Cape Coast Metropolitan Research Articles

Anaemia and glucose-6-phosphate dehydrogenase deficiency in pregnant women in Ghana

Background/Aims Glucose-6-phosphate dehydrogenase deficiency worsens the risk of anaemia and complicates gestation and birth if poorly managed. This study investigated the prevalence and factors associated with anaemia and this deficiency in pregnant women. Methods This cross-sectional study was conducted among 369 pregnant women at the Cape Coast Metropolitan Hospital, Ghana. Multiple logistic regression was used to investigate the relationship between anaemia and various sociodemographic variables. Results The prevalence of anaemia was 41.2% at 13 weeks' and 66.7% at 36 weeks' gestation. Overall, 29.8% of participants were glucose-6-phosphate dehydrogenase deficient. Age (P=0.024)and marital status (P=0.009) were significantly associated with anaemia at 13 weeks. Gravidity (P=0.014) and employment status (P=0.001) were significantly associated with anaemia at 36 weeks. Conclusions There was a high prevalence of co-morbid anaemia and glucose-6-phosphate dehydrogenase deficiency at 13 and 36 weeks' gestation. Future studies should consider genetic and dietary factors that may contribute to gestational anaemia. Implications for practice Clinicians and midwives should be aware of the factors that can affect anaemia and glucose-6-phosphate dehydrogenase deficiency, particularly in areas where deficiency is prevalent. Early detection could allow individualised treatment.

Sediments Composition and Morphology of the Fosu Lagoon Barrier Beach, Bakaano, Cape Coast, Ghana

This research examined the Fosu Lagoon Barrier Beach sediment composition at Bakaano in the Cape Coast Metropolis. The researchers focused on the physical attributes of the Fosu Lagoon Barrier Beach at Bakaano in Cape Coast and analysed its sediment composition. The paper analysed twelve (12) samples or specimens of soils/sediments at the laboratory to determine the sediment composition of the barrier beach. The physical dimensions of the barrier beach were measured in the field with a tape measure and a Global Positioning System (GPS). The study established that the Fosu Lagoon Barrier Beach is approximately 130m long and 58m wide. It is shallow in height, about 10m above sea level and composed mainly of coarse sand particles. The granulated sand composition has made this barrier beach fragile. Aside from wave action, human-induced factors were prominent in the catchment area, such as sand mining and artificial breaching of the barrier, accounting for the temporal changes in its physical characteristics. The paper recommends that the Cape Coast Metropolitan Assembly should play a critical role in protecting and maintaining the feature by regulating threatening human activities carried out on it.

Dynamics of antimicrobial resistance and virulence of staphylococcal species isolated from foods traded in the Cape Coast metropolitan and Elmina municipality of Ghana

The impact of staphylococci on food poisoning and infections could be higher than previously reported. In this study, we characterised the occurrence and coexistence of antimicrobial resistance and virulence genes of staphylococci isolates in foods. Staphylococci were isolated from 236 samples of selected street-vended foods and identified. The pattern of antimicrobial resistance and virulence genes in the staphylococci were assessed using disc diffusion, PCR and analysis of next-generation sequencing data. The food samples (70.76 %) showed a high prevalence of staphylococci and differed among the food categories. Forty-five Staphylococcus species were identified and comprised coagulase-negative and positive species. Staphylococcus sciuri (now Mammaliicoccus sciuri), S. aureus, S. kloosii, S. xylosus, S. saprophyticus, S. haemolyticus and S. succinus were the most abundant species. The staphylococcal isolates exhibited resistance to tetracycline, levofloxacin, ciprofloxacin, norfloxacin, gentamicin and amikacin and susceptibility to nitrofurantoin. Antimicrobial susceptibilities were also reported for cefoperazone, ceftriaxone, cefotaxime, nalidixic acid and piperacillin-tazobactam. The antimicrobial resistance and virulence genes commonly detected consisted of tet, arl, macB, van, gyr, nor, optrA, bcrA, blaZ, taeA and S. aureus lmrS. The isolates frequently exhibited multiple resistance (30.42 %) of up to eight antimicrobial drug classes. The isolates predominantly harboured genes that express efflux pump proteins (50.53 %) for antibiotic resistance compared with inactivation (10.05 %), target alteration (26.72 %), protection (7.67 %) and replacement (3.17 %). The virulence determinants comprised genes of pyrogenic toxin superantigens (eta, etb, tst), adhesions (clf, fnbA, fnbB, cna, map, ebp, spA, vWbp, coa) and genes that express exoproteins (nuclease, metalloprotease, γ-hemolysin, hyaluronate lyase). There was a statistically significant difference in the prevalence of staphylococci isolates and their antimicrobial resistance and virulence profile as revealed by the phenotypic, PCR and next-generation sequencing techniques. The findings suggest a higher health risk for consumers. We recommend a critical need for awareness and antimicrobial susceptibility and anti-virulence strategies to ensure food safety and counteract the spread of this clinically relevant genus.

Analysis of seven micronutrients in breast milk of lactating mothers from the Central Region of Ghana using epithermal neutron activation

Background: Breast milk contains various micronutrients which nourishes a baby with nutrition, and therefore the endorsement for exclusive breastfeeding during the first six months after birth. Such micronutrients, if in excess, can have adverse effects on the baby.
 Objective: The levels of seven micronutrients in breast milk obtained from 27 lactating mothers in the Cape Coast Metropolitan area have been determined using Epithermal Neutron Activation Analysis (ENAA). This technique was used because it is suitable for performing both qualitative and quantitative multi-nutritional analyses on samples, and offers accuracies and sensitivities superior to those attainable by other methods.
 Materials and Methods: During the analysis, a- 3 mm thick flexible boron was used to cut-off thermal neutrons so as to assess epithermal neutrons, thereby creating an activation energy which measured the levels of micronutrients in the breast milk. The standard reference materials used were the International Atomic Energy Agency (IAEA)-336; IAEA-407, IAEA-350 and National Institute of Standard and Technology (NIST) USA SRM 1577b. The Relative standardization method was used in the quantification of the micronutrients, with an accuracy of about 94.7 %. The micronutrients are Sodium (Na), Magnesium (Mg), Potassium (K), Calcium (Ca), Manganese (Mn), Copper (Cu) and Iodine (I).
 Results: Except for iodine which had levels below the recommended dietary allowance (RDA), the remaining micronutrients had levels above the upper limit of the RDA, with Manganese being the highest.
 Conclusion: The levels recorded are directly linked to the food intake of the mothers, and therefore the need for pregnant and lactating mothers to be mindful about what they eat. Children could be exposed to metabolic disorders and diseases as a result of such high levels.

Government Covid-19 Stimulus Package, Smes' Awareness, Accessibility, and Challenges in Cape Coast

Purpose: This is to analyze the level of knowledge of the government's COVID-19 stimulus package among SMEs in the Cape Coast Metropolitan area. Research methodology: Quantitative and descriptive approaches were used in the investigation. Purposive sampling was used to sample 234 SMEs; a structured questionnaire was used to gather data; descriptive and inferential statistics were used; and SPSS version 20 was used to enter, transform, and analyze the data. Results: The result indicates SMEs have a poor level of awareness. The SMEs have a low level of access, and it was also discovered that the SMEs confront numerous problems in obtaining packages, particularly when political affiliation is taken into account. Limitations: The study was small and focused on a single urban area. Since the pandemic is still with us and has a significant impact on commercial transactions, more research should be undertaken in a large study region. Contribution: The theory clearly shows why, for SMEs to develop and the sector to perform in support of any country's economy during a pandemic like COVID-19, the government, as the controller of money and other resources, needs to provide the necessary financial package, whether implicit or explicit, to oil a crumbling sector due to the pandemic.

Prevalence of Asymptomatic Malaria Parasitemia among Blood Donors in Cape Coast, Ghana: A Cross-Sectional Study.

Malaria is an important transfusion-associated infection in many parts of the world, particularly in sub-Saharan Africa, where it is endemic. We studied the prevalence of malaria parasites among blood donors in the Cape Coast Metropolitan Area. A malaria parasite examination was added to the blood donor screening protocol for 240 voluntary and replacement blood donors (224 males and 16 females) between December 2020 and July 2021. Overall, 2.5% (6/240) had Plasmodium falciparum trophozoites detected in their blood sample. The remaining had no parasites detected. Four of the 148 who passed the blood donor screening tests were infected. The remaining two with malaria parasites failed one screening test. These included one donor with "hepatitis B + P. falciparum" and another with "syphilis + P. falciparum" parasite coinfection. All blood donors who had malaria parasites detected in their blood were males. Most donors, 45.8% (110/240), were in the 26-35 age group, with the highest prevalence of 1.3% (3/240). Blood group O was predominant (75.0%, 180/240), followed by B (12.9%, 31/240), A (11.3%, 27/240), and AB (0.8%, 2/240). All malaria parasites detected were among individuals with blood group O. Moreover, 96.3% (231/240) were rhesus-positive and had the highest prevalence of 2.1% (5/240). Screening of blood donors in Ghana does not include malaria, although there is the potential for transmission through blood products. Malaria transmission via blood transfusion remains an issue of public health concern, as indicated in the results of this current study. We recommend studies on malaria prevention, pretransfusion and posttransfusion, and pathogen reduction technology.

Comparative use of artificial structures and natural vegetation by birds in a built-up urban area in Ghana

Our understanding of how birds use human supplementary resources, especially artificial structures and patchy vegetation within urban areas, is limited. Our study compared the use of artificial structures versus natural vegetation by birds in built-up areas in the Cape Coast Metropolitan Assembly (CCMA) in the central region of Ghana. Using point count technique, we recorded bird species and the activities performed as well as the substrates they use in residential and commercial areas within the CCMA. We found that the mean bird abundance that used artificial structures did not differ significantly from those that used natural vegetation. The mean species richness that used artificial structures was found to differ significantly from those that used natural vegetation. The study also found a significant difference in activities performed by bird species and the substrate type used for daily life activities. Across species, birds showed preference for trees, shrubs, and natural vegetation structures for perching, feeding, and singing, whereas artificial structures such as billboards, telecommunication masts, ceilings of buildings, pylons, buildings, opening in street lights, and windows of buildings were preferred for nesting. These results demonstrate that although not a replacement for natural resources, artificial structures, when combined with natural vegetation, could contribute significantly to the survival of urban birds. Conservation practitioners could encourage urban mosaic landscapes of built and green spaces to conserve and restore populations of birds.

Accountant Competence and Independence in Providing Accountancy Services to Small and Medium-Sized Entities: Evidence from a Developing Economy Perspective

In most developing nations, such as Ghana, SMEs provide a significant portion of the GDP to ensure economic growth, employment, income stability, and poverty alleviation. Despite the aforementioned duties, most of these SMEs are currently failing as a consequence of poor performance. By this, the study investigates accountants’ competence and independence in delivering accounting services to small and medium-sized organisations as a method of sustaining their vitality and allowing them to play the expected crucial roles as the engine of growth in the country’s economic development. The study delivered questionnaires to a sample of eight hundred and seven (807) employees who were selected using the purposive sampling technique from the targeted demographic. The descriptive and inferential quantitative techniques were utilised to investigate the influence of the independent factors on the dependent variable in the Cape Coast Metropolitan Assembly. Descriptive statistics such as frequency and percentages whilst inferential statistics such as correlation and regression were run using SPSS version 23. The results of the study show that competence and independence have a positive and significant effect on how well accounting services are delivered among SMEs in Ghana. The findings of this study may be utilised as a source of reference and beneficial information for researchers, additional studies, and parties who require it to get too concerned concerning accountants’ competence and independence in delivering accountancy services

Determination of Sulphate Ion Concentration in Some Ground Water in the Cape Coast Metropolitan Area, Central Region, Ghana and Its Effects on Concrete Brick with Admixture of Sawdust Ash

The admixture was prepared from Sawdust waste (SDA) and was pyrolysis by placing it in a Nabertherm (SN224350) at a controlled condition. The SDA was characterized using X-ray diffraction technique and applied as an admixture in producing concrete brick with good cementitious properties. Some key factors that contribute to concrete durability such as compacting, curing ages and the essence of quality water were taking into accounts.The sulphate ion concentration in ground water source was determined and its effects on concrete brick with 5 % SDA, 15 % SDA and 25 % SDA replacement were assessed and its compressive strength reported.5% replacements of sawdust ash, concrete brick (no curing) was found to have suffered greater attack at 28 days immersion period as compared to concrete bricks cured for 3 days and 7 days. 3 days curing and no curing of concrete brick showed a greater resistance against Sulphate intrusion with 25% sawdust ash replacements at 28 days immersion period. Premature curing of concrete brick for 7 days, with an increase in sawdust ash replacement were even more vulnerable to sulphate ion attack than concrete brick with 3 days curing and no curing.

Prevalence and Adverse Effects of Maternal Obesity among Women Attending Antenatal Care Clinics at a Metropolitan Hospital in Southern Ghana

Background: Maternal obesity and its associated health complications increase; however, area-specific data is lacking in Ghana. We attempted to assess the prevalence and adverse effects of maternal obesity in Ghana. Methods: Study population were women booking to, and gave birth to infants in Cape Coast Metropolitan Hospital, Ghana, during February 2018 to January 2019 (n = 510). Body mass index (BMI) during the first trimester was identified and analyzed in relation with outcomes/complications. Results: Incidence of maternal obesity (overweight/obese, BMI ≥ 25) was 37.3%. Of them, 34.4% had maternal complications such as postpartum haemorrhage, foetal distress, and cephalo-pelvic disproportion (in this order). The caesarian rate was 20.5%. Among the non obese women only 20% had maternal complications and the caesarian section rate was 16.2%. Obesity was positively correlated with maternal age and parity but was not with low socio-economic status. Obese women were more likely to have obstetric complications. Conclusions: Obese women were more likely to suffer obstetric complications and to have cesarean. Although present data was a confirmation of the existing data in other parts of the world, we believe that these data may be useful in making area-specific health policy.

Large Variations in Malaria Parasite Carriage by Afebrile School Children Living in Nearby Communities in the Central Region of Ghana.

Background Indicators of successful malaria control interventions include a reduction in the prevalence and densities of malaria parasites contained in both symptomatic and asymptomatic infections as well as a reduction in malaria transmission. Individuals harboring malaria parasites in asymptomatic infections serve as reservoirs for malaria transmission. This study determined the prevalence of asymptomatic malaria parasite carriage in afebrile children attending six different schools in two districts, the Cape Coast Metropolitan Assembly (CCMA) and the Komenda Edina Eguafo Abirem (KEEA) of the Central Region of Ghana. Methods This cross sectional study recruited afebrile children aged between 3 and 15 years old from six randomly selected schools in the Central Region of Ghana. Finger-pricked blood was collected and used to prepare thick and thin blood smears as well as spot a strip of filter paper (Whatman #3). Nested PCR was used to identify Plasmodium falciparum, Plasmodium malariae, Plasmodium ovale, and Plasmodium vivax in DNA extracted from the filter paper spots. The multiplicity of P. falciparum infection was determined using merozoite surface protein 2 genotyping. Results Out of the 528 children sampled, PCR identified 27.1% to harbor Plasmodium parasites in asymptomatic infections, whilst microscopy identified malaria parasites in 10.6% of the children. The overall PCR estimated prevalence of P. falciparum and P. malariae was 26.6% and 1.3%, respectively, with no P. ovale or P. vivax identified by PCR or microscopy. The RDT positivity rate ranged from 55.8% in Simiw to 4.5% in Kuful. Children from the Simiw Basic School accounted for 87.5% of all the asymptomatic infections. The multiplicity of P. falciparum infection was predominantly monoclonal and biclonal. Conclusions The low prevalence of asymptomatic malaria parasite carriage by the children living in the Cape Coast Metropolis suggests that the malaria control interventions in place in CCMA are highly effective and that additional malaria control interventions are required for the KEEA district to reduce the prevalence of asymptomatic malaria parasite carriers. No molecular evidence of P. ovale and P. vivax was identified in the afebrile children sampled from the selected schools.

Development Of A Model For The Care Of The Aged In The Cape Coast Metropolitan Area, Ghana

Development Of A Model For The Care Of The Aged In The Cape Coast Metropolitan Area, Ghana

Maternal dietary diversity and pattern during pregnancy is associated with low infant birth weight in the Cape Coast metropolitan hospital, Ghana: A hospital based cross-sectional study

BackgroundThis study investigated the associations between mother's dietary diversity score and dietary patterns during pregnancy and the odds of low birth weight at the Cape Coast Metropolitan Hospital in Ghana. MethodsMothers attending the postnatal clinic from January to August 2016 at the Cape Coast Metropolitan Hospital were included. Dietary information during pregnancy was assessed with a food frequency questionnaire. In reference to the women's dietary diversity score, women were categorized into low, medium or high dietary diversity score groups. The primary outcome was low birth weight and was defined as weight <2500 g at birth. Factor analysis was conducted to identify maternal dietary patterns and a multivariable logistic regression analysis was used to determine the associations between dietary diversity score and dietary patterns with low birth weight. ResultsThe prevalence of low birth weight in infants was 43.8% (95% CI = 39%–49%). After adjusting for covariates, the odds of low birth weight was four times higher in the low dietary diversity score group compared to the high dietary diversity score group (odds ratio [OR] = 4.29, 95% confidence interval [CI], 1.24–6.48). Three dietary patterns namely "Western", "Traditional" and "Healthy", which explained 58.23% of the total variance in food intake were identified. The subjects in the highest quartiles of “healthy” and “traditional” dietary pattern scores had significantly lower odds of low birth weight (healthy: OR = 0.23, 95% CI, 0.19–0.39, P trend <0.0001; traditional: OR = 0.14, 95% CI, 0.06–0.35, P trend <0.0001, respectively) compared to those in the lowest quartiles of dietary pattern score. ConclusionLow dietary diversity score during pregnancy was associated with higher odds of infant low birth weight whereas dietary patterns considered as “healthy” and “traditional” during pregnancy were associated with lower odds of infant low birth weight. Findings of this study suggests that higher dietary diversity and “healthy” and “traditional” dietary patterns during pregnancy may be protective of LBW in the study area.

Perceptions of government stakeholders on ageing and assisted care in the Cape Coast Municipal Area

Aim: To explore the perceptions of government stakeholders on assisted care for the aged in a Metropolis, in Ghana.&#x0D; Method: This is a qualitative sub-study of a larger study on developing a model for the care of the aged in the Cape Coast Metropolitan area. The following questions were put to the key informants: Have you noticed an increase in the number of the aged in the communities? What are government plans for the aged? How is the welfare and the caring from traditional attention, what is your view on the introduction of assisted care in Ghana? Data was collected through key-informant in-depth interviews with 10 government stakeholders directly in charge of policy implementation in the metropolis. Data collection took place over a period of four months from October 2016 to January 2107. The interviews were digitally recorded and transcribed verbatim, coded and analyzed.&#x0D; Findings: There were no preparations made for ageing, the government had plans and strategies for aged care. Traditional caring provision is inadequate and the concept of assisted living is regarded with mixed feelings. Some informant described assisted caring as an unaccepted practise that should not be encouraged.&#x0D; Conclusion: Those implementing the policies are not certain of the feasibility of the programme. Awareness of assisted living should be promoted so that the community can make their own decisions.

Hepatitis C Sentinel Seroprevalence, Cape Coast, Ghana

Objectives: Sentinel studies have targeted prenatal women as they are largely descriptive of the reproductive bracket, and prevalence data may be extended to the general population. This study determined the seroprevalence of hepatitis C virus (HCV) infection among pregnant women attending antenatal clinic at the Cape Coast Metropolitan Hospital. Methods: Whole blood samples were collected from 258 pregnant women aged between 15-45 years, from September 1st through December 31st, 2018. Separated plasma was stored and later screened for HCV antibodies. Results: Out of the total, 2.7% (7/258) tested seropositive for HCV antibodies. The 20 - 29 years age group recorded the highest prevalence of 1.6% (4/258, χ2 = 4.260, p = 0.513). According to the 2018 HIV Sentinel Surveillance report, the prevalence of HIV infection in the Cape Coast Metropolitan Area was 3.4% (17/500). Also, the prevalence of HIV among the 20-29 years age group was 1.8% (9/500). The 15-24 years, proxy group for new infections recorded 0.8% (2/258) for HCV and 0.2% (1/500) for HIV infection. Conclusions: The seroprevalence determined in this study is classified ‘intermediate,’ according to the WHO guidelines for the care and treatment of persons diagnosed with chronic hepatitis C virus infection. The WHO currently does not recommend routine HCV testing for pregnant women; however, this study highlights the need for urgent public health interventions aimed at reducing the infection rate. J Microbiol Infect Dis 2020; 10(1):52-55.

Teaching as Inquiry: Teachers Understanding and its Implication for Teaching and Learning

Teaching as inquiry (TAI) is described as a component of effective pedagogy that has significant impact on learning outcome. Based on this premises, the study sought to examine TAI and its implications for teaching and learning in the Cape Coast Metropolis, Ghana. The descriptive survey design was adopted for the study and a sample of 160 basic school teachers was selected from three circuits within the Cape Coast Metropolis. A questionnaire and an interview guide were used in collecting the data for the study. Data obtained from the questionnaire were analyzed using descriptive statistics (frequency count, percentages and means and standard deviations) whereas the interview data was transcribed and presented by doing thematic analysis. The study revealed that majority of the respondents had knowledge about TAI. In addition, the study showed that the teachers engaged in TAI practices such as reflecting and questioning their methods of teaching, identifying the academic needs of students before planning instruction and engaging in projects and research concerning the subject and content to be delivered. Findings from the study showed that teachers who participated in the study have embraced the concept of TAI very well and considering how they can mentor and lead others. It was recommended that the Cape Coast Metropolitan education office should organize intermittent workshops and training for teachers on TAI to help teachers build specific skills and refinements for reflection and action and planning strategies to support learners to learn specific things (content or skills) that teachers can specifically monitor in terms of student outcomes.

Ghanaian senior high school science students’ conceptions about change of state of matter

The article was based on the assertion that students’ conceptions greatly influence the extent to which they grasp concepts. Based on this claim, this study sought to examine students’ concepts and the reasons associated with learners’ alternative conceptions relative to change of state of matter. This study employed the survey design hinged on retrospective and prospective paradigms. A sample of 240 final year (Form 3) science students were randomly selected from five senior high schools located within the Cape Coast Metropolitan area, Ghana to participate in this research. The findings revealed that about three-quarters of the students held varied alternative conceptions on change of state of matter. Additionally, the results indicated that a number of reasons underpin why learners hold alternative conceptions of change of state of matter. For instance, students hold the alternative conception that temperature changes during phase transition and are also unable to interpret the numerical representation of the change of state of matter. It was, therefore, recommended that teachers should develop activities aimed at leading students to the development of scientifically correct conceptions thereby helping them correct their alternative conceptions.Key Words: Alternative conceptions; change of state of matter; correct conception; latent heat; senior high school students

Practices, Challenges and Perceived Influence of Classroom Assessment on Mathematics Instruction

Assessment is a powerful tool for raising the standards of teaching and learning of mathematics at the junior high school level. This study therefore explored the perceived influence of assessment on the teaching and learning of mathematics in junior high schools of OLA Circuit in Cape Coast Metropolitan area. The research design used for the study is a concurrent triangulation mixed method design. A simple random sampling technique was used to select four (4) public junior high schools out of eight (8) schools in the circuit. A multi-stage sampling procedure was employed to select the schools and participants for the study. A total of 134 participants comprising 15 teachers and 119 students participated in the study. The data for the study were mainly collected through questionnaires and interviews. Findings of the study revealed that class exercise, homework, and trial work were the most common mode of assessment used by teachers during mathematics instruction. Again, the study discovered that teachers faced some challenges in the implementation of classroom assessment. The study therefore makes certain recommendations likely to improve on the quality of assessment practices in mathematics classrooms in the focal schools.

Households’ solid waste separation practices in the Cape Coast Metropolitan area, Ghana

This study sought to investigate household solid waste separation practices in the Cape Coast Metropolis, Ghana. Specifically, the study examined previous and existing solid waste separation practices, challenges associated with household separation of solid waste and willingness of households to separate waste. Employing a descriptive research design and a mixed-method approach, a multi-stage sampling method was used to obtain data from 215 household respondents and 7 keys informants. Data for the study were gathered through interview guide, questionnaires, and observation across low, middle and high-income communities over a period of 2 months from 6th June, 2016 to 8th August, 2016. The study found that most residents, regardless of their residential income zones, rarely separate their solid waste. However, there were general indications of residents’ willingness to separate waste at source, especially when there is demand and market for the separated waste. Major challenges that were identified to impede future solid waste separation among respondents include low demand for separated waste because there is no waste recycling plant in the metropolis as well as residents’ inability to afford waste separation bins. To promote and facilitate household solid waste separation programmes, the study recommends that the central government and Cape Coast Metropolitan Assembly (CCMA) in conjunction with their development partners should assist in the provision of waste separation bins. In addition, CCMA, within its entrusted authority, should promulgate and enforce by-laws to regulate the waste separation process.

Caregiver’s Perceptions Regarding Assisted Care in the Cape Coast Metropolitan Area

Caregiver’s Perceptions Regarding Assisted Care in the Cape Coast Metropolitan Area