is caused by the human immunodeficiency virus (HIV), emerged in the 1980s as the most terrifying epidemic of modern times. The AIDS pandemic affects primarily young to middle-aged adults, on whom both the national economy and family survival depend. HIV/AIDS has the potential to devastate human development, setting countries backward in their efforts to increase infant and child survival, achieve longer life expectancy and promote better life chances through education, as well as productive and secure livelihoods. Worldwide, AIDS kills more than 8,000 people every day; one person every 10 seconds, while one child dies and one child is infected every minute. Out of a total of 39.4 million adults (defined as people aged 15-49) and children (defined as people below age 15) estimated to be living with HIV as of end of 2004, 25.4 million of them, representing about 64%, are from sub-Saharan Africa (UNAIDS/WHO 2005). Available evidence indicates that whereas 10.6 million adults lived with HIV/AIDS in 1994 in sub-Saharan Africa, there were about 30 million adults and children living with the disease by 2003, with 3.5 million new infections in 2002 alone (UNAIDS/WHO 2004; 2002). According to the estimates of UNAIDS (2002), the HIV prevalence rate in adults aged 15-49 ranges from 1.6 to 11.8% in Western Africa, from 0.1 to 2.6% in Northern Africa, from 3.6 to 12.9% in Central Africa, and from 2.8 to 15.0% in Southern Africa. Of the 45 countries most severely affected by HIV/AIDS, 35 of them (78%) are in sub-Saharan Africa (United Nations, 2001)9. It is conceded that there are no simple explanations as to why some countries are more affected by HIV than others. However, poverty, illiteracy and engaging in identified risk behaviours account for much of the epidemic (Mba, 2003a; Caldwell, 2000; Mbamaonyeukwu, 2001a; 2000; Philipson and Posner, 1995). People who are infected with HIV often have no symptoms of disease for many years and can infect others without realising that they themselves are infected. The HIV continues to spread in Africa and around the world, moving into communities previously little troubled by the epidemic and strengthening its grip on areas where AIDS is already the leading cause of death in adults. Unless a cure is found, or life-prolonging therapy can be made more widely available, the majority of those now living with HIV will die within a decade. Against this background, it is important to raise awareness and expanding knowledge about the deleterious effect of HIV/AIDS on Africa’s life expectancy, with particular reference to South Africa and Ghana, for possible policy interventions. Apart from the fact that relevant data to warrant this study are available for the two countries, available evidence suggests that about 3.1% of the adult population in Ghana are living with the HIV virus, while the prevalence rate is about 21.5% in South Africa. Besides, South Africa has the highest number of HIV/AIDS persons in the world (6 million people; 600 die everyday). It should be noted also that many southern and eastern African countries had HIV prevalence rates 136 POPULATION, HEALTH AND DEVELOPMENT in the late 1980s similar to those currently found in Ghana, but the situation worsened rapidly. This suggests that an unchecked epidemic could lead to much higher prevalence levels in Ghana. The two countries are therefore selected because they lie at opposite ends of the spectrum, so that analyzing their HIV/AIDS profiles will reveal more clearly the devastating impact of the pandemic. Given these unsettling realities, it is important to find out what some of the severely affected countries are doing to combat the HIV/AIDS pandemic. In particular, the following key research questions are addressed in this study: What are the current HIV/AIDS prevalence levels across Africa? How far have we come with respect to combating HIV/AIDS? What is the contribution of HIV/AIDS mortality to the overall mortality of South Africa and Ghana? To what extent will life expectancy be enhanced if HIV/AIDS were absent in the mortality experience of these countries? What are the successes that have been chalked in the endeavour to combat HIV/AIDS? What lessons have been learnt? and...Item Population, health and development in Ghana: Attaining the millennium development goals(African Books Collective, 2007) Mba, C.J.; Kwankye, S.O.The Millennium Development Goals address poverty, hunger, disease, illiteracy, environmental degradation, and discrimination against women, by the year 2015. In this volume scholars and policymakers in the fields of population and health reflect on the attainments of some of these goals, on the basis of empirical evidence in the Ghanaian context. The eight paper, with an introduction by the editors, synthesises papers presented at a seminar held in Ghana on ?Population, Health and Development in Relation to the Millennium Development Goals?, organised by the Population Association of Ghana. © Population Association of Ghana, University of Ghana, Legon, 2007. All rights reserved.Item Introduction(Population, Health and Development in Ghana: Attaining the Millennium Development Goals, 2007) Mba, C.J.; Kwankye, S.O.Introduction Stephen O. Kwankye and Chuks J. Mba The Population Association of Ghana (PAG), in line with its aim of furthering the scientific study of population and related activities with a view to improving the quality of life of the people of Ghana, organized a two-day Population Seminar in Accra in collaboration with the Ghana Health Service and the National Population Council Secretariat on 26th – 27th October 2005 on the theme: Population, Health and Development in Relation to the Millennium Development Goals. This book is the outcome of the seminar. A number of papers were presented during the twoday seminar which brought together over 100 participants from the academic, health, civil society and the media to deliberate on key findings of the research papers in relation to the overall drive towards the Millennium Development Goals (MDGs). The presentations covered issues of population, health, infant and child mortality, sexual and reproductive health of adolescents, HIV/AIDS and survival, water and sanitation, among others. The principal objective of the seminar was to create the platform to engage both researchers, policy makers/implementers and the media in discussions on the critical population and health related issues that should be subjects of concern in order to chart a common cause towards the attainment of the MDGs by 2015. Dr. Gloria Quansah Asare of the Ghana Health Service chaired the opening session of the Seminar. In her 1 Chapter address, she underscored the relevance of the theme of the Seminar for the development of Ghana. According to her, health (preventive and curative) is an issue for all members of the household and therefore should be of concern to everyone. She called on researchers to involve the health sector in their work and re-enforced the commitment of the health sector to such a process of partnership . She expressed the hope that there would be further discussions beyond the presentation of research papers at the Seminar as a way of informing policies towards the attainment of the MDGs. Prof. S.K. Gaisie, the Interim President of PAG, in his welcome address stressed the relevance of using science to solve problems that afflict the human population of every country. Describing the Seminar as a novelty from a young association such as PAG, he drew attention to the fact that population interacts with all development variables and cautioned that “we cannot postpone action because of ignorance”. He therefore called for serious attention to be given to research findings to direct the nation’s policy actions, emphasising that functional integration of population into development is what Ghana needs as a country if indeed she wishes to achieve any of the MDGs by the set date. In her address, Mrs. Esther Apewokin, the Executive Director of the National Population Council (NPC) Secretariat, acknowledged the pool of expertise the membership of PAG has and called on them to use their research findings to assist in addressing populationrelated problems especially towards poverty reduction as one key component of the MDGs. In the submission of Mr. Amadu Bawa from the UNFPA Ghana Office, who represented the UNFPA Representative in Ghana, he stressed that one of the main aims of the UNFPA is to ensure that any pregnancy is wanted and women are treated with dignity. He acknowledged that research could be very frustrating due to funding problems. However, one cannot make any development progress by ignoring research. He was therefore glad that the UNFPA was associated with the 2 POPULATION, HEALTH AND DEVELOPMENT Seminar and pledged the support of the UNFPA towards the publication of the Seminar papers to expand their dissemination. The publication of this book is therefore a fulfilment of that pledge for which PAG is very much grateful. The Minister of Health, Hon. Major (Retd.) Courage Quashiga, gave the keynote address. In presenting his address, the Minister did not hide his commitment to crusading a cause that would lead to a change in the way of doing things in the health sector. He was of the opinion that the population of any nation includes all ages that must be converted into human resource. He noted that of the eight MDGs, three are directly related to health and the other five indirectly. Quoting from the 1992 Republican Constitution of Ghana, the Minister of Health made it clear that the mandate of his Ministry is to reduce ill-health. He recalled that the Government’s approach towards the attainment of middle-income status by the year 2015 is founded on good...Item Population growth, water/sanitation and health(Population, Health and Development in Ghana: Attaining the Millennium Development Goals, 2007) Gaisie, S.K.; Gyau-Boakye, P.G.Health services are utilized to reduce mortality and to prolong life. Clean water and sanitation also have a considerable effect on reducing mortality and morbidity. In fact, water is a necessary condition for human existence. Life is therefore sustained by continuous circulation of water. Improved health depends on increasing household water supplies. Population expansion tends to engender severe water sustainability problems such as rapidly increasing water scarcity (and/or food scarcity) and protection of water quality in order to avoid the menace of water-related diseases (e.g. diarrhoea, cholera, guinea worm etc.). It has been estimated that, in addition to rising demand, continued population growth implies that the actual ceiling of the affordable water use would decrease to half its present level when the population doubles its size and to a quarter when it quadruples its size (Falknermark, 1990). Population growth therefore consumes potentially available water in order to meet an increasing water demand. The influence on population of natural resource constraints is reflected, among other things, in water scarcity that generates high levels of morbidity among the population. Development involves, among other things, meeting rising water demand for improved health, quality of life, and food security. Population expansion, as noted earlier on, places severe constraints on the water availability to achieve these goals. Thus, as a result of water shortages , it is increasingly becoming an uphill task to provide for future improvements in the quality of life. Consequently, increasing water scarcity in response to unavoidable population growth and food and water needs that go with it forms the greatest challenge for humanity to address. There is therefore the need to raise awareness of increasing water shortage due to rapid population expansion so that realistic policy options to reduce the threat can be identified and urgently formulated and implemented . This is crucial for the ongoing poverty reduction programme because poverty reduction in a developing country is critical for sustainable development. This chapter attempts to assess the amount of water available for use in the Volta, South Western and Coastal river systems; estimate the percentage of the overall availability that can be made accessible for withdrawal; determine the relationship between present water demand levels and population size or relationship between population size and levels of water scarcity; estimate the future water demand in terms of projected population ; and infer the impact of water scarcity on health. Access to Sources of Drinking Water The results of the 2000 Population and Housing Census indicate that about 40% of the households in the country have access to pipe-borne water (14% within and 26% outside the households) and tankers provide water to 2% of the households. One third of the households obtain their drinking water from wells and boreholes while the remainder of the households (25%) depend on natural sources such as springs, rain water, rivers, streams, lakes and dugout wells. 92 POPULATION, HEALTH AND DEVELOPMENT Drinking water needs to be of a quality that denotes a tolerable level of risk. The quality of water that is consumed is widely known as an important transmission conduit for infectious diarrhoeal and other diseases. Thus, water produced for direct consumption and ingestion via food should be of a quality that does not pose a significant risk to human life. Figure 1 shows that a sizeable proportion of households in the country obtains drinking water from unprotected sources. Under normal circumstances, pipe-borne water is regarded as safe for human consumption. What one is not sure of is the extent to which the other sources are well protected. A significant proportion of the households consume water from rivers, streams, lakes, springs and dugout wells, a major health concern. The sources are indicative of a substantial risk to the health of the members of the households. Furthermore, where water supplies are intermittent as a rule rather than an exception, as in many parts of the suburbs in the capital cities and towns, the risk of contaminated water finding its way into the domestic water supplies will escalate. Even where water is supplied through multiple taps in the household, but the supply is intermittent as constantly being experienced in most parts of Accra, a further risk to health may result from mal-functioning of the water borne facilities. Figure 1 also shows that drinking water is obtained at different levels of service.Item Fertility decline in Ghana: Implications for public policy(Population, Health and Development in Ghana: Attaining the Millennium Development Goals, 2007) Gaisie, S.K.2 Chapter Fertility Decline in Ghana: Implications for Public Policy S. K. Gaisie Introduction The population of Ghana has undergone a structural transformation since the beginning of the fertility decline in the late 1980s. Accompanying the decline are a number of issues that need to be investigated or researched into in order to assess their demographic, social, political and economic impact. Sample surveys (i.e. 1960 Post-Enumeration Survey, 1968/69 Demographic Sample Survey and 1971 Supplementary Inquiry) provided the information required for determination of the level of fertility in the 1960s and 1970s. All the estimates of the total fertility rates indicated that the country’s fertility was high and stable, lying in the neighbourhood of between 6.7 and 7 children per woman. A total fertility rate of 6.9 children per woman appeared to be the most plausible estimate (Gaisie, 1969; 1974; Gaisie and deGraft Johnson, 1976). Estimates based on the 1979/1980 Ghana Fertility Survey (GHS) data indicate that total fertility rate for the period 1960s to mid-1970s ranged between 6.85 and 6.99 children per woman. Evaluation and adjustment of the data for the recent period (1975-1980) yielded a total fertility rate of 6.69 as compared with the reported one of 6.47 (Gaisie, 2005). All told, the estimates derived from the data sets spanning a period of more than 25 years show that the level of fertility was high and stable during the 1960s, 1970s and early 1980s. The reported total fertility rates derived from the 1993, 1998 and 2003 Demographic and Health Surveys data indicate a significant and steady fertility decline since then; falling from 6.43 in 1988 to 5.50 in 1993, 4.55 in 1998 and then to 4.44 in 2003. However, the need to detect and measure trends in fertility with accuracy and sensitivity in a society that is experiencing population expansion is crucial for competent planning. For instance, plausible fertility estimates based on reliable data are critical for construction of population projections as well as for monitoring and evaluating action programmes for reducing the rate of growth via family limitation. A number of estimation procedures and strategies were therefore employed to derive plausible estimates of fertility levels and trends during the transition period. The results are presented elsewhere (Gaisie, 2005). Substantive issues and their implications are the subject-matter of this chapter. Quantum and Pace of Decline Three estimation procedures yielded estimates which suggest that the level of fertility in Ghana fell from about seven children per woman in the 1960s and 1970s to 4.6 children per woman by the turn of the last century; a decline of 33% during the 43 year period (1960-2000) or an annual decline of 0.8% as depicted in Figure 1. The average number of children born to a Ghanaian woman was reduced by 2.3 children; a reduction of 0.05 children per year during the entire period. The pace of the decline, however, increased to 0.2 children per year during the late 1980s and the 1990s and slowed down considerably to 0.04 children per year by the beginning of the 21st century with the total fertility rate falling from 4.8 in the late 1990s to 4.6. The change was much more marked among the younger women (20-35-year olds) 14 POPULATION, HEALTH AND DEVELOPMENT than among the older cohorts, particularly during the second half of the 1990s. However, the decline appears to have stalled. Figure 1. Total Fertility Rate: 1960-2003 Fertility Decline and High Rate of Growth Fertility trends affect the rate of growth by determining the number of births women have, and the size of the different generations. In a majority of the African countries where fertility is above replacement level, children outnumber their parents by substantial amounts and the children in turn have more children than required to replace their parents’ generations even when fertility level is declining (Table1). Consequently, as fertility falls, the number of births to relatively large generations of parents is higher for some time than the number of deaths in the population, most of which are that of grand parents and great grand-parents. This process tends to maintain a relatively high positive population growth rate even though fertility is falling. In most of the countries where fertility rate is reported to be falling, overall population growth rates are relatively high, implying that fertility rate is still high and in consequence...Item Adolescent sexuality and reproductive health in Ghana: Some results from a survey of Cape Coast And Mankrong(Population, Health and Development in Ghana: Attaining the Millennium Development Goals, 2007) Kwankye, S.O.4 Chapter Adolescent Sexuality and Reproductive Health in Ghana: Some Results from a Survey of Cape Coast and Mankrong Stephen O. Kwankye Introduction Adolescent sexuality and reproductive health issues are increasingly becoming of concern in many sub-Saharan African countries. This is especially the case when viewed in the context of the HIV/AIDS pandemic, a situation , which puts many young persons particularly females at risk. This constitutes a serious problem considering that most of these sexual activities are taking place outside wedlock and without contraception. As a result, teenage pregnancies and their accompanying child delinquency and poor development of female adolescent victims are unfolding problems that Ghana will have to contend with for a long time. One fundamental barrier that has worked seriously against policies that have aimed at addressing adolescent sexuality problems in Ghana has been the sociocultural environment within which the interventions are being evolved and or implemented. In Ghana, it is felt in many circles that it is culturally unwelcome to discuss sexual issues with adolescents. Again, sections of the society and even some family planning service providers frown upon the provision of family planning services to these youngsters. For example, according to the 1994 Situation Analysis of Family Planning Service Delivery Points in Ghana, 40% of service providers expressed their unwillingness to provide family planning services such as intra-uterine device (IUD) and injectables to unmarried adolescents and 25% of them would not administer the pill under the same conditions (Ghana Statistical Service, 1994). Such an unfriendly socio-cultural environment has often overtly or covertly not permitted open and frank discussions regarding issues of sexuality and reproductive health particularly among adolescents. Thus, as a result of their engagement in unprotected sex, the chances of further enhancement of their socio-economic development are often and largely foreclosed due to unplanned pregnancies and, or sexually transmitted infections (STIs) including HIV/AIDS. In Ghana, the three Demographic and Health Survey reports of 1993, 1998 and 2003 have indicated that overall a little more than one in every 10 female adolescents of 15-19 years have begun childbearing at a time they are expected to be in school (GSS and MI, 1994; 1999; 2004). The conditions are again made fertile for criminal abortion to thrive in Ghana. Data are not readily available on abortion in Ghana, but in a society where adolescents are largely indulging in sex with little or no family planning practices, the probability exists for pregnant adolescents who still want to continue their education to resort to induced, and unsafe abortion which is likely to contribute to high maternal mortality ratios in Ghana. Data on reported AIDS cases in Ghana suggest that a higher proportion of HIV contraction takes place during adolescent ages of 15-19 years. For example, available data on reported AIDS cases by age indicate that for both males and females, almost 75% of the cases were reported among persons aged 20-39 years and 4% among ado54 POPULATION, HEALTH AND DEVELOPMENT lescents aged 15-19 years. The inference is that considering that the incubation period of the disease ranges between 5 and 12 years or more, it is possible that many of the reported cases in the age group 20-39 must have been contracted within adolescent ages. Adolescent childbearing rates in Ghana have been found to be highest in the Central Region in 1993 (33.3%) and 2003 (34.1%) (see GDHS reports of 1993 and 2003). At the same time, the region has been shown to have one of the highest levels of poverty in the country in 1998/1999 (Government of Ghana/UNFPA, 2004). Linked to the high sexual activity among young women is their low contraceptive use. For example, current contraceptive use for modern methods in 1993 was 5.0% and 8.3% among women of 15-19 and 20-24 years respectively compared to 9.3% among all women in Ghana (Ghana Statistical Service, 1994). The corresponding figures for 1998 were 4.8% and 10.4% among women of 15-19 and 20-24 years respectively as against 10.7% among all women in Ghana. In 2003, modern contraceptive use was 6.4% and 15.4% among married females of 15-19 and 20-24 years respectively compared to 20.7% among all women in the country. The implication is that low contraceptive use among adolescent and young women may foreclose education and employment opportunities to many of them as they expose themselves to risks of unplanned...Item Doing gender work in Ghana(Africa After Gender?, 2007) Manuh, T.7 Doing Gender Work in Ghana Takyiwaa Manuh “What can we do for African women?” “What about micro-credit?”1 my new friends asked, as we sat sipping wine in the lounge of a beautiful residence hall of a small American college in mid-2005. As the interrogation progressed, I was amazed at the almost absolute lack of knowledge about Africa and its people in the twenty-¤rst century by these well-meaning, well-educated senior women college professors attending a women’s studies conference. The exception was one person who had her own West African ties and whose son or daughter had almost been caught in the cross-¤ghting in la Côte d’Ivoire. Where and how was I expected to start off as I was inundated by the barrage of questions and liberal good feeling? How much of Africa was I expected to cover, and which African women would be the object of our concern that evening? I had escaped from the dance and was making my way to my dorm room, when I was hailed to join the group. I had accepted but had not bargained for the “African Women 101” course I was being called upon to deliver. The old weariness set in as I watched these specialists of Latin America and Asia attempt to explain their lack of speci¤c or even general knowledge of African issues in our highly interconnected globalized world where CNN beams news of happenings even as they occur. What indeed can any woman anywhere do for African women that they cannot do for themselves? How did this thinly disguised unconcern, shallowness, and ignorance repackaged as mild interest intersect with the almost frenzied activities and contestations around gender in several African countries by women who might claim kinship at a certain level with some of my new friends? The disconnect I was experiencing sent me back many years in recollection of another event. It was the early 1980s and this was an arid time in Ghana. Books and reading material were, like soap and sugar, considered “essential commodities.”2 In response to this scarcity, the Cultural Affairs Of¤cer at the United States Information Service provided some academics in the arts and social sciences at my university access to articles in two or three journals they considered valuable for their work. Typically, one selected a few articles from the table of contents of the chosen journals, and copies of these articles arrived free of charge. Signs: The Journal of Women in Society and Culture had been one of my selections, and through this facility, I was able to share in a larger intellectual community located elsewhere. However, it became increasingly dif¤cult for me to make any selections when the Signs table of contents arrived because I found it harder and harder to relate to what I considered to be abstract, surreal, and narcissistic theorizings on dreams, bodies, and other individualistic projects that increasingly suffused the pages of the journal. This was especially so as I compared these writings with the very real issues of lack of rights and democratic space, Structural Adjustment Programs (SAPs) and their privations, the increasing dictate of the international ¤nancial institutions in Ghana and several African countries, and the responsibilities and possibilities that faced me as a woman and scholar. My opinion of Signs persisted for much of the early to mid-1990s when I lived in the United States, and my disaffection was reinforced by what I experienced in women’s studies programs at the university where I was located. For someone who had been a scholar and an activist, these were very lonely times, as I found little to relate to in what was offered as women’s studies. Returning to Ghana in 1998, I was struck by the pace of work around democratization and political space, trade, economic policymaking, and gender, mostly by civil society activists. While both women and men worked on all the other issues, gender work was almost exclusively “women’s work,” even as it encompassed and extended beyond the issues civil society activists were engaged in. Thus, antiviolence projects and activities around women’s economic rights and political participation were mainly the domain of female gender activists, with the exception of a gender development “institute” whose executive director was male. How has gender become institutionalized around Africa and in Ghana? What issues have animated gender activism in Ghana? What forms have gender debates in Ghana taken and how...Item Introduction: When was gender?(Africa After Gender?, 2007) Miescher, S.F.; Manuh, T.; Cole, C.M.Introduction: When Was Gender? Stephan F. Miescher, Takyiwaa Manuh, and Catherine M. Cole In scholarship—as in real estate—location matters. This is especially true in the ¤eld of African gender studies. During the past two decades, the relationship between gender studies scholars based in Africa and those based in North America and Europe has been strained, even explosive. This is due in part to differences in political environments and experiences of racism, as well as interpretations of feminist ideologies and different political alliances and coalitions . North-South tensions erupted at a historic women’s studies conference in Nigeria in 1992, the ¤rst international conference on Women in Africa and the African Diaspora (WAAD). Convener Obioma Nnaemeka was driven by a concern about the commodi¤cation of African women in women’s studies and feminist scholarship and “their marginalization in the process of gathering, articulation , and disseminating knowledge” (1998a, 354). Nnaemeka brought together scholars and activists from inside and outside Africa. On the ¤rst day, three unanticipated controversies exploded: 1) a demand for the exclusion of white participants, 2) an objection to the presence of men, and 3) an ideological¤ght over different currents of feminism, such as (Northern/white) feminism, womanism, and Africana womanism. This episode serves as a revealing entry point into the themes and objectives of Africa After Gender? At the WAAD conference, identity politics drove much of the controversy: African-American and British-African participants¤rst raised the possibility of excluding the handful of whites who attended. Their concerns illustrated, as Nnaemeka describes it, “the complexity and heterogeneity of the category ‘woman’/‘black woman’”(1998a, 369). Most African participants, especially the Nigerian hosts, as well as some Diaspora Africans rejected the exclusion of whites. Participants from Southern Africa were, as one might expect,divided.The controversy revealed the powerful violence of racism that has affected people of African descent anywhere, from the Western hemisphere to Cape Town. However, as Nnaemeka argues, it also showed that in order for protests to be “strategically relevant,” they must be well chosen in terms of location and moment. Dialogues should not be abandoned for insurgency, “unless we have proven the inef¤cacy of the former” (ibid.). When, in her keynote address, Ama Ata Aidoo embraced the label “feminist,”she was urged by an African American to abandon the term and instead endorse “Africana woman- ism” (Aidoo 1998; Nnaemeka 1998a, 370). Generally, African participants were less interested in semantics, and they prioritized actions over the rhetoric of naming their struggles. Some foreign participants objected to the participation of male presenters. However, many African women responded that they had successfully collaborated with male scholars and activists in their joint endeavors for societal change. These divergent views on participation at the conference demonstrated how much location matters in the constitution of women’s studies and feminist scholarship. Sex-based and race-based exclusionary practices in the United States and Europe, such as the all-female classroom or the all-black organization, have a different meaning in most African settings. While separate gendered spaces including schools have a long history, political demands focus less on such gender divisions. Rather, activists struggle for improved health and education for African women. These were for many participants the main priority of the conference.1 The controversies that emerged at the WAAD conference provide an interesting case study that highlights the dif¤culty of forming coalitions around women’s and gender issues. One can see the arti¤ciality of any blanket statements about “women” in Africa which earlier generations of scholars were tempted to make in the face of an African studies discipline that had been overwhelmingly masculinist.2 Yet the WAAD conference also showed the strength of these alliances, for activists, bureaucrats, and scholars from all over the continent and, indeed, the world, attended the conference in droves. Their participation , however fraught, provided tangible evidence that something dramatic and palpable was happening with women’s and gender issues in Africa. Gender is one of the most dynamic areas of Africanist research today, as is evident by a host of new journals, articles, and books dedicated to the topic. Interest in gender is not just academic: the subject has gained widespread currency among the general populace in Africa, from taxi drivers and market traders to policymakers. Aided by nongovernmental organizations (NGOs) and foreign assistance programs that claim the concept in their mission statements, gender has come to mean something in Africa, even if there is little agreement about...