BackgroundWaste poses a threat to public health and the environment if it is not stored, collected, and disposed of properly. The perception of waste as an unwanted material with no intrinsic value has dominated attitudes towards disposal. This study investigates the domestic waste practices, waste disposal, and perceptions about waste and health in an urban community.MethodsThe study utilised a mixed-method approach. A cross-sectional survey questionnaire and in-depth interview were used to collect data. A total of 364 household heads were interviewed in the survey and six key informants were interviewed with the in-depth interviews.ResultsThe results of the study revealed that 93.1% of households disposed of food debris as waste and 77.8% disposed of plastic materials as waste. The study also showed that 61.0% of the households disposed of their waste at community bins or had waste picked up at their homes by private contractors. The remaining 39.0% disposed of their waste in gutters, streets, holes and nearby bushes. Of those who paid for the services of private contractors, 62.9% were not satisfied with the services because of their cost and irregular collection. About 83% of the respondents were aware that improper waste management contributes to disease causation; most of the respondents thought that improper waste management could lead to malaria and diarrhoea. There was a general perception that children should be responsible for transporting waste from the households to dumping sites.ConclusionProper education of the public, the provision of more communal trash bins, and the collection of waste by private contractors could help prevent exposing the public in municipalities to diseases.

A19 (F= 3.16 and F= 3.15). The results from the regression model showed that as age increases, the expenditure rises especially at old ages. Patients from lower income groups spent more on ambulatory services than those in higher income groups, as well as individuals living in regions with very high level of social exclusion. Among other main determinants, individuals that looked for private health care attention along with those that perceived their health problems as severe increased their health expenditure. ConClusions: Out of pocket expenditure has been regressive among health care users at IMSS. Therefore especial attention to lower income patients should be paid.

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This article poses the problem of public consultation in developing countries and applies a solution in Ghana as a test case. It describes the theoretical rationale for deliberative consultation with random samples, describes specific criteria for success, and then assesses an application under the challenging conditions of a developing country. It builds on notions of "deliberative democracy," and shows how they can be practically realized in an African context through "Deliberative Polling" (DP). The challenge is that the context is one of the poorest parts of one of the poorest countries in Africa. Rather than consulting just stakeholders, or self-selected populations, or using conventional surveys, DP's have the advantage of consulting random samples with deliberation in depth in confidential surveys so that the opinion changes can be evaluated at the individual level, free of social pressures for consensus. Is this practical in this context? A DP was conducted in Tamale, Ghana on issues of water, sanitation, hygiene and food security. Criteria for success for DPs that have been applied in highly developed countries are discussed and then applied in Ghana under challenging conditions.

Introduction:In Northern Ghana, a combination of torrential rains coupled with the spilling of the Bagre dam in neighboring Burkina Faso in the past few years has resulted in perennial flooding of communities. This has often led to the National Disaster Management Organization (NADMAO) the main disaster responder agency in Ghana, being called upon to act. However affected communities have never had the opportunity to evaluate the activities of the agency. The aim of this study is therefore to assess the performance of the main responder agency by affected community members to improve on future disaster management.Methods:A mixed qualitative design employing a modified form of the community score card methodology and focus group discussions was conducted in the 4 most affected communities during the last floods of 2012 in the Kasena-Nankana West district of the Upper East Region of Northern Ghana. Community members comprising of chiefs, elders, assembly members, women groups, physically challenged persons, farmers, traders and youth groups formed a group in each of the four communities. Generation and scoring of evaluative indicators was subsequently performed by each group through the facilitation of trained research assistants. Four Focus group discussions (FGDs) were also conducted with the group members in each community to get an in-depth understanding of how the responder agency performed in handling disasters.Results:A total of four community score cards and four focus group discussions were conducted involving 48 community representatives. All four communities identified NADMO as the main responder agency during the last disaster. Indicators such as education/awareness, selection process of beneficiaries, networking/collaboration, timing, quantity of relief items, appropriateness, mode of distribution of relief items, investigation and overall performance of NADMO were generated and scored. The timing of response, quantity and appropriateness of relief items were evaluated as being poor whereas the overall performance of the responder agency was above average.Conclusion:NADMO was identified as the main responder agency during the last disasters with community members identifying education/awareness, selection process of beneficiaries, networking/collaboration, timing of response, quantity of relief items, appropriateness of relief items, mode of distribution of relief items, investigation and overall performance as the main evaluative indicators. The overall performance of NADMO was rated to be satisfactory.Key words:Kasena-Nankana West district, NADMO, community score card, Rural Northern Ghana