Regional Institute for Population Studies
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Item Women’s post-abortion contraceptive use: are predictors the same for immediate and future use?(University of Ghana, 2020-03-05) Kayi, E.; Biney, A.This study sought to identify the socio-demographic, reproductive, partner-related and facility-level characteristics which are associated with immediate and subsequent uptake of post-abortion contraception. The study used the 2017 Ghana Maternal Health Survey (GMHS) data which comprised 1,383 women who had an abortion within the five years preceding the survey. Binary logistic regression analyses were performed to examine associations between the predictor variables and outcome variables, both immediate and subsequent contraceptive use. The findings indicate that age, type of place of residence, and health provider’s pre- or post-abortion family planning counselling were significantly associated with both immediate and subsequent use of modern contraception. Compared to women had induced abortion service provision from health professionals, women who had their abortion from non-health professionals were twice as likely to use contraception immediately post-abortion. Among subsequent contraception users, the predictors included marital status, contraceptive use at index pregnancy, and place where abortion was performed. Partner-related characteristics were not significantly associated with both immediate and subsequent contraceptive use. The study findings are relevant and informative for designing target interventions to facilitate contraception use among young post-abortion women. Expanding access to and availability of post-abortion family planning counselling and services, in addition to the availability of a variety of modern contraceptives, is key to increasing the contraceptive prevalence rate among post-abortion womenItem The Role of Mobile Phones in the Social Lives of Informal Micro-Women Traders in Accra(University of Ghana, 2019-10-17) Ussher, Y.This article explores the functional role of mobile phones in livelihood development of Ghanaian women in the informal economy. With a qualitative approach and the Sustainable Livelihood Framework (SLF) providing a guide to the study, women micro-traders in four markets were interviewed to ascertain the spill over effects of mobile phones in trading onto in their social lives. The findings of the study showed that the integration of mobile phones into trading activities reduced transaction and transportation cost as well as wastage which in turn led to earning of better incomes. With such better incomes the livelihood outcomes of these traders have improved as they have become financially empowered to the extent of becoming sole breadwinners of their families and households, gain recognitions in the groups/associations they belong to and enhanced their socio-economic status. Such financial empowerment has changed the previous traditional trend of men being financially in charge of their families and households. Mobile phone, as livelihood asset (physical asset) has therefore led to better livelihood outcomes through the livelihood strategies, (i.e. market trade) these women traders involved in. With good livelihood outcomes, these women have overcome vulnerabilities and marginalisation in the Ghanaian economyItem 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 Community perceptions on sexual activity and stroke(University of Ghana, 2019-09-19) Sanuade, O.Stroke is a major cause of morbidity and mortality in Ghana and sometimes comes with multifaceted complications including sexual dysfunction. While evidence is clear that living with stroke can result in sexual dysfunction, there are contradictory views regarding the causal association between sexual activity and stroke. This study explores perceptions of Ghanaian local communities on the role of sexual activity on stroke causation. This was a cross-sectional qualitative study. Thirty (30) focus group discussions (FGDs) were conducted in five communities across Ghana (Ga Mashie, Tafo, Gyegyeano, Chanshegu and Agorve) between October and November 2017. Data were analysed through a thematic approach. Participants generally believed that sexual activity can cause a stroke. They mentioned that the dynamics through which sex can trigger a stroke include sex positions (i.e. having sex while standing and on the floor), high frequency of sex, having sex when older and engaging in indiscriminate sex. This study shows the need to pay critical attention to these community perceptions when developing intervention strategies for stroke in Ghana. This study also highlights that discussion about sexual activity in Ghana is more complex than the current health education programme allows, and so demands a ‘comprehensive sex education approach’ rather than a ‘disease-centered approach’.Item Postpartum and Post-abortion Contraception and Sexual Inactivity among Single Adolescent and Young Adult Females in Ghana(University of Ghana, 2019-04-25) Atiglo, Y.This study assesses the relationship between pregnancy outcomes and pregnancy-preventive behaviours among unmarried young women intending to delay childbearing. Using data from the 2014 Ghana DHS among 1,118 single women aged 15–24 years, the study assessed how childbirth and abortion are related with sexual inactivity and use of modern contraception. Postpartum women were thrice as likely as nulligravid women and twice as likely as post-abortion women to use contraceptives. Post-abortion women were least likely to be sexually inactive. Duration of sexual experience was positively associated with the likelihood of a met need, particularly among the postpartum, and negatively associated with sexual inactivity among the ever-aborted. Prior pregnancy outcomes have significant implications for secondary abstinence and contraceptive use among unmarried young women. Efforts must be strengthened towards increasing access to modern contraceptives for young women who present for abortions in GhanaItem Contraceptive Use and Method Mix Dynamics in Sub-Saharan Africa(University of Ghana, 2019-02-14) Bawah, A.Method mix refers to the distribution of contraceptive use among the sexually active population. The subject of contraceptive method mix has become of specific importance because it provides perspectives on both the demand and supply side determinants of contraceptive prevalence. This paper proposes to conduct extensive analysis of trends in contraceptive use and method mix dynamics in sub-Saharan Africa. The study examines how contraceptive method mix dynamics have changed over time, assesses trends by marital status, and investigates determinants of method choice and their changes over time. Preliminary findings and their implications are discussed.Item 'A War Remembered: Biafra at 50'(2018-03-29) Phillips, J.F.; Bawah, A.By some estimates, the Nigerian Civil War was the greatest catastrophe ever to have occurred in Africa. Over the June, 1967 to January, 1970 period, the conflict may have claimed as many as two million lives. This presentation will be delivered by a former relief officer of the International Committee of the Red Cross who participated in the Biafra relief action over the May to October, 1969 period as an entry-level logistics worker, and from November 1969 to July 1970 as a “UN Forward Observer” assigned to the Third Division of the Nigerian Army. The presentation outlines causes and consequences of the conflict, procedures followed by the relief action, and examples of strategies that failed to have their intended impact. Lessons from Biafra attest to the value of implementation science in crisis situations. Ghana’s humanitarian diplomacy prior to the conflict will be reviewed.Item Orthomolecular Medicine and Biochemical Basis of Health(2018-02-22) Olu-Sawyerr, E.; Biney, A.Dr. Olu-Sawyerr has specialised in the treatment of chronic/degenerative diseases, including cancer and infertility, and success rate in all cases is remarkably high. This seminar will focus on a discussion about his use of orthomolecular medicine as the best means to improving and sustaining one's healthItem Community-Based Health Planning and Services (CHPS) as a Gateway to Reducing Maternal and Child Mortality in Rural Ghana - A Community-level Analysis(2017-11-09) Wright, K.Institutional maternal mortality in Ghana has decreased between 1990 and 2010, by a narrow margin of 216 to 164 deaths per 100,000 live births. Continued focused intervention is essential to accelerate the rate of decline. Contributing factors of this trajectory have been attributed to sustainability of quality access to care and infrastructure, workforce availability, and leadership stability. Strengthening of community-based primary health services such as, Community-Based Health Planning and Services (CHPS) aims to reduce mortality by removing financial barriers and improving quality access to care. While quantitative data is essential, studies often overlook the community level impact of health systems. Transcripts from qualitative group discussions within 8 communities- functional and non-functional CHPS zones- in the Northern and Volta regions of Ghana (2017), were analyzed to critically assess communities’ experiences with community health services and their vital role in improving health outcomes, and reducing maternal and child mortality in the region.Item Estimating the Cost of Primary Healthcare Delivery in Ghana: Evidence from a Three-year Study of Seven Districts in Northern Ghana(2017-11-09) Kanmiki, E.Background: Over the past two decades, Ghana has developed a comprehensive community-based primary healthcare services program as its flagship strategy for achieving universal access to healthcare. However, there is paucity of knowledge on the cost burden of delivering these services so as to enhance efficient allocation of resources, planning, budgeting and forecasting. This paper provides a cost analysis of primary healthcare services in seven rural districts of northern Ghana. Methods: Cost data form public primary healthcare facilities from seven districts in the Upper East region of Ghana were systematically collected over a three-year period. Adapting five health system building blocks as analytical cost components, we computed the unit cost, total cost and per capita cost of primary healthcare service delivery. Results of both financial and economic cost are presented. Internally generated funds and the quantum of cost recovered over the study period were also examined. Results: The financial cost of primary healthcare delivery was ~$11 per capita and that of economic cost was ~$10 per capita per year. There was not much difference in per capita cost over the three-year study period. Human resource was the highest cost component accounting for about 77% of cost, followed by medicines (13.4%), service delivery (8.0%), leadership (0.9%) and health information cost (0.6%). Only 23% of cost was recovered through internally generated funds. Conclusion: The per capita cost of delivering community-based primary healthcare services in Ghana is substantially low. Human resource is the highest cost component of primary healthcare delivery in Ghana. Internally generated funds amounted to only a small fraction relative to cost incurred. This raises issues of self-sustainability and depicts the continuous huge dependence on government and external donor support.Item Polygamy and Welfare Implications for Women: Evidence from 12 West African Countries(2017-09-28) Owoo, N.; Asuming, P.Despite a decrease in its prevalence over the past century, polygamy remains a prominent feature in many African countries. While there is no universal consensus, there is a general negative perception of the practice of polygamy, given the noted adverse effects of this practice on women, and often times, children as well. Using data from recent rounds of the Demographic and Health Surveys on 12 West African countries, and a series of pooled probit estimations, the study seeks to examine the evidence on the correlation between polygamy and women’s acceptance of domestic violence and their degree of autonomy and decision-making power within the household. We address potential selection complications by employing a propensity score matching (PSM) technique. We find that while women in polygamous households are more likely to be accepting of abuse, they are also more likely to have autonomy in various decision-making processes within their households. Results also indicate that although polygamy is correlated with women’s acceptance of abuse, some of these effects are mediated by the socioeconomic statuses of the various households. This research provides some useful policy implications. First, calls to ban the practice of polygamy may be supported, given that this practice is affiliated with a higher acceptance of abuse by women. Nonetheless, the higher associated autonomy and decision-making power for women in polygamous unions should also be taken in consideration as a potential unexpected outcome of these unions. Second, efforts to increase women’s autonomy and reduce domestic violence may also take into factors such as the age at first marriage, employment and education of women.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 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 Trade of Analysis for Emission Reduction (The Case of the Ethiopia Sugar Corporation)(2016-03-15) Kassa, E.There is an emerging expansion in area and investment in the Ethiopia sugar production. As sugarcane area expands, the pre harvest burning which is practiced to remove the leaf from the steam is growing and this contributes to the increase in air pollution. Understanding environmental and economic impacts of this practice will help to develop economically feasible and environmental friendly production system. Thus, the study aims to identify the trade-offs between economy and environment with regard to the pre harvest burning as well as to suggest policy measure that will lead the ESC to have a contribution to fulfill some part of the INDC of Ethiopia.Item Underutilized Indigenous Vegetables (UIVs) for Dietary Diversity: Implications for food security in the era of Climate Change in Southwest Nigeria(2016-03-15) Abu, M.; Tanimonure, V.A.With resurgence in the importance of Underutilized Indigenous Vegetables (UIVs) in human nutrition, income generation and adaptation to climate change in South west Nigeria through NiCanVeg project, there is need to empirically validate the impact of the project on the dietary diversity of the participants. A multistage sampling technique will be employed to select 120 participants and 120 non-participants in the study area. The study will use a well-structured questionnaire to elicit information from the respondents. The data collected will be analysed using descriptive statistics, dietary diversity score, propensity score matching and logit regression. The study envisaged better dietary diversity score among the participants.Item Participatory Geographical Information System (PGIS) and drivers of Mangrove forests loss and their implications on the people’s livelihoods(2016-03-10) Zahor, Z.K.; Codjoe, S.N.A.Tanzania’s coastal communities, including the people of Zanzibar, largely depend on mangroves for fishing, wood for construction and for fuel. The increasing threat of mangroves disappearance due to anthropogenic and climate change factors would therefore affect the livelihood of coastal communities living in close proximity to the said forests. In the last decade, there has been a strong drive towards integrating Geographical Information System (GIS) into community-cantered initiatives, particularly to deal with spatial information gathering and forest planning. Despite the increased use of participatory GIS methods in the developed and developing world, little has been published in Africa on the innovation because of cost and low accuracy levels of PGIS compared with conventional GIS. Moreover, most studies conducted on PGIS and forest management have been at the national and regional levels. This situation demonstrates the need for local scale studies on PGIS and the contribution of anthropogenic and climatic factors on mangrove forest loss. A number of studies have been conducted in Zanzibar on GIS and PGIS and forest planning and management. Majority of the research activities have been focusing on farming strategies, landscape characterization and community stakeholders’ knowledge in landscape assessments. However, studies on mangrove forest loss have been few. Majority of these few studies conducted in Zanzibar have relied on conventional GIS and non-spatial participatory approaches. These techniques often show the status of the situation but such tools can hardly capture the reasons and the manner in which the situation occurs. Participatory GIS is highly needed to provide more precise information about all aspects of mangrove forests loss. Moreover, most PGIS studies conducted in Zanzibar, like in other developing countries, have only involved local communities during data collection. This approach has increased the many questions on the authenticity of PGIS output. This study therefore will involve local people in data processing and analysis, which is a new dimension in the PGIS application. In this research local knowledge will be collected through traditional public meeting, GPS transect walks and mapping exercise using the most recent digital geo-referenced aerial photographs (2015, 0.5m pixel size). Kernel density and hotspot techniques will be used to analyse information from community mapping while supervised classification technique will be used to analyse satellite images so as to inform on the status and trend of mangrove forest.