The objective of this study is first, to investigate the level of heavy metals in soils from Agbogbloshie e-waste processing site (AEPS), the degree at which these heavy metals contaminate the area and finally, to assess the carcinogenic and non-carcinogenic health risk of heavy metals on workers and residents in around the AEPS. 132 soil samples were collected from the study area and the samples analyzed for Ba, Cd, Co, Cr, Cu, Hg, Ni, Pb and Zn heavy metals after appropriate preparations were made. Results of the analysis showed mean concentrations of Cd, Cr and Ni considered as carcinogenic were lower than permissible levels of Dutch and Canadian soil standards. Mean concentrations however of Cu, Pb and Zn were between 100% and 500% higher than the permissible levels. Assessment of the degree of Contamination indicated Ni<Ba<Co<Cr<Zn<Hg<Cu<Cd<Pb in an increasing order as contributing to the degree of contamination with according to the degree of contamination index the burning, dismantling, residential and commercial considered as very highly contaminated. The health risk analysis of individual heavy metals in soil indicated non-carcinogenic risk of Cr, Hg and Pb with hazard index above the safe level of 1 in the burning and dismantling areas and as such could trigger neurological and developmental disorders in children less than six (6) years.

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Aim: This article draws on the poverty and access to health care framework to explore the barriers to access and utilization of primary health care among aged indigents under the Livelihood Empowerment Against Poverty Programme (LEAP) in Ghana. Background: Although many developing countries have made progress in extending primary health care to their populations following the Alma-Ata Declaration of 1978, the establishment of the Millennium Development Goals, and the Sustainable Development Goals (SDGs), barriers remain pervasive, particularly among vulnerable population groups. Previous studies have hardly paid in-depth attention to this important indicator for measuring progress toward achieving SDG 3. Methodology: To this end, we conducted a case study of access to health care services and utilization among aged indigents enrolled on the LEAP programme in the Daffiama Bussie Issa District of the Upper West. We collected and analyzed qualitative data from indigents aged 65 years and above, health care providers, and staff of the LEAP and the National Health Insurance Scheme (NHIS). Findings: Our analysis found geographic inaccessibility of health care, high costs of drugs and related services, exclusion of essential services from NHIS benefits package, and irregular transfer of cash to negatively influence access and utilization of health care among aged LEAP beneficiaries in the district. In addition to the need to strengthen the economy, provide health infrastructure and human resources for health in rural areas, the government needs to review the beneficiaries’ bimonthly stipends to reflect the daily minimum wage, eliminate the delay in payments, and review the benefits package of the NHIS to include essential services and medical devices commonly used by aged people. Yet implementing these recommendations has affordability implications that require innovation to mobilize additional resources and create the desired fiscal space and institutions that can sustainably implement universal coverage programmes such as the LEAP.

Background In Ghana, tuberculosis (TB) case detection is low (< 34%). Existing scientific evidence suggest access to TB diagnostic tests play an essential role in TB case detection, yet little has been scientifically documented on it in Ghana. This study, therefore, sought to map TB diagnosis sites, and describe the geographic availability and physical accessibility to TB diagnosis in six regions of Ghana to inform scale-up and future placement of TB diagnostic tests. Methods We assembled the geolocation and attribute data of all health facilities offering TB diagnosis in Upper West Region (UWR), Upper East Region (UER), Ahafo, North-East, Northern, and Savannah regions. QGIS was employed to estimate the distance and travel time to TB diagnosis sites within regions. Travel time estimates were based on assumed motorised tricycle speed of 20 km (km)/hour. Results Of the total 1584 health facilities in the six regions, 86 (5.4%) facilities were providing TB diagnostic testing services. This 86 TB diagnosis sites comprised 56 (65%) microscopy sites, 23 (27%) both microscopy and GeneXpert sites, and 7 (8%) GeneXpert only sites (8%). Of the 86 diagnosis sites, 40 (46%) were in the UER, follow by Northern Region with 16 (19%), 12 (14%) in UWR, 9 (10%) in Ahafo Region, 5 (6%) in North East, and 4 (5%) in Savannah Region. The overall estimated mean distance and travel time to the nearest TB diagnosis site was 23.3 ± 13.8 km and 67.6 ± 42.6 min respectively. Savannah Region recorded the longest estimated mean distance and travel time with 36.1 ± 14.6 km and 108.3 ± 43.9 min, whilst UER recorded the shortest with 10.2 ± 5.8 km and 29.1 ± 17.4 min. Based on a 10 km buffer of settlement areas, an estimated 75 additional TB diagnosis sites will be needed to improve access to TB diagnosis services across the six regions. Conclusion This study highlights limited availability of TB diagnosis sites and poor physical accessibility to TB diagnosis sites across five out of the six regions. Targeted implementation of additional TB diagnosis sites is needed to reduce travel distances to ≤ 10 km.