Upper East Region Research Articles

Mycotoxigenic Fusarium species and zearalenone concentration in commercial maize kernels in northern Ghana.

The fungal genus Fusarium contains many toxigenic pathogens of maize with associated yield losses, reduction of grain quality, and accumulation of mycotoxins in harvested grains. To determine zearalenone (ZEN) concentration and identify the various Fusarium species in commercial maize grains, a survey of 75 maize samples, collected from 11 market centers in the five regions in northern Ghana was identified based on morphological characteristics, sequence analysis of the internal transcribed spacer region, and polymerase chain reaction using species-specific primers. ZEN levels were determined using HPLC. ZEN contamination was recorded in 33.3% of the maize samples, with concentrations ranging from 0.61 to 3.05µg/kg. Based on VERT1/2 and TEF 1-α sequencing, F. verticillioides was the most prevalent species in the studied samples: 40.35% from the Upper East Region, 28.07% from the North East Region, 19.30% from the Upper West Region, 10.53% from the Savannah Region, and 1.75% for the Northern Region. Other fungal species found were F. equiseti and F. solani. A higher number of the Fusarium isolates were found in white maize (609 isolates from 27 samples) compared to yellow maize (225 isolates from 23 samples).

It takes a village: A pilot cross-randomized trial to enhance pregnancy care and support in northern Ghana.

Maternal mortality remains a challenge in Ghana, where 263 women per 100 000 live births die during pregnancy or childbirth. Barriers to reaching the recommended antenatal care (ANC) include poor access to quality health care, cultural factors, and lack of support for pregnant women. We piloted two cross-randomized interventions: durbars, or local community meetings that incorporated education about ANC and supporting pregnant women, and an enhanced ANC model that added phone calls and a home visit to standard care. The study took place in 30 villages in the Upper East Region of Ghana between August 2021 and November 2022. We tracked 277 women during pregnancy, with 120 women randomly assigned to the enhanced ANC intervention and 142 women living in villages randomized to the durbar intervention. Women who were randomized to the enhanced ANC intervention were 13.2 percentage points (pp) (95% confidence interval (CI) = 0.1, 24.3) more likely to have average or above average knowledge of pregnancy danger signs, 22.1 pp (95% CI = 9.1, 36.5) more likely to have a birth plan, 28.2 pp (95% CI = 13.0, 42.4) more likely to prepare the plan with their partners, and 16.4 pp (95% CI = 0.9, 29.3) more likely to pay for delivery with funds set aside in birth plan. They were also 35 pp (95% CI = 16.1, 48.1) more likely to make blood donor arrangements than control women who made birth plans. We found no impact of the durbar intervention on study outcomes. Evidence from this pilot suggests that interventions that increase interactions between health providers and pregnant women outside of the health facility may substantially improve women's experience during pregnancy and maternal health outcomes. Providing structured ways for men to get engaged in ANC increased their involvement. Although we found no evidence the community meetings improved study outcomes, larger studies with repeated meetings and community-wide surveys are needed to make causal conclusions. American Economic Association RCT Registry: 10360; ISCRNT: ISRCTN95961119.

Application of Analytical Hierarchy Process (AHP) and Multi-Criteria Evaluation (MCE) for a case study and scenario assessment of flood risk in the White Volta Basin of the Upper East Region, Ghana

In recent years, Ghana, particularly the inhabitants of the Upper East Region, has experienced profound impact of flooding, largely attributable to the complex interplay of climatic factors. This research embarks on a comprehensive assessment of flood risk zones nestled within the White Volta Basin, situated in the Upper East Region. The study employs advanced cartographic methodologies and uses Geographic Information Systems (GIS) in conjunction with the Analytical Hierarchy Process (AHP) to systematically categorize areas susceptible to inundation. Leveraging geospatial datasets acquired from satellites such as Landsat and Sentinel. Topographic, slope, and Land Use/Land Cover (LULC) maps have been constructed. The empirical findings underscore the susceptibility of specific regions, including the Talensi District, territories within Bawku West, and some segments of the Bolgatanga Municipal area, to escalated flood risk. Additionally, the research underscores the high vulnerability of communities such as Nunku, Tolla, Zaare, Pwalugu, Balungu, Winkongo, Biung, and Tongo to the negative impact of inundation. Significantly, the study unveils a pivotal factor in the perpetuation of flood devastation—namely, the role of water discharge. This intrinsic linkage between discharge rates and flood occurrences underscores the pressing need to address this critical component in mitigation strategies to reduce adverse impacts on the basin’s resident communities. The insights derived from the study offer some level of hope for residents, providing essential knowledge concerning flood-prone areas and optimal timing for agricultural activities to safeguard their cherished livelihoods.

Social vulnerability to food insecurity in Sub-Saharan Africa: exploring the connection between climate change, funeral rites and food insecurity in rural Ghana

ABSTRACT Climate Change and food security remain one of the topical issues discussed globally. In Ghana, the literature has reported on the effects of climate change on the food consumption patterns of many households due to low adaptive capacity and inefficient food production systems. In addition to climate change as a threat to food security, funeral rites also play a major role in household food insecurity. However, the link between climate change, funeral rites and food security as indices of social vulnerability has been less investigated. Using a qualitative-dominance approach to research with 8 key informant interviews, 4 focus group discussions (FGDs) and a questionnaire, the analysis revealed that climate change and funeral rites are critical determinants of food insecurity in the Kassena Nankana Municipality of the Upper East Region of Ghana. The results show that while climate change affects the food production systems, the poorly harvested farm produce and livestock are used for the funeral rites of the deceased’s household family. While being sensitive to the cultural aspects of the uses of farm produce and livestock for funeral rites, and given the prevailing climatic conditions, the study recommends the need for traditional authorities and households to consider holding less expensive funeral rites which do not expend future food needs and resources. Again, localised climate change adaptation strategies need to be developed by the Ministry of Food and Agriculture to support the activities of agriculture in the municipality which is widely known to be susceptible to climate change.

The impact of the RTS,S malaria vaccine on uncomplicated malaria: evidence from the phase IV study districts, Upper East Region, Ghana, 2020–2022

BackgroundThe RTS,S malaria vaccine has been prequalified for use in endemic settings prioritizing areas with moderate to high disease transmission. The impact of a vaccine at the population level may differ from observations during clinical trial due to programmatic, and individual-related factors, among others. The objective of this study was to assess the impact of the RTS,S malaria vaccine on uncomplicated malaria among children aged 12–59 months in the Phase IV study districts, Upper East Region, Ghana.MethodsA retrospective study was conducted using routine malaria surveillance data for the period 2020–2022. The burden of uncomplicated malaria was compared between the implementing (Kasena Nankana East and West districts) and comparator areas (Builsa North and South districts). The impact of RTS,S malaria vaccine was assessed by estimating the percentage reduction in uncomplicated malaria and incidence averted in the implementing area, accounting for the effect of confounders.ResultsOver 50,000 episodes of uncomplicated malaria among children aged 12–59 months were included in the study. Uncomplicated malaria was reduced by 33% (95%CI 29–36) over the entire study period, but the malaria incidence averted declined from 324/1,000 (95% CI 298–339; p < 0.0001) in 2020 to 287/1000 (95% CI 274–299; p < 0.0001) in 2022.ConclusionThe RTS,S malaria vaccine significantly reduced the burden of uncomplicated malaria among children aged 12–59 months in the implementing area. The sequential marginal declines in malaria incidence averted over the study period might be due to waning of protective immunity and acquisition of natural immunity as children age. Strengthening uptake of the currently recommended vaccines and other malaria control interventions is required to improve public health impact.

Remote Sensing and Field Data Analysis to Evaluate the Impact of Stone Bunds on Rainfed Agriculture in West Africa

This study evaluates the effectiveness of stone bunds in enhancing soil moisture, vegetation health, and crop yields in Ghana’s semi-arid Upper East Region, an important area for agricultural productivity in West Africa. In this region, agricultural practices are heavily impacted by erratic rainfall and poor soil moisture retention, threatening food security. Despite the known benefits of traditional soil conservation practices like stone bunds, their effectiveness in this context has not been fully quantified. Field and remote sensing data were used to evaluate the influence of stone bunds on soil moisture dynamics, vegetation growth, and crop yield. Experimental plots with and without stone bunds were monitored for climate, soil water infiltration, and soil moisture and analyzed using the NDVI from Sentinel-2 satellite imagery over two growing seasons under sorghum production (2022–2023). The results indicated that stone bunds enhanced soil moisture retention and increased infiltration rates. The NDVI analysis consistently revealed higher vegetation health and growth in the plots with stone bunds, particularly during critical growth periods. The intermediate results of the conducted experiment indicated that stone bunds increased sorghum yields by over 35% compared to the control plots. The substantial agronomic benefits of stone bunds as a soil and water conservation strategy were evident, improving soil water infiltration, water retention, vegetation health, and crop yields. The findings support the broader adoption of stone bunds in semi-arid regions to enhance agricultural productivity and resilience against climate variability. Further research is recommended to explore the long-term impacts and the integration of stone bunds with other sustainable farming practices to optimize rainfed agricultural outcomes.

Groundwater fluoride contamination, sources, hotspots, health hazards, and sustainable containment measures: A systematic review of the Ghanaian context

Groundwater quality is globally threatened by geogenic and human activities. These activities release high levels of potentially toxic elements, such as fluoride (F−), which pose significant threats to human health. This has become a global issue, especially in developing countries such as Ghana. Despite efforts to address this issue, knowledge gaps still need to be addressed to ensure safe and healthy drinking water for all Ghanaians. Moreover, Ghana has been reported to be a fluorosis-endemic country but the sources and exact hotspots of F− enrichment in the aquifers on a countrywide scale are lacking in the available literature. Understanding the quality of water used for diverse purposes in Ghana is necessary to achieve the United Nations Sustainable Development Goals like good health and well-being (SDG 3) and clean water and sanitation (SDG 6), among others. Therefore, this study synthesized all previous studies on groundwater F− contamination in Ghana, to identify the sources of F− enrichment in groundwater, delineate the hotspots for fluorosis, assess the associated human health risks, identify the best sustainable defluoridation methods, and recommend policy intervention for high groundwater F− threat to aquifers in Ghana. In the Ghanaian context, F− contamination in groundwater is largely from geogenic sources like the weathering of fluoride-bearing rocks (granitoids and carbonate sedimentary lithologies) from the Birimian and Voltaian Supergroups and the dissolution of fluoride-rich minerals (fluorapatite, amphiboles, fluorite, biotite, and muscovite). Hotspots for high groundwater F− in Ghana are mainly restricted to the Upper East Region (0.10–5.00 mg/L), North East Region (0.01–13.29 mg/L), Northern Region (0.1–11.6 mg/L), and the White Volta River Basin (0.04–3.79 mg/L). The mean and maximum values of F− in these hotspots exceed the maximum permissible level (1.5 mg/L) set by the World Health Organization and Ghana Standards Authority. Most people in these areas suffer from dental fluorosis. Therefore, affordable and sustainable defluoridation technologies as well as community-based initiatives are recommended to deal with this menace.

Determinants of livelihood diversification in an integrated agricultural and non-agricultural livelihood system in Ghana

The diversification of livelihoods by households has been widely acknowledged as a way to overcome food insecurity and poverty challenges in developing countries. Diversification of livelihoods helps spread the risk among multiple livelihood earning activities to provide households with a range of their food needs all year round. By examining the integrated livelihood systems of 405 rural farm households in the Upper East Region of Ghana, empirical evidence is provided in this study using the Sustainable Livelihoods Framework to advance arguments in the literature for the creation of sustainable strategies that improve diversified livelihood systems. The mean diversification indices estimated were 0.45 for agricultural diversification systems, 0.32 for non-agricultural diversification systems and 0.59 for integrated agricultural and non-agricultural diversification systems. With the use of the Cragg two-step regression model, we demonstrate that the decision to diversify and the extent of diversification of rural livelihoods are distinct decisions and are influenced by distinct sets of factors. Similarly, for the three categories of livelihood diversification studied, the effect of these factors also differed. The results emphasize the significance of access to good road network, credit and market information in encouraging rural farm households to diversify their livelihoods. In the short term, improving access to credit and market information through community-based initiatives can provide immediate support to rural households. Communities should also organize local markets and cooperatives to strengthen their economic resilience. While government and stakeholders should focus on long-term infrastructure projects, these community actions can complement such efforts and contribute to achieving global and regional goals targeting food insecurity and poverty eradication.

Total quality management, supplier quality and operational efficiency in the public health sector in the Upper East Region of Ghana

The purpose of this study was to examine the role that Total Quality Management (TQM) plays in ensuring operational efficiency via supplier quality in public health sector in the Upper East Region. Specifically, the study examined the effect of TQM on supplier quality; effect of TQM on operational efficiency; effect of supplier quality on operational efficiency and finally assessed the mediating role that supplier quality plays in the relationship between TQM and operational efficiency within these health sectors in the Upper East region. Structured questionnaire was utilized to solicit primary data from the study’s respondents. The selection of 174 sampled respondents from the total population of 352 public health facilities were done using a simple random sampling procedure. Also, version 24 of the IBM SPSS software and the SmartPLS model was utilised to process the data. The demographic characteristics of the respondents were analysed with the help of descriptive tools such as means and standard deviation, while inferential statistical tools was employed in testing the cause-and-effect hypothesised relationships between the variables. The findings revealed that total quality management had a positive significant effect on supplier quality. Likewise, the objective two showed that total quality management had a positive statistically significant effect on operational efficiency. The third objective showed that supplier quality had a positive statistically significant effect on operational efficiency, and the fourth research objectives revealed a positive statistically significant mediating effect of supplier quality in the relationship between total quality management and operational efficiency. The study recommended that, management of health facilities within the Upper East region should emphasize on putting measures in place to ensure the improvement of their TQM practices to help set standard that will ensure that suppliers goods and services conform to quality standards

Adherence to Hygiene Protocols and Doxycycline Therapy in Ameliorating Lymphatic Filariasis Morbidity in an Endemic Area Post-Interruption of Disease Transmission in Ghana.

Filarial lymphedema (LE) remains a significant global problem despite the progress made toward elimination of lymphatic filariasis (LF). In Ghana, the main approach to LF is preventive chemotherapy, but this has minimal impact on individuals who have already developed LE. In 2018-2020, a 24-month randomized, double-blind, placebo-controlled trial was conducted to evaluate the efficacy of stringent hygiene measures using the Essential Package of Care with or without additional administration of doxycycline (DOX) to improve filarial leg LE. This study enrolled 356 participants with LE stages 1-3 from two districts in the Upper East Region of Ghana. In addition to regular training on appropriate care for their affected legs, participants were randomized to receive 6 weeks of either 200 mg/day DOX (n = 117), 100 mg/day DOX (n = 120), or matching placebo (n = 119). Participants were seen every 2 months, with clinical measurements done at 6, 12, 18, and 24 months to assess the status of affected legs. There was a trend toward later appearance of acute attacks after DOX, but surprisingly, DOX showed no effect on LE stage progression. In all groups, leg LE improvement was more common (DOX 200 mg: n = 23 [20%]; DOX 100 mg: n = 23 [19.5%]; placebo: n = 32 [27.4%]) than LE worsening (DOX 200 mg: n = 2 [1.7%]; DOX 100 mg: n = 3 [2.5%]; placebo: n = 2 [1.7%]). Overall, these data show a strong benefit from adherence to a strict hygiene protocol, with some added potential benefit for DOX in preventing acute attacks.

Factors Contributing to Low Immunization Coverage among Children 0-59 Months in Bolgatanga Municipality: A Study in Upper East Region, Ghana

Factors Contributing to Low Immunization Coverage among Children 0-59 Months in Bolgatanga Municipality: A Study in Upper East Region, Ghana

Prevalence and predictors of common mental disorders among mothers of preterm babies at neonatal intensive care units in Ghana.

The impact of preterm babies' admission at the Neonatal Intensive Care (NICU) on the mental health of mothers is a global challenge. However, the prevalence and predictors of Common Mental Disorders (CMDs) among this population remain underexplored. This study assessed the predictors of CMDs among mothers of preterm infants in the NICUs in the Upper East Region of Ghana. A cross-sectional study was conducted, targeting mothers of preterm babies in two hospitals in the Upper East Region. The Self-Report Questionnaire (SRQ-20) was used to collect data from 375 mothers of preterm babies admitted to the NICUs. Statistical analyses were done using SPSS version 20. The study found a prevalence of 40.9% for CMDs among mothers of preterm babies admitted to the two NICUs. The predictors of CMDs were unemployment (aOR 2.925, 95% CI 1.465, 5.840), lower levels of education (aOR 5.582, 95% CI 1.316, 23.670), antenatal anxiety (aOR 3.606, 95% CI 1.870, 6.952), and assisted delivery (aOR 2.144, 95% CI 1.083, 4.246). Conversely, urban residence (aOR 0.390, 95% CI 0.200, 0.760), age range between 25 and 31 (aOR 0.238, 95% CI 0.060, 0.953), and having a supportive partner (aOR 0.095, 95% CI 0.015, 0.593) emerged as protective factors. This study emphasizes the imperative of addressing maternal mental health within the NICU setting for preterm births.

Women’s autonomy, neonatal, infant and under-five mortality in the Upper East Region of Ghana

Child mortality remains a major health challenge in Sub-Saharan Africa. Child survival is greatly influenced by household circumstances and mother’s healthcare choices. Notwithstanding tremendous investment in women empowerment in Ghana, there is limited empirical evidence on whether women’s autonomy translates into better child mortality outcomes. To examine the association between women’s autonomy and neonatal, infant and under-five mortality in the Upper East Region of Ghana. Data were obtained from a randomized cluster household survey among 15–49 years old women in seven districts in the Upper East Region. Data analysis was restricted to 3,243 women who reported ever having given birth. Based on Principal Component Analysis (PCA), we constructed an autonomy index categorized into least, moderate, and high autonomy based on responses to six questions regarding household decision-making. Bivariate and multivariate logistic regressions were used to assess the association of women’s autonomy status and mortality outcomes. Attaining secondary education or higher was significantly associated with infant mortality (adjusted odds ratio (aOR) = 0.39, CI = 0.16, 0.94) and under-five mortality (aOR = 0.39, CI = 0.18–0.87). Also, maternal age was significantly associated with neonatal, infant, and under-five mortality, while living in rural setting was significantly associated with lower risk of neonatal (aOR = 0.38, CI = 0.19–0.75) and under-five (aOR = 0.63, CI = 0.48–0.83) mortality. However, we found that compared to women with least autonomy, infants of those with moderate autonomy (aOR = 1.76, CI 1.07–2.89) and high autonomy (aOR = 1.75; CI = 1.04–2.93) were significantly more likely to die. In this study setting, women’s autonomy was not predictive of child mortality. Interventions that aim to improve child mortality should pay attention to community and family level factors that promote increase utilization of essential early childhood interventions.

Analysis of Seasonal Time Poverty and Aspirations in the Upper East Region of Ghana

While studies on aspiration formation have progressively gained the interest of development practitioners and policymakers, little is known about the link between seasonal time poverty and aspirations. This study uses primary data on 337 smallholder households in rural northern Ghana to examine the relationship between seasonal time poverty and aspirations about income, assets, child education, and social status from household headship and age perspectives. The results indicate that seasonal time poverty is correlated with higher aspirations of income and assets but a lower social status. The effect is more significant in dry than wet seasons, and more evident in female- and adult-headed households. The findings are robust to alternative estimation methods for addressing endogeneity. Income is identified as the main potential channel through which seasonal time poverty influences aspirations formation and the implications of the findings are discussed. HIGHLIGHTS In Ghana, seasonal time poverty is positively associated with income and asset aspirations. Seasonal time poverty reduces social status aspiration. The effect of seasonal time poverty on aspiration is higher among women and adults. Programs that promote rural household income must be targeted, pursued, and sustained to improve aspirations.

The Nexus between Environmental Factors and Behaviour Change in the Upper East Region of Ghana: The Mediating Role of Marketing Strategies

This study aimed to explore the mediating role of marketing strategies in the relationship between environmental factors and behavior change in healthcare utilisation. A cross-sectional survey design was conducted using a random sampling technique to select 474 healthcare workers from six Health Directorates across Municipalities and Districts in the Upper East Region of Ghana. The target population from which the sample size was determined was 1980. The theories that guided this study were the Health Belief Model and the Theory of Planned Planned Behaviour. A structured questionnaire was designed using a five-point Likert scale and administered to the respondents. The data was collected over three months from February to April. A Structural Equation Model (SEM) with AMOS was employed to analyse the data. Findings revealed that marketing strategies mediate the relationship between environmental factors and behaviour change. The predicted hypotheses were found to be positive and significant. The study highlights the importance of marketing strategies in disseminating health-related information, which influences positive behaviour change toward healthcare utilisation. The study found that marketing strategies play a crucial role in disseminating health information and promoting behaviour change. The mediating role of marketing strategies in the relationship between environmental factors and behaviour change was established. All hypotheses were confirmed, demonstrating the key role of marketing strategies in improving health outcomes through behaviour modification. It is recommended that healthcare facility managers consider incorporating marketing strategies into their strategic plans to optimise outcomes.

Relationship between dietary diversity and haemoglobin concentration among women of reproductive age (15−49 years) in the Upper East Region of Ghana

Purpose The purpose of this study is to investigate the relationship between dietary diversity and haemoglobin concentration of women of reproductive age (WRA), 15−49 years in the Binduri District, of the Upper East Region (UER) of Ghana. Design/methodology/approach This cross-sectional study was conducted among 153 non-pregnant, non-lactating WRA from three randomly selected communities in the Binduri District of the UER of Ghana. Socio-demographic information, 24-h dietary recall and minimum dietary diversity scores (DDS) of the women were obtained using an interviewer-administered questionnaire. Haemoglobin concentration of the participants was measured by finger prick using Hemocue 301 Analyzer and classified according to WHO standards. Linear regression analysis was used to assess the relationship between DDS and haemoglobin concentrations of the participants. Findings Total study participants were 153 with mean age of 32.8 ± 8.7 years. Anaemia prevalence of 66.7% and a mean DDS of 4.0 ± 1.2 was recorded. DDS was found to be a strong predictor of haemoglobin concentration (p = 0.00, R2 = 0.48). Practical implications Interventions that increase DDS may be effective in improving haemoglobin levels of WRA. Originality/value The results showed that DDS is a strong predictor of haemoglobin concentration of the WRA in this study. As the dietary diversity of the women increased, their mean haemoglobin concentration also improved. To the best of the authors’ knowledge, this is the first study of its kind to be conducted in the study area.

Gender vulnerability and coping strategies to changing provisioning ecosystem services in Bongo and Kassena-Nankana West districts in the Upper East Region of Ghana

ABSTRACT Ecosystems provide a wide variety of life-sustaining services but are currently facing severe degradation due to changing land use and cover. Women are presumed to be more affected by declines in provisioning ecosystem services (PES). These claims have not been empirically proven across all contexts and have been contested by recent studies. Few studies in Ghana have attempted to examine this gendered environmental change phenomenon. Underpinned by the vulnerability theory, this paper employed an eclectic methodological approach to examine gender differences in vulnerability and coping with changing PES in Ghana. The findings reveal that both males and females depend highly on agricultural and woodland ecosystems for their livelihood needs. The deterioration in the total areas of the major ecosystems has resulted in significant declines in vital PES such as wild edible fruits and vegetables, medicinal plants and building materials for both men and women over the past decade. The study further reveals that the decreases in fuelwood supply affect women more than men because the former group mostly cooks food in their households, using fuelwood. As adaptation mechanisms, male farmers mostly planted trees on their farms to reclaim unfertile land and conserve forests, while female farmers engage in fruits and vegetable trade in the markets, as well as used non-indigenous spices to enhance the taste of food. Both males and females have also resorted to relying on orthodox medicines contrary to the past. To increase ecosystem resilience, the mainstreaming of ecosystem integrity adaptation practices into national adaptation plans is paramount.

Psychosocial determinants of parents’ intention to support reproductive health education in Ghana

ABSTRACT Promoting sex education is key to addressing the adverse sexual health outcomes among adolescents. The successful adoption and implementation of Reproductive Health Education (RHE) in schools depends on the support of curriculum owners and other stakeholders such as parents. The study explored socio-demographic and psychosocial factors influencing parents’ intentions to support the adoption and implementation of RHE in primary and high schools in Ghana. A cross-sectional survey was conducted with 387 (Mean age = 43.6 years) parents in the Upper East region of Ghana. Pearson’s correlation and regression analyses were used to examine socio-demographic and psychosocial factors influencing the stated intention to support the adoption and implementation of RHE in schools. Parent’s intention was best predicted by descriptive norms (β = .24, p < .001), and injunctive norms (β = .20, p < .001) towards supporting RHE. Other factors that predicted intention to support were beliefs about the outcomes of teaching both abstinence-only education and RHE. The findings point to the need to involve and gain support from religious leaders in the development and roll-out processes of RHE programmes. Moreover, they highlight the need for effective RHE programmes with the potential to yield positive sexual and reproductive health outcomes among adolescents and young people.

Assessment of expanded programme on immunization routine data quality in the upper east region of Ghana

BackgroundData quality is a major challenge for most health institutions and organizations across the globe. The Ghana Health Service, supported by other non-governmental organizations, has instituted various strategies to address and improve data quality issues in regional and district health facilities in Ghana. This study sought to assess routine data quality of Expanded Programme on Immunization, specifically for Penta 1 and Penta 3 vaccines.MethodsA descriptive cross-sectional study design was used for the study. A simple random sampling method was used to select thirty-four health facilities across seven sub-municipalities. Records from the Expanded Programme on Immunization (EPI) Tally Books and Monthly Vaccination Summary Report were reviewed and compared with data entered into the District Health Information Management System 2 (DHIMS2) software for the period of January to December 2020. The World Health Organization Data quality self-assessment (DQS) tool was used to compare data recorded in the EPI tally books with monthly data from summary reports and DHIMS2. Data accuracy ratio was determined by the data quality assessment tools and STATA version 14.2 was used to run additional analysis. A data discrepancy is when two corresponding data sets don’t match.ResultsThe results showed discrepancies between recounted tallies in EPI tally books and summary reports submitted as well as DHIMS2. Verification factor of 97.4% and 99.3% and a discrepancy rate of 2.6 and 0.7 for Penta 1 and Penta 3 respectively were recorded for tallied data and summary reports. A verification factor of 100.5% and 99.9% and a discrepancy of -0.5 and 0.1 respectively for the same antigens were obtained for the summary reports and DHIMS2. Data timeliness was 90.7% and completeness was 100% for both antigens.ConclusionThe accuracy of Penta 1 and Penta 3 data on EPI in the Upper East Region of Ghana was high. The data availability, timeliness and completeness were also high.

Embracing Business Sustainability: The Case of Small and Micro Tourist Accommodation In The Upper East Region

Purpose: This study holds significant importance as it delves into the degree to which small and micro tourist businesses (SMTBs), particularly small lodging businesses in the Upper East Region of Ghana, have adopted the concept of sustainability. This investigation is crucial for understanding the current state of sustainability in the tourism industry. Design/Methodology/ Approach: This study employed a purposive sampling technique and conducted a comprehensive survey of 196 lodging facility owner-managers. The responses of 144 participants were meticulously examined to gauge the level of sustainability embraced by their companies. A 5-point Likert-type scale, ranging from 1 (not at all) to 5 (very much so), was used to measure the responses. The statistical techniques of ANOVA and frequency analysis were employed to investigate and test the means of the variables and their significance across business categories. Findings: The findings revealed that, depending on the type of business, there are notable variations in the following areas: 1) attitude toward accepting sustainability; 2) application of sustainability for their enterprises; and 3) understanding of the obstacles to applying sustainability among owner-managers of lodging houses. Research Limitation/Implication: This study was only exploratory due to some practical constraints and methodological limitations that prevented the inclusion of a wide range of sectors. It also focused on SMTBs in only the Upper East Region of Ghana. Practical Implication: A policy foundation is necessary for small businesses to respond dynamically to changing business and social environment trends. For example, environmental marks in the manufacturing industry, environmental tourism management practices, and environmental tourism consumption experiences should be introduced and rewarded, and related promotion measures should be specified. Social Implication: The study recommends policy options for improving SMTB sustainability and how their establishments can impact the environment and society. Originality/Value: The study's originality is how SMBTs respond to environmental sustainability concerning their business characteristics at the local level. Secondly, the Upper East Region of Ghana has many tourism businesses; hence, there is a need to understand the concept of sustainable tourism specifically applied to business activities.