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The paper examines the community representation outcomes of the modified taungya system (MTS) as a decentralized forest management intervention. It addresses how reforms in the name of decentralized forest governance and community participation have reinforced or weakened democratic representation in Ghana. Following both quantitative and qualitative techniques with in-depth interviews, questionnaires and focus group discussions as data collection techniques and a sample size of 200 respondents from four forest-dependent communities, the paper presents the type of community representation understood as responsive and downwardly accountable leadership resulting from decentralization and recognition of local authorities under the MTS forest management intervention. It is highlighted that the establishment of the modified taungya groups (MOTAGs) creates the requisite democratic space for community representation of privileged members of MOTAGs in forest governance in the communities studied. However, failure of the Forest Commission (FC) acting as intervening agent, to transfer adequate decision-making power and resources, disregard for policy and implementation guidelines and the dearth of arable lands for local people's livelihood security, collectively undermine the local authorities' capacity to be responsive and downwardly accountable which contribute to disgruntled representation of the local people in forest management. Thus, this paper shows how democratic representation has been subverted as a result of inadequate power and resources transferred to local authorities expected to provide appropriate representation for the local people under the MTS forest management intervention. In a much broader sense, the results show that decentralization does not always guarantee the production of democratic representation within the local arena, especially where authority and capacity of local institutions and representatives to deliver responsive and downwardly accountable local governance are inadequate. [ABSTRACT FROM AUTHOR]

This study investigated gender differences in the use of traditional and complementary medicine (TCM) in Ghana. Using an interviewer-administered questionnaire, we collected data from March to June 2013 from 324 randomly sampled adults in the Ashanti region. The prevalence of TCM use in the prior 12 months was 86 percent. Females constituted the majority (61 percent) of TCM users. Female TCM users were more likely than male users to have had only a basic education, been traders (p ˂ .0001), and have health insurance (p ˂ .05). Using multiple logistic regression, TCM use was associated with urban residence for females (odds ratio [OR] = 7.82; 95 percent confidence interval [CI]: 1.28-47.83) but negatively related for males (OR = 0.032; 95 percent CI: 0.002-0.63). Being self-employed was associated with TCM use among males (OR = 7.62; 95 percent CI: 1.22-47.60), while females’ TCM use was associated with higher income (OR = 3.72; 95 percent CI: 1.21-11.48) and perceived efficacy of TCM (OR = 5.60; 95 percent CI: 1.78-17.64). The African sociocultural structure vests household decision-making power in men but apparently not regarding TCM use, and the factors associated with TCM use largely differed by gender. These findings provide ingredients for effective health policy planning and evaluation. Adoption and modernization of TCM should apply a gendered lens. [ABSTRACT FROM AUTHOR]

The need for the poor, the marginalised and socially excluded to live healthier and longer lives has in recent times become paramount in the development literature and policy discussions seeking to achieve the Millennium Development Goals (MDGs). In response to this, attempts are being made to redirect the research focus to examine socio-economic factors underpinning disease occurrence and ill health for health planning policies and practices to benefit the poor and vulnerable in society. Tliis paper explores the relationship between socio-economic conditions and health outcomes. It identifies and examines through participatory rural assessment techniques, basic socio- economic factors acting as significant pathways through which poverty increases the susceptibility of rural households to diseases. It seeks to address the reasons why the poor are poorer in health in rural communities of the Amansie West district of Ghana. This paper thus emphasises how social stratification and inequalities could affect quality of life of people in any given society, hence supporting the theory of social suffering and its implications on societal health. [ABSTRACT FROM AUTHOR]