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This study examines the role of poverty in the acquisition of and the adherence to antiretroviral therapy (ART) and prescribed clinical follow-up regimens among HIV-positive women. We conducted in-depth interviews with 40 women living with HIV (WLHIV) in Ghana and 15 stakeholders with a history of work in HIV-focused programs. Our findings indicate that financial difficulty contributed to limited ability to maintain treatment, the recommended nutrient-rich diet, and clinical follow-up schedules. However, enacted stigma and concurrent illness of family members also influenced the ability of the WLHIV to generate income; therefore, HIV infection itself contributed to poverty. To further examine the relation between finances, ART adherence, and the maintenance of recommended clinical follow-up, we present the perspectives of several HIV-positive peer counselor volunteers in Ghana's Models of Hope program. We recommend that programs to combat stigma continue to be implemented, as decreased stigma may reduce the financial difficulties of HIV-positive individuals. We also recommend enhancing current support programs to better assist peer counselor volunteers, as their role directly supports Ghana's national strategic HIV/AIDS plan. Finally, additional investment in poverty-reduction across Ghana, such as broadening meal assistance beyond the currently limited food programs, would lighten the load of those struggling to combat HIV and meet basic needs. [ABSTRACT FROM AUTHOR]

The livelihoods of persons living with HIV/AIDS (PLWHAs) in Ghana and sub-Saharan Africa have generally been under-researched using the social context approach. Employing the social context explanatory framework, we explore the livelihoods and challenges facing 38 PLWHAs in the Lower Manya Krobo Municipality (LMKM) in the Eastern Region of Ghana. LMKM has the highest prevalence of HIV/AIDS in Ghana. In-depth interviews have been conducted with participants who are out-patients at either of the two HIV/AIDS clinics in the study area. Their family relations, healthcare, healthcare seeking, and health status have been explored. The findings show the participants to generally be poor, have poorer health, and to have had some challenges to healthcare seeking, including food insecurity. They also lack sufficient support from family and romantic partners. Most have family members and romantic partners who had succumbed to HIV/AIDS. The participants generally have a high burden of child dependents, including orphans from HIV/AIDS. Our explanatory model confirms that the participants are caught at the interphase of intrapersonal, interpersonal, community, and national vulnerabilities that are interdependent and reciprocal. Safety-net provisions such as the National Health Insurance scheme provide them with inadequate social protection. For improved health status and general livelihood, we recommend more pro-active social support for the participants and their dependents. Furthermore having stakeholders make greater efforts is recommended for strengthening Ghana's economy against shocks. [ABSTRACT FROM AUTHOR]

Ghana implemented the National Health Insurance Scheme (NHIS) in 2005 with the intention of providing residents with quality affordable healthcare. Over the past few years, concerns have been raised about the quality of healthcare clients receive. This study assesses the experiences of NHIS subscribers with the quality of care they receive under the scheme by both private and public hospitals. The results from the 56 interviews show that the majority of the subscribers were dissatisfied with the overall quality of healthcare they received in both private and public hospital because of the long waiting hours, the poor attitude of nurses and the demand for payment of additional money. Even though clients who visited the private hospital paid for all services, excluding consultation, their level of satisfaction with the quality of healthcare was relatively higher than those who visited the public hospital. The paper concludes that NHIS clients do not receive the quality of healthcare the scheme promised, and this has implications for premium renewals and health-seeking behaviour. [ABSTRACT FROM AUTHOR]

Recently, Ghana has been plagued by increasing and disastrous fire emergencies, yet little research exists on Ghana’s fire response system. This paper examines the emergency fire response system in Kumasi, Ghana’s second largest city. We use spatial analysis to evaluate the geographic distribution of existing fire stations and their service areas, and identify coverage gaps based on specified response times. Our results show that large portions of the Kumasi Metropolitan Area are underserved, a situation that partly explains the huge losses in property and lives during recent fire outbreaks. Efficient location of fire stations using simple location–allocation models can help to improve response to fire emergencies and reduce the cost of fire outbreaks in African cities. [ABSTRACT FROM PUBLISHER]