No abstract

Globally, nearly 37 million people are living with HIV with about 70 percent of these living in Sub-Saharan Africa (SSA). Stigma and discrimination remain one of the major barriers to preventing new infections in the country. However, misconceptions about HIV/AIDS have been indicated as one of the key drivers of the disease. Efforts to prevent new infections have not been entirely successful. Therefore, this study aims to examine the trends and distribution in comprehensive knowledge of HIV and AIDS and determine the factors associated with comprehensive awareness of HIV and AIDS among adult women and men. The study relies on data from three rounds of Ghana Demographic & Health Surveys conducted in 2003, 2008 and 2014 to show trends. Logistic regression was used for multivariate analysis. The thematic mapping of HI/AIDS comprehensive knowledge was conducted using ArcGIS version 10.4 using GPS coordinates in the 2014 GDHS which contained aggregated individual characteristics and HIV knowledge scores.While comprehensive HIV and AIDS knowledge is above 50% among adult population in Ghana, the results show a significant decrease in comprehensive knowledge from 72% in 2008 to 59% in 2013. The strongest predictors for having comprehensive knowledge were found to be education; gender, marital status, locality, occupation and wealth status. The paper demonstrates that preventive activities leading to improvement in the comprehensive knowledge of HIV and AIDS in Ghana is needed. Sound knowledge about HIV and AIDS is critical for the adoption of behaviours that reduce the risk of HIV transmission. Education on HIV prevention must be expanded to improve the comprehensive knowledge of the disease.

Childhood vaccination has been promoted as a global intervention aimed at improving child survival and health, through the reduction of vaccine preventable deaths. However, there exist significant inequalities in achieving universal coverage of child vaccination among and within countries. In this paper, we examine rural-urban inequalities in child immunizations in Ghana. Using data from the recent two waves of the Ghana Demographic and Health Survey, we examine the probability that a child between 12 and 59 months receives the required vaccinations and proceed to decompose the sources of inequalities in the probability of full immunization between rural and urban areas. We find significant child-specific, maternal and household characteristics on a child’s immunization status. The results show that children in rural areas are more likely to complete the required vaccinations. The direction and sources of inequalities in child immunizations have changed between the two survey waves. We find a pro-urban advantage in 2008 arising from differences in observed characteristics whilst a pro-rural advantage emerges in 2014 dominated by the differences in coefficients. Health system development and campaign efforts have focused on rural areas. There is a need to also specifically target vulnerable children in urban areas, to maintain focus on women empowerment and pay attention to children from high socio-economic households in less favourable economic times.

Purpose The purpose of this paper is to assess the trends of socioeconomic-related inequalities in maternal healthcare utilization in Ghana between 2003 and 2014 and examine the causes of inequalities in maternal healthcare utilization in Ghana. Design/methodology/approach Data are drawn from three rounds of the Ghana Demographic and Health Survey collected in 2003, 2008 and 2014, respectively. The authors employ two alternative measures of socioeconomic inequalities in health – the Wagstaff and Erreygers indices – to examine the trends of socioeconomic inequalities in maternal healthcare utilization. The authors proceed to decompose the causes of inequalities in maternal healthcare by applying a recently developed generalized decomposition technique based on recentered influence function regressions. Findings The study finds substantial pro-rich inequalities in maternal healthcare utilization in Ghana. The degree of inequalities has been decreasing since 2003. The elimination of user fees for maternal healthcare has contributed to achieving equity and inclusion in utilization. The decomposition analysis reveals significant contributions of individual, household and locational characteristics to inequalities in maternal healthcare. The authors find that educational attainment, urban residence and challenges with physical access to healthcare facilities increase the socioeconomic gap in maternal healthcare utilization. Originality/value There is a need to target vulnerable women who are unlikely to utilize maternal healthcare services. In addition to the elimination of user fees, there is a need to reduce inequalities in the distribution and quality of maternal health services to achieve universal coverage in Ghana.

No abstract