BackgroundIn spite of the adverse health and financial implications of smoking, it still remains one of the leading causes of preventable diseases and deaths in the world. Key to discouraging the habit of smoking is knowledge of the drivers of smoking. In Ghana, though smoking behaviours are relatively more associated with adult males than youth and adolescents, studies on smoking behaviours of adult males are scant. This study, therefore, investigates the determinants of cigarette smoking and smoking intensity among adult males in Ghana.MethodsData were obtained from the most recent Ghana Demographic and Health Survey (DHS) conducted in 2014. Based on the 2014 GDHS, a negative binomial-logit hurdle model was estimated to explore the socioeconomic and demographic characteristics associated with cigarette consumption and smoking intensity among adult males in Ghana. To ensure robustness, separate estimations were performed for the respective logit and negative binomial models used in the two-part model.ResultsWe find that men in lower socioeconomic category (poor and low education) have a higher likelihood to smoke. Also, age proved significant in explaining smoking behaviors in Ghana. Moreover, religion and region of residence are reported to affect cigarette consumption decision. Furthermore, we find that among the men who smoke, those between the ages of 44 and 60 years and have attained approximately primary education have a higher likelihood to smoke greater quantities of cigarette daily. Also, the smokers who reside in the Upper East and Upper West regions are reported to smoke more intensely than their counterparts in the Greater Accra region.ConclusionSince smoking remains one of the major causes of diseases and deaths the world over, the current study provides recent empirical evidence based on a nationally representative sample for public health policies geared towards smoking reduction and ultimately cessation. This study suggests that public policies that promote higher educational attainment and improved incomes (wealth) are crucial in smoking reduction and cessation in Ghana.

Using the 2014 Ghana Demographic and Health Survey, this study explores the correlates of early sexual debut among 2,746 (males = 670 and females = 2,076) sexually active youth aged 15 to 24 years in Ghana. The results indicate that males aged 15 to 19 years (odds ratio [ OR] = 8.84, p < .001) and who had basic education ( OR = 3.17, p < .001) were significantly more likely to initiate sexual debut early. Urban males who had used modern contraceptive ( OR = 0.35, p < .001) were significantly less likely to initiate early sexual debut. Meanwhile, females aged 15 to 19 years ( OR = 4.26, p < .001); who had used modern contraceptive ( OR = 1.99, p < .001); with no formal ( OR = 2.90, p < .001) or basic ( OR = 3.12, p < .001) education; with partial access to media ( OR = 1.58, p < .01); and from the Akans ( OR = 1.73, p < .001), Ewes ( OR = 1.92, p < .001), and other ethnic groups ( OR = 1.63, p < .001) were significantly more likely to initiate early sexual debut. However, employed females living in rural areas ( OR = 0.70, p < .01) and those with average ( OR = 0.54, p < .01) or rich ( OR = 0.51, p < .01) household living in urban areas were significantly less likely to initiate early sexual debut. Interventions and policies targeting those living in both rural and urban areas are therefore needed for adolescent males and females in their early teens before they start engaging in sexual intercourse.

Background Ghana’s National Health Insurance Scheme (NHIS) has witnessed an upsurge in enrollment since its inception in 2003, with over 40% of the Ghanaian population actively enrolled in the scheme. While the scheme strives to achieve universal health coverage, this quest is derailed by negative perceptions of the quality of services rendered to NHIS subscribers. This paper presents an analysis on perceptions of service quality provided to subscribers of Ghana’s NHIS with emphasis on rural and urban scheme policy holders, using a nationally representative data. Methods The study used data from the 2014 Ghana Demographic and Health Survey. Ordered logistic regressions were estimated to identify the correlates of perceived quality of care of services rendered by the NHIS. Also, chi-square statistics were performed to test for significant differences in the proportions of subscribers in the two subsamples (rural and urban). Results Rural subscribers of the NHIS were found to identify more with better perception of quality of services provided by the NHIS than urban subscribers. Results from the chi-square statistics further indicated that rural subscribers are significantly different from urban subscribers in terms of the selected socioeconomic and demographic characteristics. In the full sample; age, out-of-pocket payment for healthcare and region of residence proved significant in explaining perceived quality of services rendered by the NHIS. Age, out-of-pocket payment for healthcare, region of residence, wealth status, and access to media were found to be significant predictors of perceived quality of services provided to both rural and urban subscribers of the NHIS. The significance of these variables varied among men and women in rural and urban areas. Conclusion Different factors affect the perception of quality of services provided to rural and urban subscribers of Ghana’s NHIS. Health financing policies geared toward improving the NHIS-related services in rural and urban areas should be varied.

Purpose Against the background that Ghanaians seldom purchase insurance policies, the purpose of this paper is to investigate the determinants of life insurance uptake among male and female household heads in Ghana. Design/methodology/approach The study employs data on 775 male and 233 female household heads from the sixth round of the Ghana Living Standards Survey. Adjusted Wald test statistics and logistic regressions are employed for the empirical estimations. Findings Results from the adjusted Wald test show that the sampled male household heads significantly differ from their female counterparts in terms of the selected socioeconomic and demographic characteristics. Though ill health status, higher wealth, being self-employed or in wage or salaried employment and residing in either of the three northern regions (upper east, upper west and northern regions) in Ghana broadly affect the demand for life insurance among both male and female heads, other factors are peculiar to either parties. Particularly, whereas female heads who are married and those with more dependants have a higher propensity of purchasing life insurance policies, their male counterparts with higher education are more likely to buy life insurance policies. Research limitations/implications The paper adds to the paucity of cross-sectional studies on life insurance demand in Africa. Practical implications Based on the explored determinants, insurers could better regulate the purchase of their products by taking into consideration the gender differences to maximize their sales and enhance economic growth and development. Originality/value This paper explores the gender dynamics in the determinants of life insurance demand in a developing country, Ghana. Besides, findings from related literature are reported to be mixed. Though the current paper is not wholly nationally representative, it utilizes data from across all the ten administrative regions of Ghana. To the best of the authors’ knowledge, no prior study has been conducted in this manner.

This paper explores the predictors of HIV/AIDS awareness and knowledge among older and younger Ghanaian women of reproductive age. Logistic regression was estimated using the 2014 Ghana Demographic and Health Survey data. Results indicate that older Ghanaian women are significantly different from their younger counterparts in terms of the selected socio-economic and demographic characteristics that influence awareness and knowledge of the epidemic. In all, the respondents’ age, region of residence, wealth status, education, marital status and religious affiliation were found to significantly predict knowledge and awareness of HIV/AIDS among women. In addition, pregnancy status and place of residence proved to be significant correlates of HIV/AIDS awareness among Ghanaian women. The study suggests that higher social status is critical in determining whether women of reproductive age are aware of and knowledgeable about the epidemic. Thus, there is the need for policies and interventions to target messages taking into account the varied socio-economic and demographic backgrounds of women in Ghana. Further, health education interventions should be sensitive to the changing technological landscape in order to develop messages that can be delivered via mobile phones, whether as reminders or ringtones, and therefore enhance health knowledge and promote behaviour that brings about desirable health outcomes.

Malaria remains a significant health threat in Ghana, and by extension, many sub-Saharan African countries. It is caused by the protozoan parasite Plasmodium, which is transmitted by female Anopheles mosquitoes, which usually bite between sunset and sunrise [1]. Africa accounted for 93% of the 228 million malaria cases in 2018 [2]. Globally, malaria caused 405,000 estimated deaths in 2018, with Africa accounting for 94% of the total deaths. Children below 5 years are the most vulnerable group affected by malaria. They accounted for 67% of all malaria deaths worldwide [2].Since malaria is a preventable disease, various measures have been instituted to prevent or curb its spread globally. Indoor residual spraying (IRS), intermittent preventive treatment in pregnancy, seasonal malaria chemoprevention, and insecticide-treated nets (ITNs) are among the preventive measures [1,3]. This study focuses on ITNs. To reduce malaria-related morbidities and mortalities, there has been mass distribution of ITNs to countries battling malaria.

Aim:The objective of this study was to examine the interactive effect of gender, rural-urban residence, and socioeconomic status on early sexual debut among young adults in Ghana Methods: The study used the 2014 Ghana Demographic and Health Survey with a sample of 2746 sexually active youth (males = 670 and females = 2076) aged 15-24. We used multivariate logistic regression to analyse the data.Results: Our results showed that female youth in urban areas and those from the wealthiest households were less likely to initiate early sexual debut. Additionally, youth resident in urban areas from rich households are less likely to initiate early debut. However, a-3 way interactive effect revealed that female youth resident in urban areas from rich households were found to be more likely to initiate early debut. Conclusion:Our findings underscores that a gender-based sexual and reproductive health interventions and programmes may be more appropriate for adolescent females in rich households living in urban areas. These interventions should reach these teenagers before they start engaging in sexual intercourse.

Background The slow pace of fertility decline in Africa relative to other parts of the world has important implications for the region’s economic development. Modern contraceptive use is seen as important population control and family planning strategy by governments worldwide. This paper examines the socioeconomic determinants of modern contraceptive use and choice among Ghanaian men and women. Methods We use the most recent and nationally representative Ghana Demographic and Health Survey conducted in 2014. The analysis is observational, with no causal implications. Bivariate and multivariate methods are used to analyse the data. We first use logistic regression to explore the correlates of modern contraceptive use among Ghanaian men and women. Second, we explore the socioeconomic factors influencing the choice of modern contraceptive methods among contraceptive users using multinomial logistic regression. We classify the modern methods of contraception into three groups: long-acting reversible contraceptives (LARC), short-acting contraceptives (SAC), and permanent contraceptives. Results Marital status proves to be the most significant predictor for both men and women, with women in monogamous unions having a greater propensity to use modern methods of contraception (OR = 1.4, p < 0.00). We also find that different factors affect the use and choice of modern methods of contraception among men and women in Ghana. Muslim men had a higher likelihood than Catholics to choose the permanent (sterilisation) method (OR = 11.9, p < 0.05), while their female counterparts were 0.25 times less likely to choose sterilisation over SAC (p < 0.05). Moreover, women who ever tested for HIV had higher use of LAC than the SAC ((RRR = 1.6, p < 0.01). The modern contraceptive users (women) with at most basic education were more likely than those with tertiary education to choose LAC over SAC. Finally, rural women with health insurance were 0.75 times (p < 0.01) less likely to use modern methods of contraception. Conclusions The paper reiterates the need to intensify and sustain public health education on the health benefits of using modern methods of contraception among the adult population. The paper suggests that including family planning services on Ghana’s national health insurance benefits package is commendable. It can promote modern contraceptive use and curtail unwarranted population growth.