West Municipality Research Articles

Stakeholder Participation for Sustainable Solid Waste Management in Ga West Municipality, Accra – Ghana

Purpose: This study assessed the participation of identified stakeholders in solid waste management (SWM) in Ga West Municipality. The specific objectives of the study included the examination of the interests, importance and influence of identified stakeholders as well as an assessment of their strengths, weaknesses, threats and opportunities.
 Methodology: Qualitative research methods were used for data collection. This involved using semi-structured interviews with open and close ended questions, informal interviews, focus group discussion and observation. The study identified ten (10) stakeholders. They included households, market traders, food processors, schools, lorry stations, Ga West Municipal Assembly, skip site operators, scavengers, Private waste operators and waste disposal facility. The study employed multiple sampling techniques. Stakeholder analysis was used to understand stakeholder roles, responsibilities and power influence relations. Strength, Weakness, Opportunity and Threat (SWOT) analysis was carried out to assess the internal and external merits, prospects and challenges facing these stakeholders in sustainable SWM.
 Findings: The findings of the study revealed that stakeholder involvement in SWM was low. Opportunities existed for compost and recycling but half of the total waste generated was uncollected and recovery rate was very low.
 Recommendation: This study proposes stakeholder consultation and involvement, recognition and integration of scavengers and intensification of public education on solid waste collection, reduction, reuse, recovery and recycling.
 Unique contribution to theory, practice and policy: Stakeholders had varying degree of interest, importance and capacity to influence SWM. All stakeholders had peculiar strengths, weaknesses, opportunities and threat which must be carefully exploited and managed for the achievement of a sustainable SWM.
 Keywords: sustainability, strengths, weaknesses, opportunities, threats and influence

Efficacy of Artemether-Lumefantrine on various Plasmodium falciparum Kelch 13 and Pfmdr1 genes isolated in Ghana

IntroductionArtemether-Lumefantrine (A-L) remains the drug of choice for the treatment of uncomplicated malaria in Ghana. However, the pharmaco-activity of A-L has not been assessed on various Plasmodium falciparum Kelch 13 and Pfmdr1 genes. Therefore, this study sought to determine the therapeutic efficacy of A-L on P. falciparum parasites isolated from Ghana. MethodsThe clinical study was done in Ga West Municipality, Ghana, where 78 uncomplicated malaria patients were recruited with prior consent. The patients were treated orally with A-L according to national treatment guidelines. Baseline parasitaemia was determined before treatment and 8-hourly parasitaemia posttreatment were determined till initial clearance of parasitaemia and at days 7, 14, 21, and 28. Kelch 13 and Pfmdr1 genes were genotyped by sequencing using baseline samples. Parasite clearance characteristics were determined using Parasite Clearance Estimator beta 0.9 application. ResultsFive Kelch 13 (F446I, S466N, R539I, A578S, and A676S) and three Pfmdr1 mutations (N86Y, Y184F and D1246Y) were identified in 78 infected samples. About 8% of the samples contained two Pfmdr1 double mutations (N86Y & D1246Y and Y184F & N86Y). Additionally, three samples (3.8%) were found to contain both Kelch 13 mutations and Pfmdr1 wild type genes. In all patients, parasitaemia persisted within the first 24 h of A-L therapy. However, at hour 40, only two patients were parasitaemic while all patients were aparasitaemic at hour 48. The genotypic profiles of the two persistent parasites at hour 40 were F446I and D1246Y, and R539I, Y184F, and N86Y. The slope half-life of the former was 6.4 h while the latter was 6.9 h and their respective PCT99 were 47.9 h and 49.2 h as well as a clearance rate constants of 0.109 and 0.092 respectively. ConclusionThis study reports the effectiveness of A-L on various P. falciparum mutant alleles. However, continuous surveillance of Kelch 13 mutations and Pfmdr1 gene in Ghana and regular assessment of the therapeutic efficacy of A-L and other artemisinin derivatives is recommended.

Assessing policymaker and taxpayer attitudes towards public finance for urban sanitation: the case of sanitation surcharges in two Ghanaian municipalities

ABSTRACT Municipal Authorities (Assemblies) in Ghana have been unable to generate adequate revenue to effectively manage sanitation. To address this challenge, the Akuapem North and Ga West Municipalities have recently introduced a sanitation surcharge, which is collected through property rates. Using a mixed-method approach, this paper assesses the attitudes of policymakers and taxpayers towards the policy and the implications for its effective implementation. Qualitative data were collected through interviews with officials of the Municipal Assemblies while quantitative data were collected through a survey of 832 randomly selected property owners. The study revealed that policymakers’ de jure acceptance of the policy has not translated into de facto implementation. Although most taxpayers support the policy, a significant minority of them oppose it due to lack of trust in the Assemblies. Therefore, the Assemblies need to devise effective communication strategies, and enhance transparency in the use of revenue collected through the surcharge.

Enteroparasitism in Hard-to-Reach Community Dwellers: A Cross-Sectional Study in Ga West Municipality in Ghana.

Ga West Municipality in Ghana is predominantly rural with about forty-eight hard-to-reach communities. Several infectious diseases such as Buruli ulcer, tuberculosis, yaws, schistosomiasis, and malaria are prevalent in the municipality. However, the prevalence and characteristics of enteroparasites in the municipality are unknown. Therefore, this cross-sectional study determined the prevalence of enteroparasites in these hard-to-reach communities. Samples were collected from five communities, namely, Opah, Otuaplem, Dedeman, Onyansana, and Manchie. A total of 538 stool samples were collected from the community dwellers. Each sample was examined with eosin-saline wet preparation and formol-ether concentration technique. Body mass index, haemoglobin, and albumin concentrations were used to assess nutritional status. Seven different parasite species were identified in 178 community dwellers (33.1% prevalence (95% CI: 0.29–0.37)). The individual prevalence of the identified parasites was Schistosoma mansoni (13.4%), Entamoeba histolytica (7.2%), Ascaris lumbricoides (6.9%), Giardia lamblia (5.0%), hookworm (4.8%), Strongyloides stercoralis (4.8%), and Balantidium coli (1.6%). Among the 178 parasitized individuals, 68.0% were singly infected while 31.5% had dual parasitism. Significantly higher infections were associated with Onyansana dwellers (p = 0.019), participants aged 16–20 years (p = 0.006), unmarried participants (p < 0.001), those without formal education (p = 0.044), and crop farmers (p = 0.044). However, among the Akan tribe (p = 0.015), Christians (p = 0.03), and participants with higher incomes (p = 0.012), infections were found to be lower. Compared to monoparasitism, dual parasitism was significantly associated with underweight (17.8 vs. 20.3 kg/m2), anaemia (7.7 vs. 9.8 g/dL), and malnutrition (27.6 vs. 31.9 g/L of albumin concentration). These findings underscore the fact that the Ga West Municipality is heavily burdened with different species of enteroparasites. Therefore, education on personal hygiene to reduce parasitic infections must be intensified while implementing regular mass deworming exercise in the municipality.

Implications of self-medication in pregnancy for Safe Motherhood and Sustainable Development Goal-3 in selected Ghanaian communities

ObjectivesThis study explored self-medication in pregnancy and its implications for achieving Safe Motherhood and Sustainable Development Goal-3 initiatives in some Ghanaian communities. Study designA facility-based cross-sectional descriptive design using mixed method approach of data collection. MethodsMulti-staged simple random and purposive sampling techniques were used to select 136 pregnant women from public Antenatal Clinics in Efutu and Agona West municipalities in the Central Region of Ghana from June to August 2018. Quantitative data were collected using structured questionnaires and analyzed with Statistical Package for Social Sciences version 23.0 whilst interview guides were used to collect qualitative data via Focus Group Discussions and content analysis done. ResultsSelf-medication in the study area is a common practice among most (88%) pregnant women of all socioeconomic backgrounds, those in the first trimester of pregnancy (68.7%) and routine Antenatal clinic attendants (69%). Religion (p ​= ​0.003) and educational (p ​= ​0.004) backgrounds of respondents were significantly associated with self-medication in pregnancy and motivated by reproductive intentions, availability of medicines, time factor, media advertisements and societal influences relating to beliefs, fears, expectations and perceptions. Majority (90%) of respondents had no side effects. ConclusionsA nation-wide evaluation of public health education on the dangers of self-medication in pregnancy and implementation of drug regulatory policies are highly recommended in Ghana.

Tuberculosis surveillance system evaluation: case of Ga West municipality, Ghana, 2011 to 2016.

Evaluate the Tuberculosis (TB) surveillance system in the Ga West Municipality to determine if it is achieving its objectives, and to assess its attributes and usefulness. Descriptive analysis of primary and secondary data. Stakeholder interviews and record reviews on the objectives and operation of the surveillance system at all levels of the system. We evaluated the system's operation from 2011-2015 using the Centers for Disease Control and Prevention (CDC) updated guidelines for evaluating public health surveillance systems and the World Health Organisation (WHO) TB surveillance checklist for assessing the performance of national surveillance systems. The TB surveillance system in the municipality was functional and operated at all levels for timely detection of cases, accurate diagnosis, and case management. The system improved management of TB/HIV co-infections. The average time taken to confirm a suspected TB case was one day. The registration of a confirmed case and subsequent treatment happen immediately after confirmation. The municipality detected 109 of 727 TB cases in 2015 (case detection rate=15%). The positive predictive value (PPV) was 6.4%. There was one diagnostic centre in the municipality. Private facilities involvement in TB surveillance activities was low (1/15). The Tuberculosis surveillance system in the Ga West Municipality is well structured but partially meeting its objectives. The system is timely, stable and acceptable by most stakeholders and useful at all levels. It has no major data quality issues. Private health facilities in the municipality should be well incorporated into TB surveillance. This work was supported by Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana through the support of the West Africa Health Organization (Ref.: Prog/A17IEpidemSurveillN° 57212014/mcrt) to B-YA.

Progress towards eliminating tuberculosis in Ga West Municipality, Ghana: analysis of tuberculosis surveillance data, 2017.

To assess the progress made towards the actualization of the 80% reduction in incident cases, monitor trends and to assess the quality of GWM TB surveillance data from 2012 to 2016. The study was descriptive secondary data analysis. Tuberculosis cases recorded in the District Health Information Management Systems (DHIMS) and municipal TB registers. The Municipal TB Coordinator was interviewed for clarification on the data. A TB patient was defined as one who coughed persistently for two weeks or more. Trend of TB cases in Ga West Municipality. A total of 441 TB cases were registered of which 68.9% were smear positive. Males were (67%). Age group 35-44 years were the most affected (28.6%). The incidence rose from 21.5 (2012) to 41.6 (2015). The 2016 incidence was 40.7 (± 5.63) per 100,000 population. This is significantly different from the current national incidence of 156 (p < 0.05). Data was 95% complete. Discrepancies existed between data in registers compared to the DHIMS but were not statistically significant. The 80% reduction in incident cases target may not be attained by the GWM due to the rising number of incident cases. However, data quality is good. The study was funded by the authors.

ICT Infrastructure, ICT Competencies, and Teachers’ Workload: Critical Factors that Influence Social Studies Teachers’ Integration of Technology in the Kwahu West Municipality of Ghana

The purpose of this study was to investigate factors that influence basic school social studies teachers’ integration of technology in the teaching of Social Studies in schools within the Kwahu-West Municipality of Ghana. The study sought to address the following objectives: To what extent do ICT infrastructure, teachers’ ICT competence and work load influence basic school social studies teachers’ integration of technology in their lessons in the Kwahu-West Municipality of Ghana? The study was a descriptive survey. Proportional simple random technique was employed in selecting sample size of eighty-one (81) Junior High School social studies from 46 public basic schools within the Kwahu West Municipality of Ghana. The data for the study was collected using questionnaires to solicit responds from the teachers. A Cronbach Alpha value of .860 was obtained for the reliability of the items on the questionnaires. The data of the study was analyzed using Multiple Regression Analysis which established Rsquare (R 2 ) value of 0.7090 at 0.05 alpha level of significance. From the analysis, it was established that basic school teachers’ integration of technology in their social studies lessons were heavily influenced by the ICT infrastructure of their school, their ICT competence and their workloads in terms of number of periods they handled a week and other co-curriculum activities they have been asked to engage in. It was recommended that Government through Ministry of Education and other relevant stakeholders should ensure the provision of art-of-craft ICT infrastructure in basic schools within the municipality coupled with organization of regular in-service programs for teachers to upgrade their knowledge on technology integration. Keywords: Basic School, Kwahu West, Technology, Workload, Social Studies, Integration. DOI: 10.7176/JEP/11-14-08 Publication date: May 31 st 2020

The influence of socio-environmental determinants on hypertension. A spatial analysis in Athens metropolitan area, Greece.

SummaryIntroductionWhile epidemiological and pathophysiological aspects of hypertension are still being investigated, there is an increased global interest between hypertension and social health determinants and environmental factors that this study aims to examine.MethodsThe sample size used in this work included 2,445 individuals, from Athens metropolitan area, who were randomly enrolled in ATTICA study, during 2001 to 2002. Principal component analysis (PCA), Poisson regression modeling and geographical analysis, based on Geographic Information Systems (GIS) technology, were applied.ResultsGeographical analysis and thematic mapping revealed that the West municipalities of Athens had the lowest socio-environmental status. Three components were derived from PCA: high, low and mixed socio-environmental status. Poisson regression analysis showed that high socio-environmental status, educational and economic level were negatively correlated with hypertension in some sectors of Athens (p < 0.05, for all).ConclusionsThrough the use of geospatial surveillance the underlying epidemiology of hypertension, and those at greater risk, can be more precisely determined. This study underlines the need to account for environmental factors when developing public health policies and programs for effective hypertension prevention or reduction.

English

Rural-urban migration, a multidimensional phenomenon, is becoming part of the daily reality in Ghana and many other developing countries. For instance, the impact of migration on households whose member(s) migrated is relatively not very clear. A study was therefore undertaken to examine and explain the impact of rural-urban migration on rural migrant&rsquo;s households&rsquo; livelihood in three communities in Agona West Municipality, Ghana. Snowballing technique was used to select and interviewed 121 respondents to obtain information on the motives of migration and the impact of remittances on household livelihoods. Eight male and female heads of households were purposively selected from each village for the focus group discussion. Frequencies, percentages, diagrams and tables were used to explain the data obtained. The study identified two types of households; the migrant and non-migrant households. Also it was observed that males, were often forced to migrate because of their poor living conditions and low educational attainment, the better-off migrant households characterized with higher educational attainment on the other hand, often migrate in order to accumulate more wealth. The better-off migrant households are therefore positively impacted; better access to health-care, more education opportunities, and agriculture than the poor migrant households. The study therefore recommended that government policy on poverty and employment especially for rural areas need to be revisited for better employment opportunities in the rural areas for the young adults and thereby curb the drift to urban areas.&nbsp; &nbsp; Key words: Migrant households, non-migrant households, poor households, better-off households, remittances, socio-economic status, household livelihoods. &nbsp

Factors Contributing to Low Tuberculosis Case Detection in West Akim Municipality of the Eastern Region of Ghana: A Community and Health Facility Based Study

This research has a keen interest into assessing health and community related factors that contribute and influences low TB case detection rate in the West Akim Municipality of the Eastern region of Ghana. Data was collected from a target group of community members and health workers using a well-structured questionnaire. Data from the field was collected using Epi Info 7 and then, exported to Microsoft Excel and finally transferred to SPSS version 24 for the analysis. Some statistical techniques such as descriptive statistics, reliability of scale, t-test of independence, chi-square and analysis of variance was used to obtain results from the data analysis. Community related factors that has been identified as possible contributors to low TB detection rate are as follows, the availability of alternative means of health care (traditional healers, prayer camps, and herbs to manage suspected cases of TB. This turns to keep people away from the health facilities. The long time (2 days) it takes for an individual to get tested and to receive his/her tested results (time of diagnostics). The high levels of experienced stigma associated with psychological distress on suspected people with TB and on friends and relatives living with TB patients. the low knowledge of TB among some reasonable number of community members. The study also identified the possible health related factors influencing low TB case detection rate such as, Low TB trained personals and low TB education during health talks in creating awareness that TB is preventable, curable and treatable and that suspected people with TB (cough for more than two weeks) should seek medical attention. Community health nurses not including TB screening as part of their home visitation program and low level of contact tracing could also contribute to the low case detection rate. The highly inadequate number Gene Xpert machines, DOT centres and laboratories for the diagnostics of TB. The study also found that, TB stigma even existed among health care providers against suspected patients. This negatively influence the health seeking behavior among suspected patients. This study became necessary to generate information for the Ghana national TB control Programme for appropriate remedial actions to be taken to forestall any catastrophe that may result from undetected and untreated TB cases in the West Akim municipality. Keywords: Gene Xpert machines, DOT Centres, Stigmatization, Psychological Distress, TB screening, Low TB Case Detection. DOI: 10.7176/JHMN/72-11 Publication date: March 31 st 2020

Self-medication among pregnant women in two municipalities in the Central Region of Ghana

Self-medication in pregnancy is a concern in Ghana. We assessed the practice among 136 pregnant women in Effutu and Agona West Municipalities using facility-based, cross-sectional design and mixed method approach of data collection. Our findings show that pregnant women of varying backgrounds self-medicate for sociocultural and economic reasons, with 69% prevalence, motivated by cheaper treatment cost (17%), minor ailments (29%) and positive outcomes (33%). Commonly used medications include antibiotics (23%), pain killers (20%) and herbal preparations (19%). We recommend further studies on pharmacological compositions of the medications used and effects on pregnancy outcomes to inform policy and programs decisions.

The Role of the Auditor-General in the Promotion of Efficient Financial Management in Municipalities: A Case Study of the North West Province

That South African municipalities, in vast majority, are experiencing serious financial problems is well-known to anyone with an interest in local government sector. Given that, the study considers the role of the Auditor-General (AG) in promoting sound financial management in municipalities. The disciplinary perspectives from which the inquiry is considered are law and public administration. The context for this consideration is the North West, a province which is inundated by poorly performing municipalities that are literally on the brink of financial and operational collapse. The study proceeds from the premise that efficient financial management practices are essential to the long-term sustainability of municipalities. The role of the AG is key in this regard in that the latter is a watchdog over state coffers and the pivot of the oversight mechanism over the management of public finances. Furthermore, the AG strives to institutionalise and promote a culture of good governance, accountability and transparency in municipalities. It achieves this through routine auditing and provision of audit recommendations that seek to improve municipalities’ internal controls. However, this purpose gets undermined, and eventually defeated, in the instance where audit recommendations are being ignored. Of concern is that the non-implementation of audit recommendations has become a norm in most municipalities in the North West. The study has considerable breadth in its analysis of this problem by looking closely into three municipalities: Mahikeng, Ditsobotla and Tswaing. It is not immediately clear why this trend is emerging or has emerged. In that note, a resolve to embark on this study was impelled by a sense of commitment to try to understand the real issue behind this trend and to see how best it can be countered. This brings the study to then ask: How can the AG’s recommendations be better and adequately given effect in the North West municipalities? In response, it will be argued that this issue cannot be solved by the AG alone. What is needed, instead, is the development of an action plan, policy and institutional framework that will guide and facilitate the multi-agency approach and inter-institutional collaborations towards addressing the problem. Further argument will be advanced to say that the efforts undertaken to reconstitute and strengthen the legal framework governing the AG through the 2018 amendments to the Public Audit Act do not constitute a magic bullet solution to the dismal downward trajectory across the North West municipalities, as contemporary narratives seek to suggest.

Hunger Project credit facility and maize productivity in Ghana

This paper evaluated the effect of credit facility on the productivity of participants of the Hunger Project in Ghana. Primary data was collected from randomly sampled 170 beneficiary and non-beneficiary smallholder maize farmers of the project in the Kwahu West Municipality. Descriptive statistics and the endogenous switching regression model were used to analyse the data. The results showed that gender, number of livestock owned by the farmer, previous year’s maize income, farmers’ perception of lending procedures of the Project and farmers’ perception of the distance between residence and the epicenter (loan center) were the factors influencing farmers’ decision to take part in the Hunger Project credit programme. The study also revealed that farmers who benefited from the programme had a significant increase in maize output: thus, the credit facility significantly influenced farm productivity. In addition to maize farming, farmers should be encouraged to keep livestock, and the project management should open loan centres close to the farmers to improve access to loan by the farmers, particularly current non-beneficiaries, to improve their productivity. This should be supported by an extension of education and training.

Role of Early Warning Systems in Flood Disaster Preparedness: Insights from Asamankese in the West Akim Municipality of Ghana

Rampant flood disasters are increasingly causing devastating impacts of human societies. Early warning systems on the other hand are proactive ways through which the impact of flood disasters can and have been reduced in some jurisdictions. This study sought to assess household's awareness of early warning systems and how effective early warning systems are towards reducing impacts of flood disaster is Asamankese Township in the West Akim municipality of Ghana. A survey was conducted with 200 households in the township and the results show that, residents in Asamankese, a rapidly developing center of commerce in the Eastern region of Ghana, demonstrate a high level of awareness of early warning systems. The findings also show that, for early warning systems to be effective, active participation of community members must be encouraged in the design of early warning systems. There was an observed disjunction between dissemination of early warning system and residents' ability to act per the directives of early warnings received. This study hence recommended that, the local authorities, the government and other key stakeholders should engage the community and device holistic strategies that enable residents to take practical actions towards early warnings to ameliorate the adverse effect of floods.

Relationship between Educational and Occupational Status of Parents and their involvement in Adolescents’ Academic Achievements in Agona West Municipality

The study was conducted to know whether education level and occupational status of parents in the Agona West Municipality of Ghana have any significant relationship with parental involvement in adolescent academic achievement. The cross-sectional survey and correlational research designs were employed and data were collected with the use of a structured questionnaire. The questionnaire was self-administered to the 310 basics 8 pupils that were purposively sampled from the 6 randomly selected schools. Findings revealed that, in the Agona West Municipality, education level of both mothers and fathers had a significant relationship with parent’s ability to engage in school based activities of pupils as well as encouraging the pupils with respect to their academic achievement. However, occupational status of only fathers had a significant relationship with parent’s ability to involve in school based activities. Additionally, no significant relationship between a parent’s occupational status and their ability to encourage pupils with respect to their academic achievement was found. The authors provide guidance implications and recommendations based on the findings from the study.

Food safety knowledge and self-reported practices among school children in the Ga West Municipality in Ghana

BackgroundKnowledge in food safety influences food safety attitudes of people which could result in behavioural changes. Inadequate knowledge in food safety among consumers, especially children, increase their risk of getting foodborne diseases. Implementing food safety educational programs in schools is key in improving the food safety knowledge of the school children. This study is aimed at assessing the food safety knowledge and practice of students in the Ga West district of Ghana. MethodA cross-sectional study was conducted on food safety knowledge and practices of students in the basic schools in the Ga West District of the Greater Accra Region-Ghana. A total of 1500 questionnaires were self-administrated to students in the 104 schools. ResultOut of the 1343 respondents, 694 (51.7%) of them were female whiles 649 (48.3%) were male. The mean age of the students was 13years (Std Dev of ±1.9) with their ages ranging from 7 to 21 years. The food safety knowledge level of the students was inadequate with a mean score of 5.8 (std Dev ± 1.6) representing 64.08% of the maximum total food safety knowledge score. 59.6% (801) of the students had adequate level of food safety knowledge. The food safety practice among the respondents was generally appropriate with a mean score of 36.19 (std Dev ± 5.1) representing 80.4% of the maximum total food safety practice score. 90.2% (1211) of the students reported to be engaging in appropriate food safety practice. With the exception of the demographic characteristic ‘age’ and ‘class’ (p-value < 0.001), no statistical difference was observed in the level of food safety knowledge and practices among the various demographic characteristic of the student. There was a positive correlation between food safety knowledge and practices (coefficient of 0.2 and p-value < 0.001). Most of the students indicated that they first look out for the cleanliness of the surrounding of the vendor and then the vendors neatness before they buy or eat from a food vendor. ConclusionEven though the food safety knowledge level of the students was inadequate, the food safety practice was generally appropriate especially their hand washing practices.

Evaluation of Buruli Ulcer Disease Surveillance System in the Ga West Municipality, Ghana, 2011-2015.

Background Buruli ulcer (BU) is one of the most neglected tropical diseases caused by Mycobacterium ulcerans. M. ulcerans infection may manifest initially as a pre-ulcerative nodule, a plaque, or oedema which breaks down to form characteristic ulcers with undermined edges. The Ga West Municipality is an endemic area for Buruli ulcer, and we evaluated the BU surveillance system to determine whether the system is meeting its objectives and to assess its attributes. Materials and Methods We used a checklist based on Centers for Disease Control and Prevention (CDC) updated surveillance evaluation guidelines, 2006. We reviewed records and dataset on Buruli ulcer for the period 2011–2015. The evaluation was carried out at the national, regional, district, and community levels using the Ga West Municipality of the Greater Accra Region as a study site. Interviews with key stakeholders at the various levels were done using an interview guide, and observations were done with a checklist. Data were entered and analyzed using Epi info 7. Results A total of 594 cases of Buruli ulcer were reported from 2011 to 2015 in Ga West. The number of confirmed cases decreased from 109 in 2011 to 17 in 2015. The system was useful, fairly simple, flexible, representative, and fairly acceptable. The system was sensitive with a PVP of 45.3%. Although the data quality was good with 85% of case report forms completed, there was under-reporting (3.6%), some discrepancies of data at the district, regional, and national levels. The system was moderately stable, and timeliness of reporting was 30.7%. Conclusion The Buruli ulcer surveillance system is meeting its set objectives, and the data generated are used to reliably describe the epidemiologic situation and evaluate the results for actions and plan future interventions. There is a need for timely submission of data. We recommend that the National Buruli Ulcer Control Program (NBUCP) provides logistical support to treatment centres.

Influence of Head Teachers’ Instructional Supervisory Practices on Teacher Retention, And Gender on Their Supervisory Practices: A Study of Public Basic Schools in Swedru Circuit ‘A’, Agona West Municipality, Ghana

Influence of Head Teachers’ Instructional Supervisory Practices on Teacher Retention, And Gender on Their Supervisory Practices: A Study of Public Basic Schools in Swedru Circuit ‘A’, Agona West Municipality, Ghana

Influence of Food Security Status and Anemia-Related Knowledge on Perceptions About 2 Nutritious Underutilized Foods Among Ghanaian Caregivers.

Nutritious underutilized foods (NUFs) significantly contribute to sustainable dietary diversity but are often unused for many reasons. We assessed the influence of food security status (FSS) and anemia-related knowledge (ARK) on perceptions about Solanum torvum (turkey berry) and Rhynchophorus phoenicis Fabricius (palm weevil larvae) among Ghanaian caregivers. A cross-sectional survey was conducted among 891 caregivers (aged 20-49 years), who have children 6 to 59 months old, from Upper Manya Krobo district (Eastern region), Kumasi metropolitan (Ashanti region), Ho municipality (Volta region), La-Nkwantanang-Madina, and Ga West municipality (Greater-Accra region), Ghana. Food security status, ARK, and perceptions about the 2 NUFs were obtained using pretested semi-structured questionnaire. Logistic regression models were used to determine effect of FSS and ARK on perception outcomes. Thirty-six percent of caregivers were food secure, while 13.9%, 28.4%, and 21.7%, respectively, were mildly, moderately, and severely food insecure. Most caregivers (62.0%) scored above 70% on ARK. High favorable perception was significantly lower for palm weevil larvae than that for turkey berry. Food secure caregivers were 4.5 times more likely to have poor favorable perceptions about palm weevil larvae than food insecure caregivers (P = .03). However, food secure caregivers were 2.9 times more likely to have high favorable perceptions about turkey berry than food insecure caregivers (P < .001). Caregivers' knowledge about anemia was associated with high favorable perception about turkey berry by 3.3-fold (95% confidence interval: 2-5.5, P = .001). Nutrition education about turkey berry and palm weevil larvae is needed to encourage their use for promoting nutrient density of complementary and household foods.