Research Articles

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A research article reports the results of original research, assesses its contribution to the body of knowledge in a given area, and is published in a peer-reviewed scholarly journal. The faculty publications through published and on-going articles/researches are captured in this community

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Now showing 1 - 10 of 74
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    Design and methodology of a mixed methods follow-up study to the 2014 Ghana Demographic and Health Survey
    (Global Health Action, 2017) Staveteig, S.; Aryeetey, R.; Anie-Ansah, M.; et al.
    Background: The intended meaning behind responses to standard questions posed in large-scale health surveys is not always well understood. Systematic follow-up studies, particularly those that pose a few repeated questions followed by open-ended discussions are well positioned to gauge the stability and consistency of data and to shed light on the intended meaning behind survey responses. Such follow-up studies require extensive coordination and face challenges in protecting respondent confidentiality during the process of recontacting and reinterviewing participants. Objectives: We describe practical field strategies for undertaking a mixed methods follow-up study during a large-scale health survey. Methods: The study was designed as a mixed methods follow-up study embedded within the 2014 Ghana Demographic and Health Survey (GDHS). The study was implemented in 13 clusters. Android tablets were used to import reference data from the parent survey and to administer the questionnaire, which asked a mixture of closed- and open-ended questions on reproductive intentions, decision-making, and family planning. Results: Despite several obstacles related to recontacting respondents and concern about respondent fatigue, over 92 percent of the selected sub-sample were successfully recontacted and reinterviewed; all consented to audio recording. A confidential linkage between GDHS data, follow-up tablet data, and audio transcripts was successfully created for analysis. Conclusions: We summarize the challenges in follow-up study design, including ethical considerations, sample size, auditing, filtering, successful use of tablets, and sharing lessons learned for future follow-up surveys.
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    The Associations of Dyadic Coping and Relationship Satisfaction Vary between and within Nations: A 35-Nation Study
    (Frontiers in Psychology, 2016) Hilpert, P.; Aryeetey, R.; Randall, A.K.; et al.
    Objective: Theories about how couples help each other to cope with stress, such as the systemic transactional model of dyadic coping, suggests that the cultural context in which couples' lives influence how their coping behavior affects their relationship satisfaction. In contrast to the theoretical assumptions, a recent meta-analysis provides evidence that neither culture nor gender influences the association between dyadic coping and relationship satisfaction, at least based on their samples of couples living in North America and West Europe. Thus, it is an open question whether the theoretical assumptions of cultural influences are false or whether cultural influences on couple behavior just occur in cultures outside of the Western world. Method: To examine the cultural influence, using a sample of married individuals (N = 7973) from 35 nations, we used multilevel modeling to test whether the positive association between dyadic coping and relationship satisfaction varies across nations and whether gender might moderate the association. Results: Results reveal that the association between dyadic coping and relationship satisfaction varies between nations. In addition, results show that in some nations the association is higher for men and in other nations, it is higher for women. Conclusions: Cultural and gender differences across the globe influence how couples’ coping behavior affects relationship outcomes. This crucial finding indicates that a couple relationship education programs and interventions need to be culturally adapted, as skill trainings such as dyadic coping lead to differential effects on relationship satisfaction based on the culture in which couples live.
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    Prevalence and predictors of overweight and obesity among school-aged children in urban Ghana
    (BMC Obesity, 2017) Aryeetey, R.; Lartey, A.; Marquis, G.S.; et al.
    Background: Childhood overnutrition is a serious public health problem, with consequences that extend into adulthood. This study aimed to determine the prevalence and determinants of overweight and obesity among school-age children in two urban settings in Ghana. Methods: This cross-sectional study involved 3089 children (9–15 years) recruited between December 2009 and February 2012 in Accra and Kumasi, Ghana. Socio-demographic, dietary, and physical activity data were collected using pretested questionnaires. BMI-for-age z-scores were used to categorize anthropometric data of the children as thin, normal, or overweight/obese. Determinants of overweight were examined using multiple logistic regressions. Results: Seventeen percent of children were overweight or obese. Children who reported lower participation (< 3 times/week) in sports activity were 44% more likely to be overweight or obese (AOR = 1.44; 95% CI: 1.07, 1.94). Maternal tertiary education (AOR = 1.91, 95% CI: 1.07, 3.42), higher household socioeconomic status (AOR = 1. 56, 95% CI: 1.18, 2.06), and attending private school (AOR = 1.74, 95% CI: 1.31, 2.32) were also associated with elevated risk of overweight and obesity. Conclusions: Physical inactivity is a modifiable independent determinant of overweight or obesity among Ghanaian school-aged children. Promoting and supporting a physically active lifestyle in this population is likely to reduce the risk of childhood overnutrition.
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    Dietary patterns and associated risk factors among school age children in urban Ghana
    (BMC Nutrition, 2018) Ogum Alangea, D.; Aryeetey, R.N.; Gray, H.L.; et al.
    Background: Understanding dietary patterns in the study of diet-disease relationships is crucial for designing dietary behavior interventions. This study aimed to determine associations between dietary patterns and background characteristics among school-age children (9–15 years) in Ghana. Methods: A cross-sectional sample of 487 urban-dwelling children aged 9–15 years was recruited using simple random sampling from 24 schools (12 private and 12 public) in the Ga-East Municipality in Southern Ghana. A 7-day food frequency questionnaire was used to record children’s consumption of over 100 unique food items. Principal component analyses based on 14 food groups were used to describe emerging dietary patterns (DP). BMI-for-age z-scores segregated by sex were derived using WHO Anthro plus software. Linear regression was used to test associations between ‘diet factor’ scores, and weight status controlling for age. Results: Four DPs were identified that explained 53.2% of the variation in the diets of children: (1) energy dense; (2) starchy root staples and vegetables; (3) cereal-grain staples and poultry; and (4) fish & seafood. Energy-dense DP characterized by processed meat, fried foods, and sugary foods was associated with child overweight/obese status after controlling for age, sex, SES, and school type [F(5, 484) = 6.868, p < 0.001]. Starchy root with vegetable DP was negatively associated with overweight/obese status, private school attendance, and higher SES after controlling for age at the bivariate level. However, the relationship between ‘starchy root staples and vegetables’ DP and overweight/obese status lost significance after controlling for other covariates. Conclusion: Our data identified energy-dense dietary patterns to be significantly associated with childhood overweight and obesity. Targeted dietary messages are required to address energy-dense dietary patterns among school-age children.
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    Socio-economic differences in cost of pregnancy-related health services in the peri-urban Accra, Ghana
    (Journal of Public Health, 2014) Aikins, M.; Aryeetey, R.; Dako-Gyeke, P.; et al.
    Background Financial and physical barriers are known to limit access to maternal health services in developing countries. These limitations are often compounded by the low socio-economic status of women. This study examined socio-economic differences in health services costs incurred by pregnant women. Methods A cross-sectional cost survey of 300 women who had delivered a live birth in the last 12 months was undertaken. Results Majority of the women were aged between 20 and 39 years. About 63% of the women claimed they were registrants of the National Health Insurance Scheme (NHIS). However, only 64% of them provided valid NHIS identification cards. There were relatively more insured women in the rich quintiles (44%) compared with insured women in the poor quintiles (33%). Generally, women who were in the rich quintile incurred the highest average medical and non-medical costs, spent the highest time before service provision, and lost the highest average incomes. Conclusions Women's socio-economic differences play a critical role in access to health services. We recommend that awareness campaigns on the NHIS must be intensified. The Ghana Health Services through its Community-based Health Planning Service should carefully structure its home visits to cover education on pregnancy-related health services.
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    Contribution of scaling up nutrition Academic Platforms to nutrition capacity strengthening in Africa: local efforts, continental prospects and challenges
    (Proceedings of the Nutrition Society, 2017) Laar, A.K.; Aryeetey, R.N.O.; Annan, R.; et al.
    Addressing contemporary nutrition problems often requires the application of knowledge from multiple disciplines. The scaling up nutrition (SUN) movement harnesses multiple sectors for effective global and in-country planning and implementation. Although the role of knowledge networks (academia and research institutions) is recognized, the how of engaging knowledge networks in the current SUN architecture is only now becoming apparent. For relevant sectors to play their roles effectively, observed capacity gaps, particularly in developing country settings, need to be addressed. The present paper presents the work being undertaken by the Ghana SUN Academic Platform (AP), a local knowledge network, towards strengthening nutrition capacity in Ghana. The AP presently provides technical support, evidence, and capacity towards scaling up effective nutrition interventions in Ghana and beyond. The data presented draws heavily on the observations and collective experiences of the authors in practice, complemented by a review of relevant literature. The ultimate goal of the AP is to build a cap acity of professionals from nutrition and cognate sectors (including planning, agriculture, health, economics, research, and academia). This is an essential ingredient for effective and durable SUN efforts. The paper recognizes that both disciplinary and interdisciplinary capacity is required for effective SUN efforts in Africa, and offers an approach that utilizes cross-sector/inter-professional, peer-learning, and experiential learning initiatives.
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    Child development in rural Ghana: Associations between cognitive/ language milestones and indicators of nutrition and stimulation of children under two years of age
    (Canadian Journal Of Public Health, 2017) Ahun, M.N.; Aryeetey, R.; Colecraft, E.; et al.
    OBJECTIVES: Two studies aimed to assess the provision of nutrition and psychosocial stimulation in the home and to examine associations between mental development and nutrition and stimulation using a validated measure of development milestones. METHODS: The first study consisted of secondary analyses of health and nutrition data from 1081 mother-child pairs (the children aged 0–12 months) and their households in Ghana’s Eastern Region. For the second study, the Ghana Milestones Measure, consisting of items assessing cognitive and language development, was used to assess child development in a subsample (N = 330) of Study 1 participants one year later (children 10–24 months of age). This measure was mother-reported and had been validated in a separate community in Ghana. Correlation and linear regression analyses were used to analyze the data. RESULTS: Family assets and maternal education were identified as key factors of the family context. Both variables were positively associated with preventive health practices (r = 0.08 to 0.13, p < 0.0001 to 0.01), and dietary diversity (r = 0.15, p = 0.0001 to 0.0006), and negatively associated with maternal depressive symptoms (r = −0.19 to −0.12, p < 0.0001). Taller children had higher receptive (standardized beta = 0.16; p = 0.04) and expressive (0.21; 0.003) language, but not cognitive (0.15; 0.07) milestone scores, and psychosocial stimulation was positively associated with all three milestones (receptive = 0.13, p = 0.01; expressive = 0.21, p < 0.0001; and cognitive = 0.24, p < 0.0001). CONCLUSION: Our study provides the first validated measure of children’s language and cognitive development in Ghana, finding associations with nutrition and stimulation. The Ghana Milestones Measure can be used to assess and help promote children’s mental development.
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    Breastfeed4Ghana: Design and evaluation of an innovative social media campaign
    (Maternal & Child Nutrition, 2019) Harding, K.; Aryeetey, R.; Carroll, G.; et al.
    Although targeting health behavior change through social media campaigns has gained traction in recent years, few studies have focused on breastfeeding social media campaigns. Within the context of rising social media utilization and recent declines in exclusive breastfeeding practices in Ghana, we implemented Breastfeed4Ghana is a Facebook‐ and Twitter‐based breastfeeding social media campaign. This study determined the feasibility of implementing Breastfeed4Ghana and evaluated its impact on breastfeeding knowledge in Ghana. Key performance indicators of the campaign were monitored on social media platforms, Facebook and Twitter. An online cross‐sectional survey was conducted across three time points (n = 451) assessed breastfeeding knowledge, campaign exposure, and understanding and acceptability of Breastfeed4Ghana among Ghanaian adults. Modified Poisson models were used to assess the relationship between campaign exposure and breastfeeding knowledge, adjusting for survey time point, sex, and parenthood status. The campaign acquired 4,832 followers. Based on follower demographics collected from Facebook and Twitter analytics, the target population was successfully reached. Campaign exposure among survey participants was 42.3% and 48.7% at midline and endline, respectively. Campaign acceptability was high (>90%), and >44% of those exposed to the campaign also shared the campaign with others. However, 61.0% of those exposed did not know or could not remember the purpose of the campaign. Campaign exposure was not associated with higher breastfeeding knowledge (APR [95% confidence interval] = 0.96 [0.73, 1.26]). Breastfeed4Ghana was highly feasible. However, campaign understanding yielded mixed findings and may explain the limited impact on breastfeeding knowledge.
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    Moringa Oleifera Leaf Consumption On The Vitamin A And Haematological Status Of School Children In Ada-East District, Ghana
    (Int. J. Food, Nutrition and Public Health, 2017) Glover-Amengor, M.; Aryeetey, R.; Owusu, W.B.; et al.
    Background: Vitamin A deficiency (VAD) could be prevented by the consumption of pro-vitamin A (β-carotene)-rich Moringa oleifera (M. oleifera) leaves. M. oleifera grows well in many developing countries and dried leaves also retain a high percentage of β-carotene in storage; they could thus serve as an excellent, convenient source of this pro-vitamin A carotenoid. This study assessed the efficacy of the supplementation of dried M. oleifera leaves on the vitamin A and haematological status of children in Ada-East district, Ghana. Methodology: Children aged 5–12 years were supplemented thrice a week at 0.2 g/kg body weight for nine weeks. Background data were collected on the socio-demographic status of the children. Data were collected on the children's vitamin A and haematological status at baseline and at the end of the study. Malaria and hookworm morbidity were also assessed at baseline and the end of the study. Results: There was a significant increase in mean serum vitamin A levels after supplementation (end of study) in the intervention group (p,0.05), but not in the control group. Haematological parameters Haemoglobin (HGB), Red Blood Count (RBC), Haematocrit (HCT), and Mean Corpuscular Volume (MCV) did not show any significant changes in either group (p,0.05). A bivariate analysis, however, showed a significant association between vitamin A and haematological indices in the intervention group, but not in the control group. Conclusion: M. oleifera leaf consumption significantly increased the vitamin A status of children in Ada-East district, Ghana, has the potential to increase children's haematological status. It could thus play a major role as a food-based strategy in vitamin A deficiency control.
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    Conference on ‘Nutrition dynamics in Africa opportunities and challenges for meeting the sustainable development goals’
    (Proceedings of the Nutrition Society, 2017) Aryeetey, R.; Colecraft, E.; Holdsworth, M.; et al.
    Although a substantial amount of nutrition research is conducted in Africa, the research agenda is mainly donor-driven. There is a clear need for a revised research agenda in Africa which is both driven by and responding to local priorities. The present paper summarises the proceedings of a symposium on how evidence can guide decision-makers towards context-appropriate priorities and decisions in nutrition. The paper focuses on lessons learned from case studies by the Evidence Informed Decision Making in Nutrition and Health Network implemented between 2015 and 2016 in Benin, Ghana, and South Africa. Activities within these countries were organised around problem-oriented evidence-informed decision-making (EIDM), capacity strengthening and leadership, and horizontal collaboration. Using a combination of desk-reviews, stakeholder influence-mapping, semi-structured interviews and convening platforms, these country-level studies demonstrated a strong interest in partnership between researchers and decision-makers, and the use of research evidence for prioritization and decision-making in nutrition. Identified capacity gaps were addressed through training workshops on EIDM, systematic reviews, cost-benefit evaluations, and evidence contextualization. Investing in knowledge partnerships and the development of capacity and leadership are key to driving the appropriate use of evidence in nutrition policy and programming in Africa.