Issaka Kanton Osumanu

Household environmental and behavioural determinants of childhood diarrhoea morbidity in the Tamale Metropolitan Area (TMA), Ghana

Abstract Diarrhoea is the second most important cause of morbidity and mortality in the Tamale Metropolitan Area of Ghana, after malaria. This study examined the relative roles of environmental and behavioural risk factors in transmitting diarrhea in children under 5 years. A stratified sample of residential areas of the metropolis was employed in order to examine disparities in the prevalence of childhood diarrhoea among households with differing socio-economic and environmental conditions. Logistic regression models were employed to examine the significance of several environmental and behavioural risk factors in causing childhood diarrhoea. There is significant association between childhood diarrhoea morbidity and toilet sharing (p < 0.01), depending on water from vendors (p < 0.01), storing water in pots (p = 0.02) and frequently consuming prepared foods from street vendors (p = 0.04). The results show the importance of behavioural risk factors in re-enforcing deficiencies in environmental services to determine childhood diarrhoea morbidity. The paper argues that behavioural changes, even within situations of inadequate water and sanitation services, can lead to substantial reductions in the incidence of childhood diarrhoea in the metropolis.

Private sector participation in urban water and sanitation provision in Ghana: experiences from the Tamale Metropolitan Area (TMA).

African governments, like most countries in the developing world, face daunting tasks in their attempts to provide effective and equitable water and sanitation services for their ever increasing urban populations. Consequently, the past few years have witnessed increased private sector participation in urban water and sanitation provision, as many African governments strive to improve access to water and sanitation services for their citizens in line with Millennium Development Goal 7 (MDG7). Since the early 1990s, the government of Ghana and many local authorities have entered into various forms of public-private partnerships in urban water and sanitation provision. This article examines the outcome of such partnerships using the Tamale Metropolitan Area (TMA) as a case study with the aim of providing policy guidelines for the way forward. The article argues that the public-private arrangement for water supply and sanitation infrastructure management in the Tamale Metropolis has done nothing that an invigorated public sector could not have possibly achieved. It concludes that there can be no sustainable improvement in water and sanitation provision without political commitment, stakeholder ownership, and strong support for community driven initiatives.

Contextual Issues in Health Care Financing in Africa: Drawing on the Ghanaian Experience

The search for appropriate policy of financing healthcare in Africa in general is far from over. However, Ghana, unlike many of the emerging economies in sub-Sahara Africa, has made great strides in this area of policy formulation and development with the introduction of a National Health Insurance Scheme (NHIS). Ghana’s search for an acceptable policy on healthcare financing dates back to the colonial era and the immediate post-independence period through the ‘cash and carry’ system to the present health insurance regime, which is still seeking refinement to meet the hopes and aspirations of many Ghanaians. The main objective of the NHIS is to provide equitable and universal access to essential healthcare for all citizens. This paper examines the tortuous path of health care financing policies in Ghana by outlining its historical antecedents and current perspectives.

The Contribution of Donor Support Programs to Decentralized Development: Learning from the District Level in Ghana

ABSTRACT Donor aid has over the years turned out to be a very decisive development component for most developing nations, but aid is often criticized for ineffectiveness. This article seeks to share perspectives on the relevance of direct project or program support and the need to refrain from homogeneity in aid research by assessing the contribution of the Government of Ghana/European Union (GoG/EU) Micro-Projects Programme in the Nadowli District of Ghana from 1997–2009. The findings acknowledge positive impacts of the program in the district. There are sector consistencies between the donor interest and local development priorities in health, education and the water and sanitation sectors. However, selectivity of project within and among sectors brings potential conflicts of interest and tradeoffs between the program and local community needs. The results imply a reexamination of decentralized development through a lens of new partnership between donors’ interest and local needs. Stepping up community awareness to ensure full participation in project design, execution, operation, and maintenance could serve as a start-up platform for new partnerships. It is imperative to align donor interest with local realities, which prompts a rethinking of adoption of new project approaches such as co-development, design, and implementation.