Amansie West District Research Articles

Access and utilization of maternal healthcare in a rural district in the forest belt of Ghana

BackgroundPoor maternal health delivery in developing countries results in more than half a million maternal deaths during pregnancy, childbirth or within a few weeks of delivery. This is partly due to unavailability and low utilization of maternal healthcare services in limited-resource settings. The aim of this study was to investigate the access and utilization of maternal healthcare in Amansie-West district in the Ashanti Region of Ghana.MethodsAn analytical cross-sectional study, involving 720 pregnant women systematically sampled from antenatal clinics in five sub-districts was conducted from February to May 2015 in the Amansie-West district. Data on participants’ socio-economic characteristics, knowledge level and access and utilization of maternal health care services were collected with a structured questionnaire. Odds ratios were estimated to describe the association between explanatory variables and maternal healthcare using generalized estimating equations (GEE).Results68.5, 83.6 and 33.6% of the women had > 3 antenatal care visits, utilized skilled delivery and postnatal care services respectively. The mothers’ knowledge level of pregnancy emergencies and newborn danger signs was low. Socio-economic characteristics and healthcare access influenced the utilization of maternal healthcare. Compared to the lowest wealth quintile, being in the highest wealth quintile was associated with higher odds of receiving postnatal care (adjusted odds ratio [aOR]; 95%CI: 2.84; 1.63, 4.94). Use of health facility as a main source of healthcare was also associated with higher odds of antenatal care and skilled delivery.ConclusionThis study demonstrates suboptimal access and utilization of maternal healthcare in rural districts of Ghana, which are influenced by socio-economic characteristics of pregnant mothers. This suggests the need for tailored intervention to improve maternal healthcare utilization for mothers in this and other similar settings.

Tensions and controversies regarding child labor in small-scale gold mining in Ghana

The recent resurgence in small-scale mining in Ghana has coincided with falling enrolments in schools, leading to public concerns about the participation of children and young people in mining work. The engagement of children and young people in gold mining is also perceived to diminish efforts to improve education, inviting abolitionist actions from the government. This has created tension between government and its functionaries on one hand and young workers and their families on the other. Drawing on qualitative research, this article explores controversies around young people’s involvement in small-scale mining and governments’ efforts to curtail it in Amansie West District, Ghana. We discuss the tensions between securing individual/household livelihoods and societal interest in reducing child labor. The study findings underscore not only the importance of work in the lives of young workers and their households but also its positive implications for educational pursuits as well as for future livelihood prospects. Whereas the abolitionist framework emphasizes children’s right to education, it fails to acknowledge that the income generated through work makes schooling possible for most children. We conclude that policies rooted in global ideologies of work-free childhoods are at odds with prevailing sociocultural and economic realities.

Analysis of mine water from four decommissioned pits in south-western Ghana – implications for remediation programmes for mine closure

Research into water quality status of accumulated water in decommissioned pits is a grey area in Ghana and could be of significant benefit in the effectiveness of remediation of pits after mining. Water sampled from four decommissioned pits in Amansie West District were analysed for their water quality status. Seasonal variations of physico-chemical parameters for determining water quality were reported as well as their average values. In general, the ion concentrations varied from season to season but were within World Health Organization (WHO) maximum permissible limits (MPL) with the exception of boron. Similar observation was made for heavy metals/trace elements analysed, with the exception of As and Fe. Seasonal and average concentrations of As were higher than the WHO MPL. Similarly, the mid-season concentration of Fe recorded from a water sample collected from one pit was higher than WHO limits. Turbidity levels were significantly higher in two pits. The studies revealed that some parameters for water quality determination were above WHO acceptable limits for potable water, an indication that the effect of mining on water quality from water bodies investigated persisted after mine closure. Hence remediation programmes should be broadened to include effective reclamation of mine water accumulated in pits during mine closure.

Mining Effects on Rural Livelihoods, Adopted Strategies and the Role of Stakeholder and Regulatory Institutions in Ghana. Evidence of the Amansie West District of Ghana

The study determines the effects of mining on rural livelihoods, adopted strategies and the role of stakeholder and regulatory institutions. The study achieves this by investigating the status of key rural livelihood indicators, what influence the choice of livelihood strategies in mining communities and the assessment of institutional performance. The role of institutions even though a key instrument in ensuring sustainable livelihoods is mostly not considered in livelihood studies of developing countries. The study employed both quantitative and qualitative methods of data analysis. The significant difference in the means of income, yield value and labour cost between non-mining and mining communities is an evidence of the threat posed on communities in the study area by mining and its activities. The multinomial logit result showed that farmers’ choice of livelihood in mining communities was influenced by gender, age, family size, leadership status of household head, labour cost, annual household income, number of years of education and extension training. Farmers diversified into non-farm and off-farm livelihood strategies in order to increase or sustain income in mining communities. The study determined the performance of stakeholder and regulatory institutions through their relations and how effective functions are performed. Four (4) institutions namely EPA, MoFA, COCOBOD and Amansie West District Assembly were found significant in their relations to other institutions whilst three (3) institutions were found significant in the performance of their functions. The study concluded that poor relations and ineffective performance of stakeholder and regulatory institutions resulted in unregulated exposure and depletion of livelihood resources such as land, forest and water bodies in mining communities. The study therefore recommended that there should be inter-institutional policy that would link stakeholder and regulatory institutions together for effective performance of functions and sustainable livelihoods.

Effects of Illegal Mining Activities on Water Resources for Irrigation Purposes, Amansie West District, Ghana

Effects of Illegal Mining Activities on Water Resources for Irrigation Purposes, Amansie West District, Ghana

Correlation Analysis of Irrigation Water Quality parameter from the major rivers in the Amansie West District, Ashanti Region, Ghana

Correlation Analysis of Irrigation Water Quality parameter from the major rivers in the Amansie West District, Ashanti Region, Ghana

Incentives to yield to Obstetric Referrals in deprived areas of Amansie West district in the Ashanti Region, Ghana.

BackgroundObstetric referrals, otherwise known as maternal referrals constitute an eminent component of emergency care, and key to ensuring safe delivery and reducing maternal and child mortalities. The efficiency of Obstetric referral systems is however marred by the lack of accessible transportation and socio-economic disparities in access to healthcare. This study evaluated the role of socio-economic factors, perception and transport availability in honouring Obstetric referrals from remote areas to referral centres.MethodsThis was a cross-sectional study, involving 720 confirmed pregnant women randomly sampled from five (5) sub-districts in the Amansie west district in Ghana, from February to May 2015. Data were collected through structured questionnaire using face-to-face interviewing and analyzed using STATA 11.0 for windows. Logistic regression models were fitted to determine the influence of socio-demographic characteristics and pregnancy history on obstetric referrals.ResultsAbout 21.7 % of the women studied honoured referral by a community health worker to the next level of care. Some of the pregnant women however refused referrals to the next level due to lack of money (58 %) and lack of transport (17 %). A higher household wealth quintile increased the odds of being referred and honouring referral as compared to those in the lowest wealth quintile. Women who perceived their disease conditions as emergencies and severe were also more likely to honour obstetric referrals (OR = 2.3; 95 % CI = 1.3, 3.9).ConclusionClients’ perceptions about severity of health condition and low income remain barriers to seeking healthcare and disincentives to honour obstetric referrals in a setting with inequitable access to healthcare. Implementing social interventions could improve the situation and help attain maternal health targets in deprived areas.

Particulate Matter and Noise Impact Studies of Waste Rock Dump

Adansi Gold Company Limited identified an economically viable gold deposit at Nkran in the Amansie West District of Ghana. Mining of this deposit requires the disposal of waste rock materials at a proposed waste rock dump near Nkran and Koninase communities. Since particulates and noise emissions from the operational activities at the dump are inevitable, it becomes necessary to conduct particulates and noise impact studies. The potential impact of particulates and noise from the proposed Nkran waste rock dump on the Koninase and Nkran communities were studied. Baseline TSP, PM10 and noise data were collected over a period of 14 days at the various monitoring locations in the communities. Since the period was characterised by dry weather conditions, TSP (mainly road-induced) were generally higher than permissible levels. PM10 and noise levels compared well with acceptable limits. Results of air quality modelling suggest that occupiers of building structures at Koninase and Nkran may not be affected by particulate emission from the waste dump. However, sound pressure level modelling indicates that the waste rock dump has a potential to alter background noise levels at Koninase and Nkran. Thus, conducting site-specific induction to raise awareness, use of noise bund or green buffers (vegetation) among other recommended strategies would control ambient noise levels. Keywords: Particulates, Noise, Air Pollution, Mining, Waste dump

Particulate Matter and Noise Impact Studies of Waste Rock Dump

Adansi Gold Company Limited identified an economically viable gold deposit at Nkran in the Amansie West District of Ghana. Mining of this deposit requires the disposal of waste rock materials at a proposed waste rock dump near Nkran and Koninase communities. Since particulates and noise emissions from the operational activities at the dump are inevitable, it becomes necessary to conduct particulates and noise impact studies. The potential impact of particulates and noise from the proposed Nkran waste rock dump on the Koninase and Nkran communities were studied. Baseline TSP, PM10 and noise data were collected over a period of 14 days at the various monitoring locations in the communities. Since the period was characterised by dry weather conditions, TSP (mainly road-induced) were generally higher than permissible levels. PM10 and noise levels compared well with acceptable limits. Results of air quality modelling suggest that occupiers of building structures at Koninase and Nkran may not be affected by particulate emission from the waste dump. However, sound pressure level modelling indicates that the waste rock dump has a potential to alter background noise levels at Koninase and Nkran. Thus, conducting site-specific induction to raise awareness, use of noise bund or green buffers (vegetation) among other recommended strategies would control ambient noise levels. Keywords: Particulates, Noise, Air Pollution, Mining, Waste dump

PHS147 - Incentives to Honor Maternal Health Referrals in a Setting with Inequitable Access to Health Care in the Amansie West District in Ashanti Region

PHS147 - Incentives to Honor Maternal Health Referrals in a Setting with Inequitable Access to Health Care in the Amansie West District in Ashanti Region

Home birth without skilled attendants despite millennium villages project intervention in Ghana: insight from a survey of women's perceptions of skilled obstetric care.

BackgroundSkilled birth attendance from a trained health professional during labour and delivery can prevent up to 75 % of maternal deaths. However, in low- and middle-income rural communities, lack of basic medical infrastructure and limited number of skilled birth attendants are significant barriers to timely obstetric care. Through analysis of self-reported data, this study aimed to assess the effect of an intervention addressing barriers in access to skilled obstetric care and identified factors associated with the use of unskilled birth attendants during delivery in a rural district of Ghana.MethodsA cross-sectional survey was conducted from June to August 2012 in the Amansie West District of Ghana among women of reproductive age. Multi-stage, random, and population proportional techniques were used to sample 50 communities and 400 women for data collection. Weighted multivariate logistic regression analysis was used to identify factors associated with place of delivery.ResultsA total of 391 mothers had attended an antenatal care clinic at least once for their most recent birth; 42.3 % of them had unskilled deliveries. Reasons reported for the use of unskilled birth attendants during delivery were: insults from health workers (23.5 %), unavailability of transport (21.9 %), and confidence in traditional birth attendants (17.9 %); only 7.4 % reported to have had sudden labour. Other factors associated with the use of unskilled birth attendants during delivery included: lack of partner involvement aOR = 0.03 (95 % CI; 0.01, 0.06), lack of birth preparedness aOR = 0.05 (95 % CI; 0.02, 0.13) and lack of knowledge of the benefits of skilled delivery aOR = 0.37 (95 % CI; 0.11, 1.20).ConclusionsThis study demonstrated the importance of provider-client relationship and cultural sensitivity in the efforts to improve skilled obstetric care uptake among rural women in Ghana.

Healthcare Professionals' Perceptions of the Benefits and Challenges of a Teleconsultation Service in the Amansie-West District of Ghana.

A teleconsultation service was introduced in the Amansie-West District, Ghana, in 2010 linking health center-based community health nurses (CHNs) with a teleconsultation center (TCC) at the district hospital. This study aimed to assess healthcare professionals' perceptions of the benefits and challenges of this service and to identify possible areas for improvement. Qualitative semistructured interviews were conducted with eight CHNs and three TCC healthcare professionals to find their views on the benefits, challenges, and recommendations for improving the service. The data were analyzed using qualitative content analysis. Interviewees were generally positive when describing the use of the teleconsultation service. They were of the opinion that the service had improved the quality of care at health centers, thus reducing the need to refer patients to the district hospital. Practical problems, such as inadequate information provided over the phone, delays in responding to calls, and the additional workload for teleconsultation staff, were viewed as important challenges to the success of the project. Interviewees identified several possible options for improving the service through extension to other levels of the healthcare system or by adding additional functionalities to their phones. Teleconsultation services have the potential to improve quality of care in rural communities. However, practical problems in the operation of the service have to be taken seriously as they threaten sustainability of the intervention. Adequate training in phone-based clinical reporting appears to be essential. Teleconsultation staff should be compensated for additional workload through a reduction of other work-related tasks.

The Constructivist Approach of Solving Word Problems Involving Algebraic Linear Equations: The Case Study of Mansoman Senior High School, Amansie West District of Ghana

The Constructivist Approach of Solving Word Problems Involving Algebraic Linear Equations: The Case Study of Mansoman Senior High School, Amansie West District of Ghana

Assessment of Trace Elements Levels in Sediment and Water in Some Artisanal and Small-Scale Mining (ASM) Localities in Ghana

The concentrations of eight trace elements, Cadmium (Cd), lead (Pb), iron (Fe), zinc (Zn), manganese (Mn), copper (Cu), mercury (Hg) and arsenic(As) in sediment and water were assessed in four artisanal and small-scale mining(ASM) localities in the Amansie West District (6°282 N 1°532 W) of Ghana along two river courses from May 2011 to July 2011. Triplicate water and sediment samples were randomly taken at five different points at each of the localities and the elements determined using Atomic Absorption Spectrophotometer (AAS ). Using the Geoaccumulation Index( Igeo) assessment, the sediments were found to be polluted to different degrees with Cu (Uncontaminated to moderately contaminated/Moderately contaminated), Hg (Uncontaminated to moderately contaminated/Moderately contaminated) and As (Moderately contaminated/Moderately to strongly contaminated). The Enrichment Factor (EF) indicated human influence - artisanal mining activities on the sediment concentration of Cd and Pb for all the localities and only some of the localities for the rest of the trace elements. The elements are major sediment pollutants ( EF > 2) in one or more of the localities. The I geo and EF gave diverse status of the sediment qualities of the localities. Cd, Pb, Hg and As water concentrations in the four artisanal mining localities were all found to be above the WHO maximum acceptable of levels for drinking water. Inhabitants in the mining localities face the risk of getting various diseases by drinking the waters contaminated with the trace elements.

A Mathematical Model to Predict the Prevalence and Transmission Dynamics of Tuberculosis in Amansie West District, Ghana

In this paper, a Susceptible Exposed Infected Recovered (SEIR) epidemiological model is formulated to determine the transmission of tuberculosis. The equilibrium points of the model are found and their stability is investigated. By analyzing the model, a threshold parameter R0 was found which is the basic reproductive number. It is noted that when R0 1 the disease will persist in the population and become endemic. The model has two non–negative equilibria namely the disease – free equilibrium and the endemic equilibrium. The graphical solutions of the differential equations were developed using Matlab as well as the computer simulations.

Production Function Analysis of Fish Production in Amansie-West District of Ghana, West Africa

The study aimed to obtain the estimates of a production function for fish production in the Amansie-West District of Ghana, West Africa, using primary data collected from 45 registered farmers. Factor elasticities and returns to scale were estimated, as well as the coefficients for various factors of production. The results indicate that the total area of ponds, weight and size of fingerlings and feed had a significant and positive relationship with fish output (P<.01), in the production of fish in the study area. The production technology used in the district also exhibited increasing returns to scale. There is therefore the need to carry out a wider estimation of the cost functions and economic efficiency of fish production, to enable farmers minimize the cost of production toward efficient and profitable optimum. We recommend changes in public policy to promote improved yields for existing fish ponds in the area with reference to the total pond area, feed and the number or weight of fingerlings, which have strong correlation with fish output (yields). Such policies will go a long way to boost fish production in the Amansie-West District, with a broader focus on fish farmers in other areas within the country.

Economics of Fish Production in Amansie-west District of Ghana: Implication for Food Security in West Africa

This study analyzed the economics of fish production in Amansie-West District of Ghana, West Africa. Primarydata were collected from 45 fish farmers in the district, in April, 2009. We carried out a descriptive analysis of the inputs used and output obtained byfish farmers in the district. The results show that majority (95.6%) of the fish farmers used the earthen pond type, with a mean pond area of 0.17ha. The mean number of fingerlings stocked by the farmers was 9,331.11 and the mean quantity of fish harvested was 771.96Kg. The results show a wide variation among the farmers in the use of inputs and total quantity of fish harvested, which implies that yields of fish in the area are poor and well below potential yields indicated by field trials.The study recommends changes in public policy to improve yields for existing ponds and to identify circumstances where yields can be improved for future ponds. It also recommends a further research to be carried out to estimate the production and cost functions for the fish production technology used by the fish farmers in the district to help reduce the cost of fish

The buruli ulcer morbidity in the amansie West District of Ghana: A myth or a reality?

Although there is a lot of literature on the possible causes of Buruli ulcer (BU), no one is sure where the bacterium lives in the environment. It is also a mystery how the mycobacterium enters the human body, although it is clear the bacterium is unable to do so by itself. There is therefore a lot of myth about the disease epidemiology. This research has shown that the myth surrounding the cause of the disease and the origin of the disease pathogen has affected the treatment option sought by patients and the intervention strategies put in place by health expects in the Amansie West Distrct of Ghana. Whereas some patients in the Amansie west district associate the disease with witchcraft and magico-religious beliefs, the study showed that the disease is associated with aquatic environment that have been disturbed either through mining or intense agricultural activity. The aim of this paper is therefore to expand the frontiers of the argument by examining some of the predisposing factors and to identify the spatial pattern in the distribution of BU in the Amansie West District. The paper concludes that despite the myth, the disease causing organism thrives well in arsenic rich aquatic environment. However because of the widely rooted wrong perception, any attempt to manage the disease must first target the myth, in order to manage the reality. Key words: Buruli ulcer, morbidity, myth, reality, mycobacterium ulcerans.

Temporal Relationship of Environmental Arsenic and M. ulcerans Infection in the Amansie West District

Temporal Relationship of Environmental Arsenic and M. ulcerans Infection in the Amansie West District

Geospatial Modelling of Buruli Ulcer Prevalence in Amansie West District, Ghana

Buruli ulcer (BU) is a disease caused by mycobacterium ulcerans (MU). The large number of cases and the complications currently associated with the disease as well as its long-term socio-economic impact could have a substantial effect on the rural economy. Knowledge gaps about the exact mode of transmission and factors that pre-dispose to infection motivated this study. This study employed geographical information systems (GIS) and geostatistics to establish relationship between BU and postulated risk factors in Amansie West District of Ghana. Semivariograms were computed to determine the strength and spatial dependency of the pattern of disease as well as summarize the variation. The risk of developing the disease was estimated by kriging. Ordinary kriging was chosen in the variogram modeling. The BU data sets exhibited a highly positively skewed histogram with possible outlying. The length of spatial autocorrelation (practical range) was much longer than sampling interval (lag size).The kriged map showed that there are large patches of BU disease in the southern part of the study area with few isolated cases in the other parts.. The research revealed that the disease is prevalent in the southern portion of the district which is drained by rivers Oda and Offin. The southern portion is also characterized by intense mining and agricultural activity. The paper concludes that intense human interaction with aquatic environment may be responsible for the high prevalence of BU in the District.