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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Item Improving Health Outcomes By Strengthening Public Sector Capacity In Social And Behaviour Change Programming In Nigeria: A Qualitative Study.(BMJ Group, 2025-01-02) Ankomah, A.ABSTRACT Objective This paper examines the outcomes of the public sector capacity strengthening (PSCS) approach and how they contribute to the promotion of maternal, newborn, and child health, and nutrition (MNCH+N), family planning (FP) and malaria prevention-related outcomes. Design The qualitative study implemented from July to August of 2022 used the outcome harvesting methodology and key informant interviews to elicit information including most significant change (MSC) stories to evaluate project outcomes over 5 years (2017–2022). Setting The study was conducted in Sokoto, Kebbi, Nasarawa, Bauchi and Ebonyi states of Nigeria. Participants The study focused on public sector stakeholders who were exposed to the PSCS intervention and were selected from government agencies. Nine study participants were engaged per state, bringing the total number of participants to 45. Data were analysed thematically and elicited MSC stories were analysed for content. Results The PSCS approach empowered stakeholders at the individual level to disseminate MNCH+N, FP and malaria prevention messages, monitor health and social and behaviour (SBC) activities and increase the demand for health services. At the organisational level, the approach facilitated coordination of SBC activities, enabled training cascades and promoted adherence to health service guidelines. At the system level, it strengthened ward development committees to address health challenges. Challenges hindering stakeholders’ application of PSCS-acquired skills include inadequate workforce, negative attitudes of health workers, funding constraints, cultural barriers, lack of government ownership and limited accessibility. Conclusions This study shows that the PSCS approach is an effective model to scale up capacity for SBC in MNCH+N, FP and malaria prevention programmes. In response to documented supply-side challenges impeding the application of gained knowledge and skill, we recommend inclusive health worker recruitment, sensitisation programmes for health workers, government ownership, improved security, healthcare infrastructure and transportation systems.Item Energy Consumption And Inclusive Growth In Sub-Saharan Africa: Does Foreign Direct Investment Make A Difference.(Elsevier Ltd., 2025-01-24) Abor, J. Y.In line with the quest to achieve inclusive and sustainable growth, this paper examines the potential impact of energy consumption and foreign direct investment (FDI) and their interactive effect on inclusive growth for 32 Sub-Saharan Africa (SSA) countries from 2000 to 2019. The results of the two-stage system generalised method of moment (2SGMM) show that energy consumption induces inclusive growth. However, there is evidence of a non-linear relationship between FDI and inclusive growth, where FDI dampens inclusive growth to a certain point and begins to induce it after that point. Notably, the results reveal that FDI can effectively form synergies with both renewable and non-renewable energy consumption to promote inclusive growth in SSA. Also, our empirical results from the GMM is robust to Diskroll and Kraay methodology, which caters for cross-sectional dependence. We recommend that African leaders focus on attracting FDI to finance their energy needs, partic ularly in the area of low-carbon or renewable energy sources, by leveraging private sector capital investments to achieve inclusive growth and also promote sustainable development.Item Caregiver Acceptability Of Seasonal Malaria Chemoprevention In Two Districts In The Upper West Region, Ghana: A Cross-Sectional Study.(Springer Nature, 2025-01-14) Diarra, Y.; Bonful, H. A.; et alAbstract Background Acceptability of malaria chemoprevention interventions by caregivers is crucial for overall programme success. This study assessed coverage and acceptability of Seasonal Malaria Chemoprevention (SMC) in selected com munities in the Northern part of Ghana. Methods An analytical cross-sectional design was conducted from“July 23rd to August 4th, 2020—a 12-day period that covered 5 days of the frst SMC implementation cycle and 7 days post-implementation. Using a stratifed multi stage sampling technique, a total of 495 caregivers providing care for 569 eligible children aged 3–59 months from randomly selected households in the study communities were enrolled into the study. Acceptability of SMC was assessed on a set of 19 questionnaire items-8 of the items measured caregivers’ perceptions and 11 items meas ured children’s reaction to administered medicines. Univariable and stepwise multivariable logistic regression analyses were performed to assess the predictors of acceptability of SMC at a 95% confdence interval and a p-value of 0.05. Results SMC coverage was 95.1% (541/569). Caregivers had a good level of knowledge of SMC (n=475; 96.0%; 95% CI 94.2—97.7%) and a good perception of SMC (n=471; 95.2%; 95% CI 93.3–97.0). Seven out of ten caregivers (70.9%; 95% CI 66.9–74.9%) had good acceptability of SMC. For 7 out of 28 children who did not receive the SMC interven tion, their caregivers intentionally refused them the intervention. Of those that received the treatment, 17.2% (n=85; 95%CI 13.8–20.5%) of caregivers had at least one leftover amodiaquine tablet after the third day of treatment. Caregiv ers who practice Christianity or Islam had better acceptability than caregivers who practice African traditional religion (p<0.001). Conclusion Health authorities and stakeholders can work towards bridging the gap between knowledge and SMC treatment practices of caregivers through continuous education, adherence counseling, and efective monitoring of SMC practices in malaria-endemic countries. Keywords SMC, Caregivers, Malaria, Acceptability, Ghana, Upper West region, Amodiaquine–sulfadoxine– pyrimethamineItem Balancing finance and sustainability: The impact of financial access on carbon emissions through innovation and entrepreneurship in a global study.(Elsevier Inc., 2025-01-13) Domfe, G.This study examines the interplay between financial access, innovation, entrepreneurship, and carbon emissions using a dataset of 149 countries over 24 years (2000–2023). Employing two stage least squares (2SLS) techniques to address endogeneity, the findings reveal that financial access significantly boosts innovation and entrepreneurship, which are key drivers of economic growth. However, financial access may also increase carbon emissions if not aligned with sus tainable practices. Innovation reduces emissions by fostering environmentally friendly technol ogies, while entrepreneurship initially contributes to emissions but can mitigate this effect when supported by sustainable financial practices. The study highlights the importance of financial policies that promote green innovation and sustainable entrepreneurship, offering actionable insights for policymakers to achieve economic growth while addressing global carbon emissions.Item AP39, A Novel Mitochondria-Targeted Hydrogen Sulfide Donor, Promotes Cutaneous Wound Healing In An In Vivo Murine Model Of Acute Frostbite Injury(Elsevier Masson SAS., 2025-01-28) Dugbartey, G.J. et alFrostbite injury refers to cold tissue injury which typically affects the peripheral areas of the body, and is associated with limb loss and high rates of morbidity. Historically, treatment options have been limited to supportive care, leading to suboptimal outcomes for affected patients. The pathophysiology of frostbite injury has been understood in recent years to share similarity with that of cold ischemia-reperfusion injury as seen in solid organ transplantation, of which mitochondria play an important contributing role. The present study investigated whether AP39, a novel mitochondria-targeted slow-releasing hydrogen sulfide donor, applied top ically in a vehicle cream at 200 nM or 1 µM could mitigate frostbite injury and promote wound healing in mice. Frostbite injury was induced continuously for 3 min on the dorsal skin of C57BL/6 mice (Mus musculus) using magnets frozen on dry ice (-80 ◦C). AP39, delivered via a vehicle cream, was used daily to treat frostbite injury until animals were euthanized on day 15 after induction of frostbite injury. Wound tissues were stained with hematoxylin and eosin along with immunofluorescence staining with cleaved caspase-3, CD31, KI-67, CD163, fibronectin and cytokeratin. While 200 nM AP39 improved granulation tissue maturation (p < 0.001), angio genesis (p < 0.01) and cell proliferation (p < 0.001) compared to vehicle control, 1 µM AP39 further increased granulation tissue formation compared to other frostbite groups (p < 0.001). Thus, AP39 promoted frostbite wound healing, and therefore could be considered as a treatment option for patients with frostbite injury.Item Antimicrobial Resistance Levels of Non-Tuberculous Bacteria Isolates from Sputum of TB Patients in Ghana.(Dove Medical Press Limited, 2024-12-18) Morgan, P.A.; Ntiamoah, D.O.; Asare, P.; Mintah, I.S.; Osei-Wusu, S.; et alBackground: Patients with tuberculosis (TB) often harbor diverse bacteria in their sputum, including both commensal and opportunistic pathogens. This study aimed to characterize the sputum microbiota of TB patients before and after the intensive phase of anti-TB treatment and assess changes in bacterial diversity and antibiotic resistance profiles. Methods: A total of 162 patients with TB (128 males, 34 females; age range 18–82 years) provided sputum samples at baseline, of which 72 provided follow-up sputum after two months of intensive phase treatment. Sputum samples were cultured on standard agar plates, and distinct colonies were identified by Gram staining and bio-typing using MALDI-TOF mass spectrometry. Antibiotic susceptibility testing of the identified Gram-positive and Gram-negative bacteria was performed using the Kirby–Bauer method according to the CLSI guidelines. Results: At baseline, 209 bacterial isolates were recovered, dominated by Gram-positive bacteria (GPB), particularly Streptococcus oralis (19.6%) and Staphylococcus aureus (13.9%). After treatment, the isolation rate significantly decreased (from 129% to 95.8%; p = 0.000002), with a shift towards Gram-negative bacteria (GNB) dominated by E. coli. High rates of antibiotic resistance were observed for both the GNB and GPB, notably to ampicillin (86.7%), tetracycline (74%), amoxicillin (70.3%), and sulfamethoxazole (63%) for GNP, and PEN (76.9%) for the GPB. 53% of S. aureus isolates were phenotypic Methicillin-resistant S. aureus (MRSA) and 57.7% of suspected extended-spectrum Beta-lactamase (ESBL) producers were confirmed positive, predominantly carrying the blaCTX-M-1 gene. Conclusion: The observed antibiotic resistance among the identified isolates, including MRSA and ESBL, underscores the need for routine antibiotic susceptibility testing and judicious antibiotic use in Ghana. Further research is needed to explore the long-term consequences of these microbiome shifts on TB treatment outcomes and risk of secondary infections. Plain Language Summary: Tuberculosis (TB) continues to be the leading cause of adult mortality owing to a single infectious disease. The interplay between TB, diabetes, and HIV has become prominent in current TB research. However, the influence of these interactions on lung microflora, other than TB bacilli, has not been extensively explored. Notwithstanding, there is a potential interaction between these non-tuberculous bacteria and TB bacilli, which may impact disease progression and treatment outcomes of TB disease, irrespective of co-infection with HIV or comorbid diabetes. We observed antibiotic resistance among identified non tuberculous bacteria isolated from the lungs of TB patients in Ghana, irrespective of co-infection with HIV or comorbidity with diabetes, including resistance to the commonly used drugs for treating bacterial diseases. This underscores the need for routine antibiotic susceptibility testing and judicious antibiotic use in Ghana.Item A qualitative study of lived experience and life courses following dam release flooding in Northern Ghanaian communities: Implications for damage and loss assessment(PLoS ONE, 2024) Asamoah, M.; Dzodzomenyo, M.; Gyimah, F.T.; et al.Background Dams provide water for industrial, agricultural, and domestic use, particularly in arid regions. However, controlled dam releases due to heavy rainfall may affect downstream communi ties’ livelihoods and life courses such long-term impacts may be omitted from damage and loss assessments. This study aims to assess the lived experiences and long-term conse quences of dam release flooding for downstream populations, comparing these with the typ ical scope of a damage and loss assessment (DaLA). Methods This research was conducted in two flood-prone districts in the White Volta basin, Ghana, subject to dam spillage. Four Focus Group Discussions (FGDs) with community opinion headers, household heads, chiefs, local politicians, and institutional staff were conducted and analysed, alongside semi-structured interviews with twelve opinion leaders and disas ter-related institutions. Results Flood-affected communities struggled to attract partners for marriage due to stigmatisation from flooding impacts. Women outside flooded areas rejected male members’ marriage pro posals, while communities offered young girls for marriage to wealthy men for greater finan cial security. Out-migration of female members to seek better livelihoods frequently led to divorce, subsequently affecting children’s education and well-being. Participants reported long-term trauma from flood-related contact with dangerous wildlife, travel disruption, disease risk, livelihood loss, and accidents. Such life course events and long-term trauma would be omitted from a DaLA exercise. Conclusion Beyond its immediate impacts, flooding undermines family relationships and marriage, impairing children’s education and traumatises affected communities. We recommend liveli hood diversification programmes, psychological support and family counselling to address these long-term impacts, with expansion of DaLA’s scope to underpin such support.Item West-African-Monsoon-Systems-Responses-to-Global-OceanRegional-Atmosphere-Coupling(Journal of Climate, 2024) Tamoffo, A.T.; Weber, T.; Klutse, N.A.B.; et al.This study explores the added value (AV) of a regional Earth system model (ESM) compared to an atmosphere only regional climate model (RCM) in simulating West African monsoon (WAM) rainfall. The primary goals are to foster discussions on the suitability of coupled RCMs for WAM projections and deepen our understanding of ocean– atmosphere coupling’s influence on the WAM system. The study employs results from dynamical downscaling of the ERA-Interim reanalysis and Max Plank Institute ESM, low resolution (MPI-ESM-LR), by two RCMs, atmosphere only (REMO) and REMO coupled with Max Planck Institute Ocean Model (MPIOM) (ROM), at ;25-km horizontal resolu tion. Results show that in regions distant from coupling domain boundaries such as West Africa (WA), constraint conditions from ERA-Interim are more beneficial than coupling effects. REMO, reliant on oceanic sea surface temperatures (SSTs) from observations and influenced by ERA-Interim, is biased under coupling conditions, although coupling offers potential advantages in representing heat and mass fluxes. Contrastingly, as intended, coupling improves SSTs and mon soon fluxes’ relationships under ESM-forced conditions. In this latter case, the coupling features a dipole-like spatial structure of AV, improving precipitation over the Guinea Coast but degrading precipitation over half of the Sahel. Our extensive examination of physical processes and mechanisms underpinning the WAM system supports the plausibility of AV. Additionally, we found that the monsoonal dynamics over the ocean respond to convective activity, with the Sahara– Sahel surface temperature gradient serving as the maintenance mechanism. While further efforts are needed to enhance the coupled RCM, we advocate for its use in the context of WAM rainfall forecasts and projections.Item Intervention to improve adverse event reporting in the emergency department: Protocol of a systematic review and meta analysis(PLOS ONE, 2024) Poku, C.A.; Bayuo, J.; Kwashie, A.A.; Ofei, A.M.A.Background Adverse event reporting is crucial for improving patient safety and identifying areas for improvement in the emergency department. Many interventions have been employed in that regard, and have been found to increase adverse event reporting rates in various settings. All published research that studied the various interventions and their effectiveness on adverse event reporting in the Emergency Department will be reviewed in this paper. Methods CINAHL, PubMed, Medline, Cochrane Reviews Library, EMBASE, Scopus, OVID, Science Direct and Web of Science will all be searched. Studies published since January 2000 that investigated the interventions to improve adverse event reporting will be included. Two inde pendent reviewers will execute the selection and extraction process, and we will carry out a qualitative synthesis. A meta-analysis, if possible, will be undertaken. Discussion The present study will summarize interventions to improve adverse event reporting. It will also determine effective approaches to enhancing adverse event reporting in the emer gency department. The outcome of the study will provide novel dimensions into possible interventions to improve patient safety through adverse event reporting.Item Digital financial inclusion and inclusive development in lower middle-income countries: the enabling role of institutional quality(Journal of Chinese Economic and Foreign Trade Studies, 2024) Ababio, J.O-M.; Yiadom, E.B.; Ofori-Sasu, D.; Sarpong–Kumankoma, E.Purpose – This study aims to explore how institutional quality links digital financial inclusion to inclusive development in lower-middle-income countries, considering heterogeneities. Design/methodology/approach – The study uses dynamic generalized method of moments to analyze a balanced panel data set of 48 lower-middle- income countries (LMICs) from 2004 to 2022, sourced from various databases. It assesses four variables and conducts checks for study robustness. Findings – The study reveals a positive link between digital financial inclusion and inclusive development in LMICs, confirming theoretical predictions. Empirically, nations with quality institutions exhibit greater financial and developmental inclusion than those with weak institutions, emphasizing the substantial positive impact of institutional quality on the connection between digital financial inclusion and inclusive development in LMICs. For instance, the interaction effect reveals a substantial increase of 0.123 in inclusive development for every unit increase in digital financial inclusion in the presence of strong institutions. The findings provide robust empirical evidence that the presence of quality institutions is a key catalyst for the benefits of digital finance in inclusive development. Originality/value – This study offers insights into digital financial inclusion and inclusive development in LMICs. It confirms a positive relationship between digital financial inclusion and inclusive development, highlighting the pivotal role of institutional quality in amplifying these benefits. Strong institutions benefit deprived individuals, families, communities and businesses, enabling full access to digital financial inclusion benefits. This facilitates engagement in development processes, aiding LMICs in achieving Sustainable Development Goals.