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An introduction is presented in which the editor discusses topics within the issue including aspects of sexual and reproductive health, young people's sexual health and influence of political and social power on control over sexual and reproductive choices.

Much of the existing literature on student engagement focuses on what happens within the higher education environment or what the institution has direct control over, restricting understanding of how issues outside of the institution affect engagement. This paper argues that efforts to improve student engagement should be broadened to incorporate issues relating to the family. It employed a case study design in order to develop a broad and more in-depth understanding of how family influences the amount of time and effort students invest in their learning in a large public university in Ghana. It was established that engagement is influenced by family expectation, financial and social support, as well as monitoring of students’ academic performance. The unique contribution of the study is that it broadens current understandings of engagement because it adds an aspect that has not been highlighted in current work on engagement, making a case for institutions to work more with families to get a broader understanding of challenges students face in order to provide comprehensive support. [ABSTRACT FROM PUBLISHER]

An introduction is provided in which the author discusses articles in the issue on topics including counseling in Africa, prediction of academic success in southwestern Nigeria, and the experiences of college students from Ghana who are studying in Great Britain.

Water resources are increasingly under pressure from population growth, economic activity, and climate change/variability. Using survey and community meetings, the paper analyzed water resources accessible to three farming communities in the Offinso North District and the effects of rainfall changes on their farming livelihood. The study revealed that the households depended on water from three sources, namely: groundwater through boreholes for drinking and domestic use; surface water through streams for drinking, domestic use and irrigating vegetable farms and atmospheric water (i.e. rainfall) for farming. For about 80% of the respondents, changes in rainfall pattern adversely affected their crops yield which has implication on their livelihoods. Access to irrigation facilities was virtually absent. Also, the non-application of water harvesting techniques for farming thus left these smallholder farmers to the 'mercies of the weather'. Education on climate change and adaptation strategies coupled with technological know-how on water management is recommended for the communities in this forest-savanna transition zone where abrupt changes in rainfall pattern are new to their livelihoods. [ABSTRACT FROM AUTHOR]

The practice of adult males moving from rural areas into urban centres is a common phenomenon in Ghana. The result is that there are a series of consequent impacts on areas of origin especially on households and families. Using in-depth interviews, this paper discusses the economic, social, psychological and emotional effects that women experience as a result of the absence of husbands. Some major findings were that women were expected to work on the farms, feed their children and at the same time support their extended family households. As a result, women experienced different forms of distress arising out of material and social circumstances of their lives, yet not much has been done to address this situation. The paper recommends that interventions for rural women must take into account the experiences of left-behind women. Particularly, the emotional needs of these women must be considered by providing counseling services in addition to the economic empowerment programmes. [ABSTRACT FROM AUTHOR]

Background: This paper explored the health beliefs and behaviours of families towards the health needs of children with intellectual and developmental disabilities (IDD) in Accra, Ghana. The aim was to inform health promotion strategies for the children and their families. Method: Twenty‐two parents of children with IDD participated in this study. Semi‐structured interviews were the primary means of data collection. The interviews were analysed using constant comparison. Results: The signs that alerted the parents that the children might be ill included high temperature, vomiting and excessive sleep. The parents explained that some children expressed feelings of ill‐health through verbal or non‐verbal communication. Most of the parents self‐prescribed medication for the children or waited for symptoms to persist for a while before accessing health care because they experienced difficulties managing the behavioural challenges associated with the IDD of the children in public and attitudinal barriers when accessing health care. The parents did not often patronise health facilities in their neighbourhoods due to private health insurance requirements for accessing care at designated facilities, poor confidence in neighbourhood facilities and long‐term established relationships with facilities elsewhere. Further, many parents did not patronise religious interventions for the children. However, some parents explained that in addition to seeking medical care to address the physical symptoms of the children's disabilities and/or illnesses, they sought religious interventions because they believed that there could be a spiritual dimension to the situation. Conclusion: The findings highlight key areas to address in health promotion for children with IDD and their families in Accra, Ghana. [ABSTRACT FROM AUTHOR]

The importance of cultural factors has been a contested issue in psychological research and practice around the world. This paper argues for the importance of conducting psychological research and practice with respect to the cultural context of Ghana. The first part of this article focuses on definition of culture as a concept in psychology and the challenges and theoretical positions of the relationship between culture and psychology. The essay further focuses on the factors necessitating the shift from cross-cultural thinking to cultural thinking in psychological research and practice in the country. The final part of the essay examines the implications of cultural thinking for research methodologies in psychological research and practice in Ghana. It assertively concludes that psychological science can aid service users better if its Westernized focus is challenged and realigned with the cultural context of the country. [ABSTRACT FROM AUTHOR]

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Tropical Medicine & International Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The Millennium Development Goals (MDGs), an initiative by the United Nations, consisted of eight broad goals, which were envisaged to improve the living conditions of the world’s populations. In spite of the momentum and investments made to achieve the MDGs, significant challenges still exist at the global and national levels. In Ghana, the attainment of some MDGs was uneven across the goals and within the country. This paper critically reviews the implementation of the health MDGs in Ghana: specifically, MDG 4, MDG 5 and MDG 6. The study focuses on drawing key lessons from the national implementation strategies and institutional reforms adopted by Ghana towards achieving these health MDG targets.Methods: The study uses content analysis of policy documents in selected programmatic interventions which have been deemed influential in reaching the health MDGs in Ghana.Results: In brief, the results indicate that 73% of the 37 MDG indicators for Ghana were either achieved or could show significant progress. Ghana did not achieve MDG 4 and MDG 5 due to the slow progress it made in improving child and maternal health. The study indicates that key investments need to be made in the health sector, especially in the areas of access to good quality care, to narrow gaps in access and financing.Conclusions: Reducing maternal and child mortality in Ghana will require transforming the sectors that drive development, such as energy, agriculture and transportation. It is expected that the lessons learnt will enhance evidence-based policy-making towards achieving the SDGs in Ghana. [ABSTRACT FROM AUTHOR]

Even though cervical cancer is quite a prevalent disease in Ghana, there is hardly any study on this disease. This paper sought to explore the experiences of cervical cancer patients living with the disease with emphasis on their knowledge about the disease before and after the diagnosis. Qualitative data were collected through in-depth interviews with cervical cancer patients undergoing treatment in a specialised cancer treatment health facility in rural Ghana. Cervical cancer patients had inadequate knowledge about the disease, its symptoms, risk factors, treatment and prevention prior to being diagnosed of the disease. These patients were diagnosed late because they usually sought treatment elsewhere before reporting to health facilities. They experienced physical, psychological, economic and social disruptions in their daily lives, which affected their quality of life. It is evident that lack of knowledge about cervical cancer constitutes a threat to its prevention and treatment. Intensive health education through the mass media and community health promotion outreaches can be a sure way of creating adequate knowledge about cervical cancer in Ghana. Treatment and care for cervical cancer patients should incorporate counselling sessions, which should take into consideration the different levels of disruption the women experience and the implications for their wellbeing and management of the condition. [ABSTRACT FROM AUTHOR]

Purpose This paper aims to investigate the influencing dynamics of culture (national and organizational), employee characteristics, employee job satisfaction and organizational commitment in determining the organizational performances of firms in the retail banking sector in a developing country such as Ghana.Design/methodology/approach A conceptual framework linking national and organizational cultures to employees’ job satisfaction, job characteristics, organizational commitment and organizational performance was developed, and their measurement scales were adapted to guide the empirical investigation. Data were collected using a questionnaire filled in by 300 employees in nine retail banks in Ghana. The results were first analyzed by carrying out data reduction of the measured scales by using the Statistical Package for the Social Sciences-based factor analysis approach. The reduced data obtained from the factor analysis were then analyzed for model goodness fit by using the Analysis of Moment Structures-based structural equation modeling approach.Findings Effective organizational performance of retail banks in Ghana is directly influenced by the relationships among organizational culture, employee job satisfaction and organizational commitment.Research limitations/implications The study sample was drawn from a single sub-sector of the Ghanaian economy. Replications and extensions of the study in different sectors that are experiencing high growth will help test the robustness and generalizability of the findings.Practical implications The study provides empirical knowledge that could be used to understand the influencing interrelationships among organizational culture, employee job satisfaction and organizational commitment on the organizational performances of retail banking firms in a developing country context.Originality/value The study adds to the literature as one of the most comprehensive studies of the links between culture, job satisfaction, employee characteristics and organizational commitment toward organizational performance within the banking sector in Ghana to date. [ABSTRACT FROM AUTHOR]

Based on a two-sided ethnographic study in Accra, this paper analyses Chinese–Ghanaian employment relations from the perspectives of psychological contract, cross-cultural equity expectations and foreignness. Reaching beyond racially framed allegations of each other that are informed partly by politicized media discourses, structural analysis shows that mutually contradictory, culturally grounded expectations regarding their employment relationship are central to the understanding of conflict between Chinese employers and Ghanaian employees. Central to the frictions of mutual equity expectations is the feeling of existential vulnerability that – although particular for each group – is shared by both Chinese migrant employers taking high financial risks in an unfamiliar and potentially hostile environment and their local employees recruited almost exclusively from economically marginalized groups. [ABSTRACT FROM AUTHOR]

This paper reports the findings of a qualitative study investigating the impacts of renting a home on the psychosocial health of tenants in the Accra Metropolitan Area (AMA) in Ghana. In-depth interviews (n = 33) were conducted with private renters in Adabraka, Accra. The findings show that private renters in the AMA face serious problems in finding appropriate and affordable rental units, as well as a persistent threat of eviction by homeowners. These challenges tend to predispose renters to psychosocial distress and diminishing ontological security. Findings are relevant to a range of pluralistic policy options that emphasize both formal and informal housing provision, together with the reorganization and decentralization of the Rent Control Board to the district level to facilitate easy access by the citizenry.

Concerned with the negative impacts of user fees on healthcare access and utilisation, following the enactment of a law in 2003, the Ghanaian government replaced the ‘cash-and-carry’ system with a National Health Insurance Scheme (NHIS). Even though many Ghanaians rely on traditional medicine (TRM) for reasons of culture, cost and personal preference, the incipient NHIS does not cover the services of TRM practitioners. Consultations with health policy-makers suggest that, in as much as the government recognises the invaluable contributions of TRM practitioners and would like to incorporate them in the incipient scheme, the provision of TRM in the country is still too disorganised, with few if any formal protocols and codes of conduct. Consequently, the inclusion of TRM practitioners in the NHIS is premature. This scholarly review seeks to bring TRM and its practitioners into the mainstream of healthcare provision in Ghana. Possibilities for medical pluralism in Ghana will be discussed with reference to best practices in countries such as China, India and Vietnam. This paper promotes medical pluralism in the form of Active Collaboration Between Fully Recognised Health Systems where there will be equity, mutual respect and understanding among traditional healers and physicians. [ABSTRACT FROM PUBLISHER]

This paper explores the perception of health and environmental concerns of workers and residents living close to e-waste recycling sites in Ghana using both qualitative and quantitative research techniques. The social constructionist approach and a logit regression model were adopted to examine the rationale of their claims and concerns which have hitherto been unknown and unexplored. We find that workers’ environmental and health perceptions were seriously downplayed and do not match those of epidemiological studies, revealing a lack of convergence between lay and expert knowledge. This study further shows a respondent-specificity rationale; the perception of those directly involved in the processes was mainly influenced by economic considerations, while some at bestdisplayed “genuine” ignorance. We recommend that all policy interventions incorporate approaches that have a better chance of arriving at conclusions economically meaningful to participants and that facilitate greater understanding of health and environmental issues. [ABSTRACT FROM PUBLISHER]

Using pooled data from the 1998 and 2003 Demographic and Health Surveys, this paper investigates the association between religion and contraceptive behavior of married women in Ghana. Guided by the particularized theology and characteristics hypotheses, multinomial logit and complementary log-log models are used to explore denominational differences in contraceptive adoption among currently married women and assess whether the differences could be explained through other characteristics. We found that while there were no differences between women of different Christian faiths, non-Christian women (Muslim and Traditional) were significantly more likely to have never used contraception compared with Christian women. Similar observations were made on current use of contraception, although the differences were greatly reduced in the multivariate models. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In treating illness and suffering, the Akan anti-witchcraft shrine is often presented as a model of unchanging, tightly bounded and antiquated ideals. This fails to acknowledge the extensive repertoire of Ghanaian witchcraft discourses and contemporary divinatory practices uncovered at Akan anti-witchcraft shrines. This paper analyses how one of the most popular Akan anti-witchcraft shrine in Europe, in an eastern banlieue of Paris, diagnoses the seemingly common and innocuous coughs and colds suffered by recently arrived, unskilled female Ghanaian migrants as something more socially and economically malignant, witchcraft. Successful treatment combines divinatory techniques, paracetamol medicines and positive thinking in order to empower clients and present them with the possibility of new social and gainful employment prospects. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Services for people with communication disability in Majority World countries are limited. The need for such services seems to be gaining much attention in some Majority World countries such as Ghana. The University of Ghana commenced its Master of Science in Speech & Language Pathology program in 2016.1 received Speech Pathology Australia's grant for Majority World Countries and Developing Communities. This paper reports on the benefits of the visit I undertook to Australia in May 2018 and reflects on the value of building global professional networks for improving rehabilitation services. [ABSTRACT FROM AUTHOR]

This paper discusses Wright's travel narrative of the Gold Coast/Ghana, and particularly the politicized psychology it develops as an analytic tool. Paying close attention to the effects of colonial economic control on daily life, Wright discusses such classically psychoanalytic concepts as the return of the repressed, the Oedipal conflict, and anal eroticism in terms of West African daily life, often considerably revising both Freudian concepts and his own notion of black identity in the process. While the African American tradition gave him the means to articulate psychic life with historical realities, the Freudian intervention gave him license to focus on sexual and scatological topics that had yet, in 1954, to receive serious consideration as political matters. Hence, "Black Power" is an enormous resource for contemporary critical efforts towards reading psychoanalysis, African American culture, and political struggles of the global South in combination. [ABSTRACT FROM AUTHOR]

In contexts where healthcare regulation is weak and levels of uncertainty high, how do patients decide whom and what to trust? In this paper, we explore the potential for using Signalling Theory (ST, a form of Behavioural Game Theory) to investigate health-related trust problems under conditions of uncertainty, using the empirical example of ‘herbal clinics’ in Ghana and Tanzania. Qualitative, ethnographic fieldwork was conducted over an eight-month period (2015–2016) in eight herbal clinics in Ghana and ten in Tanzania, including semi-structured interviews with herbalists (N = 18) and patients (N = 68), plus detailed ethnographic observations and twenty additional key informant interviews. The data were used to explore four ST-derived predictions, relating to herbalists' strategic communication (‘signalling’) of their trustworthiness to patients, and patients' interpretation of those signals. Signalling Theory is shown to provide a useful analytical framework, allowing us to go beyond the primary trust problem addressed by other researchers – cataloguing observable indicators of trustworthiness – and providing tools for tackling the trickier secondary trust problem , where the trustworthiness of those indicators must be ascertained. Signalling Theory also enables a basis for comparative work between different empirical contexts that share the underlying condition of uncertainty. [ABSTRACT FROM AUTHOR]

Colonialism was not only a political imposition but also a cultural one that both affected and infected institutions and ways of knowing and being of colonised societies. The vestiges of colonial power that originated during the colonial period of European global domination persistently influence minds and behaviours associated with the institution of marriage through the axes of meta-colonialism, and represent forms of epistemic violence against indigenous people. The depiction of modern/colonial mentalities about marriage (e.g., the so-called White wedding) as an optimal expression of human nature and love—and thus a key to personal happiness—have become part of the Ghanaian/African cultural experience. For example, Eurocentric practice of White wedding has been systematically naturalised and pushed down on Ghanaian/African people as the most enlightened, valid and standard form of marriage, supplanting the indigenous and ancestral forms of knowledge and being associated with marriage. Drawing insights from cultural psychology, we discuss the coloniality of mind and being associated with marriage, particularly the popular practice of White wedding, and examine how marriage practices in Ghana have become associated with Western social, cultural and economic interests propagated by colonial discourses of modernity, social change and development. We argue that the valorisation of European White wedding and the inferiorisation of African traditional marriage practices are corollary of colonial and meta-colonial narratives that promote(d) White normativity. We posit that psychological knowledge and practice, informed by Western ontologies and epistemologies, provided ideological support for colonisation and the perpetration and perpetuation of scientific racism. We thus contend that, given its complicity, the present discipline of scientific psychology cannot be an effective tool to dismantle the ill-effects of past and present unequal power relationships that result(ed) from colonisation. A decolonial psychological science that enables critical consciousness and serves as a necessary catalyst for liberating minds and being is thus required. [ABSTRACT FROM AUTHOR]

This paper describes some epistemic cultural considerations which shape the uses of psychology. I argue the study of mind is bound by the metaphysical background of the given locale and era in which it is practiced. The epistemic setting in which psychology takes place will shape what is worth observing, how it is to be studied, how the data is to be interpreted, and the nature of the ultimate explanatory units. To demonstrate conceptual epistemic constraints, I discuss metaphor use in psychology. In addition, epistemic constraints shape the praxes that arise from structural study of the mind. In order to illustrate this cultural constraint, I discuss Soviet Psychology and provide a contrast between practical uses of psychoanalysis in India, Egypt, and rural Ghana. In response to these conceptual and practical epistemic limitations, psychology could adapt methods drawn from history and anthropology. [ABSTRACT FROM AUTHOR]

BackgroundThere is little knowledge about the psychosocial distress of children affected by human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) in Ghana, to aid the planning of services. This study investigated mental health problems among children affected by HIV/AIDS, compared with control groups of children orphaned by other causes, and non-orphans.MethodThe study employed a cross-sectional survey that interviewed 291 children and their caregivers. Both children and caregivers completed the Strengths and Difficulties Questionnaire that measured children's psychosocial wellbeing. Verbal autopsy was used to identify whether children lost one or both parents from AIDS.ResultsThe results indicated that controlling for relevant sociodemographic factors, both children's self-reports and caregivers’ reports indicate that both children living with HIV/AIDS-infected caregivers and children orphaned by AIDS were at heightened risk for mental health problems than both children orphaned by other causes and non-orphans. The findings further indicated that a significant proportion of orphaned and vulnerable children exhibited symptoms for depression and other psychiatric disorders (approximately 63%) compared with 7% among the non-orphaned group. Caregivers gave higher ratings for children on externalizing problems and lower on internalizing problems, and vice versa when the children's self-reports were analysed.ConclusionsThe findings suggest that both children and their informants have diverse yet complementary perspectives on psychological outcomes. The study discusses the theoretical and practical implications of these findings and urgently calls for necessary intervention programmes that target all children affected by HIV/AIDS to effectively alleviate psychological distress and enhance the mental health of these children. [ABSTRACT FROM PUBLISHER]

Background: Health worker density per 1000 population in Ghana is one of the lowest in the world estimated to be 2.3, below the global average of 9.3. Low health worker motivation induced by poor working conditions partly explain this challenge. Albeit the wage bill for public sector health workers is about 90% of domestic government expenditure on health in countries such as Ghana, staff motivation and performance output remain a challenge, suggesting the need to complement financial incentives with non-financial incentives through a community-based approach. In this study, a systematic community engagement (SCE) intervention was implemented to engage community groups in healthcare quality assessment to promote mutual collaboration between clients and healthcare providers, and enhance health worker motivation levels. SCE involves structured use of existing community groups and associations to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements made and rewards given to best performing facilities for closing quality care gaps. Purpose: To evaluate the effect of SCE interventions on health worker motivation and experiences with clients. Methods: The study is a cluster randomized trial involving health workers in private (n = 38) and public (n = 26) primary healthcare facilities in two administrative regions in Ghana. Out of 324 clinical and non-clinical staff randomly interviewed at baseline, 234 (72%) were successfully followed at end-line and interviewed on workplace motivation factors and personal experiences with clients. Propensity score matching and difference-in-difference estimations were used to estimate treatment effect of the interventions on staff motivation. Results: Intrinsic (non-financial) work incentives including cordiality with clients and perceived career prospects appeared to be prime sources of motivation for health staff interviewed in intervention health facilities while financial incentives were ranked lowest. Intervention health facilities that were assessed by female community groups (Coef. = 0.2720, p = 0.0118) and informal groups with organized leadership structures like Artisans (Coef. = 0.2268, p = 0.0368) associated positively with higher intrinsic motivation levels of staff. Conclusion: Community-based approach to health worker motivation is a potential complementary strategy that needs policy deliberation to explore its prospects. Albeit financial incentives remain critical sources of staff motivation, innovative non-financial approaches like SCE should complement the latter. [ABSTRACT FROM AUTHOR]

Purpose: Although social capital influences health-related decisions and behavioural patterns in many developing countries, minimal attention has been paid to the nuances of its effect on healthcare. This paper examines how bonding social capital affects healthcare delivery for inpatients in Ghana. Methods: Semi-structured in-depth interviews were used and thematic analysis method employed to analyse the data. Interviews were conducted with health professionals and relatives and close friends of inpatients in three public health facilities in Ashanti region. Results: Relatives and close friends of inpatients were a critical source of instrumental support such as provision of meals, laundry services, running errands and financial assistance as well as emotional support. These functions—that were both 'expected' and 'encouraged'— reduced the burden on the health facilities, which apparently had limited resources to offer adequate care. However, the relatives of inpatients sometimes inadvertently obstructed efficient healthcare delivery through actions such as extending 'unapproved' alternative care to patients. Moreover, the process of contributing towards health and well-being of the sick exposed the relatives to health risks due to poor living conditions. Conclusion: A well-defined and befitting role must be devised for at least an immediate social relation of inpatients to improve the positive effects of bonding social capital on healthcare delivery. [ABSTRACT FROM AUTHOR]

Religion has long been recognized as a powerful tool capable of shaping the lives of people in many societies. In this study, we draw insights from discursive psychology to explore the influence of religious beliefs and practices on the perpetration of husband-to-wife abuse and the entrapment of victims in Ghana. Semi-structured focus group discussions and in-depth individual interviews were conducted with 40 participants, comprising 16 (60%) perpetrators (men), 16 (60%) victims (women), and eight (20%) key informants from rural and urban Ghana. Participants' discursive accounts suggest that both perpetrators and victims invoke religious instructions on gender norms to legitimize male authority over women in marriage. While perpetrators construct husbands' conjugal authority over their wives in terms of prescriptive religious norms, victims construct their entrapment in abusive relationships in terms of proscriptive theology of divorce in the bible. The double-edged role of religion in providing both motivational and inhibitory support for wife abusers is also discussed. [ABSTRACT FROM AUTHOR]

This paper presents findings from research about the psychological effects of rape among 15 Ghanaian and 15 Liberian rape survivors comparing them with 15 Ghanaian and 15 Liberian women not raped living in Ghana. We found that both Liberian and Ghanaian rape survivors had increased levels of depression and that both Ghanaian and Liberian women who had been raped by familiar perpetrators exhibited higher levels of depression than those raped by strangers. Liberian survivors exposed to limited cognitive behavioural counselling exhibited lower levels of depression despite being displaced and living in a refugee camp. Our findings on the psychological effects of rape and the mitigating effects of counselling are the first of their kind for Ghanaian and Liberian women. We hope that the dissemination of these results will encourage the provision of counselling for all women who find themselves victimized by rape. [ABSTRACT FROM AUTHOR]

Abstract: This paper examines community effects on health knowledge in a developing country setting. We examine knowledge about the etiology and prevention of child illnesses using a unique 2002 representative survey of communities and households in Ghana. We find that community context matters appreciably, even after adjusting for the anticipated positive effects of an individual''s education, literacy, media exposure and household socioeconomic status. The proportion of literate adults and the presence of a market in a community positively influence a person''s health knowledge. In other words, even if a person herself is not literate, living in a community with high levels of literacy or a regular market can still positively affect her health knowledge. Our results suggest that social networks and diffusion play a key role in these community effects. In turn, these results offer policy implications for Ghana and sub-Saharan Africa. [Copyright &y& Elsevier]

This paper examines whether previously suggested reasons for having children: economic, social and psychological values of child can be identified among a group of sub-Sahara women, and the extent to which a spiritual value of child can be identified on the basis of African's belief in ancestors and its influence on their daily lives. Two groups of Ghanaian mothers--270 women (mean age = 42.14 years) with adolescent-aged child and 264 mothers (mean age =31.41 years) with a young child--participated in the study. Exploratory factor analyses found mixed support for the existence of social and psychological values of child. Economic values of child could not be identified. However, spiritual values of child came out as a clear factor, and accounted for about 10% of the explained variance, albeit the explained valiance was less than that from social and psychological values of child. The implications of these for family planning in sub-Sahara Africa and for fighting HIV/AIDS are discussed. [ABSTRACT FROM AUTHOR]

Critical studies on men and masculinities have gained significant momentum in feminist scholarship in the past decades. The growing interest in feminist scholarship has focused broadly on how male-bodied people construct, negotiate, and express masculine identities. Despite this growing interest, insufficient attention has explored how rurally based Ghanaian men construct and negotiate their masculinities in intimate relationships. Situated within critical discursive psychology and drawing on 16 semi-structured in-depth interviews and 6 focus group discussions with adult men in northwestern Ghana, the results show that dominant notions of masculinity provide a broad context through which participants' narratives, negotiations, and experiences on intimate partner violence could be understood. Findings suggest that various cultural narratives and metaphors were deployed to support men's controlling behaviors and/or intimate violence against women. The implications of how harmful masculine ideologies could frustrate efforts that target the development and promotion of a socially just and less oppressive society are presented and discussed. [ABSTRACT FROM AUTHOR]

Issues concerning competence of practicing psychologists have not been critically investigated in Ghana. This study used the three-dimensional cube model of core competencies as a framework to explore competencies of professional psychologists in active clinical health practice in Ghana. Sixteen clinical psychologists with 1 to 20 years of practicing experience were interviewed on adequacy of their graduate training for practice as well as maintaining post-training competence. The results suggested that training equipped the practitioners mainly for research and teaching but less so for clinical practice. Reflective practice was underdeveloped leading to critical challenges in emotional and cultural competencies. Structural support for continuous professional development was limited. Implications for professional psychology training, research and practice are discussed. This study is the first to explore competence issues in professional psychology practice in Ghana, and it contributes to the global discourse on continuous competence in psychology. [ABSTRACT FROM AUTHOR]

Introduction: Women's reproductive health decision-making is indispensable for improving their reproductive health and achieving Sustainable Development Goal three. This study explored the association between reproductive health decision-making capacity and unintended pregnancy among women in Ghana. Materials and methods: We used data from the 2014 version of the Ghana Demographic and Health Survey. The unit of analysis for this study was pregnant women at the time of the survey (679). Bivariate and multivariable analyses were conducted using Pearson chi-square tests and binary logistic regression respectively. Results: We found that women who had the capacity to make reproductive health decision [AOR = 0.61; CI = 0.51–0.89] were less likely to experience unintended pregnancies, compared to those who did not have the capacity. Age was found to have a statistically significant influence on unintended pregnancy, with women aged 25–29 years [AOR = 0.29; CI = 0.13–0.63], 30–34 years [AOR = 0.18; CI = 0.08–0.45], and 35–39 years [AOR = 0.26; CI = 0.10–0.68] being less likely to experience unintended pregnancy compared to those aged 15–19 years. Women with primary level of education were more likely to have unintended pregnancies, compared to those with no education [AOR = 2.07; CI = 1.12–3.84]. Conclusion: This study has filled the gap in the already existing literature on the association between reproductive health decision making capacity and unintended pregnancy in Ghana and has created a room for specific interventions geared towards reducing unintended pregnancies, especially among women who are not capable of making reproductive health decisions, women aged 15–19 years, those with primary education, Traditionalists and unmarried women. [ABSTRACT FROM AUTHOR]

Health disparities research in low- and middle-income countries (LMICs) is hampered by the difficulty of measuring economic status in low-resource settings. We previously developed the EconomicClusters k-medoids clustering-based algorithm for defining population-specific economic models based on few Demographic and Health Surveys (DHS) assets. The algorithm previously defined a twenty-group economic model for Cameroon. The aims of this study are to optimize the functionality of our EconomicClusters algorithm and app based on collaborator feedback from early use of this twenty-group economic model, to test the validity of the model as a metric of economic status, and to assess the utility of the model in another LMIC context. We condense the twenty Cameroonian economic groups into fewer, ordinally-ranked, groups using agglomerative hierarchical clustering based on mean cluster child height-for-age Z-score (HAZ), women’s literacy score, and proportion of children who are deceased. We develop an EconomicClusters model for Ghana consisting of five economic groups and rank these groups based on the same three variables. The proportion of variance in women’s literacy score accounted for by the EconomicClusters model was 5–12% less than the proportion of variance accounted for by the DHS Wealth Index model. The proportion of the variance in child HAZ and proportion of children who are deceased accounted for by the EconomicClusters model was similar to (0.4–2.5% less than) the proportion of variance accounted for by the DHS Wealth Index model. The EconomicClusters model requires asking only five questions, as opposed to greater than twenty Wealth Index questions. The EconomicClusters algorithm and app could facilitate health disparities research in any country with DHS data by generating ordinally-ranked, population-specific economic models that perform nearly as well as the Wealth Index in evaluating variability in health and social outcomes based on wealth status but that are more feasible to assess in time-constrained settings. [ABSTRACT FROM AUTHOR]

African migrants in Europe and continental Africans are disproportionately affected by type 2 diabetes (T2D). Both groups develop T2D at a younger age, and have higher morbidity and mortality from T2D and complications, compared to European populations. To reduce risk, and avoidable disability and premature deaths, culturally congruent and context specific interventions are required. This study aimed to: (a) assess perceptions and knowledge of T2D among Ghanaian migrants in Europe and their compatriots in Ghana and (b) identify specific perceptions and knowledge gaps that might predispose migrants to higher risk of diabetes. Data was gathered through 26 focus groups with 180 individuals, aged 21 to 70, from Amsterdam, Berlin and London and rural and urban Ashanti Region, Ghana. Thematic analysis of the data was informed by Social Representations Theory, which focuses on the sources, content and functions of social knowledge. Three key insights emerged from analysis. First, there was general awareness, across migrant and non-migrant groups, of T2D as a serious chronic condition with life threatening complications, and some knowledge of biomedical strategies to prevent diabetes (e.g healthy eating) and diabetes complications (e.g medication adherence). However, knowledge of T2D prevention and reduction of diabetes complications was not comprehensive. Secondly, knowledge of biomedical diabetes theories and interventions co-existed with theories about psychosocial and supernatural causes of diabetes and the efficacy of herbal and faith-based treatment of diabetes. Finally, migrants’ knowledge was informed by both Ghanaian and European systems of T2D knowledge suggesting enculturation dynamics. We discuss the development of culturally congruent and context-specific T2D interventions for the research communities. [ABSTRACT FROM AUTHOR]

Stigmatization of persons cured of leprosy (PCLs) is a long standing social problem especially in the developing world, which often leads to their isolation from mainstream society. This study presents the voices of PCLs in the Cured Lepers' Village in Ho, a community located in Southern Ghana. The study collected data through in-depth interviews and focus group discussions with 20 participants. Findings indicate that PCLs continue to live a significant number of years in the Cured Lepers' Village after they are cured of leprosy. This situation is due to several factors such as stigma (including self-stigma), isolation, and neglect. Fear of the disease and compliance with religious and sociocultural beliefs, and regulations regarding leprosy were identified as reasons for the isolation of people affected by the disease. The study recommends a comprehensive public education program on leprosy targeting community leaders to help re-integrate PCLs into their communities and calls for social workers to be part of this process. [ABSTRACT FROM AUTHOR]

The use of traditional medicine for the treatment of various disorders is not a new practice. Indeed, various categories of traditional healers form a large part of the healthcare workforce in many low- and middle-income countries, and given the paucity of mental health professionals in these countries, traditional and complementary medicine practitioners are utilised even more so for mental disorders. In Ghana, efforts have been made to formalise and standardise the work of traditional medicine practitioners. This goal is still mostly unmet, partly due to the lack of scientific knowledge of their beliefs, methods, and practices in mental healthcare. Very few studies have documented this knowledge. In this article, we report on some of the methods that are used by traditional Ghanaian herbalists in treating mental disorders. Eight herbalists working within the Greater Accra Region, who specialised in mental health, were interviewed through individual semi-structured interviews. Thematic analysis showed that traditional herbalists' work in treating mental disorders revolved around four key themes: the method of diagnosis; the treatment methods used; the mode of administering the treatment; and the purpose of the specific treatment. These themes are discussed with reference to their potential implications for patients' care and outcomes. [ABSTRACT FROM AUTHOR]

Social workers are increasingly embracing international perspectives and roles to address persistent human rights issues. This study examines solutions to property rights disputes involving Ghanaian women who are widowed from the perspectives of Akan men and women in four communities. Property ownership is fundamental to the economic survival of women and their children, but millions of women around the world lose their rights to property following the deaths of their husbands. We conducted focus groups with 102 participants in four Akan communities to generate local, culturally viable solutions for preventing property rights violations and resolving them when they do occur. [ABSTRACT FROM AUTHOR]

Traditional and alternative medicine is an integral part of the mental healthcare system of many African countries. The treatments and practices of these traditional and alternative healers will be influenced by their ideas about the causes and effects of mental disorders. With the concept of explanatory models of illness as a framework, we examined the notions of different categories of traditional and faith healers about mental disorders. Using case vignettes, we conducted interviews with 36 participants to explore their beliefs about the causes, course and effects of a serious mental disorder, a common mental disorder and a disorder driven by social circumstances. From our data, there was consensus about what constituted a serious mental disorder. However, the other disorders were not seen as mental disorders. Although there was an acknowledgement of biological and social causes of serious mental illness, the dominant view was that of supernatural causes. The most significant effect of mental illness reported was a loss of social connectedness and productivity. These models are discussed with reference to their implications for collaboration, mental health literacy efforts, as well as biomedical practice. [ABSTRACT FROM AUTHOR]

Aim To explore the challenges facing hospital nurse managers (HNMs) in selected hospitals in the Volta region of Ghana. Method The study, which had an exploratory qualitative design, involved the recruitment of 12 HNMs from six public hospitals in the Volta region of Ghana. Purposive sampling was used and data were collected through semi-structured interviews. The conventional content analysis approach was adopted for data analysis. Findings The study revealed several managerial challenges of being HNMs in performing their roles. These include: a lack of managerial preparedness, clear job descriptions and support; interference by other managers; and inadequate nursing staff and material resources. All these compromised the quality of nursing care. Participants found their role tedious and stressful, but also regard it as an opportunity to learn new ideas. Conclusion HNMs face several challenges that negatively affect their performance. There is a need for succession planning, career development and mentoring programmes to strengthen HNMs' leadership and management skills to help them provide high-quality nursing care. [ABSTRACT FROM AUTHOR]

Background: The use of herbal medicines in developing countries has been increasing over the years. In Ghana, since 2011, the government has been piloting the integration of herbal medicine in 17 public hospitals. However, the strengths and the weaknesses of the integration have not been fully explored. The current study sought to examine the strengths and weaknesses of the integration using the WHO health systems framework. Methods: This study used qualitative, exploratory study design involving interviews of 25 key informants. The respondents had experience in conducting herbal medicine research. Two key informants were medical herbalists practising in hospitals piloting the integration in Ghana. We used Framework analysis to identify the perspectives of key informants in regards to the integration. Results: Key informants mostly support the integration although some noted that the government needs to support scale-up in other public hospitals. Among the strengths cited were the employment of medical herbalists, utilization of traditional knowledge, research opportunities, and efficient service delivery by restricting the prescription and use of fake herbal medicine. The weaknesses were the lack of government policies on implementing the integration, financial challenges because the National Health Insurance Scheme does not cover herbal medicine, poor advocacy and research opportunities, and lack of training of conventional health practitioners in herbal medicine. Conclusions: Researchers view the integration of the two healthcare systems–biomedicine, and herbal medicine– positively but it has challenges that need to be addressed. The integration could offer more opportunities for researching into herbal medicine. More training for conventional health professionals in herbal medicine could increase the chances of better coordination between the two units. Additionally, strong advocacy and publicity is needed to educate more people on the integration and the utilization of the services. [ABSTRACT FROM AUTHOR]

Background Since 2008 Italy has been the destination of the 'central Mediterranean route', used by migrants to reach Europe. The aim of this study is to describe demographic characteristics and health problems of migrants at the time of arrival on the Italian coasts, focussing on dermatological and infectious diseases. Methods Cross-sectional study of data routinely collected (n = 6, 188) by the National Institute for Health Migration and Poverty (INMP) in the centres for migrants of Lampedusa and Trapani-Milo (2015–16). Logistic models were performed to identify factors associated with scabies, varicella and the occurrence of two or more not related diagnosis. Results The average age was 21.6 years; 83.5% of the patients were males. The most frequent countries of origin were Eritrea, Nigeria, and Somalia. The most frequent diagnosis was scabies (58% of patients), skin infections, pediculosis and dermatitis; respiratory infections and varicella were the most represented infectious diseases. The diagnosis of scabies was more probable among Somalis (OR: 11.60) and Eritreans (OR: 10.05); the diagnosis of varicella was more probable among Ghanaians (OR: 13.58) and Nigerians (OR: 9.79). Somalis (OR: 4.10) and Eritreans (OR: 3.32) were the patients more likely to receive two or more diagnosis. Conclusions The majority of the diseases affecting migrants is in most cases, related to the migration experience and is likely not to represent a major threat for public health. Up-to-date information regarding the burden of diseases is needed in order to identify the health needs of incoming migrants and to arrange the appropriate response in terms of health services provision. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a significant global public health problem. Understanding risk factors is crucial for developing prevention programmes. Yet, little evidence exists on population-based prevalence and risk factors for IPV in West Africa. Our objective was to measure both lifetime and past year prevalence of IPV and to determine factors associated with past year physical or sexual IPV experience. This population-based survey involved 2000 randomly selected women aged 18 to 49 years living in 40 localities within four districts of the Central Region of Ghana. Questionnaires were interviewer-administered from February to May 2016. Respondents were currently or ever-partnered, and resident in study area ≥12months preceding the survey. Data collected included: socio-demographics; sexual behavior; mental health and substance use; employment status; 12-month and lifetime experience of violence; household food insecurity; gender norms/attitudes; partner characteristics and childhood trauma. Logistic regression modelling was used to determine factors associated with sexual or physical IPV, adjusting for age and survey design. About 34% of respondents had experienced IPV in the past year, with 21.4% reporting sexual and or physical forms. Past year experience of emotional and economic IPV were 24.6% and 7.4% respectively. Senior high school education or higher was protective of IPV (AOR = 0.51[0.30–0.86]). Depression (AOR = 1.06[1.04–1.08], disability (AOR = 2.30[1.57–3.35]), witnessing abuse of mother (AOR = 2.1.98[1.44–2.72]), experience of childhood sexual abuse (AOR = 1.46[1.07–1.99]), having had multiple sexual partners in past year (AOR = 2.60[1.49–4.53]), control by male partner (AOR = 1.03[1.00–1.06]), male partner alcohol use in past year (AOR = 2.65[2.12–3.31]) and male partner infidelity (AOR = 2.31[1.72–3.09]) were significantly associated with increased odds of past year physical or sexual IPV experience. Male perpetrated IPV remains a significant public health issue in Ghana. Evidence-based interventions targeting women’s mental health, disabilities, exposure to violence in childhood, risky sexual behavior and unequal power in relationships will be critical in reducing IPV in this setting. [ABSTRACT FROM AUTHOR]

In African societies, kinship ties determine how women are socialized, their access to power and wealth, as well as custody of children, often considered important factors in married women’s experience of intimate partner violence (IPV). Yet studies that examine how kinship norms influence IPV are scant. Using in-depth interviews collected from women identifying with both matrilineal and patrilineal descent systems, we explored differences in Ghanaian women’s experiences of IPV in both kin groups. Results show that while IPV occurs across matrilineal and patrilineal societies, all women in patrilineal societies narrated continuous pattern of emotional, physical, and sexual assault, and their retaliation to any type of violence almost always culminated in more experience of violent attacks and abandonment. In matrilineal societies, however, more than half of the women recounted frequent experiences of emotional violence, and physical violence occurred as isolated events resulting from common couple disagreements. Sexual violence against matrilineal women occurred as consented but unwanted sexual acts, but patrilineal women narrated experiencing violent emotional and physical attack with aggressive unconsented sexual intercourse. Contextualizing these findings within existing literature on IPV against women suggests that policies aimed at addressing widespread IPV in Ghanaian communities should appreciate the dynamics of kinship norms. [ABSTRACT FROM AUTHOR]

Background: Traditional healing methods are considered central to mental health care in low-income countries such as Ghana, because they are perceived to be more easily accessible, more affordable and generally ascribe similar causal beliefs to those of the patients. However, not much is known about the work of traditional healers largely because their methods are shrouded in mysticism and secrecy. There is a need to understand the ideology and beliefs of traditional healers surrounding mental disorders, including knowledge about their practices in mental health care. Aims: In this article, we discuss the causal beliefs and treatment methods of traditional medicine-men from Accra, Ghana. We also describe their diagnostic and treatment methods for mental disorders. Methods: Eight medicine-men, indigenous to the Greater Accra Region, were interviewed through individual semi-structured interviews. The data were analysed through thematic analysis. Results: The medicine-men’s beliefs about mental illness were dominated by supernatural ideas. Mental illness was also seen as a form of punishment or resulting from envy, and there was a strong reliance on spiritual direction from the gods for diagnosis and treatment. Conclusion: These themes are discussed with emphasis on their potential implications for patients, as well as for collaborative efforts. [ABSTRACT FROM AUTHOR]

Objective: Using our previously developed and tested Adolescent Sexual and Reproductive Health (SRH) Stigma Scale, we investigated factors associated with perceived SRH stigma among adolescent girls in Ghana. Methods: We drew upon data from our survey study of 1,063 females 15-24yrs recruited from community- and clinic-based sites in two Ghanaian cities. Our Adolescent SRH Stigma Scale comprised 20 items and 3 sub-scales (Internalized, Enacted, Lay Attitudes) to measure stigma occurring with sexual activity, contraceptive use, pregnancy, abortion and family planning service use. We assessed relationships between a comprehensive set of demographic, health and social factors and SRH Stigma with multi-level multivariable linear regression models. Results: In unadjusted bivariate analyses, compared to their counterparts, SRH stigma scores were higher among girls who were younger, Accra residents, Muslim, still in/dropped out of secondary school, unemployed, reporting excellent/very good health, not in a relationship, not sexually experienced, never received family planning services, never used contraception, but had been pregnant (all p-values <0.05). In multivariable models, higher SRH stigma scores were associated with history of pregnancy (β = 1.53, CI = 0.51,2.56) and excellent/very good self-rated health (β = 0.89, CI = 0.20,1.58), while lower stigma scores were associated with older age (β = -0.17, 95%CI = -0.24,-0.09), higher educational attainment (β = -1.22, CI = -1.82,-0.63), and sexual intercourse experience (β = -1.32, CI = -2.10,-0.55). Conclusions: Findings provide insight into factors contributing to SRH stigma among this young Ghanaian female sample. Further research disentangling the complex interrelationships between SRH stigma, health, and social context is needed to guide multi-level interventions to address SRH stigma and its causes and consequences for adolescents worldwide. [ABSTRACT FROM AUTHOR]

Multiple perpetrator rape (MPR) is criminalised in Ghana but there is a dearth of research and official statistics on the phenomenon. This study explores some of the key characteristics of MPR in Ghana as reported in the media. Keyword search of the news archives of 9 Ghanaian media outlets generated 57 cases of MPR reported from January 2000 through June 2016. Content analysis of the cases showed 61 all-female victims and 57 all-male perpetrator groups. The average victim age was 17.9 years and the modal perpetrator-group size was two. The majority of the victims knew at least one member of the perpetrator groups. The perpetrator groups approached their victims outdoors but raped them indoors, using violent techniques to compel compliance. Although the characteristics of MPR in Ghana, as observed in this study, are comparatively similar to those found in other African countries, further studies are recommended for a nuanced understanding of MPR in Ghana. [ABSTRACT FROM PUBLISHER]