Williams Agyemang-Duah

Reducing poverty through fiscal decentralization in Ghana and beyond: A review

Abstract The unfinished agenda in the theory and practice of fiscal decentralization is how fiscal decentralization affects the universal plague of poverty reduction in developing economies. Focusing on developing economies especially Ghana, and also employing secondary sources of information, this paper made an attempt to provide a holistic review of the concept of fiscal decentralization and its effects on poverty reduction from the optimist and pessimist views. The paper affirmed that fiscal decentralization has the potential for poverty reduction when it is characterized by greater financial autonomy of the local units with proper budgetary allocation, prioritization, accountability and responsiveness. Accountability and proper regulation may reduce some institutional setbacks such as corruption from the system. We, therefore, recommended for a more effective, efficient, and transparent institutional and legal framework to ensure effective fiscal transfer between the central and local governments in order to eliminate various lapses associated with fiscal decentralization as highlighted by the pessimists.

Does the Ghanaian livelihood empowerment against poverty programme lead to an increase in household productive livelihood assets? Analysing the Ashanti scenario

Abstract This study draws evidence from 180 respondents who were beneficiaries of the Livelihood Empowerment Against Poverty (LEAP) programme with the underpinning objective of whether the LEAP beneficiaries are able to acquire other productive livelihood assets. Descriptive research involving both quantitative and qualitative methods were used. The study used questionnaires and focus group discussions to obtain data from the respondents. Data were analysed using the descriptive statistics from the SPSS version 17.0 and presented by tables and percentage counts. The study found that the LEAP beneficiaries do not have other preferable productive livelihood assets needed to expand their livelihood options, largely due to the low amount paid coupled with irregularity of payment. The paper therefore recommends that there should be empowerment of beneficiaries with productive capacities through the incorporation of skills and capability development into the programme. This will enhance beneficiary households to initiate new or strengthen old livelihood sources to ensure livelihood sustainability. Moreover, enrolling the LEAP beneficiaries’ caregivers who are not working in a skilled training programme that exists in communities to equip them with livelihood skills which can be used for livelihood activities, such as, baking and soap making will reduce beneficiaries’ dependence on the LEAP cash.

A Review of the Triple Gains of Waste and the Way Forward for Ghana

The postcolonial waste management practices in Ghana have consistently been identified with the discarding and disposal of waste in open dumps, wetlands, and landfills. These practices have only contributed to the glaring poor sanitation in the cities of Ghana. Insignificant quantity of the waste generated ends up in recycling and/or composting units for reuse. Given the current growth of Ghana’s population, coupled with the emerging industrialisation, the country’s overdependence on hydropower for energy and natural resources for production alone is dangerous. This paper provides a holistic review of the gains from solid waste. The paper reaffirms that, through appropriate technologies, waste possesses the intrinsic potential to generate renewable energy, resources, and income. In recommending, the main objective of waste management practices in Ghana should be about exploring the economic potentials of waste. Thus, waste disposal should be the last resort, and not the first option in waste management practices in Ghana.

Facilitators of and barriers to the use of healthcare services from a user and provider perspective in Ejisu-Juaben municipality, Ghana

ObjectiveKnowledge about the use of formal healthcare services is an important aspect of public health policy. However, there is a paucity of empirical studies on facilitators of and barriers to formal healthcare use in Ghana from the health user and provider points of view, a gap this qualitative study aims to fill.MethodsIn-depth interviews were conducted with 20 healthcare users and 15 formal healthcare providers in Ejisu-Juaben Municipality in the Ashanti Region of Ghana. A thematic analytical framework was used to analyse the data, which were then presented based on an a posteriori inductive reduction approach.ResultsFour major facilitators of healthcare use were identified: acceptance of the health insurance card, having a good relationship with the healthcare providers, quality of the service offered/professionalism and proximity to healthcare facilities. The barriers to formal healthcare use established in this study were of an economic, social, cultural and institutional nature.ConclusionThe study findings highlight the need to address barriers to the utilisation of formal healthcare by reviewing the national health insurance scheme, recruiting language interpreters at health facilities and integrating the formal and traditional systems into the mainstream national health system in Ghana. This move would help make headway toward meeting UN Sustainable Development Goal 3 of ensuring healthy lives and promoting well-being for all at all ages by 2030.

Informal health care: examining the role of women and challenges faced as caregivers in rural and urban settings in Ghana

ObjectiveGlobally, the informal health sector is continuing to experience increasing growth despite the parallel development of the formal health care sector over the years. However, studies in Ghana concerning caregiving are limited since little attention has been given to the informal health care sector. This study therefore explores the role of women as caregivers and the challenges they face in the Kumasi Metropolis and Ejisu Juaben Municipality in Ashanti Region of Ghana.MethodsIn-depth interviews were conducted with 20 caregivers from the two study areas. Data were analyzed and presented based on a content and thematic analysis approach.ResultsFindings from the study showed that caregivers perform key roles including those of a domestic, health care, economic, social and spiritual nature. However, caregivers were confronted with many challenges, including inadequate funds, inability to work effectively, prolonged stress, limited time for socialization and emotional trauma.ConclusionFor caregivers to perform their roles efficiently and effectively, government and health care authorities must provide them with immediate financial support and training. Also, in the near future policy makers should put a comprehensive policy in place to bolster caregiving in general.

Geographical Differences in Perceived Health Status Among Older Adults in Ghana: Do Gender and Educational Status Matter?

Studies have constantly reported mixed evidence on the associations between rural/urban differences and self-rated health (SRH) status among older populations. More importantly, the roles of other relevant sociodemographic characteristics such as gender and educational levels in these associations are mostly overlooked. The current study examines the geographical differences in SRH of older cohorts in Kumasi Metropolis and Bosomtwe District of Ghana. Data from a Spatial Health and Healthcare Study (SHHS) were analyzed using chi-square test and ordinal logistic regression models. Although the study discovered a statistically significant difference in SRH between the rural and urban samples, the multivariate analysis found insignificant effect in SRH between urban and rural samples after adjusting for theoretically relevant covariates. However, the interactions indicated that this association significantly strengthens for rural dwellers who were highly educated. Moreover, age, average monthly income, reporting sickness in the past 90 days, and not noticing any change in health status in retrospective to 12 months were independent predictors of SRH. Effective interventions through collaborative efforts by the Ghanaian sociopolitical structure and micro-level dynamics are needed to ensure holistic improvements in health outcomes among vulnerable older persons.

An assessment of the effects of forest reserve management on the livelihoods of forest fringe communities in the Atwima Mponua District of Ghana

ABSTRACT The effect of forest reserve management on the livelihoods of forest communities is an important, yet poorly researched issue. This study examines the effect of management on the livelihoods of communities living near the Tano-Offin forest reserve in the Atwima Mponua District of Ghana. Information was gathered from one hundred and fifty forest fringe community members in Atwima Mponua District using semi-structured questionnaires. In addition, interviews were undertaken with staff from the Forest Services Division at Nkawie, the Atwima Mponua District Assembly, and a Non-Governmental Organization. We found that the communities in the study area have limited livelihood pathways due to restrictions on their access to forest resources. Furthermore, over 70% of respondents had incomes below the international poverty line of US

Nexus between Artisanal and Small-Scale Gold Mining and Livelihood in Prestea Mining Region, Ghana

1.90 a day which was largely attributed to limited access to forest resources. We conclude that forest fringe communities in the study area and more widely across Ghana are likely to have undesirable livelihood outcomes and we stress the need for policies to involve forest fringe communities as principal participants in the process of policy formulation and decision-making regarding management of forest reserves.

Integration for coexistence? Implementation of intercultural health care policy in Ghana from the perspective of service users and providers

Drawing on the DFID’s sustainable livelihood framework, this paper explores the nexus between artisanal and small-scale mining (ASM) and livelihood in Prestea mining region, Ghana. A cross-sectional mixed method survey involving simple random and purposively sampled participants () was carried out. The results suggest both positive and negative relationships between ASM and livelihoods of the people. The study found various livelihood assets associated with ASM and how critical assets are adversely affected by ASM activities. Limited employment opportunities in rural areas (82%), economic hardships/poverty situations of people (59%), and “quick” income earnings from ASM (90%) were the major factors that influenced people to combine and use their personal assets to enable them to engage in ASM. ASM contributes to the livelihood enhancement through income generation, increased well-being and asset acquisition (50.7%), reduced vulnerabilities (31.1%), and empowerment of people (19.2%) to establish other economic activities. However, the small-scale miners and farmers as well as farmlands, forest, and water resources are most vulnerable to adverse effects of ASM activities. Accidents of various degrees, diseases, and death were the shocks in ASM. Regarding the massive impact of ASM on employment creation and poverty reduction in rural communities, it is recommended that stakeholders recast Ghana’s mineral policy to ensure concurrent environmental sustainability and socioeconomic development.