Vincent Z. Kuuire

National health insurance scheme enrolment and antenatal care among women in Ghana: is there any relationship?

The objective of this study was to examine whether enrolment in the National Health Insurance Scheme (NHIS) affects the likelihood and timing of utilising antenatal care among women in Ghana.

‘Abandoning’ farms in search of food: food remittance and household food security in Ghana

This paper examines the important place of food remittances in the context of household food security in the Upper West Region (UWR) of Ghana against a backdrop of rapid environmental change and accelerating rural poverty. Findings from in-depth interviews conducted in the UWR show a tendency toward increased dependence of rural poor families on food remittance as a strategy for coping with chronic household food insecurity amidst poverty, changing patterns of rainfall and declining soil fertility. In addition, the study also shows that while food remittance entailed spatial dispersion of the household in a context where certain household members migrate to distant agricultural-rich hinterlands, engage in migrant farming and remit agricultural produce back home, the strategy nonetheless leads to the strengthening of familial and kinship ties. The study concludes by making relevant policy recommendations that would improve household livelihood security.

Conundrum of Sexual Decision Making in Marital Relationships: Safer-Sex Knowledge, Behavior, and Attitudes of Married Women in Zambia

Recent research suggests that Zambian women face an increasing risk of contracting human immunodeficiency virus (HIV) within marital relationships. Married womens perceived ability to negotiate safer sex or adopt self-efficacy practices is recognized as critical in preventing new infections within marriage. Yet womens self-efficacy practices, such as requesting condom use or refusing sex within marriage, are influenced by individual and context-specific factors. Using the 2007 Zambia Demographic and Health Survey data from 4,306 married women, this article examines the association between married womens perceived ability to negotiate safer sex and a range of attitudinal, knowledge, and sociodemographic variables. Results from complementary log-log regression models reveal that married women who have factual knowledge about HIV transmission and prevention, as well as those who have been tested for their HIV serostatus, were more likely to report they can request that their husbands use a condom. Rural married women were more likely to report they can refuse their husbands sex compared to woman in urban areas. Likewise, married women who agree that a wife is justified in refusing her husband sex if he sleeps with other women were more likely to report they can negotiate safer sex compared to women who disagree. These findings suggest that married women are able to negotiate safer sex if they have correct factual knowledge about HIV transmission and are aware of their rights within marital relations.

NEGOTIATION FOR SAFER SEX AMONG MARRIED WOMEN IN CAMBODIA: THE ROLE OF WOMEN'S AUTONOMY

Negotiating safer sex among married women has been identified as an important determinant of vulnerability or resilience to new HIV infections. Using the Cambodia Demographic and Health Survey data of 2010, this paper examined negotiation for safer sex among 11,218 married women in the context of Cambodias highly touted reduction in HIV/AIDS prevalence. The results from a complementary log-log regression model indicate that wealthier and highly educated married women were more likely to report that they can refuse sexual intercourse and ask their husbands to use a condom. Interestingly, while women who were fully involved in decision-making on their own health care were 19% more likely to refuse sex, they were 14% less likely to be able to ask their husbands to use a condom, compared with their counterparts who were not involved in this decision-making. Women who were partially involved in decision-making on family visits were 17% less likely to be able to ask their husbands to use a condom compared with those who were not involved. In this context, involvement in decision-making may have translated into trust and risk compensation. Those who believed in HIV transmission myths were less likely to negotiate safer sex relative to their counterparts who did not hold such myths to be true. Womens ability to negotiate for safer sex is, therefore, a function of their autonomy in terms of their full participation in decision-making in health care, household expenditure and mobility. Policy implications of the capacity of women to negotiate for safer sex are delineated.

Examining risk factors for hypertension in Ghana: evidence from the Study on Global Ageing and Adult Health

Like most countries in sub-Saharan Africa, hypertension contributes substantially to morbidity and mortality in Ghana, yet nationally representative studies that examine the odds of becoming hypertensive among Ghanaians are conspicuously missing. We aimed to fill this void in the literature. The data used for analysis came from the first wave of the Study on Global Ageing and Adult Health (SAGE), collected in Ghana from January 2007 to December 2008 by the World Health Organization (WHO). A total of 5573 respondents were sampled for the study. Random-effects C-log-log models were employed in examining socio-economic, lifestyle and psychosocial factors on the odds of becoming hypertensive in Ghana. Separate models were run for male and females. Results indicated there were strong significant associations between socio-economic, lifestyle and psychosocial factors on the likelihood of becoming hypertensive, among Ghanaian men and women. Compared with the poorest, Ghanaians from wealthy households were significantly more likely to be hypertensive. Educated women, as compared with the uneducated, were also more likely to be hypertensive. Ghanaians who engaged in vigorous or intensive activities continuously, for at least 10 minutes, were significantly less likely to be hypertensive, compared to those who did not. Happier men had lower odds of becoming hypertensive, and depressed women had increased odds of reporting they were hypertensive.

Validity of Self‐Report Data in Hypertension Research: Findings From The Study on Global Ageing and Adult Health

Several studies indicate little congruence between self‐report and biometric data, yet very few have examined the reasons for such differences. This paper contributes to the limited but growing body of literature that tracks inconsistent reports of hypertension using data from the Study on Global Ageing and Adult Health (SAGE). Focusing on five countries with different levels of development (Ghana, China, India, South Africa, and Russia), this study offers a comparative perspective that is missing in the literature. Data were obtained from wave 1 of SAGE collected in 2007/2008. A multinomial logit model was used to examine the effects of demographic and socioeconomic variables on the likelihood of respondents self‐reporting that they are not hypertensive when their biometric data show otherwise. The authors also model the likelihood of respondents self‐reporting that they are hypertensive when in fact their biometric data show they are not. Socioeconomic and demographic variables were shown to be significantly associated with inconsistent reporting of hypertension. For instance, it was observed that wealth was associated with a lower likelihood of self‐reporting that one is not hypertensive when their biometric data indicate otherwise. Tracking such inconsistent reports is crucial to minimizing measurement errors and generating unbiased and more precise parameter estimates in hypertension research.

Exploring the linkage between exposure to mass media and HIV testing among married women and men in Ghana

ABSTRACT Although HIV testing is critical to the treatment and prevention of HIV/AIDS, utilization rate of HIV testing services among married women and men remains low in Ghana. Mass media, as a tool to increase overall HIV testing turnouts, has been considered one of the important strategies in promoting and enhancing behavioural changes related to HIV/AIDS prevention. Using the 2014 Ghana Demographic and Health Survey, the current study examines the relationship between levels of exposure to print media, radio, and television and the uptake of HIV testing among married women and men in Ghana. Results show that HIV testing is more prevalent among married women than their male counterparts. We also find that higher levels of exposure to radio is associated with HIV testing among women, while higher levels of exposure to print media and television are associated with HIV testing among men. Implications of these findings are discussed for Ghanas HIV/AIDS strategic framework, which aims to expanding efforts at dealing with the HIV/AIDS epidemic. Specifically, it is important for health educators and programme planners to deliver HIV-related messages through television, radio, and print media to increase the uptake of HIV testing particularly among married women and men in Ghana.

Assessing the bio-psychosocial correlates of flood impacts in coastal areas of Lagos, Nigeria

This paper explores the complex heterogeneous experiences of flood impacts based on a bio-psychosocial model of socio-economic, demographic, behavioural and environmental factors. Using ordinary least squares regression on a cross-sectional survey of 1003 individuals, flood impacts in three contiguous coastal neighbourhoods in Lagos, Nigeria, were modelled. The results show that approximately 52% of the variability in flood impact was accounted for by education, age, family structure, ethnicity, personal health concern and income. While involvement in coping was not a significant predictor of flood impacts, relocation emerged as a strong predictor. The inclusion of behavioural factors did not change the magnitude and significance of the relationship between demographic factors and flood impacts. However, the effects of age, education and personal health concern disappeared when environmental factors were controlled. The overall importance of the predictors for determining flood impact in decreasing order is as follows: income > coping strategies > ethnicity = participation in community development > family structure > personal health concerns > housing quality > reasons for living in residential locality > neighbourhood vulnerability to flood > housing vulnerability to flood.

Does the New Alliance for Food Security and Nutrition impose biotechnology on smallholder farmers in Africa

Almost one in three people who live in sub-Saharan Africa (SSA) are hungry, higher than anywhere else. This magnitude of food insecurity coupled with slow progress in regional integration, disease and epidemics, poor access to markets, gender disparities, lack of land tenure rights, and governance and institutional shortcomings on the continent have been used to justify a narrative for the inclusion of biotechnology in smallholder agriculture in SSA. The fact, however, suggests that even in the face of these challenges, smallholder farmers in SSA still produce 70% of the food on the continent. We critically examine the introduction of biotechnology in smallholder farming within the context of the New Alliance for Food Security and Nutrition and public–private partnerships in SSA. We explicitly address the bioethical concerns and implications for technology adoption goals in line with a neoliberal economic model that is encouraging smallholder farmers to adopt biotechnology as a way to secure more food for communities. This paper is not meant to pose a simplistic pro or anti stance on genetically modified (GM) crops or biotechnology, but rather to situate the debate about GM technology within issues of power, control in the global food agriculture systems, and point to the bioethical concerns that affect the lives of smallholder farmers and their families on a daily basis.

Obligations and Expectations: Perceived Relationship between Transnational Housing Investment and Housing Consumption Decisions among Ghanaian Immigrants in Canada

Abstract Transnational housing investment is a pervasive practice among many migrant groups residing in various destination countries; including Ghanaian migrants living in Canada. For many, the need to engage in transnational housing investment is beyond the standard rationale and has two prime significance; symbolic and practical utility. Engagement in this endeavour requires substantial financial commitments over extensive periods of time with potential consequences for various aspects of immigrants’ lives in their destination areas including their housing consumption. This paper examines perceived influence of such long-term commitments on housing consumption decisions among Ghanaian immigrants in the Greater Toronto Area using in-depth interviews and focus group discussions. The findings show that although engagement in transnational housing is associated with constraints on immigrants’ decision to enter homeownership, type of dwelling to rent and the neighbourhood choices, it was also associated with a sense of pride, success and integration into Canadian society. The paper concludes that a broader theoretical discussion of housing integration is necessary. Specifically, it calls for a redefinition of the measures of immigrant housing integration in particular – which narrowly considers destination parameters – to one that includes transnational factors as critical in moving the debate on understanding immigrant integration in general.