The need to improve the sexual and reproductive health (SRH) and rights of women with disabilities is increasingly acknowledged. Unfortunately, women with disabilities in low-and middle-income settings, including Ghana, face several barriers (including structural, financial, physical, social and attitudinal) to accessing SRH services and care. This paper explores the enablers and barriers to accessing SRH services and care among visually impaired women in the Ashanti and Brong Ahafo Regions of Ghana. Qualitative data from in-depth interviews and focus group discussions were collected from 21 visually impaired women, selected through purposive and snowballing sampling techniques. Thematic analysis was used to develop codes, and data were further grouped into emerging themes. The barriers to accessing SRH services and care were financial difficulties and lack of preferential treatment. The enablers which facilitated access to SRH services and care were the support provided by caregivers and friendly relationships with health providers. To address these challenges and promote access, SRH related policies, services and programmes should be inclusive of the needs of visually impaired women, and measures to remove financial challenges to service utilisation and foster positive relationships with health workers, church and community members should be adopted.

BackgroundAnaemia remains a major cause of morbidity and mortality among women and children worldwide. Because deficiencies in essential micronutrients such as iron, folate and vitamin B12 prior to and during gestation increase a woman's risk of being anaemic, adequate dietary intake of such nutrients is vital during this important phase in life. However, information on the dietary micronutrient intakes of pregnant women in Ghana, particularly of those resident in rural areas is scanty. Thus, this study aimed to assess anaemia prevalence and dietary micronutrient intakes in pregnant women in urban and rural areas in Ghana. MethodsA comparative cross sectional study design involving 379 pregnant women was used to assess the prevalence of anaemia and low intake of dietary nutrients in pregnant women living in rural and urban areas in the Ashanti region of Ghana. Anaemia status and mid upper arm circumference (MUAC) were used as proxy for maternal nutritional status. Haemoglobin measurements were used to determine anaemia prevalence and the dietary diversity of the women were determined with a 24-hour dietary recall and a food frequency questionnaire. ResultsOverall, anaemia was present in 56.5% of the study population. Anaemia prevalence was higher among rural residents than urban dwellers. Majority of the respondents had inadequate intakes of iron, zinc, folate, calcium and vitamin A. The mean dietary diversity score (DDS) of the study population from the first 24-hour recall was 3.81 ± 0.7. Of the 379 women, 28.8% met the minimum dietary diversity for women (MDD-W). The independent PLOS ONE | https://doi.) for researchers who meet the criteria for access to confidential data. predictors of haemoglobin concentration were, gestational age, maternal age and dietary diversity score. Such that respondents with low DDS were more likely to be anaemic than those with high DDS (OR = 1.795, p = 0.022, 95% CI: 1.086 to 2.967). ConclusionsA large percentage of pregnant women still have insufficient dietary intakes of essential nutrients required to support the nutritional demands during pregnancy. Particularly, pregnant women resident in rural areas require interventions such as nutrition education on the selection and preparation of diversified meals to mitigate the effects of undernutrition.Undernutrition prevalence and severity in Ghanaian pregnant women PLOS ONE | https://doi.

ABSTRACT

Introduction Waste management is an important developmental issue globally, especially in developing countries like Ghana. A key challenge of waste management in developing countries is sustainable financing. This study assesses the willingness-to-pay, an integral attribute of sustainable financing mechanism for improved solid waste management (SWM) services in Ghana. Methods A cross-sectional multicenter study was conducted in Ghana from January to August 2017 among 1560 households in four regional capitals in Ghana; Accra, Takoradi, Kumasi, and Tamale. Data were collected by using a structured interview questionnaire. Logistic regression models were used to determine the predictors of willingness-to-pay for SWM services in Ghana. Results Overall, 53.7% of the households were willing to make additional payment for improved services, with difference across study sites: 54.5%, 53.1%, 61.7%, and 46.6% in Takoradi, Tamale, Accra, and Kumasi, respectively. Willingness-to-pay for improved SWM was predicted by educational level, marital status, type of employment, and region of residence. Compared to women who had no formal education, those having senior high school (aOR (adjusted odds ratio): 2.53; 95% CI: 1.48, 4.30), postsecondary (aOR: 1.97; 95% CI: 1.08, 3.60), and tertiary education (aOR: 3.30; 95% CI: 1.91, 5.69) were associated with higher odds of willingness-to-pay for improved SWM services. Conclusion This study provides important evidence on important attribute of financing mechanism, willingness-to-pay for improved SWM services. Findings would contribute to efforts at finding sustainable financing mechanism for waste management services in Ghana.