Child malaria vaccine uptake in Ghana: Factors influencing parents' willingness to allow vaccination of their children under five (5) years.

BACKGROUND: Malaria is a substantial health burden in Ghana, particularly among children. Despite the availability of malaria vaccines, uptake remains low. Notwithstanding, there is a paucity of nationally representative studies on the factors driving hesitance towards the new malaria vaccine. In response, this study, guided by the Theory of Planned Behaviors (TPB), seeks to understand the determinants of child malaria vaccine uptake in Ghana to inform strategies for improving coverage. MATERIALS AND METHODS: We employed multiple regression model to examine the association between maternal awareness, socioeconomic status, ethnicity, geographical location, and vaccine uptake using data from the 2019 Ghana Malaria Indicator Survey (MIS). RESULTS: Maternal awareness of vaccine (OR = 2.200; P<0.01) significantly predicted higher likelihood of vaccine uptake. Household wealth was associated with child vaccination as parents in middle-income households (OR = 9.342; P<0.01), and those in poorest households (OR = 9.409; P<0.05) recorded higher likelihood of allowing their children to be vaccinated. With regards to ethnicity, parents from the Mande ethnic group (OR = 0.106; P<0.05) were less likely to allow their children to be vaccinated when compared to parents from the Akan ethnic group. Knowing that malaria is covered by National Health Insurance (OR = 2.407; P<0.05) was associated with higher likelihood of allowing child vaccination compared to not knowing. More so, geographical variations were observed as parents who lived in rural areas (OR = 0.254; P<0.05) were significantly less likely to allow vaccination of their children compared to those in urban areas. CONCLUSIONS: Enhancing awareness through education campaigns can improve child malaria vaccine coverage. Observing socioeconomic disparities in uptake and ensuring equitable access to vaccines are vital. Tailored strategies considering ethnic background and geographical location, can as well enhance acceptance of the vaccine. This study provides valuable insights for developing effective strategies to reduce the burden of malaria in children and improve coverage of uptake. This study underscores the need to improve parental awareness and the relevance of the vaccine in preventing child mortality.

Beyond Purchasing Power: The Association Between Sense of Community Belongingness and Food Insecurity Among Older Adults in Canada.

Food is a basic human need, yet a significant proportion of older Canadian adults are vulnerable to food insecurity. The health risks associated with aging make food insecurity among this subgroup a critical policy issue. In Canada, policy solutions to food insecurity are however skewed toward the provision of income support to vulnerable groups. While these income support programs are timely, little emphasis is placed on social factors such as sense of community belongingness. This is despite evidence that food insecurity is a socially mediated experience that goes beyond the ability to purchase food. Drawing data from the Canadian Community Health Survey (n = 24,546) and using negative log-log regression, we examined the association between sense of community belongingness and food insecurity among older adults. Findings show that older adults with a "very weak" (odds ratio [OR] = 1.40, p < .001) and "somewhat weak" (OR = 1.23, p < .01) sense of community belongingness were significantly more likely to be food insecure compared to those with a "very strong" sense of belongingness. This study contributes to a growing body of the literature that demonstrates the need for an integrated approach to addressing food insecurity - one that goes beyond income support to include consideration of social factors like sense of community belonging.

Alcohol misuse as a social determinant of food insecurity among smallholder farmers.

The availability and affordability of alcohol in smallholder communities have surged the misuse of alcohol. Misusing alcohol has dire health and nutrition consequences in smallholder communities. Alcohol misuse can divert household resources from essential household needs such as food and also hinder local food production. In the context of multiple stressors on smallholder farmers' livelihoods, it is crucial to assess the relationship between alcohol consumption and smallholder farmers' experience of hunger. Therefore, we used data from a cross-sectional survey involving 1100 smallholder farmers in the Upper West region of Ghana to examine the association between alcohol consumption and household food insecurity. Results showed that daily (OR = 3.81; p ≤ 0.001) and weekly/frequent (OR = 2.32; p ≤ 0.001) consumption of alcohol was significantly associated with higher odds of household food insecurity compared to no consumption. The relationship between alcohol and food insecurity was bidirectional. The experience of food insecurity was also significantly associated with higher odds of occasional or frequent alcohol consumption. While alcohol misuse can transition smallholder households into food insecurity, the household heads of food insecure households may resort to alcohol to cope with underlying stressors such as climate change and food insecurity. This calls for policy interventions to mitigate alcohol misuse through regulations, surveillance, economic disincentives and improving the social mechanisms of resilience to climate change and food insecurity in smallholder communities. However, policy approaches must be cautious not to disrupt the livelihoods of vulnerable smallholder farmers.

Geographic disparities in the time to under-five mortality in Ghana.

Globally, there has been tremendous advancement in medicine and child healthcare with increased life expectancy. That notwithstanding, the risk of under-five mortality ─ children dying before their fifth birthday remains relatively high in countries in Sub-Saharan Africa such as Ghana. In Ghana, under-five mortality remains a major public health problem that requires significant policy interventions. Using data from the 2017 Maternal Health Survey (n = 4785), we examined the geographic disparities in the time to under-five mortality in Ghana. The Kaplan Meier estimator showed significant (Log-rank: p< 0.001) rural-urban differences in the time to under-five mortality in Ghana. A disaggregated cox proportional hazards analysis showed that despite wide consensus that children in urban areas have a high survival rate, children in urban areas in northern regions of Ghana, especially the Upper West (HR = 4.40, p < 0.05) and Upper East (HR = 5.37, p < 0.01) Regions were significantly at increased risk of dying before the age of five compared to children in urban areas in the Greater Accra Region. A rural-urban comparison showed that children born in rural areas in all the other regions of Ghana were at a higher risk of dying before the age of five when compared to their counterparts in the rural areas of Greater Accra Region. Other factors such as sex of child, mothers' age and use of the internet, number of household members, ethnicity and household wealth were significantly associated with the timing of under-five mortality in Ghana. Healthcare policies and programs such as immunizations and affordable child healthcare services should be prioritized especially in rural areas of regions with a high risk of child mortality. Also, there is a need to improve healthcare delivery in urban areas, particularly in northern Ghana, where deplorable healthcare service infrastructure and delivery coupled with high poverty rates put children at risk of dying before their fifth birthday.

Exposure to mass media family planning messages among men in Nigeria: analysis of the Demographic and Health Survey data.

Background: Family planning (FP) is essential for improving health and achieving reproductive goals. Although men are important participants in FP decision-making within households in Nigeria, a country with one of the highest rates of maternal mortality, we know very little about their exposure to mass media FP messages. Methods: Drawing theoretical insights from the structural influence model of health communication and using the 2018 Nigeria Demographic and Health Survey (n = 13,294), and applying logistic regression analysis, we explored the factors associated with men's exposure to mass media FP messages in Nigeria. Results: A range of socioeconomic, locational, and demographic factors were associated with men's exposure to mass media FP messages. For example, wealthier, more educated, and employed men were more likely to be exposed to mass media FP messages than their poorer, less educated, and unemployed counterparts. In addition, compared to those in rural areas and other regions, men in urban areas as well as South East Region, were more likely to be exposed to mass media FP messages. Finally, younger men and those who belong to the traditional religion were less likely to be exposed to mass media FP messages, compared to their older and Christian counterparts. Conclusions: Based on these findings, we discuss implications and recommendations for policymakers as well as directions for future research.

Spatial analysis of climatic factors and plasmodium falciparum malaria prevalence among children in Ghana.

Malaria is a major public health problem especially in Africa where 94% of global malaria cases occur. Malaria prevalence and mortalities are disproportionately higher among children. In 2019, children accounted for 67% of malaria deaths globally. Recently, climatic factors have been acknowledged to influence the number and severity of malaria cases. Plasmodium falciparum-the most deadly malaria parasite, accounts for more than 95% of malaria infections among children in Ghana. Using the 2017 Ghana Demographic Health Survey data, we examined the local variation in the prevalence and climatic determinants of child malaria. The findings showed that climatic factors such as temperature, rainfall aridity and Enhanced Vegetation Index are significantly and positively associated with Plasmodium falciparum malaria prevalence among children in Ghana. However, there are local variations in how these climatic factors affect child malaria prevalence. Plasmodium falciparum malaria prevalence was highest among children in the south western, north western and northern Ghana.

Prevalence and Predictors of Contraceptives Use among Women Aged (15-49 years) with Induced Abortion History in Ghana.

BACKGROUND: The incidence of abortion in Ghana ranges from 27 per 1000 to 61 per 1000 women, causing gynecological complications and maternal mortality. The use of modern contraceptives and its associated factors among women aged 15-49 years have been documented. However, utilization of modern contraceptives specifically among women with induced abortion history is underreported. This study therefore aimed at determining the proportion and identifying predictors of contraceptives use in this underreported population. METHODS: This study used secondary data from the 2017 Ghana Maternal Health Survey (GMHS) for the analysis. The analysis is on a weighted sample of 3,039 women aged (15-49 years) with a history of induced abortion. Both descriptive and inferential methods were employed. The chi-square test, univariate and multivariate logistic regression techniques were used to assess statistical associations between the outcome variable and the predictors. Statistical significance was set at 95% confidence interval and p values ≤0.05. RESULTS: Out of the 3,039 participants, 37% (95% CI: 34.6, 38.84) used contraceptives. We identified women' age, union, place of residence, knowledge of fertile period, total pregnancy outcomes, and region as strong significant (95% CI, p ≤ 0.05) predictors of post induced abortion contraceptives use. CONCLUSION: Contraceptives use among this vulnerable population is low. Therefore, there is a need to provide widespread access to postabortion contraception services and enhance efforts to efficiently integrate safe abortion practices law into health services in Ghana.