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 What influences cancer treatment service access in Ghana? A critical interpretive synthesis(BMJ Open, 2022) Tuck, C.Z.; Aryeetey, R.N.O.; Akparibo, R.; et al.Objectives Multiple social-cultural and contextual factors influence access to and acceptance of cancer treatment in Ghana. This research aimed to assess the existing literature on how these factors interplay and could be susceptible to local and national policy changes. Design This study uses a critical interpretive synthesis approach to review qualitative and quantitative evidence about access to adult cancer treatment services in Ghana, applying the socioecological model and candidacy framework. Results Our findings highlighted barriers to accessing cancer services within each level of the socioecological model (intrapersonal, interpersonal community, organizational and policy levels), which are dynamic and interacting, for example, community-level factors influenced individual perceptions and how they managed financial barriers. Evidence was lacking about determinants of treatment non-acceptance across all cancers and in the most vulnerable societal groups due to methodological limitations. Conclusions Future policy should prioritize multilevel approaches, for example, improving the quality and affordability of medical care while also providing collaboration with traditional and complementary care systems to refer patients. Research should seek to overcome methodological limitations to understand the determinants of accessing treatment in the most vulnerable populations.Item Land Governance and Conflict in West Africa through Interdisciplinary Empirical Lenses(Merian Institute for Advanced Studies in Africa (MIASA), 2024-09) Narh, P.; Doumbia, L.; Tounkara, A.; Ablo, A.D.This working paper addresses the following central questions: (i) How does the commodification of land challenge distinctions between rural and urban spaces? (ii) What new forms of differentiation emerge from commodification, for example the alienation of land markets from land governance regimes? (iii) How does commodification help our understanding of the resilience of custom and egalitarianism? (iv) How useful are property rights frameworks, whether customary, statutory or new forms of tenure, for land management and sustainability? Four authors, members of the MIASA Interdisciplinary Fellow Group (IFG 6) on Land Governance, applied ethnographic and cross-sectional research methods to examine case studies in Ghana, Mali and Senegal. This research contributes to an understanding of the perceptions, discourses and practices relating to land commodification and conflicts, as well as the way in which endogenous perceptions of access to land in West Africa are expressed and adapt to changing circumstances.Item Urban physical food environments drive dietary behaviours in Ghana and Kenya: A photovoice study(Health and Place, 2021) Pradeilles, R.; Laar, A.; Irache, A.; et al.We identified factors in the physical food environment that influence dietary behaviours among low-income dwellers in three African cities (Nairobi, Accra, Ho). We used Photovoice with 142 males/females (≥13 years). In the neighbourhood environment, poor hygiene, environmental sanitation, food contamination and adulteration were key concerns. Economic access was perceived as a major barrier to accessing nutritionally safe and healthy foods. Home gardening supplemented household nutritional needs, particularly in Nairobi. Policies to enhance food safety in neighbourhood environments are required. Home gardening, food pricing policies and social protection schemes could reduce financial barriers to safe and healthy diets.Item Situational assessment and epidemiology of HIV, HBV and HCV among people who use and inject drugs in Ghana(PLOS ONE, 2024) Guure, C.; Dery, S.; da Silva, C.B.; et al.Introduction People who inject drugs (PWID) and people who use drugs (PWUD) are an important popu lation group that remain under-served in Ghana. Though PWID and PWUD are among the key populations most-at-risk to acquire sexually transmitted or blood-borne diseases, they are among those with the least access to human immunodeficiency (HIV), hepatitis B (HBV) and hepatitis C (HCV) viruses’ prevention, care and treatment services in Ghana due to lack of data on them. We provide a rapid assessment of the PWUD and PWID situation in Ghana. Methods This rapid cross-sectional design undertook consultative meetings between the study team and relevant stakeholders, including Civil Society Organizations (CSO) working with PWUD/PWID. The assessment considered a representative sample of PWID and PWUD. It was conducted in four (4) selected regions of Ghana (Greater Accra, Ashanti, Western, and Northern). Overall, 323 participants were interviewed using respondent-driven sampling (RDS) approach. Information obtained from participants were demographics, HIV risk behaviors, human immunodeficiency (HIV) and sexually transmitted infections (STI)-related knowledge HIV/HCV/HBV screening, attitude, and practices among others. Analyses were conducted using Stata version 17 and RDSAT version 7.1.46 software. Findings Drug use was found to be more prevalent among the youth with a median age of 37 years. Majority of the respondents were males (86%). About 28% of the female respondents identi fied themselves as sex workers, while about 74% have been involved in transactional sex. The median age at which respondents started using and injecting drugs was 20 and 22 years respectively. Majority (68%) of the respondents consume drugs through smoking, with 20% through snorting, inhaling or swallowing and 12% through injection. The drug mostly used among the respondents was heroin (52%). The most commonly injected drug was cocaine (55%). About 64.7% of respondents reported mixing two or more drugs. HIV prevalence among respondents was 2.5%, 12.3% among women and 17.7% among women engaged in sex work, highlighting the overlap vulnerability. The prevalence of hepa titis C was 6.0%, and Hepatitis B was 4.5%. Access to care is limited, with 63% of the respondents never been tested for HIV. Conclusion These rapid assessment findings reveal the challenging conditions for people who use and inject drugs coupled with a relatively high prevalence of HIV and Hepatitis C compared to the general population. However, it also reveals that Ghana has a window of opportunity to prevent an exponential spread of HIV and Hepatitis in this population. Therefore, there is the need to implement prevention and treatment programs for HIV and hepatitis among people who use and inject drugs including essential strategies for an enabling environment in Ghana.Item Assessing Children’s Autonomic Nervous System Activity During Structured Tasks: A Feasibility and Reliability Study in Ghana(Developmental Psychobiology, 2024) Bentil, H.J.; Daang, E.M.; Amponsah, B.; et al.The significance of physiological regulation in relation to behavioral and emotional regulation is well documented, but primarily in economically advantaged contexts. Few studies have been conducted in low- and middle-income countries. We investigated the feasibility and reliability of measuring autonomic nervous system (ANS) activity and behavior during challenge tasks in 30 children aged 8–10 years in Ghana during two visits, 1 week apart. Completeness of ANS data ranged from 80% to 100% across all tasks. There was low-to-moderate test–retest reliability of video mood induction (VMI) emotion ratings and balloon analog risk task (BART) pumps (r = 0.34–0.52). VMI elicited higher targeted emotion ratings in Visit 2 than Visit 1. Respiratory sinus arrhythmia (RSA) was higher, and pre-ejection period (PEP) was longer at Visit 2 than Visit 1 for baseline and both tasks. RSA was higher at baseline than during the VMI anger scene at Visit 1, whereas PEP was shorter at baseline than during all VMI emotion scenes at Visit 2. RSA was higher at baseline than during BART at both visits. In conclusion, ANS data collection within evocative and arousing challenge tasks was feasible in Ghana, and the tasks were generally reliable and effective in eliciting target emotions and risk-taking behavior in this sample.Item Development of Strategies and Transformation Paths for Structured and Targeted Digital Change: The Case of the Presbyterian Church of Ghana Trinity Congregation(Digitalization Cases, Management for Professionals, 2019) Asiedu, S.T.; Boateng, R.The situation faced: The Church, irrespective of its steady growth from 4 members in 1965 to 2910 members in 2015, struggles to reach out to larger (newer) communities and improve money collection. It struggles as well in reaching its local community especially its members at the right time with the right message. In brief, for the Church to engage its members and the public concerning worship service, publicizing its social activities (evangelism, donations to the needy, visits to prisons, etc.) and payment of voluntary contributions, it had to count on their physical presence in its premises. (b) Action taken: The Church developed an interactive online presence (website) with payment integration for payment of tithe, offertory, voluntary thanksgiving, etc. Social media accounts were established to help create an online community with the secondary objective of driving traffic to the website and engaging the congregation remotely outside church service hours. Mobile money and a point of sale (POS) device were used to facilitate cashless transactions. Supportive committees were set up while interconnecting existing ones. Some of the pastors upload videos to social media as a supplement to morning devotions. Events were promoted on the website and social media. (c) Results achieved: Amongst the lot, there is currently an increase in social media engagements through event posts, live streaming, images, and other post formats and also an increase in participation in church events by almost 50% on average as well as an increase in the number of website visitors from 2558 (901 unique visitors) in the first year after deployment to 11,612 visitors (5841 unique visitors) in the third year as of September 2017. Even though membership statistics surprisingly indicated a 638 decline in 2017, which is worth investigating. (d) Lessons learned: Although deploying the online system was successful, it came with its lessons drawn from challenges that cannot be ignored. These include trust in electronic payments, the need for a strategic framework in the adoption of technology, and the need to educate users. Other lessons include the need for management support and readiness of employees/volunteers and resource availability as a precursor to achieving strategic IS innovation objectives.Item Privacy Issues in Libraries with Online Services: Attitudes and Concerns of Academic Librarians and University Students in Ghana(College & Research Libraries, 2020) Avuglah, B.K.; Owusu-Ansah, C.M.; Tachie-Donkor, G.; Yeboah, E.B.This study surveyed librarians’ and students’ attitudes, perceptions, and concerns about privacy in Ghanaian universities to seek a better alignment of their perspectives in the online library context. The study adapted and applied the instrument developed by Zimmer that assessed the attitudes and practices of librarians in the United States on privacy rights and protecting patrons’ privacy in the library.1 The the study found that, between librarians and students in Ghanaian universities, there was a need for greater control over their data and a need for ethical responsibility on the part of data-collecting online library agents; both groups expressed dislike for state censorship and corporate monopoly over their data. However, despite their positive attitude about the strong role of librarians in guaranteeing their data, a significant number of them demonstrate little faith in library means to actualize the protection of their data. Finally, privacy attitudes and concerns of academic librarians were noted to align with those of university students in Ghana. Among others, it was recommended that Ghanaian academic librarians integrate privacy education and awareness creation in their universities, emphasizing the need to make informed online decisions and exposing the potential repercussions of their decisions while using online libraries and digital resources.Item Mobile Phone-Assisted Agricultural Extension Services: User Competency And Usage Frequency In Eastern Ghana(African Journal of Food, Agriculture, Nutrition and Development, 2021) Nyaplue-Daywhea, C.; Adjei-Nsiah, S.; Ahiakpa, J.K.; et al.Adoption studies have mainly focused on econometric and quantitative modeling that usually assume smallholder farmers competently adopt agricultural technologies. This study provides novel insights on user competency and frequency of usage of mobile telephony for agricultural extension services among smallholder farmers and agricultural extension agents (AEAs) and key factors that impede the adoption process. The study examined users’ competencies and mobile phone usage frequency for access and delivery of agricultural extension services in Eastern Ghana. A multi-stage sampling procedure was used to select 95 AEAs and 330 smallholder farmers in five districts of the Eastern region of Ghana and data were collected through semi-structured interviews. Descriptive statistics, Pearson correlation, and regression analyses were performed to analyze the data. Results showed substantial differences between AEAs and smallholder farmers’ competency in the use of mobile phones for agricultural extension services. Socio-demographic characteristics of smallholder farmers and AEAs correlated with the usage frequency of mobile phones for access to extension services and delivery. Educational level, amount of weekly expenditure of money on mobile phone use, mobile phone network quality, income level, and age of both AEAs and smallholder farmers had positive and significant correlations with the frequency of usage of mobile phones. User competency differentially impacts the frequency of mobile phone use in agricultural extension services between AEAs and smallholders. High call tariffs and access to recharge cards are major challenges in using mobile phones for agricultural extension in the study areas. The study shows components of the adoption theory of compatibility, and complexity where an innovation fits within the socio-cultural framework and perceived difficulty of use. Thus, the frequent use of voice calls is indicative of the early stages of the diffusion process and may diversify into other applications in the future. Farmer-based organizations should be resourced to support the training of farmers to use mobile phones to improve access to agricultural information dissemination. Integrating voice-based agricultural information services (IVRs) into the current SMS-based agricultural extension services in Ghana could potentially boost extension service delivery to smallholder farmers in the Eastern region and across the country. The Ministry of Food and Agriculture may partner with key stakeholders and mobile service providers to offer hands-on capacity building to smallholder farmers and AEAs in video calling/conferencing, multimedia service, and social media to enhance their competencies for improved agricultural extension services.Item Drivers of anaemia reduction among women of reproductive age in the eastern and upper west regions of Ghana: A secondary data analysis of the Ghana demographic and health surveys(African Journal of Food, Agriculture, Nutrition and Development, 2023) Tetteh, A.; Adanu, R.M.K.; Folson, G.; et al.Anaemia among women of reproductive age (WRA) increases the risk of pregnancy-related morbidity, mortality, and poor pregnancy outcomes. Globally, there is growing interest in reducing anaemia among WRA. In Ghana, anaemia among WRA declined at the national level between 2008 (59%) and 2014 (42%). There were also important declines at the sub-national level. The Eastern region (in the south) and Upper West region (in the north) provide an interesting opportunity to understand the decline. Identifying the drivers of anaemia reduction among WRA in Ghana provides important implementation science evidence for designing effective interventions. This current study examined the drivers of reduced anaemia prevalence in women of reproductive age using data from the Ghana Demographic and Health Surveys for 2008 and 2014. Anaemia was diagnosed as haemoglobin<12.0g/dl. Data were summarized using proportions and 95% confidence intervals. A weighted binary logistic-based multivariate decomposition technique was used to identify the potential drivers of anaemia across surveys for 2003, 2008 and 2014. Sensitivity analysis was carried out to test the robustness of the results of the decomposition analysis using haemoglobin concentration. The results of the decomposition analysis were presented as endowment and coefficient effects. Statistical analysis was carried out using Stata version 15. There was an improvement in access to water and sanitation, health services, family planning, and health insurance across surveys. Drivers of anaemia reduction over time at the national level included wealth index and maternal age, education, use of hormonal contraception and body mass index (BMI). In the Eastern region, the drivers of change were household wealth index, maternal age, hormonal contraceptive use and BMI. The drivers of change in the Upper West region, were household access to water, maternal education and BMI. The findings suggest that multi-level interventions are needed across sectors to further reduce anaemia among WRA.Item Strengthening Maternal, Infant, and Young Child Nutrition Training and Counseling in Ghana: A Community-Based Approach(Current Developments in Nutrition, 2022) Sandow, A.; Aryeetey, R.; Tice, M.; et al.Background: Evidence-based maternal, infant, and young child nutrition (MIYCN) counseling provides caregivers with essential nutrition education to optimize infant and young child feeding practices and subsequently improve child growth and development. Effective integration of responsive feeding (RF) into current MIYCN training requires working with priority communities. Objectives: The study objectives were to 1) assess MIYCN knowledge and practices among Ghanaian caregivers, 2) identify factors influencing RF/responsive parenting (RP) among Ghanaian caregivers, 3) identify barriers and facilitators influencing MIYCN training and counseling among Ghanaian health care providers, and 4) document recommendations for integrating an RF curriculum into the existing MIYCN training. Methods: This was a qualitative study, conducted within the Central Region of Ghana, based on 1) 6 focus groups with caregivers of young children (<36 mo; n = 44) and 2) in-depth interviews with health care providers (n = 14). Focus group transcripts were coded independently, consensus was reached, and a final codebook was developed. The same coding process and thematic analysis were applied to the in-depth interviews. Results: Caregivers identified 3 domains influencing the primary outcome of RF/RP knowledge and practices and the secondary outcome of MIYCN: 1) health care provider counseling; 2) support from family, friends, and community members; and 3) food safety knowledge and practice. Providers identified barriers to MIYCN provider training as well as caregiver counseling which included limited access to financial and counseling resources and limited qualified staff to deliver infant and young child feeding counseling. Identified facilitators included the availability of funding and counseling staff with adequate resources. Healthcare providers strongly endorsed integrating an RF curriculum into MIYCN training and counseling along with providing RF training and distribution of RF materials/tools to facilities. Conclusions: Healthcare providers directly influenced RF/RP practices through MIYCN counseling. Strengthening MIYCN counseling through the integration of an RF curriculum into MIYCN training is desired by the community.