To enhance the capacity for early and effective management of genital tract infections at primary and secondary levels of the healthcare system, we developed a prediction model, validated internally to help predict individual risk of self-reported genital tract infections (sGTIs) at the community level in Ghana. The study involved 32973 men and women aged 15–49 years from three rounds of the Ghana Demographic Health Survey, from 2003 to 2014. The outcomes were sGTIs. We applied the least absolute shrinkage and selection operator (LASSO) penalized regression with a 10-fold cross-validation model to 11 predictors based on prior review of the literature. The bootstrapping technique was also employed as a sensitivity analysis to produce a robust model. We further employed discriminant and calibration analyses to evaluate the performance of the model. Statistical significance was set at P-value <0.05. The mean±standard deviation age was 29.1±9.7 years with female preponderance (60.7%). The prevalence of sGTIs within the period was 11.2% (95% CI = 4.5–17.8) and it ranged from 5.4% (95% CI = 4.8–5.86) in 2003 to 17.5% (95% CI = 16.4–18.7) in 2014. The LASSO regression model retained all 11 predictors. The model’s ability to discriminate between those with sGTIs and those without sGTIs was approximately 73.50% (95% CI = 72.50–74.26) from the area under the curve with bootstrapping technique. There was no evidence of miscalibration from the calibration belt plot with bootstrapping (test statistic = 17.30; P-value = 0.060). The model performance was judged to be good and acceptable. In the absence of clinical measurement, this prediction tool can be used to identify individuals aged 15–49 years with a high risk of sGTIs at the community level in Ghana. Frontline healthcare staff can use this tool for screening and early detection. We, therefore, propose external validation of the model to confirm its generalizability and reliability in different population.

This study extends debates on implications of informal welfare for population health and well-being. It examines whether cultural and ideational precepts such as social capital, affect enrolment in National Health Insurance Scheme (NHIS) among people living with chronic disease(s) in Ghana. It also explores how NHIS enrolment explains the association between social capital and health-related quality of life (HRQoL) using empirical data from five regions in Ghana. Results indicate that bonding social capital was associated with HRQoL. Bridging and linking social capital were positively and negatively associated with enrolment in NHIS, respectively. Enrolment in the NHIS explained the relationships of trust in neighbours, bridging and linking social capital with HRQoL. Thus, while social capital can improve HRQoL of people living with chronic disease(s), it does so by, among others, influencing their participation in formal health protective services. Culturally driven informal welfare resources are critical to making formal programmes meaningful to people.

This paper discusses competing visions of the decolonization of Ghana’s economy during the first decade of the country’s independence from Britain (1957–1966), and the agency and horizon of choice available to the Ghanaian decision-makers in charge of implementing these visions. It focuses on Ghana’s construction industry, both as an important part of the national economy and as a condition for Ghana’s broader social and economic development in the context of colonial-era path-dependencies and Cold War competition. By taking the vantage point of mid-level administrators and professionals, the paper shows how they negotiated British and Soviet technological offers of construction materials, machinery, and design. In response to Soviet claims about the adaptability of their construction resources to Ghana’s local conditions, the practice of adaptation became for Ghanaian architects and administrators an opportunity to reflect on the needs, means, and objectives of Ghana’s construction industry, and on broader visions of Ghana’s economic and social development. Beyond the specific focus on the construction industry, this paper conceptualizes the centrality of adaptation in enforcing technological hegemony during the period of decolonization, and discusses African agency beyond the registers of extraction and resistance that have dominated scholarship on the global Cold War.

This article provides the first systematic account of relativization in Likpakpaln, an understudied Mabia (Gur) language of Ghana. Broadly speaking, Likpakpaln features two types of relative clauses: restrictive and non-restrictive. Both types of relative clauses are finite and marked by a relative pronoun as well as a clausal definite determiner. The first type is always headed by an indefinite noun. The second is invariably headed by a definite head noun, is additionally marked by a prosodic break, and is usually under focus. The relative pronoun is a composite form comprised of a noun class agreement marker and an invariant relative marker. A number of the features of relative clauses in Likpakpaln align it with other Mabia languages of the region, whereas others distinguish it from these languages. This analysis situates Likpakpaln within its genealogical and areal context while providing new typological perspectives on the Mabia languages as a whole.

Iron (Fe) deficiency anaemia is a public health concern among adolescent girls worldwide. Food-to-food fortification may be a sustainable and effective solution to Fe deficiency anaemia. However, the effect of food-to-food fortification on Fe deficiency anaemia reduction is understudied particularly in Ghana. This study seeks to investigate the efficacy of baobab pulp-fortified pearl millet beverage powder in improving the Fe and anaemia status of adolescent girls in Ghana. A three-arm cluster randomised controlled trial design, which will involve 258 anaemic adolescent girls (86/arm) selected through multi-stage cluster sampling in Kumbungu District of Ghana, will be used. Participants in arm 1 will receive 350 ml of baobab pulp-fortified pearl millet beverage, containing 13 mgFe (96 % of average RDA), 18·8 mg vitamin C (30·4 % of average RDA) and 222·1 mg citric acid, while participants in arm 2 will receive similar volume of unfortified pearl millet beverage, once a day, five times a week, for six months. Participants in arm 3 will receive the routine weekly Fe (60 mg)-folate (400 μg) supplementation for six months. Serum ferritin, C-reactive protein and haemoglobin (Hb) of participants will be assessed at baseline and end-line. The primary outcomes will be serum ferritin and Hb concentrations. Secondary outcomes will be prevalence of Fe deficiency, Fe deficiency anaemia and BMI-for-age. One-way ANOVA and paired t test will be used to compare means of serum ferritin and Hb levels among and within groups, respectively. This study will provide novel concrete evidence on the efficacy of pearl millet-baobab pulp beverage powder in improving Fe and anaemia status of adolescent girls.

Estimating value of statistical life (VSL) is an important input to many benefit-cost analysis (BCA) approaches, but for many low- and middle-income countries, there are limited or no data estimating VSL. Current guidance relies on extrapolation of results from high-income settings, which may be unreliable, leading to low confidence applying VSL. During 2019, we surveyed 1,820 low-income individuals (average consumption per capita USD329) across four diverse regions in Ghana and Kenya, to inform recommendations about effective spending in the development sector. We elicited VSL using a stated-preference approach, capturing the willingness-to-pay to reduce the risk of death for themselves and their children. Additionally, we conducted multiple “policy choice experiments” (PCEs) in which we asked respondents to choose, from the perspective of a decision-maker, between programs that save lives of different ages, and save lives and provide cash transfers. VSL estimates for this population fell in the range of USD66,795–USD90,453 (PPP-adjusted). We found similar results in the PCE but uncovered much stronger preferences for saving younger lives. Overall, our results suggest that VSL in low-income countries may be higher than estimates based on extrapolations from wealthy countries and that within these communities, policymakers should place more weight on saving the lives of young children. We also explore methodological learnings about how to apply and collect data for BCA in particularly low-income, low-education settings. We find that through careful training and gatekeeping, it is feasible to elicit complicated preferences in this population, and both approaches have their benefits and drawbacks.

Much of West Africa (and particularly the Sahel) may be once falling again under military government. This essay asks what, if anything, historians of Africa can contribute to an understanding of this phenomenon. I argue that writing the history and understanding the memory of military government will entail a renewed approach to political history and social theory. It will also entail confronting — just as so many citizens are currently doing — the peculiar failures of democracy in Africa's neoliberal era.

The central role of Gold Coast societies, ports, and cities in the emerging Atlantic circuit is critical to understanding the history of the Atlantic world. The study of the causes and effects of Gold Coast societies’ transition from African polities and economies to transatlantic entrepots and trading emporiums and their subsequent impact on the Americas has been the hallmark of Ray Kea's scholarship. Since the beginning of his career, Kea has been a significant contributor to the study of the African Atlantic, and the field's various debates and disciplinary evolutions. While many scholars of the Gold Coast recognize Kea's work as foundational to scholarship on the Gold Coast, engagement with his work has not been rigorous. Kea is often cited in bibliographies and aspects of his work have served as benchmarks for other forays into Gold Coast histories. However, there is a need to go beyond an appreciation for Kea as a trailblazer, passing reference of his scholarship, and bibliographic citation of his work to a more thorough and consistent discourse with his major ideas and propositions. Kea has been, for example, adept at integrating innovations and ideas in various disciplinary arenas. He dexterously applies Marxist and postmodernist theories, diverse historiographies of the Atlantic world, and conceptual tools to traditional archival and oral historical data in his analyses of Gold Coast and diasporic societies. This review essay argues for Kea's importance and the need for a deeper engagement with his work in the field by putting his work into conversation with both classic Atlantic historiographies and recent scholarship that has built off Kea's.

The advent of smart and digital cities is bringing data to the forefront as a critical resource for addressing the multifaceted transitions faced by African cities from rapid urbanization to the climate crisis. However, this commentary highlights the formidable considerations that must be addressed to realize the potential of data-driven urban planning and management. We argue that data should be viewed as a tool, not a panacea, drawing from our experience in modeling and mapping the accessibility of transport systems in Accra and Kumasi, Ghana. We identify five key considerations, including data choice, imperfections, resource intensity, validation, and data market dynamics, and propose three actionable points for progress: local data sharing, centralized repositories, and capacity-building. While our focus is on Kumasi and Accra, the considerations discussed are relevant to cities across the African continent.

There are sex-dependent differences in hematological and biochemical variables in adulthood attributed to the predominant effects of testosterone in males and estrogen in females. The Twin Testosterone Transfer (TTT) hypothesis proposes that opposite-sex females may develop male-typical traits due to exposure to relatively higher levels of prenatal testosterone than same-sex females. Additionally, prenatal testosterone exposure has been suggested as a correlate of current circulating testosterone levels. Consequently, opposite-sex females might exhibit male-typical patterns in their hematological and biochemical variables. Despite this hypothesis, routine laboratory investigations assign the same reference range to all females. Our cross-sectional study, conducted in Tamale from January to September 2022, included 40 twins, comprising 10 opposite-sex (OS) males (25%), 10 OS females (25%), and 20 same-sex (SS) females (50%), all aged between 18 and 27 years. Fasting venous blood samples were collected and analyzed using automated hematology and biochemistry laboratory analyzers. Results indicated that levels of hemoglobin, serum creatinine, gamma-glutamyl transferase, total protein, globulins, and total testosterone were significantly higher in OS males than OS females. Conversely, total cholesterol and low-density lipoprotein cholesterol were significantly higher in OS females than OS males. Unexpectedly, levels of low-density lipoprotein cholesterol and total testosterone were significantly higher in SS females than OS females. Contrary to expectations, opposite-sex females did not exhibit male-typical patterns in their hematological and biochemical variables. This suggests that the TTT effect may not occur or may not be strong enough to markedly affect hematological and biochemical variables in OS females.