Background Many governments in sub-Saharan Africa have recently sought to improve their health systems by increasing investment in healthcare facilities and introducing social insurance programmes. However, little is known about the impact of these intended improvements on public perceptions about the healthcare systems. This article examines whether and why people of different socioeconomic and ideological backgrounds are satisfied (or not) with the current healthcare system in Ghana from a social ecological perspective. Method Data were elicited from a cross-sectional mixed-method study conducted in four regions in Ghana in 2018. We used ordinal logistic regression and thematic analysis techniques to analyse the data. Results Satisfaction with the healthcare system was generally low. From our quantitative study, intrapersonal factors (e.g., being older and having good health and well-being status); interpersonal factors (e.g., linking social capital); community factors (e.g., living in rural areas); and organisational and public policy factors (e.g., trust in the health system, favouring welfare policies, and being interested in politics) were positively associated with satisfaction with the healthcare system. These were corroborated by the qualitative study, which showed that poor attitudes of health personnel, financial constraints, perceived poor health facilities, and perceived inefficacy of services contribute to dissatisfaction with the healthcare system. Conclusion Strategies to improve satisfaction with the healthcare system in Ghana should incorporate ecological perspectives by considering factors such as demographic profile, health needs, political orientation, issues of trust in the healthcare system, and the dynamics and impact of social relationships of populations concerned.
Background This article explores the multifaceted perceptions among householders about the care, efficacy and disposal of long-lasting insecticide-treated nets (LLINs), especially those regarding the end of the useful life of LLINs, and their implications for malaria control. Methods We used a cross-sectional qualitative design. Data were gathered in the Shai-Osudoku District in the Greater Accra Region of Ghana using focus group discussions and in-depth interviews. A thematic analysis technique was applied to analyse the data. Results Four findings emerged. First, participants were familiar with LLINs and the issues concerning the end of their useful life. However, the application of this knowledge was deficient. Second, characteristics of effectiveness (e.g. torn beyond repair) other than the age of a net determined the end of the useful life of LLINs. Third, social desirability and other social practices had positive and negative influences on perceptions about LLIN use and the end of their useful life. Fourth, repurposing of LLINs signified the end of their useful life. Conclusions Policies and strategies to position LLIN use as the leading resource for malaria control need to be innovative to accommodate the perceptions and practices of targeted households.
We examined the moderating role of social capital (SC) in the association of socioeconomic status (SES) and health literacy (HL) with oral health (OH) status and the intentions to use OH services (IUOHS) among older Ghanaians. Data were derived from a cross-sectional survey ( n = 522) and analyzed using ordinal and binary logistic regressions. Bridging SC moderated the relationship between HL and oral health status ( B = 0. 0.117, p < .05) and the association of SES with IUOHS (adjusted odds ratio [AOR] = 1.144; 95% confidence interval [CI] = [1.027, 3.599]). Trust modified the association between HL and IUOHS (AOR = 1.051; 95% CI = [1.014, 3.789]). Bonding SC moderated the association between SES and oral health status (B = 0.180, p < .05). However, bonding SC negatively modified the association between SES and IUOHS (AOR = 0.961; 95% CI = [0.727, 0.997]). Cognitive and structural SC modify the associations of SES and HL with OH and IUOHS.
Background. The global discourse on plastic waste generation and disposal has over the last two decades, gained traction with the aid of research-based evidence. Though observed globally, the situation is quickly deteriorating in developing countries such as Ghana. In Ghana and Africa as a whole, rapidly increasing population and rural to urban migration have been cited as factors that exacerbate the existing struggles with plastic pollution. This study aimed at identifying the determinants of unsafe plastic waste disposal among households. Methods. The study was carried out in three communities in Tamale in the Northern Region of Ghana. Data were collected from 270 randomly selected households through household surveys, key informant interviews, and direct field observations. Results. The study revealed that the majority (63.3%) of the total respondents used and disposed of their plastic waste “unsafely.” The analysis showed that the education level and household wealth were significant determinants of unsafe plastic disposal. Conclusion. The study concludes that challenges of plastic waste management are not limited to economic, technical, and institutional factors, but social factors such as human behavior are key aspects of waste management that need attention. The study, therefore, recommends strict enforcement of sanitation by-laws, promotion of education, and provision of alternatives to plastics that will minimize the need for importing and manufacturing plastics, as potential steps towards addressing unsafe disposal of plastics in the domestic environment.
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