Viral hepatitis in young adults in Accra, Ghana, is associated with Australia antigen (H.A.A.). Sera from 85 patients in hospital with viral hepatitis were available for determinations of H.A.A. Of the 16 patients whose serum was obtained within the first week of symptoms, 15 were positive. The only factor related to finding H.A.A. was the time between onset of symptoms and the collection of the serum sample. Persistence of H.A.A. was associated with persistence of jaundice in men but not in women. Previous epidemiological studies in Accra found no evidence for parenteral transmission of viral hepatitis and showed a shanty-town predilection pointing to faecal-oral transmission. It thus seems that H.A.A.-associated hepatitis is transmitted in West Africa either faecal-orally or by shanty-town associated arthropods. The finding that H.A.A. hepatitis is the usual hepatitis in young adults in Accra is in accord with the high prevalence of H.A.A. elsewhere in the general population in Africa and may be related to the high rate of cirrhosis and hepatoma in Africa.
Slums are home to a large fraction of urban residents in cities of developing nations, but little attempt has been made to go beyond a simple slum/non-slum dichotomy, nor to identify slums more quantitatively than through local reputation. We use census data from Accra, Ghana, to create an index that applies the UN-Habitat criteria for a place to be a slum. We use this index to identify neighborhoods on a continuum of slum characteristics and on that basis are able to locate the worst slums in Accra. These do include the areas with a local reputation for being slums, lending qualitative validation to the index. We show that slums also have footprints that can be identified from data classified from satellite imagery. However, variability among slums in Accra is also associated with some variability in the land cover characteristics of slums.
As cities of developing nations absorb an increasing fraction of the world’s population increase, questions have arisen about the potential for emerging inequalities in health within places that are already suffering from inadequate infrastructure. In this paper we explore the pattern of child mortality inequalities (as a proxy for overall health levels) within a large sub-Saharan African city—Accra, Ghana—and then we examine the extent to which existing residential patterns by ethnicity may be predictive of any observed intra-urban inequalities in child mortality. We find that the spatial variability in child mortality in Accra is especially associated with the pattern of residential separation of the Ga from other ethnic groups, with the Ga having higher levels of mortality than other ethnic groups. Being of Ga ethnicity exposes a woman and her children to characteristics of the places in Accra where the Ga live, in which one-room dwellings and poor infrastructure predominate. At the individual level, we find that regardless of where a woman lives, if she is of Ga ethnicity and/or is non-Christian, and if she is not married, her risks of having lost a child are elevated.
It has long been recognized that as societies modernize, they experience significant changes in their patterns of health and disease. Despite rapid modernization across the globe, there are relatively few detailed case studies of changes in health and disease within specific countries especially for sub-Saharan African countries. This paper presents evidence to illustrate the nature and speed of the epidemiological transition in Accra, Ghana’s capital city. As the most urbanized and modernized Ghanaian city, and as the national center of multidisciplinary research since becoming state capital in 1877, Accra constitutes an important case study for understanding the epidemiological transition in African cities. We review multidisciplinary research on culture, development, health, and disease in Accra since the late nineteenth century, as well as relevant work on Ghana’s socio-economic and demographic changes and burden of chronic disease. Our review indicates that the epidemiological transition in Accra reflects a protracted polarized model. A “protracted” double burden of infectious and chronic disease constitutes major causes of morbidity and mortality. This double burden is polarized across social class. While wealthy communities experience higher risk of chronic diseases...
Slums are examples of localized communities within third world urban systems representing a range of vulnerabilities and adaptive capacities. This study examines vulnerability in relation to flooding, environmental degradation, social-status, demographics, and health in the slums of Accra, Ghana by utilizing a place-based approach informed by fieldwork, remote sensing, census data, and geographically weighted regression. The study objectives are threefold: (1) to move slums from a dichotomous into a continuous classification and examine the spatial patterns of the gradient, (2) develop measures of vulnerability for a developing world city and model the relationship between slums and vulnerability, and (3) to assess if the most vulnerable individuals live in the worst slums. A previously developed slum index is utilized, and four new measures of vulnerability are developed through principle components analysis, including a novel component of health vulnerability based on child mortality. Visualizations of the vulnerability measures assess spatial patterns of vulnerability in Accra. Ordinary least squares, spatial, and geographically weighted regression model the ability of the slum index to predict the four vulnerability measures. The slum index performs well for three of the four vulnerability measures...
The overall objective of our research project is to understand the spatial inequality in health in Accra, the capital city of Ghana. We also utilize GIS technology to measure the association of adverse health and mortality outcomes with neighborhood ecology. We approached this in variety of ways, including multivariate analysis of imagery classification and census data. A key element in the research has been to obtain in-person interviews from 3,200 female respondents in the city, and then relate health data obtained from the women to the ecology of the neighborhoods in which they live. Detailed maps are a requirement for these field-based activities. However, commercially available street maps of Accra tend to be highly generalized and not very useful for the kind of health and social science research being undertaken by this project, The purpose of this paper is to describe street maps that were created for the project’s office in downtown Accra and used to locate households of respondents. They incorporate satellite imagery with other geographic layers to provide the most important visual interpretation of the linkage between imagery and neighborhoods. Ultimately, through a detailed analysis of spatial disparities in health in Accra...
The neighborhood has been used as a sampling unit for exploring variations in health outcomes. In a variety of studies census tracts or ZIP codes have been used as proxies for neighborhoods because the boundaries are pre-defined units for which other data are readily available. However these spatial units can be arbitrary and do not account for social-cultural behaviors and identities that are significant to residents. In this study for the city of Accra, Ghana, our goal was to create a neighborhood map that represented the boundaries generally agreed upon by the residents of the city using the smallest available census unit, the enumeration area (EA), as the base unit. This neighborhood map was then used as the basis for mapping spatial variations in health within the city. The first step in demarcating the boundaries was to identify features that limit a person’s movement including the major roads, drainage features, and railroad tracks that people use to partially define their neighborhood boundaries. Once an initial set of boundaries were established, they were iteratively modified by walking the neighborhoods, talking to residents, public officials, and others. The resulting neighborhood map consolidated 1,723 EAs into 108 neighborhoods covering the entire Accra metropolitan area. Results indicated that the team achieved 71 percent accuracy in mapping neighborhoods when the neighborhood keyed to the survey EA was compared with the response given by the interviewees in the 2008–2009 Women’s Health Survey of Accra when asked which neighborhood they lived in.
Rapid population growth in developing cities often outpaces improvements to drinking water supplies, and sub-Saharan Africa as a region has the highest percentage of urban population without piped water access, a figure that continues to grow. Accra, Ghana, implements a rationing system to distribute limited piped water resources within the city, and privately-vended sachet water–sealed single-use plastic sleeves–has filled an important gap in urban drinking water security. This study utilizes household survey data from 2,814 Ghanaian women to analyze the sociodemographic characteristics of those who resort to sachet water as their primary drinking water source. In multilevel analysis, sachet use is statistically significantly associated with lower overall self-reported health, younger age, and living in a lower-class enumeration area. Sachet use is marginally associated with more days of neighborhood water rationing, and significantly associated with the proportion of vegetated land cover. Cross-level interactions between rationing and proxies for poverty are not associated with sachet consumption after adjusting for individual-level sociodemographic, socioeconomic, health, and environmental factors. These findings are generally consistent with two other recent analyses of sachet water in Accra and may indicate a recent transition of sachet consumption from higher to lower socioeconomic classes. Overall...
West Africa has a rapidly growing population, an increasing fraction of which lives in urban informal settlements characterized by inadequate infrastructure and relatively high health risks. Little is known, however, about the spatial or health characteristics of cities in this region or about the spatial inequalities in health within them. In this article we show how we have been creating a data-rich field laboratory in Accra, Ghana, to connect the dots between health, poverty, and place in a large city in West Africa. Our overarching goal is to test the hypothesis that satellite imagery, in combination with census and limited survey data, such as that found in demographic and health surveys (DHSs), can provide clues to the spatial distribution of health inequalities in cities where fewer data exist than those we have collected for Accra. To this end, we have created the first digital boundary file of the city, obtained high spatial resolution satellite imagery for two dates, collected data from a longitudinal panel of 3,200 women spatially distributed throughout Accra, and obtained microlevel data from the census. We have also acquired water, sewerage, and elevation layers and then coupled all of these data with extensive field research on the neighborhood structure of Accra. We show that the proportional abundance of vegetation in a neighborhood serves as a key indicator of local levels of health and well-being and that local perceptions of health risk are not always consistent with objective measures.
A recent study of house price behavior
in U.S. cities by Gyourko, Mayer, and Sinai (2006) raises
questions about so-called superstar cities in which housing
is so inelastically supplied that it becomes unaffordable,
as higher-income families outbid residents. We consider the
case of Accra, Ghana, in this light, estimating the
elasticity of housing supply and discussing the implications
for growth and income distribution. There is not a great
deal of data available to examine trends in Accra, so our
method is indirect. First, we use a variant of the
traditional monocentric city model to calculate the
elasticity of Accra's housing supply relative to those
of other similarly-sized African cities. This suggests that
housing supply responsiveness is much higher elsewhere.
This muted supply responsiveness is consistent with the
observed higher housing prices. Second, we estimate a
number of traditional housing demand equations and reduced
form equations. Placing a number of restrictions on the
equations allows us to infer Accra's housing supply
elasticity. Taken together...
Ghana has been one of the most rapidly growing economies in sub-Saharan Africa. This growth has been aided by Ghana's improving policy environment. In light of this, the paper addresses the question of why, given its higher level of per capita income and relatively strong growth, the housing conditions of the poor in Accra are considerably worse than those in a number of other African cities with lower incomes. There are not many data available to answer this question, so the method is indirect and takes two approaches. First, a variant of the monocentric city model is used to calculate Accra's housing supply elasticity relative to those of other similarly sized African cities. The model suggests that housing supply responsiveness is considerably lower in Accra, a result consistent with the observed higher housing costs. Secondly, a number of traditional housing demand and reduced-form equations are estimated for Accra and the other cities. This allows the formation of a quantitative judgment about Accra's housing supply elasticity. Taken together, the two approaches indicate that lower-income families in Accra have such poor housing conditions because the market is extremely unresponsive to demand. The welfare costs of current housing and land policies are considerable. The results suggest that making Accra's real estate market more responsive would go a long way towards improving the effectiveness of the broader policy environment. It would also no doubt improve the housing conditions of the poor and help to reduce the city's expanding footprint.
This document reports on the findings
from the first Consultative Citizens' Report Card
exercise undertaken in the City of Accra, Ghana. The work
began in late 2009 and continues in 2010 with the
dissemination of the findings to, and consultations with,
City residents. The Citizens' Report Card was
undertaken by the World Bank with the full support and
engagement of the Mayor's office, Accra Metropolitan
Authority, Ghana. The Citizens' Report Card involved a
large-scale household survey which was designed to be
statistically representative to the sub-metropolitan level.
It incorporated Geographic Information Systems (GIS) and
Google mapping which significantly aided fielding of the
survey and which helps give a spatial dimension to the
findings. The survey gathered information from City
residents about the coverage and quality of seven core urban
services, and also gathered perception-based information on
residents' views of the efficiency and effectiveness of
City officials, on the accessibility and effectiveness of
local political representatives...
Over the last decade, and particularly the last five years, state officials in Ghana’s capital city, Accra, have intensified their resolve to ‘modernize’ the city and make it a competitive destination for global investments. In the same period, exercises by city authorities to remove or at least suppress practices of ordinary residents in the informal sector have become more frequent and intensified. Groups such as street hawkers, market women, and slum dwellers have become the main target of periodic ‘decongestion exercises’. In this dissertation I investigate how the policies and practices associated with the ‘globalizing’ and ‘modernizing’ ambition of the state intersect with the interests of the majority of urban residents whose everyday social and economic practices are concentrated in the informal sector, a sector deemed to be deleterious to the desired image for the city. I argue that contemporary city-making in Ghana is driven mainly by a combination of economic, nationalist and individual interests. In examining how cultural and social locations such as gender and ethnicity mediate the relationship between the state and residents, I demonstrate how contemporary forms of neoliberal urban governance shape, and are being shaped by...
Justice, Jonathan B.; The convergence of mobile telephony, banking services, and information systems creates significant economic opportunities on a global scale. While the adoption of mobile banking and mobile money emerged on the global scene as a tool to promote financial inclusion, new developments in the industry have created additional possibilities for this type of technology to revolutionize the practices and experiences of business owners in the Third World. This paper calls attention to the different ways in which mobile banking services and mobile payment systems are able to create value for their consumers. An empirical case study is developed using the Accra Metropolitan Assembly (City of Accra) that details the experiences of MTN Mobile Money users.; University of Delaware, Department of Urban Affairs and Public Policy; M.A.
The United Nation's World Summit on the Information Society (WSIS), that took place
between 2003 and 2005, elevated the 'information society' to the level of 'gender equality'
'environmental sustainability' and 'human rights' as one of the central Development tropes
of our time. The concept of the network has come to figure heavily in the political
discourse of both developed and developing nations and transnational agencies. These
organizations employ statistics, academic theories, popular wisdom, and utopian visions
shaped by Western experiences to extrapolate an expected impact of new technologies on
the developing world. However, to date there has been very little on-the-ground research
on the diffusion and appropriation of these technologies as it is taking place in developing
nations and how this might challenge and reorient the expectations of traditional
This thesis seeks to provide such a response drawing on the experiences of Internet café
users in Accra, the capital city of Ghana where an estimated 500 to 1000 of these small
businesses were in operation. Departing from the categories and hierarchies favoured
within Development circles, my approach is to look holistically at the way the Internet
was produced as a meaningful and useful tool through the practices of users. The
practices that defined the Internet in Accra encompassed not only individual activities at
the computer interface...
Accra has a population of about 2.3 million and is supplied with water from both the Kpong and Weija Water Works. Water from the Weija treatment plant is taken from the Weija Reservoir which is fed by Rivers in the Densu River Basin (DRB) that flow into the Reservoir at Weija. With increasing annual population growth of Accra at 4.4% and inadequate water supply to it, this study has examined the hydrological data available on the Weija Reservoir from 1980 to 2007 in an attempt to estimate runoff into the Reservoir with the view of determining whether water is available to meet its present and future demands. Results show that even though water abstraction from the Reservoir has increased almost four times since 1980, to more than 67 million m3/year in 2007, and a maximum runoff of 7.97 ± 0.21 × 10-2 km3/year was estimated in 2005, this value is less than the true runoff into the Reservoir. It was also observed that potential evapotranspiration has increased by 0.14% while precipitation has decreased by 0.93% in the DRB, indicating that runoff from the Basin into the Reservoir is probably decreasing, albeit slowly. Additionally, fishing and waste disposal methods are poor; land use practices and other anthropogenic activities in the DRB pose a threat to the sustainability of the Reservoir. Serious educational programmes and enforcement measures need to be urgently adopted to safeguard continuous water flow into the Reservoir. Proper hydrological data collection and data management practices are recommended for the Reservoir and Densu River Basin if detailed planning of the water resources of the Reservoir are to be achieved.
The essay provides a brief summary of the main argument of the Accra Document drafted by the World Alliance of Reformed Churches and entitled Covenanting for Justice in the Economy and the Earth. The focus is on discovering and describing the internal structure, the logic and focus, and thereby some of the most important implicit and explicit theological and ecclesiological convictions, suppositions and claims of the document, as far as possible in its own terminology. It then offers a tentative theological assessment, pointing out four very typical Reformed characteristics of the document, including its typical confessional nature and style. It finally suggests some ecclesiological implications arising from the document, again calling to mind four very specific characteristics of Reformed ecclesiology. On the whole, the essay serves as an invitation to further study, discussion and reflection on the challenges and calling implied in the document.
This article places the Accra Confession, accepted at the 24th General Assembly of the World Alliance of Reformed Churches (WARC) (2004), within the historical context of the WARCs struggle for economic justice in the face of globalisation. It moves beyond addressing such issues merely as ethical issues to rather viewing them as confessional issues of faith. It highlights the difficulties of the WARC to reach consensus on issues concerning economic justice. It also shows how the WARC has taken the lead in the ecumenical movement by engaging a broad spectrum of people - professionals and non-professionals, from the North and the South, rich and poor - to ensure that such a confession is a true reflection of the experiences of people at grass-roots level and that it speaks from the heart. The Accra Confession challenges Christians to take a faith stance on economic injustice.
This article provides a critical evaluation of the Accra Confession (WARC 2004). The misery in various regions of the southern hemisphere poses an extreme ethical challenge for the Christian faith; the outcry for justice should not be left unheeded. It is necessary that the causes of this misery should be clearly described before viable strategies for overcoming it can be developed. The Accra Confession seems to be rather one-dimensional in its evaluation of reality. The ethical charge implied by the term 'confession' is of little use when dealing with complex global fields of action that only rarely allow a simple equation of cause and reaction. It is not so much a 'confession' (or Bekenntnis) that is needed but rather a renewed discussion among all concerned on the best ways to achieve more justice.
Fonte: Studia Historiae EcclesiasticaePublicador: Studia Historiae Ecclesiasticae
Tipo: Artigo de Revista CientíficaFormato: text/html
Publicado em 01/05/2013EN
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In their quest for justice grounded in the Confession of Accra and, of course, the Confession of Belhar, Reformed churches worldwide - and in South Africa, in particular - will be faced with a set of unavoidable questions. The purpose of this article is to examine/consider some of the unavoidable/inevitable questions that arise among those seeking justice for all, but particularly for those who have been adversely affected by neoliberal capitalism, namely poor people - and the very earth itself. First, can the Confession of Accra be regarded as something that "fell from heaven", or is a proper historical perspective necessary to undertand something of the journey traversed by the World Alliance of Reformed Churches (WARC)? Second, does it matter whether Accra is regarded as a declaration or a confession? Third, what justice is Accra talking about? What justice was the Kairos Document of South African Christians talking about in the mid-1980s under apartheid? Fourth, are unity and justice like twin sisters, or can they be separated; is there a connection between the two? Fifth, is the search for justice based on Accra sustainable without the search for an ongoing praxis? These questions are presented as unavoidable in the quest for justice and they also highlight the very complex nature of the quest for justice.