Changing role of finance in rural small enterprise growth in Ghana

Comparison of childhood household injuries and risk factors between urban and rural communities in Ghana: A cluster-randomized, population-based, survey to inform injury prevention research and programming

Rodents serve as reservoirs and/or vectors for several human infections of high morbidity and mortality in the tropics. Population growth and demographic shifts over the years have increased contact with these mammals, thereby increasing opportunities for disease transmission. In Africa, the burden of rodent-borne diseases is not well described. To investigate human seroprevalence of selected rodent-borne pathogens, sera from 657 healthy adults in ten rural communities in Ghana were analyzed. An in-house enzyme-linked immunosorbent assay (ELISA), for immunoglobulin G (IgG) antibodies to Lassa virus was positive in 34 (5%) of the human samples. Using commercial kits, antibodies to hantavirus serotypes, Puumala and Dobrava, and Leptospira bacteria were detected in 11%, 12% and 21% of the human samples, respectively. Forty percent of residents in rural farming communities in Ghana have measurable antibodies to at least one of the rodent-borne pathogens tested, including antibodies to viral hemorrhagic fever viruses. The high seroprevalence found in rural Ghana to rodent-borne pathogens associated with both sporadic cases and larger disease outbreaks will help define disease threats and inform public health policy to reduce disease burden in underserved populations and deter larger outbreaks.

The epidemiology of Staphylococcus aureus in the community in Ghana was never investigated prior to this study. The aims of the study were: i) to assess prevalence of nasal S. aureus carriage in Ghanaian people living in an urban and a rural area, and ii) to identify phenotypic and genotypic traits of strains isolated from the two communities. Nasal swabs were collected from healthy individuals living in an urban community situated in the suburb of the capital city, Accra (n = 353) and in a rural community situated in the Dangme-West district (n = 234). The overall prevalence of nasal carriage was 21% with a significantly higher prevalence in the urban (28%) than in the rural community (11%) (p<0.0001). The levels of antimicrobial resistance were generally low (<5%) except for penicillin (91%) and tetracycline (25%). The only two (0.3%) MRSA carriers were individuals living in the urban area and had been exposed to hospitals within the last 12 months prior to sampling. Resistance to tetracycline (p = 0.0009) and presence of Panton-Valentine leukocidin (PVL) gene (p = 0.02) were significantly higher among isolates from the rural community compared to isolates from the urban community. Eleven MLST clonal complexes (CC) were detected based on spa typing of the 124 S. aureus isolates from the two communities: CC8 (n = 36), CC152 (n = 21), CC45 (n = 21), CC15 (n = 18), CC121 (n = 6), CC97 (n = 6), CC30 (n = 5), CC5 (n = 5), CC508 (n = 4), CC9 (n = 1), and CC707 (n = 1). CC8 and CC45 were less frequent in the rural area than in the urban area (p = 0.02). These results reveal remarkable differences regarding carriage prevalence, tetracycline resistance, PVL content and clonal distribution of S. aureus in the two study populations. Future research may be required to establish whether such differences in nasal S. aureus carriage are linked to socio-economic differences between urban and rural communities in this African country.

The purpose of this study was to identify factors affecting the growth of micro and small enterprises operating in Daro Lebu and Hawi Gudina districts of west hararghe zone, oromia region, Ethiopia. The study adopted both Quantitative and Qualitative research designed with arrangement of primary data collection via a cross-sectional survey. Survey Data collected through structured questionnaires from a sample of 197 MSEs selected using stratified sample techniques. The result of regression analysis revealed that access to credit, government support, Education, gender and enterprises’ age were positively significant effects on MSEs&amp;apos; growth. But, Initial capital and infrastructure were negatively associated with capital growth rate of MSEs. However, Recordkeeping, access to technology, access to market and labor found to be insignificant variable in determining enterprises’ growth. More evidence desired on factors affecting the growth of micro and small enterprises before any generalization of the results can be prepared. In addition, the empirical tests conducted only on 197 sampled enterprises employee in Daro Lebu and Hawi Gudina Districts since 2024. Therefore, the results cannot be taken as uniform to generalize for MSEs in the country. The study might help the entrepreneurs, donated to the body of knowledge on the factors affecting the growth of micro and small enterprises to take some corrective action for both planners and policy implementation in government organizations toward developing their performance and in turn contribute to employment creation, poverty alleviation, and economic development. This paper adds to the literature on factors affecting the growth of micro and small enterprises. In particular, it tests the influence of access to credit, government support, Education, gender, enterprises’ age, Initial capital and access to infrastructure on growth of enterprises. The result forward key policy implications to take a corrective action that alleviates the existing challenges of the sector and calls for further MSEs bearing evaluation research.

To the Editor: HIV-2 is said to circulate predominantly in West Africa. Reports have increased, however, that HIV-1 is becoming far more common than HIV-2 in many West Africa countries. We examined this situation among 1,077 blood donors and 1,640 pregnant women in the Upper West Region, a rural area in Ghana. The seroprevalence of HIV in blood donors was 1.6%, of which 1.1% and 0.1% were reactive to HIV-1 and HIV-2 respectively. HIV seroprevalence in pregnant women was 1.2%, with 1% and 0.1% being reactive to HIV-1 and HIV-2 respectively. The observed difference between HIV-1 and 2 was statistically significant (P < 0.001, Z score 3.48) after applying the Z test of significance for the difference in 2 proportions. The relative prevalence of HIV-1 and HIV-2 infections vary greatly within Africa. Although there has been some serological evidence of HIV-2 infection in West Africa since 1966,1 and HIV-2 said to circulate predominantly in West Africa, its prevalence is not uniform in the subregion. It has been observed that HIV-2 predominates in the most western parts of West Africa and in countries such as Guinea-Bissau, Cape Verde, and Senegal; its prevalence is greater in certain population groups.2 In contrast, in the easterly parts of the subregion, e.g. Nigeria, HIV-1 is predominant.3 Dual infection with HIV-1 and HIV-2 can be found midway and has been reported from countries such as Cote d'Ivoire, Mali, Burkina Faso4 and Ghana.5 In these populations, HIV-1 was predominant. We report the prevalence of HIV-1 and HIV-2 infections in blood donors and pregnant women in a rural community in Ghana and show the infrequent occurrence of HIV-2 in this population. Blood was collected from 1,077 first-time blood donors (August 1991–July 1992), and 1,640 pregnant women (August–November 1992) at their first prenatal visit to a health facility in the Upper West Region of Ghana. This is a rural community served by 3 hospitals with approximately 250–300 beds among them and a number of Primary Health care centers. The blood was sent to the Regional Public Health laboratory where the sera were screened for HIV-1 and HIV-2 antibodies with a recombinant Enzyme Immunoassay kit (Enzygnost Behring, Germany). Samples reactive on two occasions with the EIA were confirmed with Western blot (Lav blot I and II, Diagnostic Pasteur for HIV-2). Reactivity to gp 41 and P 31 and/or P 17 and/or P 24 constituted a HIV-1 positive blot, whereas reactivity to gp 36 and P 31 and/or P 24 and/or P 17 constituted a HIV-2 positive blot. Dual serologic reactivity was recorded in the presence of reactivity to both gp 41 and gp 36 with or without other bands. The seroprevalence of HIV antibodies in blood donors was 1.6% (17/1,077) of which 12 (1.1%) and 1 (0.1%) were reactive to HIV-1 and HIV-2 respectively. Four (0.4%) blood donors were dually reactive. Among the pregnant women, the seroprevalence of HIV was 1.2% (20/1,640), with 17 (1.0%) and 1 (0.1%) of the women being reactive to HIV-1 and 2 respectively. Dual serologic reactivity in this group was 0.1% (2/1,640). Overall, 1.1% (29/2,717) of the population studied were HIV-1 antibody positive and 0.1%(2/2,717), HIV-2 antibody positive. The observed difference between HIV-1 and HIV-2 positivity was statistically significant (P < 0.001, Z score = 3.48) after applying the Z test of significance for the difference in the 2 proportions. It has been reported from Nigeria4,6 and Cote d'Ivoire7 that HIV-2 is not the predominant Human Immunodeficiency Virus in some West African countries. The low HIV-2 prevalence (0.1%) in blood donors in this rural population compared with a prevalence of 0.9% in an urban population also in Ghana5 is in accordance with other studies that have shown higher HIV-2 prevalence in urban communities in West Africa.8 Dual serologic reactivity was recorded in 6 patients, meaning either they are infected with both HIV-1 and HIV-2 or there is some form of immunological cross reactivity present. The findings of this study add to the knowledge that the majority of morbidity because of HIV infection in certain West Africa countries is caused by HIV-1, and any strategies for control in terms of vaccine design need to take this into account.

Knowledge and understanding of hypertension and its associated health risks remain inadequate despite increasing trend of hypertension prevalence. This study was conducted to assess the prevalence, knowledge and perceptions of hypertension in rural communities in Ghana. A mixed method study involving 534 subjects was employed. Data was collected in six communities from May to December 2014 with structured questionnaires and interview guides. A logistic regression analysis was conducted to estimate the influence of the socio-demographic factors on knowledge of hypertension. Qualitative data was thematically analyzed. The mean systolic blood pressure (BP) was higher in men than women (127.42mmHg versus 124.42mmHg). The proportion of hypertensives was 21.4% and was higher among men in all age categories. Knowledge on some risk factors of hypertension was extremely low. Having formal education was associated with higher odds of knowledge of hypertension (Adjusted odds ratio [AOR]; 95% confidence interval [CI]=2.28; 1.25-4.16). Several misconceptions such as the use of agro-chemicals, fertilizers and excess vitamins were identified as causes of hypertension. This study demonstrates an increased prevalence of hypertension, knowledge gaps and misconceptions surrounding hypertension in rural communities in Ghana. This evidence is useful in streamlining interventional programmes aimed at improving knowledge and prevention of hypertension.

Purpose This study aims to explore culturally nuanced health promotion strategies that have proven effective in combating HIV/AIDS in rural communities in Ghana. Design/methodology/approach Guided by a phenomenological design, face-to-face in-depth interviews were conducted with 24 community health workers across 6 rural health facilities in the Savannah region of Ghana to understand their successful approaches to HIV/AIDS health promotion in rural cultural contexts. The data were analyzed using thematic data analysis procedure. Findings With 58.33% of the participants being male and 62.50% having worked three to five years, this study identified that in rural Ghanaian communities, HIV/AIDS health promotion achieves remarkable success through the innovative integration of community durbars – cultural gatherings that blend traditional performances with health education, sanctified by the presence of chiefs and elders who serve as cultural gatekeepers for health messaging. The study also reveals a sophisticated dual-approach strategy where health workers complement these large-scale cultural gatherings with targeted community talks at schools and Parent and Teacher Association meetings, while leveraging prenatal care visits as intimate spaces for HIV education. Research limitations/implications Only the experiences of community health workers in the Northern part of Ghana were solicited. The results of the current study could be deepened with data from Southern Ghana. Hence, the authors recommend further studies in this region that the current study did not include. This notwithstanding, the current study has clear methodological strength for replication in the other region and presents the direct voices of practitioners in rural communities. Hence, it has enormous implications for national rural health promotion policy. Practical implications The authors propose establishing permanent “cultural health hubs” in communities where health education integrates seamlessly with cultural practices through storytelling, dance and arts. These hubs should be complemented by innovative “community health apprenticeship” programs that pair young community members with both health-care workers and cultural leaders. To ensure sustainability and cultural authenticity, health centers should establish “health heritage committees” comprising traditional healers, health workers and community leaders to develop culturally grounded approaches to health communication that effectively bridge medical science with indigenous wisdom. Originality/value This study offers a novel perspective by eliciting rural community health workers’ insider views on effective HIV/AIDS health promotion in Ghana. A key finding is the strategic engagement of chiefs and elders to lend validity and convene community durbars, reflecting their influential role in rural cultures. These rare insights into leveraging traditional authority structures contribute valuable evidence for optimizing HIV/AIDS interventions in rural Ghana. Based on these, the study recommends that, despite the limited resources to engage in extensive nationwide efforts, Ghana’s Ministry of Health, through the Ghana AIDS Commission and other stakeholders, should strengthen local health facilities in rural communities to fluidly consider the nuances in rural living and adopt culturally appropriate strategies for health promotion. Future research should, instead of exploring only the northern region, include the southern region of Ghana.

The focus of the study is to investigate the role of public procurement preference schemes in enhancing the growth of small and medium-sized enterprises. The general objective of the study was: To investigate the role of public procurement preference schemes in enhancing the growth of small and medium-sized enterprises in Nyamira County, Kenya. The specific objectives included; establishing the role of 30% preference on the growth of small and medium-sized enterprises, to investigate the role of waiver of bid bond on the growth of small and medium-sized enterprises, to establish the role of local firm preference on the growth of small and medium-sized enterprises and to assess the role of easy access to procurement opportunities registration on the growth of small and medium-sized enterprises. The study was guided by agency theory. A descriptive research design was applied to the study. The study population included 35700 registered and licensed SMEs, from where a sample of 391 was arrived at by Yamane’s formula. Data collection involved the use of self-administered questionnaires. Both descriptive and inferential statistics were used to perform data analysis. The results of the model summary indicate that R2 equals 0.498 at a 0.05 significance level, thus revealing that 49.8 % of the SME growth can be accounted for by the public procurement preference scheme. The study concluded that there was a positive influence of public procurement preference schemes on the growth of small and medium-sized enterprises. The study recommended that SMEs may team up with one another under joint bidding in order to get higher chances of preference and also compete with large-sized firms for public procurement opportunities

Women’s empowerment and gender equality have been given attention by development practitioners and communities over the last two decades. Studies show, however, that in the face of the increase attention to gender equality in community development, women’s advancement, and participation in both developed and developing countries are restricted. The situation of women involvement in the community development process in Ghana is abysmal. The purpose of this study was to ascertain how colonialism, patriarchy and neoliberalism serve as barriers to women within community development processes in rural Ghana. This paper is approached from transnational feminist perspective. A total of twelve (12) women from three randomly selected rural communities in Ghana were interviewed about their community development experiences. The findings implicate Western influence and structural factors in the low participation of women in community development processes in rural Ghana. This study found that Western interference in the form of the superimposition of a neoliberal capitalist agenda has had a negative consequence on the level of participation of women in their communities. This ideology has imbued in women individualistic ideals to the detriment of traditional communal life. The women were particularly disadvantaged by the reliance on level of education and fluency in English, as requirements for local government positions since English is the national business language. The existing patriarchal norms and values in rural communities such as traditional gender roles and “name calling” militate against women within the context of community development. Western interference, colonialism, patriarchy, and capitalist ideologies continue to hinder the involvement of women in the development of their communities. It is therefore important to address these issues to help better the lives of women in rural Ghana.

ABSTRACTCocoa farming provides employment for over 800,000 households in rural Ghana, with the country currently touted as the second largest producer of cocoa worldwide. Agriculture is one of the riskiest occupations for the eyes due to the numerous ocular hazards on farms. The authors conducted an ocular health assessment among cocoa farmers at Mfuom, a rural community in the Central Region of Ghana, to examine the ocular health status and the ocular safety measures used by cocoa farmers. A structured questionnaire was used to evaluate demographic characteristics, ocular injuries, and utilization of eye care services and ocular protection, and a clinical examination was used to evaluate their ocular status. Cocoa farmers were at high risk for ocular injuries and farm-related vision disorders and utilized eye care services and ocular protection poorly. Ocular condition identified were mainly refractive error (28.6%), cataract (20.0%), glaucoma (11.7%), conjunctivitis (13%), pterygium (2.7%), and cornea opacity (2.2%). There is a need for the introduction of an interventional eye care program to help address the ocular health challenges identified among the farmers. This can be done through collaborative efforts by educational institutions, government, and other role players in the agricultural industry to improve the quality of life of the vulnerable cocoa farmers in rural Ghana.

Biomass supplies about 80% of the energy needs for cooking and heating in rural Ghana. It is predominantly used in traditional and inefficient forms (firewood and charcoal), which presents environmental and health concerns. In order to better the living standard in rural Ghana, efforts must be made to provide modern energy services. Most rural communities in Ghana are so remote that an extension of the national grid is uneconomical, hence biomass electricity provides a viable alternative. Biomass is pivotal to the socio-economic development of rural Ghana due to its easy accessibility and enormous potential in the production of varied energy forms. In this paper, a comprehensive review of biomass resources, biomass energy conversion technologies and bioenergy production potential for rural development in Ghana is provided. The most important feedstock from an energy perspective was found to be crop residues. Based on 2017 statistics, Ghana has a theoretical potential of 623.84 PJ of energy from agricultural crop residues and 64.27 PJ of energy from livestock production. Evidence from literature suggests that biomass gasification is the best conversion technology to expand electricity access rate for rural households in Ghana. The paper concludes that although ample biomass resources exist, cocoa pod husks (CPH) which is very common in rural Ghana can be pelletized and used as feedstock for rural power generation systems.

Poverty, environmental sustainability and health issues have attracted global attention in recent years. However, the public health implications of human activities within the environment are most often glossed over. As embedded in the Millennium Development Goals, the major developmental challenges of our time are poverty, environmental decay and ill health. Despite the global increase in poverty rates and the corresponding increase in morbidity and mortality rates in deprived communities, very little effort has been made over the years to juxtapose poverty, environment and health in order to elucidate the relationship between them. This paper examines the built environment situation in rural Ghana with a focus on the Amansie West District. It analyzes the impact of housing poverty and poor sanitation on the health conditions of households in rural Ghana and highlights policy approaches and gaps for ensuring environmental sustainability in Ghana. A sample of 306 rural households from nine rural areas in the Amansie West District in Southern Ghana was used for data collection with heads of households as units of inquiry. Data collection techniques included questionnaires, structured interviews, focus group discussions and participant observation. Relevant data were analyzed with both descriptive statistics and participatory housing assessment techniques. The analysis indicates that the poor-quality housing and sanitation conditions in the study area are a function of low household income levels. It further establishes a close association between housing quality and disease occurrence in the rural communities selected for this study. The paper concludes that the nature of the built environment as regards rural housing and sanitation is a significant determinant of disease prevalence in the study villages. Thus, it provides a window on the public health implications of the poor built environment in the Amansie West rural communities in Ghana.

The majority of injury deaths occur outside health facilities. However, many low- and middle-income countries (LMICs) continue to lack efficient Emergency Medical Services (EMS). Understanding current first aid practices and perceptions among members of the community is vital to strengthening non-EMS, community-based prehospital care. This study sought to determine caregiver first aid practices and care-seeking behavior for common household child injuries in rural communities in Ghana to inform context-specific interventions to improve prehospital care in LMICs. A cluster-randomized, population-based household survey of caregivers of children under five years in a rural sub-district (Amakom) in Ghana was conducted. Caregivers were asked about their practices and care-seeking behaviors should children sustain injuries at home. Common injuries of interest were burns, laceration, choking, and fractures. Multiple responses were permitted and reported practices were categorized as: recommended, low-risk, or potentially harmful to the child. Logistic regression was used to examine the association between caregiver characteristics and first aid practices. Three hundred and fifty-seven individuals were sampled, representing 5,634 caregivers in Amakom. Mean age was 33 years. Most (79%) were mothers to the children; 68% had only completed basic education. Most caregivers (64%-99%) would employ recommended first aid practices to manage common injuries, such as running cool water over a burn injury or tying a bleeding laceration with a piece of cloth. Nonetheless, seven percent to 56% would also employ practices which were potentially harmful to the child, such as attempting manual removal of a choking object or treating fractures at home without taking the child to a health facility. Reporting only recommended practices ranged from zero percent (burns) to 93% (choking). Reporting only potentially harmful practices ranged from zero percent (burns) to 20% (fractures). Univariate regression analysis did not reveal consistent associations between various caregiver characteristics and the employment of recommended only or potentially harmful only first aid practices. Caregivers in rural Ghanaian communities reported using some recommended first aid practices for common household injuries in children. However, they also employed many potentially harmful practices. This study highlights the need to increase context-appropriate, community-targeted first aid training programs for rural community populations of LMICs. This is important as the home-based care provided for injured children in these communities might be the only care they receive.

Enteropathogenic and enterotoxigenic Escherichia coli as aetiological factors of infantile diarrhoea in rural and urban Ghana

This study examines the factors affecting the growth and survival of small and medium enterprises (SMEs) in Ghana, focusing on the Bosomtwe District in the Ashanti Region. It investigates key growth variables, available funding sources, and challenges faced by SMEs. Using a quantitative and descriptive approach, data were collected from 540 SME operators and managers through primary and secondary sources, with sampling methods including quota, stratified, and convenience techniques. The findings highlight significant hindrances to SME growth, including supply delays, market scarcity, legal challenges, and difficulty in accessing customers and finance. Key growth drivers include strong customer relationships, product quality, availability, and fair competition. Debt financing, especially long-term loans from rural banks, was the main funding source. Additionally, technology, legal frameworks, economic factors, and government policies were identified as critical influencers. The study emphasizes the need for improved financing, infrastructure, and policies to support sustainable SME growth in Ghana.