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The rationale of this study is first hinged on research deficit in topic difficulty in the public administration curriculum in African universities. Further, there is no single study in the humanities, particularly public administration (PA), that has explored the efficacy of the Culturo-Techno-Contextual Approach (CTCA) in easing learning difficulties among undergraduate students except for identifying the difficulties. Without testing indigenous teaching methods in breaking difficulties in the study of PA, educational managers and teachers in African universities are unable to understand whether the lecture method or the indigenous method holds the key to breaking difficulties in the study of politics and bureaucracy within the African university system. These compelling deficits in the public administration literature necessitate this study to fill the gap. In resolving this identified problem, the study seeks to find out whether or not there is a statistically significant difference in the achievements in politics and bureaucracy between students taught using the CTCA and those taught using the lecture method. In line with this problem, the study seeks to answer the question -- is there a statistically significant difference in the achievements in politics and bureaucracy between students taught using the CTCA and those taught using the lecture method?

There have been few studies on topic difficulty in the public administration curriculum of African universities. This is further problematized by non-existent literature on the relationships between gender, future career interest and country of study on student difficulty in the study of public administration. This is a gap in the public administration literature which this study attempts to fill. The work is significant to the extent that our understanding of 'where the shirt tights' regarding topics that students find difficult will guide teachers and other stakeholders in applying appropriate remedies. The purpose of the study is to find out (a) what topics in public administration students find difficult to learn; (b) if there are statistically significant relationship between gender and concept difficulty in the study of public administration in African universities; (c) if there are statistically significant relationship between student's career interest and concept difficulty in the study of public administration; and (d) if there are statistically significant relationship between country of study and concept difficulty in the study of public administration. Quantitative method was employed with sample (N = 650). The study reports bureaucracy, decentralization, public policy and politics as moderately difficult; significant relationship between gender and concept difficulty; and significant relationship between student future career interest and concept difficulty. We suggest curriculum development that would improve students' knowledge by laying more emphasis on the perceived difficult areas in the study of public administration, gender, and encourage early students' interest in public sector career choices.

Background: Viral hemorrhagic fevers (VHFs) belong to a group of viral infectious diseases that interfere with the blood's clotting mechanism. VHF has a wide host range, including bats, rodents, or arthropods such as mosquitoes and ticks. Most VHFs emerge suddenly as outbreaks, making it difficult to predict occurrence. To be responsive to such outbreaks, the Noguchi Memorial Institute for Medical Research (NMIMR) provides high-end molecular and genomic diagnostics capability for surveillance of suspected VHFs in samples collected from health facilities across the country. Methods: Between January 2022 and December 2023, cross-sectional surveillance for viruses was conducted in patients with suspected VHF. During the period, 2586 serum or plasma samples were collected and transported under a cold chain to the NMIMR for testing. The samples were analyzed for potential VHF viruses including yellow fever, Ebola/Marburg, Lassa fever, and Dengue viruses using Real-Time Polymerase Chain Reaction Assay. Dengue positives were serotyped using the protocol of Johnson W.B et al.,2005. Whole genome sequencing was conducted using Illumina Next Generation Sequencing Technology. Using IQ-TREE, a maximum likelihood phylogenetic analysis was carried out. Results: Dengue virus (DENV) was detected in eight patient samples that subtyped to serotypes 1, 2, and 3. All dengue fever cases were resident in the Greater Accra region. The detection of serotype one increases the possibility of multiple infections in individuals and may have a worse or increased risk of severe dengue fever. Phylogenetic analysis revealed that the DENV-1 strain shared similarities to circulating strains in West Africa. Conclusion: Until the emergence of recent cases, the circulating subtype has been serotyped as Dengue one. There is therefore the need to intensify surveillance and also to control the mosquito vectors which can transmit these DENV in Ghana. [ABSTRACT FROM AUTHOR]

Background: Diabetes is a major public health issue, and over half a billion people are estimated to be living with diabetes, with 6.7 million deaths reported in 2021. The global diabetes burden has been recognised and included in the United Nations Sustainable Development Goals to achieve a zero increase in diabetes cases and reduce one-third of premature diabetes deaths by 2030. However, local beliefs about the causes of diabetes have affected its prevention and management. This study examined community beliefs and practices about diabetes and how they affect the prevention and management of diabetes in the community. Methods: This study was carried out in the Ho Municipality of the Volta Region of Ghana. We conducted 33 in-depth interviews with 18 patients with diabetes, 5 carers (caretakers of patients with diabetes), 3 traditional healers, 2 religious leaders, 3 community elders, and 2 assembly members who were purposefully selected from urban and rural areas across the municipality. The interviews were recorded digitally and transcribed verbatim. Thematic analysis was applied to analyse the data using QRS NVivo 20. Results: Diabetes was described locally as sukli dɔ (sugar disease), which affects humans. Diabetes is believed to be caused by spiritual forces (juju, bewitchment, and punishment from gods) and physical factors (unhealthy diet, physical inactivity, eating fruits and vegetables sprayed with pesticides and insecticides, sugary and starchy foods, smoking, and abuse of alcohol). In terms of the management of diabetes, participants said traditional remedies are performed for spiritual interpretation, deliverance, fortification, and cleansing before biomedical and physical remedies are sought. Diabetes was likened to HIV/AIDS, and the sufferers were described as bringing the condition upon themselves as a result of their bad deeds. They were stigmatised, coupled with delays at the hospital, and poverty has also affected the prevention and management of diabetes. Conclusion: The local belief that diabetes is caused by spiritual forces, likened to HIV/AIDS, delays at hospitals, and poverty, has affected the prevention and management of diabetes. Incorporating local beliefs and practices into the intervention design using culturally sensitive health education programmes and improving social determinants of health may help improve the prevention and management of diabetes in communities. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to ascertain the factors affecting tacit knowledge transfer from a master to an apprentice in the informal sector among hairdressers in Ghana. Design/methodology/approach: A case study was used as the research design. Convenient sampling technique was used to select 47 master hairdressers. Semi-structured interview guide was used for data collection. Data were analysed using the thematic technique. Findings: The study found that apprenticeship fee, fear of competition, delegation reasons, joy and pride of mentorship, apprentices' attitude and time, to be significant factors influencing tacit knowledge transfer from a master to an apprentice. It was also evident that time spent with master as he/she performs or works is crucial to learning as most of the learning is through socializing with the master. Research limitations/implications: The main limitation of the study is the use of the convenient sampling technique in choosing the participants. The results of this study, if it has to be generalised to all hairdressers in Ghana, it may have to be done with caution since the participants were not drawn from a pool of all master hairdressers in Ghana. Practical implications: The paper provides what apprentices must do to acquire the tacit knowledge of master hairdressers. Originality/value: This paper focuses on the holder of tacit knowledge (master hairdressers) and reveals their motivations to transfer or hoard their tacit knowledge.

Background: In May 2019, Ghana piloted the introduction of RTS,S malaria vaccine into routine immunization in 42 districts of seven of the 16 regions. The RTS,S malaria vaccine implementation programme (MVIP) post-introduction evaluation (PIE) conducted in Ghana, assessed the immunization system as well as healthcare worker and caregiver experiences during the phase-one rollout but was less expressive on quantitative grading of the respective thematic areas of the vaccine introduction plan. Given the utility of summary statistics in programme evaluation and communication, this follow-up study aimed to provide an overall rating of the country's performance regarding the MVIP. Methods: A retrospective study was conducted from 10th January to 5th February 2024. It involved review of records to assess key thematic areas of the national MVIP plan, using a study tool adapted from the WHO New Vaccine Introduction (NVI) checklist. A composite score ranging from zero to 100 per cent was generated to assess the country's overall performance regarding introduction of the malaria vaccine, rated on a Likert scale as comprehensive, good, fair, and poor. Results: The overall performance in the MVIP was rated 78.9% (30/38) corresponding to a grading of "good" on the Likert scale. Performance indicators under thematic areas including policy, national coordination mechanisms, waste management, health worker training, and pharmacovigilance were completely achieved. However, some weaknesses were exhibited in areas such as financial consideration, cold chain, logistics, and vaccine management, and monitoring and evaluation. Conclusion: Ghana's MVIP demonstrated remarkable strengths worth leveraging to improve the national immunization programme. The weaknesses observed in some of the thematic areas present opportunities to engage key immunization partners and stakeholders towards aligning efforts to ensure a more robust expansion phase. The lessons from the MVIP may be relevant to areas introducing malaria vaccine irrespective of the product type—RTS,S or R21. [ABSTRACT FROM AUTHOR]

Background : The National Malaria Elimination Programme implements the mass LLIN Distribution Campaigns in Ghana. Implementation science promotes the systematic study of social contexts, individual experiences, real-world environments, partnerships, and stakeholder consultations regarding the implementation of evidence-informed interventions. In this paper, we assess the core elements of the mass LLIN distribution campaign in a resource constrained setting to learn best implementation practices. Three core domains were assessed through the application of Galbraith's taxonomy (i.e., implementation, content, and pedagogy) for evidence-informed intervention implementation. Methods: Six districts in two regions (Eastern and Volta) in Ghana participated in this study. Fourteen Focus Group Discussions (FGDs) were conducted across these communities. Eligible participants were purposively sampled considering age, occupation, gender, and care giving for children under 5 years and household head roles. All audio-recorded FGDs were transcribed verbatim, data was assessed and coded through deductive and inductive processes. NVivo software version 13 was used for the coding process. Themes were refined, legitimized, and the most compelling extracts selected to produce the results. Results: Sixty-nine (69) caregivers of children under 5 years and sixty (60) household heads participated in the FGDs. All caregivers were females (69), whilst household heads included more males (41). Core elements identified under implementation domain of the LLIN distribution campaign in Ghana include the registration and distribution processes, preceded by engagement with traditional authorities and continuous involvement of community health volunteers during implementation. For pedagogy domain, core elements include delivery of intervention through outreaches, illustrations, demonstrations, and the use of multiple communication channels. Core elements realized within the content domain include information on effective malaria prevention, and provision of information to enhance their self-efficacy. Yet, participants noted gaps (e.g., misuse) in the desired behavioural outcome of LLIN use and a heavy campaign focus on women. Conclusion and recommendations: Although the implementation of the mass LLIN distribution campaigns exhibit components of core elements of evidence informed interventions (implementation, content and pedagogy), it has not achieved its desired behavioural change intentions (i.e. continuous LLIN use). Future campaigns may consider use of continuous innovative pedagogical approaches at the community level and lessons learnt from this study to strengthen the implementation process of evidence-based health interventions. There is also the need for standardization of core elements to identify the number of core elements required within each domain to achieve efficacy. Ethical approval: Ethical clearance was obtained from the Ghana Health Service Ethics Review Committee (GHS-ERC: 002/06/21) before the commencement of all data collection. [ABSTRACT FROM AUTHOR]

Water, energy, and food insecurity are significant challenges that affect both economies and households, particularly in developing countries. These resources have an effect on households wellbeing, businesses, and all sectors of the economy, making them critical to ensuring household well-being, which is frequently measured by quintile welfare. As a result, there has been a significant increase in interest in securitizing these resources in order to mitigate their negative effects on household's wellbeing This study provides an empirical investigation of the determinants of water, energy, and food (WEF) security and the effect of water, energy, and food security on household well-being in Ghana. This study provides an empirical investigation of the determinants of water, energy, and food (WEF) security and the effect of water, energy, and food security on household well-being in Ghana. The study used a sample of 2,735 households from the Ghana Living Standard Survey (GLSS) Wave 7. We applied an instrumental variable probit, complementary log-log and ordered Probit estimation techniques for analysis. Empirical analysis reveals several important findings. Firstly, factors such as age, credit access, household location, employment status, and livestock ownership positively contribute to household water security, while remittances, water supply management, water bills, and water quantity have negative impacts. Secondly, age, marital status, household size, remittances, and livestock ownership significantly influence household energy security. Thirdly, marital status, household income, credit access, and household size are crucial determinants of household food security, with residence and region of household location exerting negative effects. Additionally, while water and energy security have a relatively lower impact on household well-being, food security emerges as a key driver in promoting household wellbeing. The study recommends that policymakers and stakeholders design and implement robust programs and interventions to sustain households' water, energy, and food supply. [ABSTRACT FROM AUTHOR]

Industrial activities have the potential to pollute soils with a wide variety of heavy metals (HMs). In Ghana, however, assessment of HM pollution of soils in industrial areas remains limited. Accordingly, HM soil pollution in one of the industrial areas in Accra, Ghana was assessed. Soil samples were taken and analysed for HMs, including Fe, Zr, Zn, Ti, Sr, Rb, Mn, Pb, Cu, and Co, using X-Ray Fluorescence (XRF). HM geochemical threshold values (GTVs) were determined to establish soil HM pollution levels and identify areas needing remediation. Furthermore, risk assessments were conducted to evaluate the potential ecological and human health risks associated with these metals. The mean concentrations of Fe, Zn, Rb, Sr, Zr, Ti, Mn, Co, Cu, and Pb in the soils were: 27133.83, 147.72, 16.30, 95.95, 307.11, 4663.66, 289.85, 418.54, 44.97, and 112.88 mg/kg, respectively. Generally, the concentrations of HMs decreased with depth, although some lower layers exhibited elevated HM levels. Soil pollution levels were categorized as low for Fe, Rb, Zr, Ti, Mn, Co, and Cu; moderate for Sr and Zn; and considerable for Pb. Notably, the northwestern part of the study area displayed a considerable to very high degree of HM contamination. While HMs in the soils posed low ecological risk, the human health risk assessment indicated potential health effects from Co, particularly in children. The presence of HMs in the soils was noted to originate from both natural geological phenomena and human activities, including industrial operations, agricultural practices, landfill activities, and vehicular emissions. [ABSTRACT FROM AUTHOR]

Background: Diabetes is a significant contributor to kidney failure, heart attack, strokes, lower limb amputation, blindness, and other complications that negatively impact health-related quality of life (HRQOL). This study assessed the HRQOL and clinical outcomes of patients with diabetes accessing healthcare in south-eastern Ghana. Methods: This was a hospital-based cross-sectional descriptive study conducted in the Ho Municipal and Ho Teaching Hospitals in Ghana among patients with type 2 diabetes who were seeking healthcare at both hospitals for at least 12 months. Systematic random sampling technique was used to select 310 respondents out of the total sample size of 326 patients with type 2 diabetes and data were collected using diabetes-39 questionnaire. The data were analysed using STATA 16.0. Socio-demographic and clinical variables were expressed as frequencies and percentages. Differences between proportions were tested using Chi-square to identify predictors of poor HRQOL and Pearson correlation for association. The p < 0.05 was considered significant. Results: Out of 310 respondents, 171 (55.0%) had poor HRQOL. The predictors of poor HRQOL were age (p < 0.008), education (p < 0.028), employment (p < 0.001), residence (p < 0.01), duration of diabetes (p < 0.002), diabetes education (p < 0.001), BMI (p < 0.005), and glycaemic control (p < 0.001). Energy and mobility (63.2%), anxiety and worry (53.9%), and diabetes control (49.6%) dimensions were the most prevalent of poor HRQOL. Diabetes education, complications, being diabetic for 16 years and above, earning income, resident in rural area, being married, being pensioner and national Service Personnel, and diabetes comorbidities were significantly associated with HRQOL. Conclusions: More than half of the respondents had poor HRQOL. Clinical and public health efforts should focus on effective control and screening measures for the individual patients and general population. [ABSTRACT FROM AUTHOR]

The study examines the use of online public access catalogues (OPAC) at the Catholic University College of Ghana. The research aims to assess the awareness of OPAC among library users, analyze its usage, identify related challenges, and determine user satisfaction. A quantitative research approach was employed, targeting students at the Catholic University College of Ghana as the study population. Data were analyzed using version 25 of the Statistical Package for Social Sciences (SPSS). The findings revealed challenges related to the limited availability of computers for OPAC systems, with users experiencing delays due to others occupying the available computers. Additionally, respondents showed a lack of sufficient IT knowledge. To address these issues, the study recommends that the library authority invest in more hardware or computers to improve accessibility. It also suggests ongoing training for patrons to enhance their IT skills and familiarity with the system. [ABSTRACT FROM AUTHOR]

Civil society space is constantly shifting, either negatively (e.g., shrinking, narrowing) or positively (e.g., expanding). These shifts are predominantly attributed to actions by central government actors, such as the implementation and enforcement of laws. Emergent work, however, also recognizes that in the context of the Global South, the international community can take actions to shrink or expand civil society space. Recently, Ghana in West Africa—known for its democratic stability—has introduced significant legislative and administrative reforms aimed at regulating the NGO sector. We interview 20 Ghanaian service‐providing NGOs to explore perceived shifts in civil society space and the impacts of these shifts, as well as strategies service‐providing NGOs are employing in response to shifting civic space. Findings identify perceived shifts in civic space caused by international actors and the Ghanaian government, as well as strategies for combating and mitigating shifting space. [ABSTRACT FROM AUTHOR]

Over the years, Ghana has made notable strides in adopting digital approaches to address societal challenges and meet demands. While the health sector, particularly the disease surveillance structure, has embraced digitization to enhance case detection, reporting, analysis, and information dissemination, critical aspects remain to be addressed. Although the Integrated Disease Surveillance and Response (IDSR) structure has experienced remarkable growth in digitization, certain areas require further attention as was observed during the COVID-19 pandemic. Ghana during the COVID-19 pandemic, recognized the importance of leveraging digital technologies to bolster the public health response. To this end, Ghana implemented various digital surveillance tools to combat the pandemic. These included the 'Surveillance Outbreak Response Management and Analysis System (SORMAS)', the digitalized health declaration form, ArcGIS Survey123, Talkwalker, 'Lightwave Health information Management System' (LHIMS), and the 'District Health Information Management System (DHIMS)'. These digital systems significantly contributed to the country's success in responding to the COVID-19 pandemic. One key area where digital systems have proved invaluable is in the timely production of daily COVID-19 situational updates. This task would have been arduous and delayed if reliant solely on paper-based forms, which hinder efficient reporting to other levels within the health system. By adopting these digital systems, Ghana has been able to overcome such challenges and provide up-to-date information for making informed public health decisions. This paper attempts to provide an extensive description of the digital systems currently employed to enhance Ghana's paper-based disease surveillance system in the context of its response to COVID-19. The article explores the strengths and challenges or limitations associated with these digital systems for responding to outbreaks, offering valuable lessons that can be learned from their implementation. [ABSTRACT FROM AUTHOR]

Introduction: The true nature of the population spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in populations is often not fully known as most cases, particularly in Africa, are asymptomatic. Finding the true magnitude of SARS-CoV-2 spread is crucial to provide actionable data about the epidemiological progress of the disease for researchers and policymakers. This study developed and optimized an antibody enzyme-linked immunosorbent assay (ELISA) using recombinant nucleocapsid antigen expressed in-house using a simple bacterial expression system. Methods: Nucleocapsid protein from SARS-CoV-2 was expressed and purified from Escherichia coli. Plasma samples used for the assay development were obtained from Ghanaian SARS-CoV-2 seropositive individuals during the pandemic, while seronegative controls were plasma samples collected from blood donors before the coronavirus disease 2019 (COVID-19) pandemic. Another set of seronegative controls was collected during the COVID-19 pandemic. Antibody detection and levels within the samples were validated using commercial kits and Luminex. Analyses were performed using GraphPad Prism, and the sensitivity, specificity and background cut-off were calculated. Results and Discussion: This low-cost ELISA (£0.96/test) assay has a high prediction of 98.9%, and sensitivity and specificity of 97% and 99%, respectively. The assay was subsequently used to screen plasma from SARS-CoV-2 RT-PCR-positive Ghanaians. The assay showed no significant difference in nucleocapsid antibody levels between symptomatic and asymptomatic, with an increase of the levels over time. This is in line with our previous publication. Conclusion: This study developed a low-cost and transferable assay that enables highly sensitive and specific detection of human anti-SARS-CoV-2 IgG antibodies. This assay can be modified to include additional antigens and used for continuous monitoring of sero-exposure to SARS-CoV-2 in West Africa. [ABSTRACT FROM AUTHOR]

Yellow fever virus, transmitted by infected Aedes spp. mosquitoes, causes an acute viral hemorrhagic disease. During October 2021–February 2022, a yellow fever outbreak in some communities in Ghana resulted in 70 confirmed cases with 35 deaths (case-fatality rate 50%). The outbreak started in a predominantly unvaccinated nomadic community in the Savannah region, from which 65% of the cases came. The molecular amplification methods we used for diagnosis produced full-length DNA sequences from 3 confirmed cases. Phylogenetic analysis characterized the 3 sequences within West Africa genotype II; strains shared a close homology with sequences from Cote d’Ivoire and Senegal. We deployed more sensitive advanced molecular diagnostic techniques, which enabled earlier detection, helped control spread, and improved case management. We urge increased efforts from health authorities to vaccinate vulnerable groups in difficult-to-access areas and to educate the population about potential risks for yellow fever infections. [ABSTRACT FROM AUTHOR]

This paper demonstrates how two different methods used to calculate population-level mobility from Call Detail Records (CDR) produce varying predictions of the spread of epidemics informed by these data. Our findings are based on one CDR dataset describing inter-district movement in Ghana in 2021, produced using two different aggregation methodologies. One methodology, "all pairs," is designed to retain long distance network connections while the other, "sequential" methodology is designed to accurately reflect the volume of travel between locations. We show how the choice of methodology feeds through models of human mobility to the predictions of a metapopulation SEIR model of disease transmission. We also show that this impact varies depending on the location of pathogen introduction and the transmissibility of infections. For central locations or highly transmissible diseases, we do not observe significant differences between aggregation methodologies on the predicted spread of disease. For less transmissible diseases or those introduced into remote locations, we find that the choice of aggregation methodology influences the speed of spatial spread as well as the size of the peak number of infections in individual districts. Our findings can help researchers and users of epidemiological models to understand how methodological choices at the level of model inputs may influence the results of models of infectious disease transmission, as well as the circumstances in which these choices do not alter model predictions. Author summary: Predicting the sub-national spread of infectious disease requires accurate measurements of inter-regional travel networks. Often, this information is derived from the patterns of mobile device connections to the cellular network. This travel data is then used as an input to epidemiological models of infection transmission, defining the likelihood that disease is "exported" between regions. In this paper, we use one mobile device dataset collected in Ghana in 2021, aggregated according to two different methodologies which represent different aspects of inter-regional travel. We show how the choice of aggregation methodology leads to different predicted epidemics, and highlight the conditions under which models of infection transmission may be influenced by methodological choices in the aggregation of travel data used to parameterize these models. For example, we show how aggregation methodology changes predicted epidemics for less-transmissible infections and under certain models of human movement. We also highlight areas of relative stability, where aggregation choices do not alter predicted epidemics, such as cases where an infection is highly transmissible or is introduced into a central location. [ABSTRACT FROM AUTHOR]

Background: Measles has high primary reproductive number, extremely infectious and ranked second to malaria in terms of disease burden in Ghana. Owing to the disease's high infectious rate, making early diagnosis based on an accurate system can help limit the spread of the disease. Studies have been conducted to derive models to serve as preliminary tools for early detection. However, these derived models are based on traditional methods, which may be limited in terms of model sensitivity and prediction power. This study focuses on comparing the performance of five machine learning classification techniques with a traditional method for predicting measles patients in Ghana. The study was an analytical cross-sectional design of suspected measles cases in Ghana. Results: The performance of six classifiers were compared and the random forest (RF) model demonstrated better performance among other models. The RF model achieved the highest sensitivity (0.88) specificity (0.96), ROC (0.92) and total accuracy (0.92). Conclusions: Our findings showed that, despite all the six methods had good performance in classifying measles patients, the RF model outperformed all the other classifiers in terms of different criteria in prediction accuracy. Accordingly, this approach is an effective classifier for predicting measles in the early stage. [ABSTRACT FROM AUTHOR]

Introduction: Health care workers (HCWs) are crucial to the fight against COVID-19 and are at risk of being infected. We sought to determine the risk factors and associations of COVID-19 among HCWs in Ghana during the period of the pandemic. Materials and methods: A case-control study was conducted using the WHO COVID-19 HCWs exposure risk assessment tool. A HCW was categorized as "high risk" for COVID-19 if s/he did not respond "always, as recommended" to adherence to Infection Prevention and Control (IPC) measures during a healthcare interaction. A HCW was categorized as "low risk" if s/he responded "always, as recommended" to adherence to IPC measures. We used univariate and multiple logistic regression models to determine associated risk factors. Statistical significance was set at 5%. Results: A total of 2402 HCWs were recruited and the mean age was 33.2±7.1 years. Almost 87% (1525/1745) of HCWs had high risk for COVID-19 infection. Risk factors identified were profession (doctor- aOR: 2.13, 95%CI: 1.54–2.94; radiographer—aOR: 1.16, 95% CI: 0.44–3.09)), presence of comorbidity (aOR: 1.89, 95%CI: 1.29–2.78), community exposure to virus (aOR: 1.26, 95% CI: 1.03–1.55), not performing hand hygiene before and after aseptic procedures performed (aOR: 1.6, 95% CI: 1.05–2.45); not frequently decontaminating high-touch surfaces always as recommended (aOR: 2.31, 95%CI: 1.65–3.22; p = 0.001) and contact with a confirmed COVID-19 patient (aOR: 1.39, 95% CI: 1.15–1.67). Among those who came into any form of contact with confirmed COVID-19 patient, providing direct care (aOR: 2.0, 95%CI: 1.36–2.94), face-to-face contact (aOR: 2.23, 95%CI: 1.41–3.51), contact with environment/materials used by COVID-19 patient (aOR: 2.25, 95%CI: 1.45–3.49) and presence during conduct of aerosol generating procedures (aOR: 2.73, 95%CI: 1.74–4.28) were associated with COVID-19 infection. Conclusion: Non-adherence to IPC guidelines puts HCWs at increased risk of COVID-19 infection thus ensuring IPC adherence is key to reducing this risk. [ABSTRACT FROM AUTHOR]

Purpose: This study examines what constitutes competence and how a novice becoming a competent weaver is enabled by information literacy in the fabric-weavers' workplace landscape. Design/methodology/approach: Ethnography as a research design was employed using participant observation and semi-structured interviews as the data collection techniques. Findings: Competence constitutes the demonstration of Kente knowledge and mentorship capability enabled by information literacy through access to the on-the-loom and off-the-loom information in the Kente-weaving landscape. Research limitations/implications: This study explains how the transition from a novice weaver to a competent weaver is underpinned by information literacy. Originality/value: This is one of the first studies that contribute to the understanding of information literacy in the craft workplace. The study proposes a framework for weavers' information literacy practice. [ABSTRACT FROM AUTHOR]

In Ghana, aquaculture offers acceptable opportunities for generating income. Cage aquaculture has a lot of potential for growth in Lake Volta. In this region, cage aquaculture farmers perform aquaculture in a variety of ways that fall into three major groups: commercial, medium scale, and small scale. In this study, the profitability and production economics of small-scale aquaculture operations in Lake Volta were examined. The average total revenue accrued and the average total costs of production were Gh₵395231.25 and Gh₵267970.15, respectively. The overall gross margin and net return for all the farms were Gh₵130294.02 and Gh₵127,261.10 per cycle, respectively. The overall assessment of the profitability performance indicators such as the benefit-cost ratio (BCR), the return on investment (ROI), the net present value (NPV), the operating expense ratio (OE), the operating profit margin (OPM), and the gross margin ratio (GMR) were 1.47, 47.49%, Gh₵407625.47, 0.77%, 32.20%, and 33.00%, respectively. These indicators showed that small-scale cage fish farming in the study area is profitable. The sensitivity analysis further demonstrated that small-scale cage fish production was robustly profitable. In light of this, the study suggests that stakeholders educate small-scale cage aquaculture farmers on the profitability of the business and make a concerted effort to teach and equip farmers with best management practises (BMPs), water quality management, feeds, and feeding management. [ABSTRACT FROM AUTHOR]

Introduction: Ghana is the first country in sub-Saharan Africa (SSA) to aim for universal health coverage (UHC). Based on Ghana's UHC system, the accessibility and distribution of healthcare facilities were evaluated for 2020. Projecting into 2030, this study aimed at providing geographical information data for guiding future policies on siting required healthcare facilities. Ghana as a precedent for SSA was evaluated and proposed to "leave no disease behind" in the surveillance of infectious diseases (IDs). This is to reinforce the sustainable development goals (SDG) 3 agenda on health that underpins monitoring equity in "leaving no one behind." Methods: Geospatial accessibility, travel time data, and algorithms were employed to evaluate the universality and accessibility of healthcare facilities, and their future projections to meet UHC by 2030. Healthcare facilities as surveillance sites were compared to community-based surveillance to identify which would be more applicable as a surveillance system to leave no disease behind in Ghana. Findings: Ghana has 93.8%, 6.1% and 0.1% as primary, secondary and tertiary healthcare facilities respectively. It has 26.1% of healthcare facilities remaining to meet the SDG 3 health target by 2030. In terms of providing quality healthcare, 29.3% and 67.2% of the additional required healthcare facilities for optimal allocation and achieving the UHC target need to be secondary and tertiary respectively. In assessing the broad spectrum of IDs studied from 2000 to 2020, an average of 226 IDs were endemic or potentially endemic to Ghana. The majority of the studies carried out to identify these IDs were done through community-based surveillance. Conclusion: Establishing community-based surveillance sites to leave no disease behind and also providing the required healthcare facilities to reinforce leaving no one behind will enhance the universal health security of Ghana as a precedent for SSA. [ABSTRACT FROM AUTHOR]

This article analyses the contingent factors which influence the relationship between entrepreneurial passion and venture profit. While research on entrepreneurial passion is burgeoning, studies that analyse contingent factors and boundary conditions surrounding entrepreneurial passion theory are sparse. Moreover, we know very little about how the influence of entrepreneurial passion on venture outcomes might vary in emerging markets, typically characterised by higher levels of bureaucratic involvement and institutional deficiencies. We extend entrepreneurial passion theory by testing a contingent model that evaluates the influence of political connections and environmental dynamism on the relationship between entrepreneurial passion and venture profit. More specifically, we examine the role of passion on venture profit and the moderating impact of political connections and perceived environmental dynamism. Using time-lagged data from 231 small businesses in Ghana, we find that political connections amplify the potency of passion as a driver of venture profit. In addition, we find that this interaction is conditioned by environmental dynamism; specifically, the moderating effect of political connections on the relationship between entrepreneurial passion and venture profit is stronger when dynamism is high. Our fine-grained analysis increases the conceptual scope and generalisability of entrepreneurial passion to non-Western contexts. [ABSTRACT FROM AUTHOR]

Smallholder farmers in Northern Ghana regularly face shocks, challenging the sustainability of their farms and livelihoods. Different farm households and household members may be differently affected and respond with different coping strategies. We combined whole-farm modelling and farmer consultations to investigate the vulnerability, buffer and adaptive capacity of three farm types in Northern Ghana towards severe climate, economic and social shocks. We further assessed intra-household differences in respective risk mitigation and coping strategies. Our model results indicate that the drought shock would most severely affect all farm types, drastically reducing their operating profits and soil organic matter balance. The medium resource endowed farm was most affected by shocks, but all farm types could enhance their capacity to recover by adopting technology packages for sustainable intensification. Gendered coping strategies included livestock sales, post-harvest storage, activating social networks, rice processing and the collection, processing and sales of wild nuts and fruits. Farmers reported to aim at becoming more resilient by increasing their herd size and expanding their farmland, thereby risking to increase rather than reduce the pressure on natural resources. New questions arise concerning the carrying capacity of local ecosystems and resilience at community and landscape level. [ABSTRACT FROM AUTHOR]

Background: Integrated health systems with strong laboratory networks are critical in improving public health. The current study assessed the laboratory network in Ghana and its functionality using the Assessment Tool for Laboratory Services (ATLAS). Intervention: A national-level laboratory network survey was conducted among stakeholders of the Ghanaian laboratory network in Accra. Face-to-face interviews were conducted from December 2019 to January 2020, with follow-up phone interviews between June and July 2020. Also, we reviewed supporting documents provided by stakeholders for supplementary information and transcribed these to identify themes. Where possible, we completed the Laboratory Network scorecard using data obtained from the ATLAS. Lessons learnt: The Laboratory Network (LABNET) scorecard assessment was a valuable addition to the ATLAS survey as it quantified the functionality of the laboratory network and its overall advancement toward achieving International Health Regulations (2005) and Global Health Security Agenda targets. Two significant challenges indicated by respondents were laboratory financing and delayed implementation of the Ghana National Health Laboratory Policy. Recommendations: Stakeholders recommended a review of the country's funding landscape, such as funding laboratory services from the country's internally generated funds. Also, they recommended laboratory policy implementation to ensure adequate laboratory workforce and standards. [ABSTRACT FROM AUTHOR]

Market participation is both a cause and a consequence of economic development. Markets offer households the opportunity to specialize according to comparative advantage and thereby enjoy welfare gains from trade. The current literature on product marketing in Ghana is inadequate for designing and implementing effective policies to overcome problems in the marketing system, especially leguminous crops. Based on this, the study analyses the determinants of groundnut farmers' decision to participate and the level of market participation in Northern Ghana using cross-sectional data from 250 smallholder farmers. We employed the generalized double hurdle model to analyse the objectives of this study. On average, the study found that 62% of groundnut output harvested by farm households in Northern Ghana was sold on the market. The most significant determinants of market participation decision and intensity of participation in the groundnut market include extension service, distance to output market, farmer-based organization, off-farm income, output price, use of improved groundnut variety, and access to transport. We recommend that strategies and policies aiming at promoting smallholder commercialization should focus on providing rural infrastructure, market-oriented extension services, and forming farmer groups for collective marketing. [ABSTRACT FROM AUTHOR]

This article reports on the relationship between becoming information literate and the body in the Kente-weaving landscape. A mixed approach of incorporative ethnographic participant observation and semi-structured interviews with 24 participants through their roles as either master weaver, junior weaver or novice weaver at the Bonwire Kente Centre. Thematic analysis through an embodied-practice approach to information literacy (IL) frames the analysis of this study. The findings show that the body facilitates IL or knowing by understanding and making meaning of the cues afforded it from interaction and participation in the Kente-weaving practices. The body facilitates or enables IL through identifying and understanding cues in an information landscape. [ABSTRACT FROM AUTHOR]

Groundwater is increasingly being used to help meet the Sustainable Development Goals (SDGs) 2 and 6 in many parts of the world, including Ghana. Against this background, hydrogeochemical and multivariate statistical studies were conducted to determine the physicochemical characteristics and suitability of groundwater in some agrarian communities in the Upper East Region of Ghana for drinking and irrigational farming. Additional analyses were also performed to identify potential health risks associated with the groundwater use and to better understand the hydrogeochemical processes controlling groundwater evolution for its effective management. The results showed that the groundwater is typically fresh; moderate to very hard in character; undersaturated with calcite, dolomite, halite, and gypsum; and supersaturated with quartz and amorphous silica. The physicochemical characteristics of the groundwater are controlled by both anthropogenic and natural activities/processes, such as fertilizer application, irrigation return flows, rock weathering, and forward/reverse cation exchange. The total dissolved solids (TDS) (165–524 mg/L), electrical conductivity (EC) (275–873 μS/cm), sodium percentage (Na%; 9.05–17.74%), magnesium ratios (MR) (29.25–53.3%), permeability index (PI) (36.6–74.6%), and sodium adsorption ratio (SAR) (0.20–0.51) point to the possibility of using the groundwater for irrigation, however, with some salinity control. The water quality and health risk analysis also revealed that the groundwater can be used for drinking; however, the high concentrations of fluoride, which can cause noncarcinogenic health issues such as dental and skeletal fluorosis in both adults and children, must be reduced to the WHO required level of 1.5 mg/L. [ABSTRACT FROM AUTHOR]

The study examines the information exchange activities among librarians when communicating in a virtual community. Specifically, the study explores the kind of information librarians seek or share in a virtual community. The study also explores how librarians react to the shared or sought-for information in a virtual community. This study was carried out on 50 librarians in community of practice on a WhatsApp platform. Netnography as a research design was used in this study. Data were analysed using thematic content analysis techniques. The findings show that librarians share information that encourage and support one another. The findings also show that librarians share and seek related information on career and institutional work, thought-provoking information and personality quotes. In reaction to the shared information, librarians peruse shared information for their authenticity. Librarians share appreciative messages in reaction to the sharing of important and educative information. In the situation of misinformation or where suspicious information is shared, librarians counter the shared information in reaction by posting messages cautioning librarians to beware of scam. [ABSTRACT FROM AUTHOR]

Background: The declaration of COVID-19 as a pandemic on March 11 2020, by the World Health Organisation prompted the need for a sustained and a rapid international response. In a swift response, the Government of Ghana, in partnership with Zipline company, launched the use of Unmanned Automated Vehicles (UAV) to transport suspected samples from selected districts to two foremost testing centres in the country. Here, we present the experiences of employing this technology and its impact on the transport time to the second largest testing centre, the Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR) in Kumasi, Ghana. Methods: Swab samples collected from suspected COVID-19 patients were transported to the Zipline office by health workers. Information on the samples were sent to laboratory personnel located at KCCR through a WhatsApp platform to get them ready to receive the suspected COVID-19 samples while Zipline repackaged samples and transported them via drone. Time of take-off was reported as well as time of drop-off. Results: A total of 2537 COVID-19 suspected samples were received via drone transport from 10 districts between April 2020 to June 2021 in 440 deliveries. Ejura-Sekyedumase District Health Directorate delivered the highest number of samples (765; 30%). The farthest district to use the drone was Pru East, located 270 km away from KCCR in Kumasi and 173 km to the Zipline office in Mampong. Here, significantly, it took on the average 39 minutes for drones to deliver samples compared to 117 minutes spent in transporting samples by road (p<0.001). Conclusion: The use of drones for sample transport during the COVID-19 pandemic significantly reduced the travel time taken for samples to be transported by road to the testing site. This has enhanced innovative measures to fight the pandemic using technology. [ABSTRACT FROM AUTHOR]

Background: Burnout syndrome is a psycho-social disorder which develops in an individual exposed to chronic stress on the job. Health workers in sub-Saharan Africa (SSA) are at increased risk of burnout due to job-related challenges. Burnout does not only affect the job performance of employees, but could result in dysregulation of multiple physiological systems (allostatic load) in victims and predispose them to non-communicable diseases (NCDs). This study examined the association between burnout and allostatic load among health workers engaged in human resourced-constrained hospitals in Accra, Ghana.Method: This study was a hospital-based cross-sectional study involving 1264 health workers (clinicians and non-clinicians) from three public hospitals in Accra, Ghana who were recruited using a proportionate stratified random sampling technique. The participants completed a questionnaire which collected general and burnout information. In addition, each participant's anthropometric; biochemical and hemodynamic indices were measured. The allostatic load in the participants was determined using eleven (11) biomarkers from the neuro-endocrine, cardiovascular, metabolic and anthropometric measures. The relationship between burnout and allostatic overload (high allostatic load) was determined at the bivariate and multivariable levels. The data analysis was done with the aid of Stata 15.0 at a 95% confidence level.Results: The prevalence of burnout was 20.57%, higher in non-clinicians than clinicians (26.74% vs 15.64, p <  0.001). Also, non-clinical participants had higher levels of emotional exhaustion and depersonalization than the clinical participants. Over a quarter (26.27%) of the participants had allostatic overload manifesting as high allostatic load. Furthermore, for a one unit increase in overall burnout, the odds of experiencing allostatic overload was increased by 17.59 times (AOR = 17.59, 95% CI: 11.7-26.4) as compared to those without burnout and similar findings were found for the individual components of burnout syndrome with high allostatic load.Conclusion: Burnout among health workers is associated with multi-system physiological dysregulation manifesting as high allostatic load; a major risk factor for NCDs. It is recommended that measures aimed at reducing burnout and allostatic overload such as structured psychological counseling and healthy lifestyle patterns are recommended for health workers engaged in stressful work settings to reduce their risk of NCDs. [ABSTRACT FROM AUTHOR]

Purpose: This study seeks to identify locational and gendered determinants of inclusion of households in Livelihood Empowerment Against Poverty (LEAP) and estimate the respective impacts of LEAP on children education enrolment of beneficiary households in Ghana. Design/methodology/approach: The study used secondary data of the Ghana Living Standard Survey Round 7 and employed the propensity score matching (PSM) model for the analysis of the objectives. Findings: The PSM results established that different factors determine the inclusion of households in LEAP in rural and urban areas. Similarly, different factors determine the inclusion of male-headed and female-headed households in the programme. The impact of LEAP on children education is higher in urban areas compared to rural areas. The impact of LEAP on children's education is 10.4% higher in urban areas than in rural areas. Lastly, female-headed households are better at using the cash received from LEAP to take care of their wards' education relative to male-headed households. Practical implications: The study recommends that different selection criteria should be used in selecting male-headed and female-headed as well as urban and rural poor households for inclusion in the LEAP programme. Female-headed households should be prioritised for benefiting from LEAP. The social welfare department disbursing the LEAP funds in rural areas should intensify education on the need for LEAP beneficiary households to enrol their wards in schools. Originality/value: In this paper, the authors demonstrate that household inclusiveness of LEAP is influenced by locational and gendered factors. Also, the impact of LEAP on children education enrolment is relatively higher in urban areas than rural areas. Lastly, female-headed households relatively educate their wards with LEAP benefits than male-headed households. [ABSTRACT FROM AUTHOR]

Diarrheal disease remains a major global health problem particularly in children under 5 years and the emergence of antibiotic-resistant strains of causative pathogens could slow control efforts, particularly in settings where treatment options are limited. This surveillance study conducted in Ghana aimed to determine the prevalence and antimicrobial susceptibility profile of diarrhea-causing bacteria. This was a cross-sectional study carried out in five health facilities in the Ga West Municipality of Ghana between 2017 and 2021. Diarrheic stool samples from patients were collected and cultured on standard differential/selective media and isolates identified by standard biochemical tests, MALDI-TOF assay, and serological analysis. The antibiogram was determined using Kirby-Bauer disk diffusion and Microscan autoScan4 MIC panels which were used for extended-spectrum beta-lactamase (ESBL) detection. Bacteria were isolated from 97.5% (772/792) of stool samples, and 167 of the isolates were diarrheagenic and met our inclusion criteria for antimicrobial resistance (AMR) analysis. These included Escherichia coli (49.1%, 82/167), Salmonella species (23.9%, 40/167), Vibrio species (16.8%, 28/167), and Shigella species (10.2%, 17/167). Among 24 Vibrio species, we observed resistances to cefotaxime (21/24, 87.5%), ceftriaxone (20/24, 83.3%), and ciprofloxacin (6/24, 25%), including four multi-drug resistant isolates. All 13 Vibrio parahaemolyticus isolates were resistant to cefazolin. All 17 Shigella isolates were resistant to tetracycline with resistance to shigellosis drugs such as norfloxacin and ciprofloxacin. Salmonella isolates were highly susceptible to norfloxacin (40/40, 100%) and tetracycline (12/34, 35%). Two ESBL-producing E. coli were also identified with marked susceptibility to gentamicin (66/72, 91.7%) and amikacin (57/72, 79.2%) prescribed in the treatment of E. coli infections. This study showed the different bacteria implicated in diarrhea cases in Ghana and the need for differential diagnoses for better treatment outcomes. Escherichia coli , Shigella , Salmonella , and Vibrio have all been implicated in diarrhea cases in Ghana. The highest prevalence was E. coli and Salmonella with Shigella the least prevalent. Resistance to commonly used drugs found in these isolates may render bacteria infection treatment in the near future nearly impossible. Routine antimicrobial susceptibility testing, effective monitoring, and nationwide surveillance of AMR pathogens should be implemented to curb the increase of antimicrobial resistance in Ghana. [ABSTRACT FROM AUTHOR]

Progress towards the Sustainable Development Goal 7 and other related goals hinges on increased access to clean energy alternatives for all people irrespective of where they live. However, most developing countries including Ghana still rely largely on traditional biomass as the main source of household energy as a result of a myriad of challenges. From the foregoing, the present study uses the Ghana Living Standard Survey 7 (GLSS 7) household data and the multinomial logit regression model to analyse the factors that determine the transition to cleaner cooking energy in Ghana. The analysis shows that the main determinants of household energy choice in Ghana are education, household dwelling type, household size, employment and income group. Whereas education, modern housing, paid employment and higher income increase the adoption of cleaner energy, a higher dependency ratio and employment in the informal sector increase the likelihood of using unclean energy. Increased access to education and the adoption of policies to improve housing conditions, employment and incomes are recommended to encourage the adoption of cleaner energy alternatives. [ABSTRACT FROM AUTHOR]

Yellow fever is endemic in Ghana and outbreaks occur periodically. The prodromal signs due to Yellow Fever Virus (YFV) infection are non-specific, making clinical signs unreliable as the sole criteria for diagnosis. Accurate laboratory confirmation of suspected yellow fever cases is therefore vital in surveillance programs. Reporting of ELISA IgM testing results by laboratories can delay due to late arrival of samples from the collection sites as well as limited availability of ELISA kits. In this study, the diagnostic performance characteristics of a rapid immunochromatographic Standard Q Yellow Fever IgM test kit (SD Biosensor) was evaluated for the rapid diagnosis of Yellow Fever infection in Ghana. A panel of 275 sera, comprising 81 confirmed YFV positives and 194 negatives were re-tested in this study using the Standard Q Yellow Fever IgM test kit. Using the CDC/WHO Yellow Fever IgM capture ELISA as a benchmark, the sensitivity, specificity and accuracy of the Standard Q Yellow Fever test kit were 96.3%, 97.9% and 97.5%, respectively. The false positivity rate was 5.1% and there was no cross-reactivity when the Standard Q Yellow Fever test kit was tested against dengue, malaria and hepatitis B and C positive samples. In addition, inter-reader variability and invalid rate were both zero. The results indicate that the diagnostic performance of the Standard Q Yellow Fever IgM test kit on serum or plasma is comparable to the serum IgM detection by ELISA and can be used as a point of care rapid diagnostic test kit for YFV infection in endemic areas. [ABSTRACT FROM AUTHOR]

Purpose: Agriculture in Ghana is dominated by smallholder farmers in rural areas. Majority of these farmers are resource-poor and faced with serious challenges in accessing formal financial services towards farming needs attributed to the stringent requirements. To bridge this gap, village savings and loan associations (VSLA) have been promoted in rural areas as an alternative to meeting the credit needs of smallholder farmers. Credit plays a vital role in input acquisition among farmers for improved agricultural value productivity. This study assesses the contribution of VSLA to agricultural value productivity in the Northern Region of Ghana. Design/methodology/approach: The methodology is a primary cross-sectional data collected with the help of a semi-structured questionnaire. This study, therefore, applied a propensity score matching (PSM) to assess the effects of VSLA on agricultural value productivity. Findings: Results from the PSM revealed that extension contact, contract farming, television set ownership, participating in "Planting for Food and Jobs" and nature of roads, including receiving VSLA information from members' increases participation decision of farmers in VSLA. Conversely, age of a farmer, household size, distance to output market and farmers in the Sagnarigu Municipality have negatively influenced VSLA participation. The propensity score matching estimates showed that members of VSLA obtained 38.2% higher agricultural value productivity than non-members. Originality/value: Village savings and loans associations can be promoted among smallholder farmers as an effective alternative to formal financial service for inclusive development. [ABSTRACT FROM AUTHOR]

Purpose: Cocoa is regarded as a brown-golden crop, but its value chain activities are dominated by the elderly. Hence, focussing attention on the young generation of farmers is the surest way to reverse this trend and secure the future of the cocoa industry. This paper, therefore explores factors influencing youth participation in cocoa value chain activities in Ghana. Design/methodology/approach: Primary data were collected using a multistage sampling technique. The authors used a semi-structured questionnaire in collecting data via interviews. Through the theory of utility maximization, a multivariate probit (MVP) model was estimated to identify factors influencing youth participation in cocoa value chain activities in Ghana. Findings: The author found that some of the value chain activities are complementary, while others are substitutes. Participation in cocoa value chain activities is influenced by access to land, participation in training programmes in cocoa production, membership of Next Generation Cocoa Youth Programme (MASO), access to agricultural credit and other demographic characteristics. Research limitations/implications: Relevant information and youth-targeted projects enhance their participation in value chain activities. Originality/value: This paper is one of the few studies that empirically analyses drivers of youth participation in cocoa value chain activities in Africa. [ABSTRACT FROM AUTHOR]

The study was conducted to analyze and ascertain the relevance of forest to the livelihood security of rural households in Northern Ghana. Primary data were collected from 240 sampled rural households from forest fringe communities in the West Gonja District and non-forest fringe communities in the Central Gonja District. Household livelihood security was measured using six security indices. The study results revealed that forest matters significantly in terms of livelihood security, with the forest livelihood zone recording higher livelihood security than the non-forest livelihood zone. The study established using Welch's t-test a statistically and significantly higher livelihood security in the forest zone than in the non-forest zone. It is recommended that household livelihood diversification, geographical location and sustainable forest resource management are critical for policies that are aimed at alleviating rural poverty and guaranteeing rural livelihood securities. [ABSTRACT FROM AUTHOR]

Introduction: many hypertensive patients require two or more anti-hypertensive drugs, but in lowand middle-income countries there may be challenges with medication access or affordability. The objective of this study was to determine accessibility and affordability of anti-hypertensive medicines and their association with blood pressure (BP) control among hypertensive patients attending the Korle-Bu teaching hospital (KBTH) polyclinic. Methods: a cross-sectional study was conducted among 310 systematically sampled hypertensive patients attending the KBTH Polyclinic in Ghana. A structured questionnaire was used to obtain data on patient demographics and clinical characteristics, prices, availability and mode of payment of generic anti-hypertensive medicines. Results: fifty-nine patients (19.4%) made out-ofpocket payments. At the private pharmacy and hospital, 123 (40.5%) and 77 patients (25.3%) respectively could not afford four anti-hypertensive medicines. Medicines availability at KBTH was 60%. Continuous access to BP drugs at KBTH was 14.8%. Overall access was 74.9% (SD ± 41.3). Out-of-pocket affordability of the medicines was positively correlated with BP control (R=0.12, p=0.037). Obtaining medicines via health insurance only was more likely to result in BP control than making any out-of-pocket payments (OR= 2.185; 95% CI, 1.215 - 3.927). Access at KBTH was more likely to result in BP control (OR=1.642; 95% C.I, 0.843 - 3.201). Conclusion: there were access challenges although most patients obtained BP medication free. Out-ofpocket affordability is a challenge for some hypertensive patients. Access to affordable BP medication can improve BP control. These findings provide an impetus for urgently evaluating access to affordable anti-hypertensive medicines in other hospitals in Ghana. [ABSTRACT FROM AUTHOR]

Introduction: rubella is vaccine-preventable and vaccination is the most cost-effective approach to control the disease and avoid the management of congenital rubella syndrome cases. Ghana introduced the rubella vaccine into the routine immunization program in 2013. Since then there have not been any evaluation of the epidemiology of rubella. We determined the disease trends and the population demographics of rubella cases, in the Ghana national measles case-based surveillance system. Methods: we reviewed the measles case-based surveillance data from 2007 to 2017. Descriptive data statistics was done and expressed as frequencies and proportions. Chisquare test was used to establish associations. Results: a total of 11,483 suspected cases for measles received and tested for measles IgM antibodies and 1,137(12.98%) confirmed positive for the period. Of these 10,077 were negative and 250 indeterminate for measles and tested for rubella and 2,090 (20.23%) confirmed positive for rubella IgM antibodies. More females (21.45%) were affected than males (19.48%). Majority of the confirmed positives were recorded in the urban areas. Children aged 15 years or less were mostly affected. There was a statistical difference between incidence cases and sex (χ2=6.03, p-value = 0.014), or age (χ2=283.56, p-value < 0.001) or area (χ2= 6.17, p-value = 0.013). Most infections occurred during the dry season. Conclusion: children less than 15 years were mostly affected with majority being females. The highest incidence of cases was before the rains and occurred mostly in urban areas. The incidence of cases has declined significantly with the introduction of the rubella vaccine. [ABSTRACT FROM AUTHOR]

The human cutaneous anthrax case-fatality rate is ≈1% when treated, 5%-20% when untreated. We report high case-fatality rates (median 35.0%; 95% CI 21.1%-66.7%) during 2005-2016 linked to livestock handling in northern Ghana, where veterinary resources are limited. Livestock vaccination and access to human treatment should be evaluated. [ABSTRACT FROM AUTHOR]

Background: Global cases of COVID-19 continue to rise, causing havoc to several economies. So far, Ghana has recorded 48,643 confirmed cases with 320 associated deaths. Although summaries of data are usually provided by the Ministry of Health, detailed epidemiological profile of cases are limited. This study sought to describe the socio-demographic features, pattern of COVID-19 spread and the viral load dynamics among subjects residing in northern, middle and part of the southern belt of Ghana. Methods: This was a cross-sectional retrospective study that reviewed records of samples collected from February to July, 2020. Respiratory specimens such as sputum, deep-cough saliva and nasopharyngeal swabs were collected from suspected COVID-19 subjects in 12 regions of Ghana for laboratory analysis and confirmation by real-time reverse transcription polymerase chain reaction (RT-PCR). Results: A total of 72,434 samples were collected during the review period, with majority of the sampled individuals being females (37,464; 51.9%). The prevalence of SARS-CoV-2 identified in the study population was 13.2% [95%CI: 12.9, 13.4). Males were mostly infected (4,897; 51.5%) compared to females. Individuals between the ages 21–30 years recorded the highest number of infections (3,144, 33.4%). Symptomatic subjects had higher viral loads (1479.7 copies/μl; IQR = 40.6–178919) than asymptomatic subjects (49.9; IQR = 5.5–3641.6). There was significant association between gender or age and infection with SARS-CoV-2 (p<0.05). Among all the suspected clinical presentations, anosmia was the strongest predictor of SARS-CoV-2 infection (Adj. OR (95%CI): 24.39 (20.18, 29.49). We observed an average reproductive number of 1.36 with a minimum of 1.28 and maximum of 1.43. The virus trajectory shows a gradual reduction of the virus reproductive number. Conclusion: This study has described the epidemiological profile of COVID-19 cases in northern, middle and part of the southern belt of Ghana, with males and younger individuals at greater risk of contracting the disease. Health professionals should be conscious of individuals presenting with anosmia since this was seen as the strongest predictor of virus infection. [ABSTRACT FROM AUTHOR]

Objective: Describe the epidemiology of COVID-19 cases detected in the first four months of the pandemic in Ghana by person, place and time to provide an understanding of the local epidemiology of the disease. Methods: We conducted an exploratory descriptive study of all confirmed COVID-19 cases in Ghana from March 12 to June 30, 2020. Data was merged from the country's electronic databases, cleaned and summarized using medians, proportions and geospatial analysis. Design: A cross-sectional study design Setting: Ghana Participants: All confirmed COVID-19 cases in Ghana from March 12 to June 30, 2020 Interventions: None Main Outcome measures: Epidemiological characterization of all confirmed COVID-19 cases recorded from March 12 -- June 30, 2020 in Ghana by person, place and time. Results: A total of 17,763 cases were recorded with median age (IQR) of 33years (One month to 85 years). Among the confirmed cases, 10,272 (57.8%) were males and 3,521 (19.8%) were symptomatic with cough recorded in 1,420 (40.3%) cases. The remaining 14,242 (80.2%) were asymptomatic. Greater Accra region recorded the highest number of confirmed cases 11,348 (63.9%). All 16 administrative regions had recorded cases of COVID-19 by June 30, 2020 due to internal migration between the hotspots and other regions. The epidemiological curve showed a propagated outbreak with 117 deaths (CFR= 0.67%) recorded. Conclusion: A propagated outbreak of COVID -- 19 was confirmed in Ghana on March 12, 2020. Internal migration from hotspots to other regions led to the spread of the virus across the nation. Majority of cases were asymptomatic. [ABSTRACT FROM AUTHOR]

Background: Influenza is an acute viral respiratory tract infection caused by influenza virus and transmitted from person to person. Though usually seasonal in temperate climates, influenza occurs throughout the year in the tropics with outbreaks occurring at irregular intervals. On February 6, 2018, a number of students from a Senior High School (SHS) in Accra reported to a district hospital with cough, fever and other respiratory symptoms. An influenza-like illness (ILI) outbreak was suspected. We investigated to determine the magnitude and source of the outbreak and implement control and preventive measures.Methods: We interviewed health workers, staff and students of the school as well as case-patients and reviewed health records to collect data on demographic characteristics, signs and symptoms, date of illness onset and outcome. We defined ILI case as "any person in the SHS with fever (measured axillary temperature of ≥ 37.5 °C or history of fever) and cough with or without sore throat or runny nose from January 21 to February 26, 2018". We conducted active case search to identify more cases and took oropharyngeal samples for laboratory testing. We performed descriptive and inferential analysis by calculating attack rate ratios (ARR) and their exact 95% confidence intervals (CI).Results: Of the 3160 students, 104 case-patients were recorded from January 25, 2018 to February 13, 2018 (overall attack rate of 3.3%). Mean age of case-patients was 16.1 (±2.3) years with males constituting 71.2% (74/104). Sex specific attack rates were 5.6% (74/1331) and 1.6% (30/1829) for males and females respectively. Compared to females, males were 3.4 times as likely to be ill [ARR =3.4, 95%CI = (2.23-5.15)]. Nine oropharyngeal samples from 17 suspected case-patients tested positive for influenza A (H1N1)pdm09.Conclusion: Outbreak of influenza A (H1N1)pdm09 occurred in a SHS in Accra from January to February, 2018. Even though source of the outbreak could not be determined, prompt case management and health education on hand and personal hygiene as non-pharmacological factors probably contributed to the outbreak control. The outbreak ended with a scheduled mid-term break. This underscores the need for more evidence on the effect of school closure in influenza outbreak control. [ABSTRACT FROM AUTHOR]

This paper examines the internal and external challenges to the implementation of the code of conduct in the Ghana's civil service using the Controller and Accountant Generals' Department (CAGD) as a case study. The main internal challenges to the implementation of the civil service code of conduct at CAGD were found to be: the categories of staff affected by the code of conduct; 'immunity' from sanctions, nepotism; and limited checks on enforcement mechanisms. The key external challenges to the implementation of the civil service code of conduct at the CAGD are discussed in the paper and the authors make five important policy suggestions to enhance effectiveness of the implementation process. The suggestions will have value in countries with developing administrative systems. Enforcing of codes of conduct in many public sector organizations in Ghana and other developing countries can be difficult. Cronyism, nepotism and other non-merit considerations in appointments and promotions can result in employees openly flouting codes of conduct. Governments must empower their civil services to come up with well-enforced mechanisms to ensure full compliance with that country's public sector code of conduct. This paper explains how policy-makers in developing countries can move forward to prevent code violations and to resist political interference in civil service operations. [ABSTRACT FROM AUTHOR]

We examine how goat farmers' perceptions of weather variability and climate change condition their coping and adaptation behaviour. Through a survey, we obtain a household level data from goat producers in designated climate-smart and non-climate-smart villages of the Lawra and Jirapa districts in Upper West region of Ghana. Data are analysed using a multivariate probit model to assess how perceptions and other factors influence coping and adaptation strategy choices. Seven main coping/adaptation strategies are used by goat farmers to deal with weather variability and climate change. Our econometric results show that goat farmers' perceptions and being located in a climate-smart village, as well as market and extension information influence the choice of coping and adaptation strategies towards climate change. The results suggest that perceptions of weather variability and climate change have significant positive influence on all adaptation strategies, and that these adaptation strategies are complementary to each other as evidenced by their high inter-correlations. The fact that farmers located in climate-smart villages are more likely to adopt strategies that enable them to cope with and adapt to weather variability and climate change signals the need for project implementers to extend the number of villages benefiting from the climate-smart village concept. [ABSTRACT FROM AUTHOR]

This paper explores the transferable knowledge, experience or skills second-career librarians with a teaching background bring to bear or utilize in the discharge of their library work. It also explores how the transferable knowledge helps librarians and teaching librarians to discharge the roles delineated by ACRL's (2017) document. Snowball sampling method was used to locate 17 participants for this study in Ghana. Mixed methods were used for data collection; questionnaire (open-ended questions) and interview. The data were analyzed using the thematic analysis technique. The study found the following transferable knowledge, skills and experiences to library work: methodology of teaching, questioning and listening skills, knowledge of courses content, presentation, communication and good public speaking skills and human relational skills. The study found that transferable knowledge from the teaching profession help second-career (teaching) librarian to discharge to their library role effectively. [ABSTRACT FROM AUTHOR]

Ghana Health Service (GHS) has strengthened community-based surveillance (CBS) to facilitate early detection and rapid reporting of health events of all origins. Since June 2017, GHS has employed an event-based surveillance approach at the community level in a phased manner. CBS coverage has broadened from 2 to 30 districts across Ghana. Through this effort, capacity was built across all administrative levels in these districts to detect, report, triage, and verify signals, and to perform risk assessment and investigate events. Data were collected and analyzed during an evaluation of initial 2-district implementation in March 2018 and during expanded 30-district implementation in March 2019. Between September 2018 and March 2019, 317 health events were detected through CBS. These events included vaccine-preventable disease cases, acute hemorrhagic conjunctivitis outbreaks, clusters of unexpected animal deaths, and foodborne illness clusters. Eighty-nine percent of the 317 events were reported to district-level public health staff within 24 hours of detection at the community level, and 87% of all detected events were responded to within 48 hours of detection. CBS detected 26% of all suspected vaccine-preventable disease cases that were reported from implementing districts through routine disease surveillance. GHS strengthened CBS in Ghana to function as an early warning system for health events of all origins, advancing the Global Health Security Agenda. [ABSTRACT FROM AUTHOR]

The study, drawing on the political settlement approach, examines how powers, institutions, networks, and interests influence the pricing of petroleum products in Ghana. Qualitative research approach was for the study, and purposive sampling was used to interview 24 respondents. The findings suggest the existence of power struggles among the key actors in the pricing of fuel. The findings revealed that the National Petroleum Authority, bulk distribution oil companies, oil marketing companies, International Monetary Fund, and energy policy think tanks influence result into policy. Actors influence fuel prices through taxes, policy guidelines, exchange rate, and legal actions. The study recommends that capacity of the key players should be built by the Government of Ghana so as to ensure healthy competition and stability in the pricing of petroleum products in Ghana. Political interference in the pricing of fuel should be limited so that the key players can operate successfully in the petroleum downstream. [ABSTRACT FROM AUTHOR]