PurposeThe purpose of this paper is to estimate the key socio‐economic and demographic factors influencing the utilization of antenatal care services in Ghana.Design/methodology/approachThe paper utilizes the most recent Ghana Demographic and Health Survey (GDHS V) data. The dependent variable is the intensity of utilization (number) of antenatal care visits. Hence, the negative binomial regression is employed to investigate the socio‐economic and demographic correlates of the intensity of antenatal care utilization in Ghana.FindingsThe study finds that wealth status, age, ownership of health insurance (especially for rural women), educational attainment, birth order, religion and administrative region of residence are significant predictors of the intensity of antenatal care services utilization. In particular, the utilization rate increases in wealth status. The authors also found significant statistical relationship between residence and antenatal care utilization. This finding reinforces the differences in health facilities between the rural and urban areas of Ghana. The authors did not, however, find evidence for proxies for financial and physical access.Research limitations/implicationsThe GDHS survey lacks data on the distance to the nearest health facility where ANC is sought and a variable for the price of ANC visit. Proxies had to be used to capture these variables.Practical implicationsThe fact that ownership of health insurance in rural areas increases the number of ANC visits makes it imperative to intensify health insurance awareness and enrollment campaigns in the rural areas so as to bridge the rural‐urban gap in ANC utilization. Also, while the free maternal health care policy for expecting mothers is laudable, a minimum level of wealth is required to induce antenatal care visitations. This is because household wealth status still plays a major role even in a free maternal health regime.Originality/valueA new finding of the paper is the significant effect that ownership of health insurance has on the utilization of ANC services among rural women. While generally rural women have a lower propensity to use ANC services compared to urban women, the intensity of usage of ANC services tends to increase for rural women who own health insurance.

Evidence abounds in the rural livelihoods literature that rural households do not only receive a significant proportion of their incomes from non-farm sources, but also it is a significant source of employment for rural folks. This paper examines the pattern and determinants of non-farm income diversification in rural Ghana. Results show that off-farm income constituted 43 percent of rural household income in 2005/6. Female-headed households tend to have larger off-farm income shares compared to male-headed households. Non-farm income shares followed the same gender pattern albeit less pronounced. Unlike in Latin America and Asia, in rural Ghana, non-farm self-employment income is more important than non-farm wage-employment income. Regression results show that the gender composition of households, age, education, and access to credit, electricity and markets are important determinants of multiple non-farm activities and non-farm income. The findings call for strategies that can help rural households maximize the benefits from income diversification.

Purpose-The purpose of the paper is to examine the nature and extent of gender and spatial inequalities in educational attainment in Ghana. Design/methodology/approach-The paper uses the education Gini coefficient, computed on the basis of years of schooling of individuals, to assess education inequality in Ghana. Findings-The paper finds evidence of gender and spatial inequality in education in Ghana. In particular, the three northern regions have lower education attainment as well as higher education Gini coefficients compared to the rest of the country. The paper finds evidence of intra-gender and intra-spatial inequalities in education attainment in Ghana, with females contributing proportionately more to the within-inequality component of the education Gini. The paper also finds a positive correlation between poverty incidence and education inequality. Research limitations/implications-The research finds a positive correlation between poverty incidence and education inequality but requires an econometric analysis to make inferences regarding causality. Practical implications-The findings call for the design and implementation of policies not only to address between-gender and spatial inequities in education in Ghana, but also to tackle within-gender and within-spatial inequalities. The positive correlation between poverty incidence and education inequality implies the need to create greater equity in educational opportunities across the country. Social implications-The need for changes in attitudes, values and cultural practices that put girls at a disadvantage when it comes to education. Originality/value-One important and new finding of the paper is the existence of intra-gender and intra-spatial inequalities in education attainment in Ghana, with females contributing proportionately more to the within-inequality component of the education Gini.

No abstract

Research shows that participation in rural non-farm activities exerts a pronounced impact on agriculture, household farm decisions, rural development, income and welfare as well as household food security. This paper investigates the impact of participation in non-farm activities on household income and food security among farm households in the Upper East and Upper West Regions of Ghana. Using the Recommended Daily Calorie Required (RDCR) approach, the study finds that 45 percent of households in the two regions are food insecure. Propensity score matching (PSM) results indicate that participation in non-farm work has significant positive effect on household income and food security status. The policy implications of the findings are discussed.

Purpose The purpose of this paper is to investigate the effect of public and private health expenditures on selected maternal-child health outcomes in Sub-Saharan Africa (SSA). Design/methodology/approach The study utilizes panel data on 40 SSA countries spanning the period 2000-2010. The data are analyzed using the fixed effects estimation technique. Findings The results indicate that public health expenditure is inversely and significantly related to infant (IMRR) and under-five (U5MR) mortalities in SSA. Though public health expenditure has the a priori negative sign, it has no significant effect on maternal mortality (MMR) in SSA. Further, private health expenditure did not prove to be significant in improving maternal-child health outcomes (IMRR, U5MR and MMR) in SSA. Practical implications The implication of the findings is that a percentage point increase in public health expenditure (as a share of GDP) across the region will result in saving the lives of about 7,040 children every year. Hence, it is important for governments in SSA to increase their shares of health expenditure (public health expenditure) in order to achieve improved health outcomes. Originality/value Previous studies have not adequately explored the effect of various components of health expenditures – public and private – on health outcomes in the context of SSA. In addition to the focus on maternal-child health variables such as infant, under-five and maternal mortalities, the study accounts for the possibility of a non-linear and non-monotonic relationship between healthcare expenditures and health outcomes.

Purpose – The purpose of this paper is to examine the income strategies adopted by rural households in Ghana and analyzes the determinants of households’ choice of income portfolio. Design/methodology/approach – A multinomial logit approach is employed by the paper to investigate the determinants of various income strategies adopted by households in rural Ghana. Findings – Results indicate that household characteristics, location and infrastructure all play a role in explaining the adoption of income strategies other than a purely on-farm strategy by households. Education is a key determinant of income strategies involving non-farm wage employment, while access to credit and electricity play important roles in non-farm self-employment income strategies. Practical implications – The findings of the paper call for a promotion of off-farm income opportunities to complement farm incomes and to enhance access of rural households to these sources of income. Originality/value – The paper models rural household income portfolios into mutually exclusive categories which enables the application of the multinomial logit approach. The paper deviates from mainstream rural income diversification literature that has focussed on assessing the determinants of income shares.

No abstract