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Contemporary social problems in Ghana

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research topics on social issues in ghana

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  • Contemporary social problems in Ghana / Steve Tonah
  • Over fifty years of higher education in Ghana : what has happened to equity? / Agnes A. Apusigah
  • Earth shrines : prison or sanctuary? : Ghanaian "witch camps" and the dawn of the rights of culture / Jon P. Kirby
  • Making peace in northern Ghana : the role of non-governmental organizations and traditional authorities / Artur Bogner
  • Ghana at fifty : reflections on the evolution and development of culture of human rights in Ghana / Chris Dadzie
  • The challenge of ageing in rural and urban Ghana / Steve Tonah
  • Widowhood rites in Ghana : a study among the Nchumuru, Kasena and the Ga / Joana Brukum, Alice Pwamang and Steve Tonah
  • Changing trends in Ghanaian funeral celebrations : a case study of the Ga Mashi Traditional Area, Accra / Juliana Naa-Dedei Attoh
  • Street hawkers and the management of urban space in central Accra / Dzifa Akpalu
  • Chieftaincy conflicts in northern Ghana : a challenge to national stability / Alhassan S. Anamzoya
  • The legal versus the domestic treatment of child sexual defilement in Ghana / Kodjovi Akpabli-Honu
  • Indigenous farmers versus migrant Fulani herdsmen in central Ghana / Abdulai Abubakari and Steve Tonah.

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  • Published: 27 April 2023

Health and social needs of older adults in slum communities in Ghana: a phenomenological approach used in 2021

  • Priscilla Yeye Adumoah Attafuah 1 , 2 ,
  • Irma HJ Everink 2 ,
  • Christa Lohrmann 3 ,
  • Aaron Abuosi 4 &
  • Jos MGA Schols 2 , 5  

Archives of Public Health volume  81 , Article number:  74 ( 2023 ) Cite this article

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Slum-dwellers lack several essential amenities (such as water, sanitation, and electricity) which make them more vulnerable than non-slum dwellers. As there is limited to no access to health and social care services in slums, the slum environment is expected to be an even more dangerous environment for older adults, negatively impacting their quality of life (QoL). To provide an overview of the perceived (unmet) health and social care needs and how it affects the QoL, this study aims to explore the self-perceived health and social needs of older adults in urban slums in Ghana. Using a phenomenological approach, 25 semi-structured interviews were conducted between May and June 2021, in the homes of older adults in two slums in Ghana. After coding and analysing the transcripts, five main themes emerged: (a) perception of health; (b) (de)motivators of health service use; (c) perception of social care, (d) social needs, and (e) influence of phenomena on QoL. It appeared that older adults believed that spiritual powers were causing illnesses and influenced their use of formal health services. Other factors such as expired insurance cards and the attitude of healthcare workers served as demotivators for using health services.

Perceived health needs were mainly current disease conditions (arthritis, diabetes, hypertension, vision/hearing challenges), challenges with health insurance, the behaviour of some health professionals, the proximity of health facilities, and unnecessary queues at major health facilities. Unmet social needs identified by this study were a sense of neglect by family (need for companionship), requiring assistance with activities of daily living, and the need for financial support. Participants had more health needs than social needs. Health providers do not usually prioritize the care of slum-dwelling older adults. Most participants still have challenges with the National Health Insurance Scheme (NHIS). Their social needs were mainly related to financial difficulties and help with some activities of daily living. Participants expressed that they desired companionship (especially the widowed or divorced ones) and the lack of it made them feel lonely and neglected. Home visits by health professionals to older adults should be encouraged to monitor their health condition and advocate for family members to keep older adults company. Healthcare providers should exhibit positive attitudes and educate older patients on the advantages of formal health services use, as well as the need to seek early treatment as this will influence their QoL to a large extent.

Peer Review reports

What is known about the topic

Health, participation, and security can ensure a positive QoL among older adults.

Slum-dwellers lack many amenities which makes them vulnerable.

The health and social needs of older adults are numerous.

What this paper adds

The identified health and social needs from the view of the slum-dwelling older adult.

Older adults place much more importance on perceived health-related needs than social needs.

The social needs of older adults in slums in Ghana are few because the family system still exists. Yet the issue of mobility hinders the participation of slum-dwelling older adults in family activities. This creates a feeling of loneliness and neglect.

Health education through religious bodies can help provide insight into some health needs of older adults.

Introduction

Older adults living in developing countries, face various challenges regarding their health and social needs. These challenges are even more profound among older adults living in slum areas in developing countries, because of poor living environments [ 1 , 2 , 3 , 4 ] and humans are influenced by the environment. Rural-urban migration has resulted in the emergence of slums in the large cities of most developing countries like Ghana. When comparing formal settlements with slums, people living in slums lack basic amenities like water, electricity and proper collection and disposal of solid waste. They are also exposed to health risks by noise pollution, poor sanitation, and hygiene, face poor housing conditions, overcrowding and violence [ 4 , 5 , 6 ] and have limited access to health and social care services. The pollution and environmental hazards as well as the uneven road networks in the slums have negative effects on the older adult. As people age, they increasingly need support in various domains, such as mobility, self-care, social participation, and healthcare [ 7 , 8 ]. As the access to health and social care services, including primary care, disease prevention, rehabilitation and health promotion in slums is limited or non-existent, the basic needs of these older adults are often unmet. Indeed, many parts of urban Ghana can also fall into the criteria for the classification of slums because of the level of resources available in Ghana as well as poor planning for putting up structures in most parts of Ghana. For this reason, certain places have more slum characteristics than others. The slum concept for this study is based on the UN-Habitat classification of slums [ 5 ]. This states that any household with one or more of the following is classified as a slum: (1) Lack of access to an improved water source; (2) Lack of access to improved sanitation facilities; (3) Lack of sufficient living area; (4) Lack of housing durability; and (5) Lack of security of tenure. This could highly influence the quality of life (QoL) of these slum-dwellers as they age [ 2 ].

Quality of life (QoL) according to the World Health Organisation Quality of Life Group, [ 9 ] is “an individual’s perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns”. Therefore, in the context of living in slums, this study focused on older adults to explore their perception of their health and social needs as a necessary component of their entire QoL. Studies have suggested that active ageing is a major contributor to the QoL of individuals [ 10 , 11 ].

Active ageing is defined by the World Health Organization (WHO) as “the process of optimizing opportunities for health, participation and security in order to enhance the quality of life as people age” [ 12 ]. In the concept of active ageing, “active” is not limited to physical activity but the ability to continue being involved in the social, cultural, civic, spiritual, and economic affairs of society. The WHO policy framework on Active Ageing (Figure  1 ) outlines three pillars that can ensure a positive QoL among older adults [ 12 ]: health, participation, and security. The first two pillars were used in the conceptualization of this study. The first pillar, health, refers to an individual’s physical, mental, and social well-being and includes access to healthcare services, nutritional needs and a healthy environment. The second pillar, participation, refers to an individual’s involvement in spiritual, social, cultural, and community affairs. The third pillar, security is out of the scope of this study as it cannot be influenced by healthcare professionals.

figure 1

WHO policy framework on Active Ageing

Health as defined by the WHO (1948) is the “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” [ 13 ]. Health needs are associated with the treatment, management or prevention of an injury or disability, disease, illness, and the care of an individual. However, every individual can have his/her perception of what being healthy or unhealthy means. When looking at the first pillar, in this population, health issues can be enormous [ 1 , 14 , 15 , 16 ]. Studies have stated that frequent health problems of older slum-dwellers include depression, physical injuries, malnutrition, chronic diseases, and substance abuse [ 17 , 18 , 19 ]. Furthermore, a study in India revealed that social distancing protocols developed during the COVID-19 pandemic were badly implemented in slums, causing higher COVID-19 rates in slums compared to formal settlements [ 20 ] mainly because of overcrowding.

Even though these older adults suffer from severe health issues, they seem to make limited use of healthcare services [ 21 , 22 ]. Their perception of health could be a likely influence on healthcare patronage [ 14 , 18 , 57 , 63 ]. Additionally, studies show that the poor financial status of slum dwellers, in combination with the lack of healthcare facilities in the proximity could account for this [ 23 , 24 , 25 ]. Uneven walkways and decreased mobility of older adults, also limit access to healthcare services [ 21 , 26 , 27 ]. Still, even though health has a large influence on QoL, little research has been done on the health needs of this group of older slum-dwellers.

When looking at the second pillar, participation, the rationale for this pillar is that social connections are important in the QoL of older adults. The WHO advised to aim at the autonomy and independence of older adults whiles also highlighting that there may be frail, disabled older adults who may need care. In line with this, it appears that the social needs of older people are diverse [ 27 , 28 ]. Social isolation and loneliness among slum-dwelling older adults can result in a reduction in both mental and physical well-being. Social needs include love, acceptance, and relationships with family and friends. In satisfying these social needs, it is necessary to identify what is classified as a social need among older slum-dwellers. This is because mutuality is important to meet this need. For example, the older adult wants to feel a sense of belonging and connectedness to a community or neighbourhood. Staying active by joining family events or participating in social activities is particularly cherished in countries in Africa [ 27 , 28 ] and positively impacts their quality of life [ 27 , 29 ]. In slums in Ghana, recreational centres are rare. Therefore, there are not many options for older slum dwellers to engage in social activities. Also, if older slum-dwellers need social support they mostly rely on family members. However, these may not always be available [ 29 , 30 ]. Unmet social needs may lead to loneliness and social isolation, which may, in turn, cause psychological and physical health problems [ 29 , 31 ]. These two concepts: health and (social) participation are the motivators of this phenomenological study among older adults in the slums.

When looking at what is known about (unmet) health needs and social needs, studies mostly focus on populations with specific conditions such as mental illnesses, joint pains, hypertension, and diabetes [ 32 , 33 , 34 ]. Additionally, studies focus on different settings, such as rural areas [ 35 ], and mostly on populations living in developed countries [ 36 ]. However, in sub-Saharan Africa, specifically Ghana, the health, and social needs of older adults in slums have been rarely explored. The uniqueness of this study is that it is from the perspective of older adults living in urban slums. considering the needs and resources available to older adults in rural areas, their counterparts in urban slums may perceive things differently. For example, health facilities may be available but the finances to patronize them is an issue. One study published by Attafuah et al. [ 37 ] showed that older adults in slums had a moderate psychological, social, and environmental QoL and a poor physical QoL. Previous studies by the authors on the quality of life of older adults in slums revealed that the health and social needs of this population have not been explored in Ghana. To improve the QoL of this population, it is essential to have, more in-depth information on their (unmet) needs in these domains. Therefore, this study aims to describe the health and social care needs of older adults living in slums and explore how they influence their quality of life.

Materials and methods

Study design.

A qualitative exploratory descriptive design was used specifically, Husserl’s transcendental phenomenology. This design was chosen as qualitative studies allowed for in-depth exploration of the experiences of the population under consideration [ 38 ] and this phenomenological approach constantly assesses the influence of the researcher on the inquiry so that biases and preconceptions are neutralized. Leaning on the constructivism theory as we sought to understand the subjective reality of what health and social care are and their influence on the quality of life from the view of older adults in slums.

Study setting

According to Dr Richard Bofah, the country coordinator for SDGs, who gave highlights of the National Development Planning Commission (NDPC), Ghana’s report at a regional dissemination workshop, a population of 8.8 million people live in slums. Of the 23 slums in Ghana; Accra, Tema-Ashaiman, Kumasi, Tamale and Takoradi are listed as the predominant urban areas with slums. This study was performed in two slum communities (i.e., Teshie and Ashaiman) in Ghana: a fishing area and an industrial area respectively in the Greater Accra region. Teshie is a settlement with a dominated population of the Ga tribe while Ashaiman is a mixture of tribes from all over Ghana. Houses in Ashaiman slums are made of containers and wood while those in Teshie usually have mud or cement. Older adults in Teshie will normally live alone in a room but, next door are some family members; however, the same population in Ashaiman living alone have their family in the next town or the rural area. The diversity of these two slums influenced the selection choice as we wanted an overall view of the health and social needs. Figures 2 and 3 show the pictorial image of the study setting.

figure 2

Aerial (A) and street (B) view of Teshie Maami, Ghana (a slum in the Teshie community). Taken in February 2016 and culled from Google images in February 2023

figure 3

Geographic map (A) and aerial view (B) of Ashaiman-Ghana, participants from Zongo Laka, Night Market and Market Area. Images were taken in 2019 and culled from Google maps in February 2023

Participants and recruitment

Older adults were selected based on the following criteria: (1) aged at least 60 years (retirement age in Ghana); (2) lived in one of the two slums for at least 1 year; and (3) gave consent to participate. People who were severely ill, e.g., who had no energy to go through the interview session, were excluded from the study. The first author PYAA asked participants who had previously participated in a study that examined the quality of life of older adults in slums [ 37 ] for this study. Next to this, a snowballing technique was used to recruit the remaining participants. People who participated in the interview were asked if they knew others who were potentially interested in participation. This technique was most appropriate because of the nature of the slum arrangement [ 39 ]. Additionally, it has been widely used in similar settings [ 40 , 41 , 42 ]. If an older adult met the eligibility criteria, the purpose of the study was explained, as well as information on confidentiality. The interview was conducted by the first author who has experience in conducting qualitative interviews. Data collection continued until saturation was reached.

Research Questions.

What is the slum-dwelling older adults’ perception of health and social care?

What are the health and social care needs of slum-dwelling older adults?

How do the health needs of slum-dwelling older adults influence their QoL?

How do the social needs of slum-dwelling older adults influence their QoL?

How do older adults in slums cope with these potentially unmet needs??

Study instrument

A semi-structured open-ended interview guide was used to collect data from each participant. The guide was developed based on the research questions which stemmed from two pillars of the WHO policy framework on Active Ageing and in consultation with the literature on health (care) and social needs [ 34 , 35 , 36 , 43 , 44 ]. After developing the first draft of the guide, two qualitative methods experts reviewed the guide and gave suggestions for improvement whereafter the guide was pilot tested among some older adults in another slum with similar characteristics and adjusted. These suggestions were mainly focused on additional probes for the selected topics. Topics in the interview guide included (a) the current health situation/experiences of participants; (b) their health needs; (c) experiences with healthcare personnel at healthcare facilities; (d) their social needs; (e) their influence on the quality of life in old age; and (f) coping strategies adopted to meet their health and social needs. Questions asked were further probed to get more information about participants’ responses. In addition, the background characteristics of participants were gathered, including information on gender, age, place of residence and religion. The interview guide has been added in Appendix 1 .

Data collection procedure

Data were collected between May and June 2021 in the homes of the participants using face-to-face audio-recorded interviews. The first author, and two trained graduate nurses, fluent in the local languages (Twi and Ga) conducted interviews. The purpose of the study was explained orally and subjects who agreed to participate were given an informed consent form to sign or thumbprint. Interviews were done immediately afterwards, and audio recorded. The interviews lasted between 45 min and 1 h.

Rigour (Trustworthiness)

Analysis was done after the first 3 interviews so that new themes that are seen in the responses can be better probed in subsequent interviews ensuring that emerging themes were better probed in successive interviews. The same interview guide was maintained for all interviews to certify consistency. Detailed field notes were kept which allowed for verification and understanding of responses. Direct verbatim quotes were used to buttress the views of older adults. To ensure confirmability, the audio recording was replayed when reading through transcripts to confirm that the results did not include researcher bias. Additionally, a selected participant who was literate and able to read was contacted with the transcript of her voice recording to ensure what she said had been properly documented. Finally, all recordings, transcriptions, field notes, diaries and literature reviewed were kept on an external drive with the first author at the university only for the audit trail.

Ethical considerations

Ethical clearance was obtained from the Institutional Review Board of 37 Military Hospital (37MH-IRB IPN 199/2018). Also, permission from the municipal assemblies of the data collection sites was obtained. Additionally, information on voluntary participation and the right to withdraw was shared with all participants. Confidentiality and privacy were guaranteed by keeping the data of participants protected and restricted. No third party had access to the data (as specified above); this was to ensure the confidentiality of participants is protected.

Data analysis

Analysis was done using the procedure of reflective thematic content analysis where themes were generated both inductively and deductively [ 45 ]. Based on Colaizzi’s phenomenological approach seven steps were followed during the analysis [ 64 ]: (1) The first author played, listened to the audio recordings, and transcribed them verbatim. The transcripts were read several times to help the author familiarize herself with the data and make meaning of the narrations given; (2) Significant statements were noted and extracted to a separate sheet. (3) meanings were made from the statements by assigning preliminary codes to the data to describe its content. The Atlas Ti 9 software was used to manage the data. Each interview transcript was uploaded into ATLAS Ti 9 software as separate files for coding. PYAA and MI coded transcripts independently by reading individual sentences critically and allocating words or phrases that captured the meanings of the sentences; (4) patterns or themes were searched for in codes across the different interviews. Similar codes were grouped to form subthemes while similar subthemes were regrouped and refined to construct themes. Codes that fit into the two pillars of the framework for Active ageing were grouped; (5) Review of themes was done to be sure it describes appropriately the perceived health and social care needs of the sample population. The field notes served as an additional context for interpretation in making decisions about the codes and themes; To ensure that the data were well represented, a series of meetings were held between (Blinded for review) to build consensus on the agreed themes and subthemes; (6) the complete structure of themes and subthemes was used to produce the report; (7) Finally, validation of the findings was sought from some research participants to compare the researcher’s descriptive results with their experiences. Four main themes and fifteen subthemes emerged from the transcripts (See Table  2 ). The COnsolidated criteria for REporting Qualitative research (COREQ) were used to guide the reporting of this study [ 46 ].

Background characteristics of participants

A total of 22 interviews were conducted whereafter saturation was reached. After these 22, three more interviews were performed to conclude that indeed saturation was reached. Overall, 25 participants were interviewed, and fifteen (60%) of them were females. The ages of participants ranged from 60 to 86 years. These are summarized in Table  1 a. Details are given in Table 1b in the Supplementary file ( Appendix 2 ).

Organization of themes

After analysis of transcripts, four main themes were identified: older adults’ perception of health, (de)motivators of health service use, challenges of older adults, and coping strategies. Overall, eighteen subthemes were generated from the data. The themes and their corresponding subthemes are presented in Table  2 .

Older adults’ perception of health

An individual’s perception of health is an important influence on their QoL. This theme described the views of older adults about what health is, their current health status, and their view on factors that influence it. Participants felt that their health referred to their physical health, disabilities, handicaps, having a sound mind and being at peace with people. They mentioned that the ageing process, and “external powers” influence an individual’s health. Some mentioned their current disease conditions either medically or self-diagnosed. Physical disease/medical conditions, mental well-being, relationships with others and superstition were captured as subthemes. These are described below with supporting quotes from participants.

Physical disease conditions

Participants (15) mostly reported having chronic diseases such as hypertension and diabetes meant they did not have good health and were taking medications for these diseases.

“The only challenge I have now is High blood pressure. The last time I went for a check-up was around February… I buy my drugs from the pharmacy here” TOA3

Mental well-being

Participants stated that if you can reason and think normally like everyone then you are healthy. The mental well-being issues described in their view were mainly influenced by old age: forgetfulness, and excessive thinking about death. The majority (22) of the participants said they easily forget and require support in finding their misplaced items when they need them for IADLs. This also hinders their autonomy.

“I easily forget things… with my current state, I just pray for death because I cannot move anywhere always in bed. Is this what growing old is about? ” AOA3

A few participants (3), however, said they easily remembered things. One woman specifically mentioned that she was very “smart” in remembering things.

“…me I don’t forget things … I am very smart…I easily remember things” TOA1 .

Participants stated they were usually lost in their thoughts regarding one issue or the other. One participant held grudges from the past with other family members. Other older adults narrated that they think about their age mates and loved ones who had died when alone. They think excessively.

“ My daughter (referring to the interviewer ), … I can’t help it. I think a lot. To give birth and all your children turn their back on you is not a pleasant experience” TOA8 .

Relationships with others

Participants also mentioned that being at peace with people meant you are healthy. In describing their social health, all participants stated they could easily form relationships with others. Most participants expressed gratitude to technology with the development of mobile phones (non-sophisticated) as this enables them to communicate with relatives, even if they live far away.

“They call me, and I also call them, so they don’t feel so far away…thanks to the phone” AOA12 .

Eight (8) participants expressed their religion as an important part of their happiness. They maintained that having a close relationship with the church or another religious body, even after being home-bound due to immobility keeps them cheerful.

“I miss the fellowship with the bigger church. Because of my arthritis, I don’t attend church nowadays ... But they come to give me communion every month” AOA11

Widowed participants expressed they missed the companionship of their deceased spouses. They expressed the emptiness created had greatly affected them. They feel lonely and sad as there is nothing to engage in.

“Things have not been the same since my husband passed away… with my knee pains also I can’t farm so I rely on my sisters whenever I need something…there’s nothing for me to do. I sometimes feel lonely and sad” AOA11

Some female older adults became caregivers of their spouses and could hardly attend any social function.

“….my husband is battling with illness and has become bedridden, so I take care of him and the home … I cannot go anywhere … I don’t have money to employ anyone to take care of him for me” AOA4

Superstition

Various participants were under the observation that their current health status was a result of “external powers”, and they believed nothing could be changed about their health status. For instance, one participant who experienced a stroke was under the impression that this was the result of a colleague who envied him because he was “the bosses’ favourite”. Another older adult who experienced a stroke perceived he had been bewitched by his spouse.

“I have had a stroke for about 3 years now. They said my blood pressure was up, but I was not aware…I know it was my colleague from work who did this to me” AOA13 “I came back from a work trip and my wife had left with the children. Some days after I developed a stroke. I believe my wife had a hand in it… but I leave her to God” TOA8

(De)motivators of health service usage

Participants expressed that their use of health services was influenced by various factors. Some were individual concerns, beliefs in one medication or the other and various challenges with the health sector. Sub-themes that emerged in this topic were ‘perceived cause of health condition’, ‘healthcare providers’ attitude’, “challenges with the National Health Insurance Scheme (NHIS)”, “effectiveness of medications”, “the length of waiting time at health facilities”, as well as “proximity to major health facilities”.

Perceived cause of health conditions

Older adults have varying views on the causes of their diseases. Under this theme, the perception of the health status of older adults contributed to whether they will access healthcare or not. Participants who perceived their current health condition to be because of someone bewitching them did not see it necessary to visit the healthcare facility. They stated that they will not receive a cure for their disease if they go to a hospital, because it is a spiritual battle, not a “science” one.

“…I don’t go to the hospital also because this was caused by my former wife spiritually so the hospital cannot reverse it…” TOA8

Others who viewed their health condition to be a result of poor lifestyles and changes in the ageing process will visit a health facility for treatment.

“I see when I’m passing stool that I’m sick. I feel very constipated all the time… My feet also hurt when I walk for a while, old age… I plan to visit the hospital” TOA4

Healthcare providers attitude

Under this theme, participants stated that the attitude of some healthcare providers influenced older adults’ usage of healthcare services. participants described some professionals as being nice or friendly, others were rude, and some complained that some were selective in who to be nice too.

“They are sometimes nice. At times also they are busy so when I go to the hospital, they may not notice you …” AOA3

Others felt that health professionals gave preferential treatment to patients they know. Therefore, they rather practice self-medication and not waste their time going to the hospital.

“They do their work and I also watch them. I don’t have a friend there, so I wait. Usually, those who know the nurses and doctors are moved ahead fast in the queue” TOA2

Challenges with the national health insurance scheme (NHIS)

Another important factor influencing health services use is issues with the NHIS. Some issues discussed included expired cards, financial difficulties renewing cards, poor services provided to those with valid cards, non-subscription to the NHIS and limited coverage of services provided by the scheme.

Most participants (20 out of 25) did not have a valid National Health Insurance Scheme (NHIS) card due to financial challenges.

“I previously used the card but when it expired, I currently don’t have money to renew it…” AOA12

Participants narrated that when they utilised the NHIS card, the standard of services provided was not acceptable. They were also not treated with respect because health professionals felt they were not paying for services.

“ When you go with the card, there is no rush to attend to you, they lump us together at one corner and attend to those who pay out of pocket…” AOA9

Some older adults narrated that they have never had an NHIS card. They explained that queues for patients on the NHIS card are usually long and stagnant, so they preferred to seek healthcare from pharmacy shops.

“I have never subscribed to the scheme… I prefer to buy from the pharmacy than to go to the hospital… The queues are too long, and the services provided are poor” TOA7 .

There were also complaints about NHIS not providing a lot of health services which could have benefitted older adults.

“The health insurance does not cover my physiotherapy… but most of my drugs are covered” AOA3

Effectiveness of medications

Participants had diverse views and beliefs regarding the potency of the medications prescribed.

Some participants felt that conventional medications were not working as expected, and therefore looked for alternative treatments, such as herbal therapies.

“I want to be able to walk well but still nothing is happening that is why I am doing herbal” AOA3

However, this view was not shared by everyone: some participants preferred conventional medications as they viewed herbal medications as not safe.

“I have heard of people who have had reactions and even died after taking herbal preparations. I don’t trust herbal medicine…I don’t think it is safe” TOA3 .

The length of waiting time at health facilities

Almost all participants complained they had to wait a long time to be served at the health facility.

“…if I have to go to the hospital, I have to get up very early otherwise I join a long queue and spend the whole day there” TOA2

Proximity to major health facilities

All participants admitted that there was a health facility close by. However, they explained that there was limited health care provision in these centres. For instance, in the Teshie slum, they only provided first aid. Most participants expressed that larger healthcare facilities were situated far away and therefore, transportation is required.

“… the clinic at the centre is hardly active. You only meet people who come for weighing children…but for us the old people we need the bigger hospital which is far from us…” TOA5

Older adults’ interpretation of social care

Participants expressed that being in good relationships, supported by family and friends, having some assistance with laundry, cooking etc., and receiving financial assistance for their medications and day-to-day needs meant that they cared for them. Sub-themes that emerged in this theme are “good relationships with friends and family”, “assistance with Instrumental Activities of Daily Living (IADL)”, and “financial assistance for health and basic care”.

Good relationships with friends and family

All participants except one had a good relationship with their family members. Even when not living together, they maintained communication.

“We are on good terms. We call each other and meet occasionally at funerals and family meetings” TOA5

Receiving support with instrumental activities of daily living (IADL)

Some participants (16) were fortunate to have neighbours and family around who assisted with shopping and washing. They appreciated this and said it took a burden off. They could not imagine having to do everything by themselves.

“…my grandchild here helps me wash my clothes and … I send her on errands so it helps me a lot.” AOA8

Having financial support

Participants stated that financial assistance from their children and some family members helped them to meet their day-to-day needs. Some relied solely on their children for purchasing medications. When these are not forthcoming, they become very disturbed. Some also sell drinking water so they can save some money for difficult times.

“My son always sends money for my medicine. I sell this bottled water here to those who come to the church so that I use the money for myself.” TOA2

Challenges of older adults

Participants narrated that they have challenges with social care as well as health care and these influence their quality of life. They mentioned needs like companionship, financial assistance for their basic needs and assistance with washing, shopping and sometimes cooking. They also stated they experienced difficulty sleeping, and mobility problems, and sometimes they feel stigmatized by health workers. Sub-themes that emerged are isolation, assistance with activities of daily living, and financial support, sleep deprivation, limitation in activities and stigmatization by health workers.

Most participants stated that they will love to have people visit them to keep them company. One participant narrated he had been neglected by his wife and children for a long time. Additionally, his extended family members (family members who are not spouses or children) have ignored him as he currently has no money and had problems with his mobility. He feels isolated.

“……I was here with my wife and the children before she left with the children…I don’t know what she told them, so no one visits me… No one visits me, they only wave at me when going to family meetings…” TOA8

Assistance with IADLs

Some participants mentioned they were unable to perform instrumental activities of daily living easily usually because of immobility and needed assistance with various tasks, such as mobilising, washing, doing laundry, and going to the market.

“I cook food for myself, but I need help, especially with going to the market and washing some clothes… I do get help sometimes” TOA3

“…I can’t do anything for myself, I need to be carried to the washroom and everywhere…” TOA8 .

Financial assistance for health and basic care

Irrespective of the age of the participants, many of them were still working to be able to financially support themselves. Still, they argued needing financial assistance as well for basic care.

“…the sachet water I sell here is not enough to feed and pay medical bills for my husband …if the government will come to our aid, we will be grateful” AOA15

The study also explored the impact of perceived needs on the QoL of slum-dwelling older adults. Most participants said they encountered sleeping difficulty for one reason or the other. Reasons ranged from noise in the environment, and body pains to missing loved ones and worrying about money for upkeep.

“I will say that I struggle to sleep most often because of the noise from the bar opposite. Also, I have pains all over my body…it makes me very dull and sluggish during the day.” AOA6 “… I am always thinking about my late husband and my friends who have passed on…my husband was my companion and source of financial support. My life has not been the same since he left last year.” TOA9

A few slum-dwelling older adults explained that mobility problems limited their participation in activities they would have wished to engage in. Others also mentioned that the absence of meeting places for older adults restricted the social activities of older adults in the slums.

“I am not able to move about on my own because of the stroke. I used to attend family gatherings but not anymore…and no one visits me” TOA8 “aside from this big tree there is no meeting place where we can sit and socialize as older adults. We have to always be indoors or sit in front of our house. When it rains, we can’t sit under the tree…even the front of this house gets flooded (laughs). ” AOA7

Some participants were deterred from visiting health facilities because of perceived stigma and searching for alternate treatment when they are not well.

“…they (health workers) are selective in who they attend to first. I join long queues and stay for hours in the hospital…I look for other treatment when I am not well.” AOA13

Coping strategies

The theme of coping strategies referred to how older adults managed their socioeconomic and health needs. Participants either supported themselves by engaging in petty trading, or other menial jobs, or relying on others for support. Two subthemes emerged: social support and religious engagements.

Social support

Physical support, financial support, and self-support were themes that emerged from the subtheme ‘social support’. Participants mentioned that they received some physical and financial support from family members and friends most of the time. They expressed that because of their ability to develop relationships, they could also rely on people who are not family members to assist with things in the home. However, they also do a few things to support themselves.

Physical support

Participants discussed that they sometimes received support for healthcare, and IADL from their children, good Samaritans, and neighbours. Additionally, extended family members provided updates on family meetings for participants with mobility problems.

“…good Samaritans sometimes pass by to visit but I wash my clothes by myself, and my sisters also help” TOA4 “I am glad my wife is around me because she helps me greatly and I owe it all to her support” TOA10

Financial support

Most participants were not previously formally employed and therefore do not receive pension remittances. Children of older adults were the main supporters of their parent’s finances. More than half of the participants reported that their children provided financial support for either food or medications.

“My older children usually send me something ( money) every month for our upkeep. I am not working now because at 71 I am very old” AOA13

Siblings also gave support for food. Other family members also provide some financial support. Those who lived alone received donations from some family members who visit.

“I help my sisters to prepare kenkey (food made from ground corn) for sale and they give me food when we are done” TOA4 “I don’t work because of my age, and I am not strong enough. … other family people who visit me give me money” TOA7

Sometimes neighbours also help. Given the uncoordinated arrangements in the slums, the entrance to someone’s house is someone’s place for selling. These neighbourly sellers also provided financial support for some older participants in the slum.

“… my child supports me, but she also goes to work so this lady here selling charcoal comes to my aid and sometimes buys food for me” TOA8

Self-support

To help meet their financial needs and be engaged, most participants were involved in some form of activity for money for their daily upkeep. Older adults stated that they did not want to burden their children and were reluctant to depend solely on their children for financial and social support.

“My children are working and have the means to help but I decide not to be a liability. Even though they will help when I ask, I am also selling. It also keeps me active” TOA3 “I can wash my clothes and cook my food. I buy my ingredients from a woman next door, so I don’t need to go to the market. I don’t like disturbing people, so I try to do things by myself” AOA11

Some older adults who live alone explained that they help themselves by working and doing what they can to get money as they often buy food from vendors.

“…I live alone, and this place is not big, so I do everything myself…because I am a driver, I buy food from the station. I only come home to sleep….” AOA14 .

Religious engagements

Participants relied on religious engagements to relieve sadness, loneliness, and boredom. Religiosity is one major aspect of the life of Ghanaians and most especially older adults.

Some older adults expressed that talking to God minimizes sadness.

“I get sad when I hear my age mates are dying. When I am sad, I chat with God. I pray and discuss a lot of issues with Him” TOA4

Other participants sang hymns to relieve idleness and loneliness.

“I was a chorister, so I sing hymns when I am alone” AOA8 .

A few older adults explained that reading the Bible and preaching to customers were some religious engagements they employed to cope with boredom.

“If I am to be idle, I engage myself in reading the Bible” TOA1 .

This study aimed at exploring the perceived health and social care needs of older adults in two slums. When comparing responses from the two slums on their views on health and social care needs, they all have similar views. The main variation was in their “financial needs”. Most people in the slum close to the industrial area were actively engaged in informal jobs and could have enough money to care for themselves. Almost all the participants who lived alone were also in this slum. So, there is a high probability that they had a low dependency rate therefore they could manage their finances and did not have to rely so much on others.

Perceived health needs were mainly current disease conditions (arthritis, diabetes, hypertension, vision/hearing challenges), challenges with health insurance, the behaviour of some health professionals, the proximity of health facilities, and unnecessary queues at major health facilities. Unmet social needs identified by this study were a sense of neglect by family (need for companionship), requiring assistance with activities of daily living, and the need for financial support. Older adults often had difficulty sleeping as they thought of how to meet their needs and also waited on death. Generally, it was observed that there were more perceived health needs than social needs among these older adults. This leads to the question of whether older slum-dwellers perceive health-related needs as more important.

Our study found nine perceived issues related to the health of older adults living in slums: (1) disease condition, (2) mental well-being, (3) relationships with others, (4) attitudes of health care providers, (5) National Health Insurance Scheme (NHIS), (6) effectiveness of medications, (7) proximity to health facilities, (8) superstition and (9) length of waiting time in health care facilities. The themes fit into the two pillars of the WHO policy framework on Active Ageing which was used in the study conceptualisation.

To improve self-perceived healthcare needs, participants mentioned that access to healthcare facilities should be improved by (a) having more well-equipped health facilities close to slums, (b) reducing waiting time for healthcare services, (c) decreasing costs for healthcare use by restructuring the NHIS, (d) increasing and improving the services provided under the insurance scheme. Furthermore, how an individual perceived his/her health condition also influenced the use of modern health services. An example is that participants who attributed their illness to spiritual powers such as “bewitchment” are not likely to visit modern healthcare facilities for treatment. A reason for this is that in African countries, spirituality is often regarded as an explanation for many occurrences. These findings are consistent with studies in Tanzania [ 47 ] and Malawi [ 48 ] where bewitchment and spirituality were linked to eclampsia and anaemia. The belief that spirituality influences health status, made participants believe that medications were unable to reverse their health status, influencing healthcare use. Therefore, educating slum dwellers on finding, understanding, appraising, and applying health information to make health-related decisions, also known as health literacy, might improve their self-perceived health [ 49 ]. Health education should take the strong spiritual and religious beliefs of this population into account.

In the slums, as most older adults are low-income earners compared to formal settlement, financial constraint is a major barrier to the utilization of healthcare services among older adults living in slums. This finding is consistent with that of Fayehun, et al. [ 50 ], and Cadmus, et al., [ 51 ] which were conducted in Nigeria. The findings on the use of the NHIS card, the attitude of health professionals, and the length of waiting time influencing the healthcare use of older adults also agree with findings by Agyemang-Duah, et al. [ 52 ] in a rural Ghanaian community. The NHIS is supposed to be free for all older adults above 70 years however this does not seem to be the case. Participants also complained about the poor and inadequate services provided under the NHIS. As most older adults in this study had expired health insurance cards, they often purchase medications from the pharmacy or prepare herbal medications when not well. This confirms a study by Awoke et al., [ 53 ] and Amiresmaili, et al., [ 54 ] which postulated that possession of health insurance cards influenced the utilization of healthcare services.

In this study, we also observed that some participants patronized pharmacies and herbal preparations more than the hospitals. The findings also confirm a study in Mumbai by Naydenova, et al. [ 55 ] where some participants utilised pharmacies and alternative medications instead of the healthcare facility.

Older adults in this study perceived social care to be having good relationships with family and friends and receiving both physical and fiscal assistance for basic care needs. This is similar to previous studies where participants referred to social care as having support from family and friends, support for self-care and instrumental support (monetary) [ 60 , 61 , 62 ]. It appears that the unmet social needs among older slum-dwellers were fewer than expected based on the living conditions in the slum. Most participants appreciated social support from family and friends. This finding confirms the quantitative study by Attafuah et al. [ 37 ] where the older adults in the slum appeared to have a moderate QoL in the social domain. Findings from this study revealed three social needs (1) companionship; (2) assistance with IADLs; and (3) financial assistance for food and medications. When looking at companionship, most participants desired the company of friends and family, but they had to make do with phone calls because of distance. One participant felt he had been neglected by family and close friends. When looking at the other factors influencing social needs, most participants argued that they needed assistance with IADL and financial support for basic needs. These were also found by Iriarte, & Jimenez, [ 56 ] among ethnic/racial minority groups in Chile. Married men in the current study viewed their wives as their main support system, consistent with findings by Tkatch et al., [ 57 ]. According to Iriarte, & Jimenez [ 56 ], a caregiver must be healthy to care. However, in our study, some older adults who are not physically fit themselves were caregivers of their spouses because there is no one to take up the role. In agreement with Cash, et al. [ 58 ], caregiver responsibility is seen as an expectation in marriage. This perspective additionally supports research on both the benefits of social support and the reciprocity of social support exchanges or being able to both give and receive, as having significant benefits for older adults in slums. According to Akinrolie, et al., [ 59 ], the feeling of reciprocity could be the reason why children were the main social support system for older adults. This also affirms the bond between children and parents in the Ghanaian setting despite the breakdown of the extended family system. Another finding was that most participants were currently engaged in menial jobs because as they stated, they did not want to depend too much on their children. This occurs as most slum dwellers are into non-formal employment and hence do not benefit from pensions in their old age. Also because of the high level of illiteracy in the slum, private pension schemes are not widely known.

On the influence of the perceived health and social needs on their QoL, participants mentioned that they had difficulty sleeping because of pain in their joints. Additionally, they have mobility issues, and this restricts participation in activities. At the health facilities, they sometimes feel stigmatized by health workers coupled with feelings of loneliness from family neglect/absence hence they try to keep to themselves. This prevents them from going to health facilities and negatively affects their QoL. Generally, having a good perception of health and social care issues has a positive influence on QoL as stipulated by Ingrand, [ 63 ]. Participants who harboured superstitious beliefs about disease conditions do not rate their QoL as good and had issues with everyone around them.

This study also sheds some light on strategies older adults used to cope with unmet needs. It is observed that slum dwellers are better able to cope with unmet social needs than with unmet healthcare needs. Even though some participants expressed a feeling of neglect from family and friends, most older adults were satisfied with the family support received. Firstly, most participants narrated they received some form of support from family and friends to help cope with their health and social needs. Children in the African setting are expected to be the primary social support for their parents. Therefore, for more than half of the participants, children provided financial support for either food or medications for older adults in the slums. Secondly, to cope with unmet social needs, older adults engaged in religious activities such as singing and evangelising to people to form relationships. Religiosity is very prominent in the African setting, and this is therefore not surprising especially in the slums as most participants showed over-reliance on God with hopes for survival and getting a better quality of life. Health education in churches could be emphasized to improve the health and social needs of the populace. Lastly, participants said they supported themselves as much as possible either by engaging in a trade or cooking their meals. This could be attributed to the need to be active and maintain autonomy as they aim to be less dependent on others.

Understanding the perceived health and social needs of older adults living in slums can help health workers in providing appropriate care. The uneven walkways and distance to major health facilities for example can be temporarily managed if health workers especially community health nurses are committed to rendering services at the doorsteps of older adults in the slum. Additionally, policy development can be directed towards providing geriatric services close to slum neighbourhoods.

Strengths and limitations

To our knowledge, this is the first study exploring the health and social needs from the slum-dwelling older adult’s perspective in Africa. Because of the qualitative nature of the study, participants had the opportunity to express themselves freely in their local languages. Varieties in background characteristics between participants were sought to increase the internal generalizability of research results in the slum setting. However, external generalizability may be difficult as additional studies in comparable contexts may reveal new meanings. A limitation of this study is that there was a lack of privacy when performing the interviews due to the slum setup: other people from the slum setting were often present and listened along. This could have influenced the answers given by participants. Secondly, older adults who were interested in participating received a breakfast package after the interview. This could have also led to selection bias. Nevertheless, the participants in this study provided significant insight into a general perspective of health and social needs that can provide researchers and clinicians with knowledge of what older adults in slums may need to improve and sustain their health. Future research should consider expanding these insights through larger populations of more slums.

Implications

This study underscores the need for improved access to health and social care services for older adults living in slums. Policymakers are advised based on the results of this study, to consider restructuring the NHIS regarding price and services provided under the scheme for older adults. In addition, the provision of well-equipped, older adult-friendly health facilities close to slums will decrease the issues of proximity and waiting time. Religious leaders should be involved in promoting health education activities among their congregations.

Participants discussed more healthcare issues than their social care needs. Health-related issues included their understanding of their health status, health insurance challenges and the attitude of health professionals. Social care needs largely emphasized by most participants related to companionship. This study presents an important understanding of the health and social needs from the perspective of older adults in the slums as this affects their overall quality of life. The provision of formal services such as improved home visits by healthcare professionals can assist in the individual education of older adults on their health needs and how to manage them. Lastly, older adults receive some social support from family and friends, but this is not consistent. Hence the creation of daycare centres for slum-dwelling older adults in nearby communities will enable socialization with peers.

Data Availability

Data is available from the corresponding author upon reasonable request.

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Acknowledgements

The authors wish to express sincere thanks and gratitude to the people who have contributed to this research, most especially to the older adults in the visited slums for their genuine perspectives.

There was no funding received.

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School of Nursing and Midwifery, University of Ghana, Legon, Ghana

Priscilla Yeye Adumoah Attafuah

Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands

Priscilla Yeye Adumoah Attafuah, Irma HJ Everink & Jos MGA Schols

Institute of Nursing Science, Medical University of Graz, Graz, Austria

Christa Lohrmann

Health Services Management Department, University of Ghana Business School, Legon, Ghana

Aaron Abuosi

Department of Family Medicine and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands

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Contributions

PA, IE, CL, AA, and JS conceptualized the study. PA conducted the interviews. PA and IE analysed the data. All authors reviewed the Section’s Introduction and Discussion and read through the final manuscript before submission.

All authors contributed to the article and approved the submitted version.

Corresponding author

Correspondence to Priscilla Yeye Adumoah Attafuah .

Ethics declarations

Ethics approval and consent to participate.

Ethical clearance was obtained from the Institutional Review Board of 37 Military Hospital (37MH-IRB IPN 199/2018). Also, permission from the municipal assemblies of the data collection sites was obtained. Additionally, information on voluntary participation and the right to withdraw was shared with all participants. Confidentiality and privacy were guaranteed by keeping the data of participants protected and restricted.

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Not applicable.

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The authors declare no competing interests.

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Attafuah, P.Y.A., Everink, I.H., Lohrmann, C. et al. Health and social needs of older adults in slum communities in Ghana: a phenomenological approach used in 2021. Arch Public Health 81 , 74 (2023). https://doi.org/10.1186/s13690-023-01056-9

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Social Work Practice in Ghana: Changing Dynamics, Challenges and Opportunities

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  • Michael Baffoe 4 &
  • Mavis Dako-Gyeke 5  

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Social Work is described as a helping profession since it is a professional practice that provides services aimed at helping societies work better for their people. It is also designed to assist people with varying degrees of social problems function better within society. While social work started in the pre-independence era as the provision of social welfare services, it is slowly making its way through the Ghanaian society. Like the Western societies where the profession developed, Ghana is also beset with a host of social problems that call for professional social work interventions. Using the history of the social work profession in the Western world as a backdrop, this chapter explores the development of the social work profession in Ghana from the colonial times to the present. It examines some of the social problems in the country that call for professional social work intervention. The chapter concludes with a call for a revamped social work education in the face of the changing dynamics of the profession which present challenges as well as opportunities to develop new practice paradigms within an indigenous context.

  • Social work
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Faculty of Social Work, University of Manitoba, Winnipeg, Canada

Assoc. Prof. Michael Baffoe

Department of Social Work, University of Ghana, Legon, Ghana

Mavis Dako-Gyeke

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Joseph Atsu Ayee

Department of Economics, University of Ghana, Legon, Ghana

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Baffoe, M., Dako-Gyeke, M. (2014). Social Work Practice in Ghana: Changing Dynamics, Challenges and Opportunities. In: Agyei-Mensah, S., Ayee, J., Oduro, A. (eds) Changing Perspectives on the Social Sciences in Ghana. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-8715-4_7

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ISSER Launches Ghana Social Development Outlook 2022 Report

20 Jun, 2023 by skdagudetse

research topics on social issues in ghana

The Institute of Social Statistical and Economic Research (ISSER) has unveiled the sixth edition of the Ghana Social Development Outlook (GSDO), a biennial report, at the ISSER Conference Facility.

Compiled by the Social Division of ISSER, the report aims to delve into the socio-economic challenges of the nation and offer solutions to address them.

In his welcome address, Prof. Peter Quartey, the Director of ISSER, emphasized that the GSDO is a biennial publication that has served as a grassroot source of information since 2012. He highlighted ISSER's commitment to providing cutting-edge research for policymaking and behavior cognition, with the GSDO being a crucial channel to convey research findings and recommendations to stakeholders.

research topics on social issues in ghana

Prof. Peter Quartey, the Director of ISSER

"This sixth edition consists of ten chapters covering various interrelated topics carefully curated by authors from the social division. These chapters explore social development issues in Education, Health, Water and Sanitation, Housing, Employment, Energy, Environment, Gender Equity, Social Relations, and Population," Prof. Quartey explained.

He further highlighted that the GSDO adds to ISSER's impressive array of publications, including annual reports published over the past 31 years. With 43 technical reports and special publications on pressing issues, ISSER is committed to organizing public events, such as the launch of institutional publications, to engage with stakeholders and foster discussions on important national matters.

research topics on social issues in ghana

A cross-section of guests at the Launch

Prof. Daniel Frimpong Ofori, the Provost of the College of Humanities, who chaired the event on behalf of the Vice-Chancellor, recognized the launch of the report as a significant milestone for ISSER. He commended the Director and his team for their continuous efforts to produce research outputs that facilitate reflection and engagement in social and economic deliberations relevant to stakeholders.

"In times of heightened global socioeconomic challenges, research-led decision making and policymaking offer the surest lifeline to achieving sustainable development that can have a meaningful and lasting impact on people. Therefore, the launch of the 2022 Ghana Social Development Outlook today couldn't have come at a better time," Prof. Ofori stated.

research topics on social issues in ghana

Prof. Daniel Frimpong Ofori, Provost, College of Humanities

He acknowledged the importance of the ten topics covered in the report, including Education, Health, Water and Sanitation, Housing, Employment, Energy, Environment, Gender Equity, Social Relations, and Population, as they address crucial social issues concerning both individuals and the nation.

Prof. Ofori congratulated the social division, faculty, and staff on their publication, which contributes to ISSER's extensive list of research dedicated to investigating issues, offering recommendations, and providing solutions to improve the country's state.

research topics on social issues in ghana

Dr. Martah Awo, the Head of the Social Division at the Institute of Social Statistical and Economic Research, provided an overview of the 2022 Ghana Social Development Outlook during the launch. She described the report as a biennial publication that critically examines development processes, analyzes their impact on social development, and provides policy directives.

research topics on social issues in ghana

Dr. Martah Awo, the Head of the Social Division, ISSER

Dr. Awo acknowledged the progress made in social development since the publication of the maiden edition in 2012. She noted that the nation has made strides in areas such as poverty reduction, equal access to education, health, and sanitation, through the implementation of major global frameworks like the Millennium Development Goals and the Sustainable Development Goals.

However, she emphasized that the period under review in the report has posed significant challenges for the nation, including the ongoing impacts of the Covid-19 pandemic, the Russian-Ukraine war, high fuel prices, inflation, the introduction of the e-levy, and challenges in the financial market.

During the event, the book was officially launched by the Chairperson, members of the ISSER management team, and other dignitaries. A seprewa spoken word performance added a cultural touch to the proceedings. The ceremony concluded with intensive open discussions among participants.

research topics on social issues in ghana

A group photo of dignitaries and guests at the Launch

The event was attended by notable individuals, including Professor Nii Ardey Codjoe, Provost of the College of Education; Professor George Owusu, Dean of the School of Social Sciences; Professor Kofi Agyekum; School of Arts; Dr. Michael Kodom, Research Fellow at ISSER; Dr. Kofi Takyi Asante, Senior Research Fellow; Rev. Prof. A. Y. Owusu, Associate Professor at ISSER; Dr. Isaac Osei-Akoto, Senior Research Fellow at ISSER; Dr. Ralph Armah, Research Fellow; heads of departments; faculty members; staff; media representatives; and students.

The launch of the Ghana Social Development Outlook 2022 report showcases ISSER's commitment to producing research that informs policy decisions and contributes to the nation's development. The report's comprehensive analysis of key social issues and its policy recommendations provide valuable insights for stakeholders to make informed decisions that will benefit both individual institutions and the nation as a whole.

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Community engagement and involvement in Ghana: conversations with community stakeholders to inform surgical research

Karolin kroese.

1 Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK

Bernard Appiah Ofori

2 Global Health Research Unit on Global Surgery, Ghana Research Hub, University for Development Studies (School of Medicine and Health Sciences) and the Tamale Teaching Hospital, Tamale, Ghana

Darling Ramatu Abdulai

Mark monahan, angela prah.

3 University of Birmingham, Birmingham, UK

Stephen Tabiri

Associated data.

Videos and a case study of this CEI activity can be found on the GSU webpages.

Involving patients and communities with health research in low- and middle-income countries (LMICs) contributes to increasing the likelihood that research is relevant in local context and caters to the needs of the population, including vulnerable and marginalised groups. When done right, it can also support empowerment of wider communities in taking ownership of their own health, lead to increased access and uptake of health services and generally improve the wellbeing of individuals. However, the evidence base of how to undertake successful community engagement and involvement (CEI) activities in LMICs is sparse. This paper aims to add to the available literature and describes how the Global Health Research Unit on Global Surgery’s (GSU) team in Ghana worked collaboratively with the Unit’s team in the UK and a UK-based Public Advisory Group to involve community stakeholders in rural Ghana with surgical research. The aim was to explore ways of reaching out to patients and community leaders in rural Ghana to have conversations that inform the relevance, acceptability, and feasibility of a clinical trial, called TIGER.

As this kind of larger scale involvement of community stakeholders with research was a novel way of working for the team in Ghana, a reflective approach was taken to outline step-by-step how the GSU team planned and undertook these involvement activities with 31 hernia patients, two Chiefs (community leaders), a community finance officer and a local politician in various locations in Ghana. The barriers that were experienced and the benefits of involving community stakeholders are highlighted with the aim to add to the evidence base of CEI in LMICs.

GSU members from the UK and Ghana planned and organised successful involvement activities that focused on establishing the best way to talk to patients and other community stakeholders about their experiences of living with hernias and undergoing hernia repairs, and their perceptions of the impact of hernias on the wider community. The Ghanaian team suggested 1:1 conversations in easily accessible locations for rural patient contributors, creating a welcoming environment and addressing contributors in their local dialects. A UK-based Public Advisory Group helped in the initial stages of planning these conversations by highlighting potential barriers when approaching rural communities and advising on how to phrase questions around personal experiences. Conversations mainly focused on understanding the needs of hernia patients in rural Ghana to then incorporate these in the design of the TIGER trial to ensure its relevance, acceptability and feasibility. When talking to patient contributors, the GSU teams found that they were more likely to open up when they knew members of the team and the opportunity to speak to local leaders only arose because of the Ghanaian team members being well-respected amongst communities. The experiences of the patient and community contributors led to changes in the study protocol, such as including women in the patient cohort for the trial, and allowed the GSU teams to confirm the relevance and acceptability of this trial. These conversations also taught the team a lot about perceptions of health in rural communities, allowed the Ghanaian team to establish relationships with community leaders that can be utilised when future studies need input from the public, and has changed the minds of the Ghanaian research team about the importance of involving patients with research.

This paper contributes to the evidence base on successful CEI activities in LMICs by providing an example of how CEI can be planned and organised, and the benefits this provides. The conversations the teams had with patient contributors in Ghana are an example of successful patient consultations. Even though there are certain limitations to the extent of these involvement activities, a solid foundation has been built for researchers and community stakeholders to establish relationships for ongoing involvement.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40900-021-00270-5.

Plain English summary

Evidence in the literature shows that research that was designed and implemented with the help of patients or other members of the community affected by the study, is more likely to be relevant to the needs of the end user. This can have positive effects on the quality and impact of the study. However, working collaboratively with patient or public contributors can have certain challenges, especially in low- and middle- income countries. For example, factors such as different languages or dialects, religious beliefs, health beliefs, level of literacy, understanding of research, and poverty can potentially make it more difficult for researchers to reach, communicate and involve relevant members of the public. On top of this, the evidence base for successfully implementing these so-called community engagement and involvement activities is sparse, making it more challenging for researchers to learn from others’ experiences.

Members of the Global Surgery Unit, who are based in Ghana, proposed a clinical trial to address the shortfall of specialist surgeons at rural hospitals. This will be achieved by training medically qualified doctors, who have not yet gone through the specialist training to become qualified surgeons, to perform inguinal hernia repairs proficiently. Before the study gets funded and a protocol can be designed, the researchers need to ensure its relevance, acceptability, and feasibility. This is usually done by getting the opinion and thoughts of key stakeholders, mainly individuals who will be affected by the research. To achieve this, the team in Ghana worked together with Global Surgery Unit members in the UK to identify the best ways to approach and have conversations with 31 inguinal hernia patients who either previously had surgery or currently live with hernias, two Chiefs (community leaders), a community finance officer and a local politician in a variety of locations in Ghana that are representative of the patient cohort for the study. The intention was to understand the impact of hernias on individual patients, their families, and entire communities to inform the relevance, acceptability and feasibility of the clinical trial, and ensure that relevant aspects are captured in the study protocol. A UK-based public advisory group provided initial input to help eliminate potential barriers of addressing patient contributors in rural Ghana.

This paper states in detail how these conversations were planned and organised, the challenges the team had to overcome, and what they learned and gained from talking to community members - which goes far beyond just informing a study.

Patient and Public Involvement (PPI), or Community Engagement and Involvement (CEI) as often referred to in global health research, is a major contributor to increasing the likelihood of research being relevant to and benefitting the population affected by it. The best way to ensure this is by involving relevant community members at all stages throughout the research cycle – from designing the study to its implementation and dissemination of findings [ 1 ]. While the definition of and even the terminology used for CEI can vary, its essence is captured by the US Centres for Disease Control and Prevention when defining community engagement: “… the process of working collaboratively with and through groups of people affiliated by geographic proximity, special interest, or similar situations to address issues affecting the well-being of those people” [ 2 ]. In health research, involving patients and the public has been shown to increase the relevance and value of the study by identifying the needs of the affected patient group or wider community, inform the feasibility and accessibility of the study intervention by identifying barriers to participation, and enhance recruitment by raising awareness of the intervention and its benefits. Research that is relevant and accessible to patients means that funding is not wasted on something that the end-user cannot or does not want to use and increases the success rate of the study and the likelihood for future funding [ 1 , 3 ]. This is why most funding bodies have now made it a requirement to incorporate a robust plan for CEI in all grant applications. This becomes even more relevant in lower resource settings, where research should aim to cater for the needs of the most marginalised, but inequalities due to language, understanding of research and poverty mean the gap between the research world and the local population is even bigger than in high-income countries [ 4 ].

Thus, the rationale for involving communities with research in low- and middle- income countries (LMICs) is not limited to solely ensuring the success of a research project. It is about providing the tools to involve the local population in all aspects of decision-making and implementation of research, with local ownership improving transparency and accountability of research and research funding. This can then lead to optimal resource allocation across diverse settings that builds on local capacity and potentially leads to research findings being accessible to and utilised by the ones in need [ 5 ].

With most funding bodies sitting in the Global North, it is crucial to ensure that research prioritisation and implementation in LMICs is led on by the Global South – here specifically representing the needs of people at grassroots level. Only then can research become meaningful and sustainable [ 5 ].

The National Institute for Health Research (NIHR)- funded Global Health Research Unit on Global Surgery (GSU) at the University of Birmingham has established a network of research hubs in LMICs to conduct surgical research. Each hub is led by a local surgeon and their team of clinical, as well as non-clinical staff. Surgical research across all hubs in form of clinical trials is prioritised annually by GSU researchers from all participating LMICs, as well as the UK-based team. Furthermore, smaller-scale pump priming studies or single site clinical trials, which can establish a proof of concept to develop larger multi-site or multi-country trials, are also funded. These are country-specific, addressing urgent health needs in individual LMICs.

In sub-Saharan Africa, a major health concern is inguinal hernias, reported to affect 10% of the overall population and up to 37% of men over the age of 55 [ 6 ]. The limited surgical workforce and the cost implications for patients traveling to hospitals and undergoing surgery are believed to pose a serious threat to entire communities. The research hub team in Ghana therefore proposed a clinical trial focusing on task-shifting in rural hospitals to build on local capacity by training non-surgeon physicians to specifically perform inguinal hernia repairs. Hernia repairs are usually do not require complex technique. The Ghanaian team called this trial TIGER (Task shifting inguinal hernia repair). The aim is to reduce the burden of hernias on communities by increasing the effective surgical workforce. Task-shifting is the delegation of specific specialist tasks to less qualified health workers and has been shown to increase surgery volume. However, careful consideration is needed about the relative risk of postoperative surgical outcomes between operations performed following task-shifting versus surgeons [ 7 ]. Training non-surgeon physicians in one specific surgery over the course of a weekend with supervision by experienced surgeons for a further few months allows for faster turnaround of a niche, skilled workforce rather than waiting years for surgeons to finish their training and reach full proficiency across the board.

Working closely with the local team in Ghana based at the University for Development Studies (School of Medicine and Health Sciences) in Tamale and the Tamale Teaching Hospital, the Unit’s UK-based CEI Manager set out to explore ways to reach out to patients with lived experience and community leaders in rural Ghana to understand the extent of the burden hernias pose on patients and whole communities. Listening to patient stories and understanding the experiences of people affected by hernias prior to designing the study protocol allowed the team to assess the relevance of TIGER, tailor the trial to local context, and ensure that research funding was allocated to areas of need.

With there still being a shortfall of evidence and inconsistency in recording and reporting of community involvement with global health research studies [ 4 ], this paper aims to provide step-by-step information on how successful involvement activities can be designed in similar settings. The paper does not only outline the reasons for involving community stakeholders and a potential way of implementing this; it also focuses on the barriers to high-quality involvement of community stakeholders in low-resource settings and limitations of the described activities for shared learning across the global health research network.

This paper outlines how community engagement and involvement activities were designed and implemented in Ghana in September 2019 and highlights the challenges and solutions as perceived by the GSU teams based in the UK and Ghana.

To explore the relevance and feasibility of the TIGER trial in rural areas of Ghana, the UK-based CEI Manager, Dr. Karolin Kroese, worked closely with the local research team, specifically the Research Hub Lead Prof Stephen Tabiri, Hub Manager Bernard Ofori Appiah and Research Nurse Darling Ramatu Abdulai. Karolin provided expertise on best practice CEI in line with the UNICEF standards (5, at draft stage at the time) from a high-income country angle, which was then adapted to local context by the Ghanaian team and a UK-based public advisory group (PAG), as outlined in the results section.

Preliminary advice on CEI activities and Ghanaian culture was provided by the PAG, specifically the Ghanaian member Angela Prah. The group consists of six members who live in the UK but are originally from some of GSU’s collaborating LMICs: Ghana, Nigeria, The Philippines, and India. The group presents an opportunity to provide initial advice on potential barriers, challenges and solutions when undertaking research or community engagement and involvement activities in LMICs. All members of the group were reimbursed for their time according to the NIHR National Standards for Public Involvement [ 8 ]. The CEI activity was reported and evaluated using the GRIPP-2 framework ([ 9 ], Additional file 2 : Appendix 3).

This paper was written in collaboration with the Ghanaian team and the public contributor, Angela Prah. Patients and community representatives in Ghana were not involved in writing this paper due to language barriers. However, when talking to patients and community leaders in regard to TIGER, consent was given for their views and opinions to be outlined in this article.

Authors’ statement on ethics and consent

The activities outlined in this publication classify as community engagement and involvement (CEI) with research, as opposed to being research. Therefore, the team did not need ethics approval according to the NIHR Involve guidelines. Conversations with patient and community contributors did not form part of a qualitative study, and therefore, no research methodology was applied to analyse findings or extract data from the conversations. Patient contributors shared their lived experiences, allowing the team to understand what mattered to this (small, yet representative) group of individuals when undergoing treatment for their hernias. This insight allowed GSU teams to gauge how relevant the proposed TIGER study is, who the patient cohort might be, and if the suggested protocol can feasibly be implemented in Ghana. Input from contributors led to recommendations being outlined for the TIGER researchers, who as a result decided to implement these when designing the study protocol. The patient contributors whose stories form part of this article are a different group to the future participants of the TIGER trial. Ethics for the trial will be obtained as per guidelines when the protocol has been finalised based on feedback from the patient contributors.

The team decided to ask contributors to sign consent forms at the start of the conversations. This was suggested by the local team with the main concern being around language barrier and the worry about community members potentially confusing research and CEI. The team wanted to be certain that contributors knew what was asked of them and equally understood the intentions of the team, not least to manage expectations. Contributors were given the opportunity to study the consent form, have the different points read out and explained to them, and then consent to the points they felt comfortable with. Some contributors did not consent to their pictures being taken and uploaded on GSU webpages, but all indicated they understood the team’s reasons for the conversation, felt comfortable sharing their stories, knew they did not have to talk about any experiences they did not want to share, and agreed to the conversations being audio-recorded. This last point was relevant for the UK-based team to ensure communication between patient contributor and translator could be followed.

Designing and planning of CEI activities for TIGER: involving the public in involving the public

TIGER was proposed by the Ghanaian research team as a study to potentially reduce the risks of surgical complications and increase access to safe surgery in rural parts of Ghana, therefore specifically supporting the health and wellbeing of a very vulnerable population of this country. Before funding from GSU could be released, the burden of hernias specifically on rural communities and therefore the relevance of this study, as well as its feasibility and likelihood of uptake by patients had to be explored. The UK-based CEI Manager therefore proposed consulting hernia patients with lived experience in rural Ghana, as they are representative of the patient cohort for TIGER.

To shape the CEI activities, a meeting with the UK-based PAG was hosted at the University of Birmingham to discuss where and how community stakeholders in Ghana can help inform the TIGER study. Particular focus was laid on barriers to involvement and potential solutions. The PAG advised to explore how patients felt about the study intervention, specifically about non-surgeon physicians performing surgeries. When looking into the proposed TIGER study design, the group furthermore highlighted barriers for patients to attend hospital appointments and participate in clinical trials, such as travel expenses, including an additional trip for follow-up for study participants. It was decided to explore this further in conversations with patient contributors in Ghana.

Based on the discussion with the PAG, the GSU teams decided to draft a template for guided discussions (Additional file 1 : Appendix 1 and 2) with patient and community contributors in Ghana, with the overarching aim for patients to share their personal experiences, which will allow the team to address the following areas:

Ultimately assessing the relevance of the TIGER trial in rural communities.

  • Acceptability of the intervention to patients – Would patients be comfortable with a trained non-surgeon physician, rather than a surgeon, performing their surgery? Focusing on what matters to patients in rural Ghana when undergoing hernia repair.
  • Feasibility of delivering the trial intervention with a focus on access to care and in-person follow-up – Will additional travel back to hospital for follow-up cause any problems for study participants?

The next step was to develop a detailed action plan. Over several weeks, the main mode of communication between the UK and Ghanaian teams was via WhatsApp. This group chat proved to be the most successful way to hold each other accountable and ensure the project progressed in a timely manner. The occasional teleconference was used for more in-depth discussions and updating the wider team.

In this time, leading up to a 7-day visit of the UK-based team (Table  1 ), travel arrangements were taken care of by the Ghanaian team, including the itinerary of hospital visits to talk to the patient contributor, booking hotels and arranging meetings with community Chiefs and religious leaders in rural villages. For safety, access, and translation reasons, it was decided that the local team would accompany the UK team on their hospital visits.

Itinerary of the Ghana road trip

The GSU team travelled to various hospitals and villages in rural in Ghana to talk to patient and community contributors

The CEI Manager travelled to Ghana with GSU’s Health Economist, Mark Monahan, who was undertaking a related project looking at the cost implication and feasibility of upscaling hernia repairs at rural hospitals.

Identifying patient contributors – hospital hopping

Four mainly rural hospitals that work with Prof Tabiri and the Tamale Teaching Hospital, and will be recruiting patients to the TIGER trial, were chosen to be the most representative for the patient cohort (Table  2 ) and therefore allow the teams to speak with relevant community members with lived experience of living with hernias and undergoing hernia repairs at the local hospitals.

Location of hospitals

The table provides the names and regions of the hospitals and the number of patients that the team talked to. Patients at four rural hospitals closely working with the GSU Research Hub at Tamale Teaching Hospital were approached and meetings with community leaders took place in Odumase, the Bono Region of Ghana

Whilst planning the CEI activities, the Ghanaian team contacted the hospitals to ensure that the staff were happy to identify patient contributors from either previous or current hernia patients and provide an office or hospital room where private conversations could take place. It proved immensely beneficial that the local team was well- connected and –respected, with hospital staff immediately agreeing to support the activities. Hospital staff then announced Prof Tabiri’s visit via local radio stations a few days prior to arrival. On the day, patient contributors voluntarily travelled the short distance to their local hospitals in order to take part in the conversations, not least because many of them were treated by Prof Tabiri previously and trusted him and his team.

To represent the patient cohort eligible to participate in the TIGER trial, community members 18 years and older could take part in the conversation with no restriction on male and female numbers. Overall, the team talked with 17 patients contributors pre- and 14 patients contributors post- hernia surgery, with six out of the 31 patients contributors being female (Table ​ (Table2). 2 ). Patient contributors and community leaders were each reimbursed for their time and travel costs with 50 Ghanaian cedis, which was suggested by the Ghanaian team as an appropriate amount. Patients contributors pre- surgery were also provided with a flat mesh, a sterilized polypropylene mesh commonly used in lower-resource settings (7x15cm), for their hernia repair, which they usually have to pay for themselves.

Conversations with patient contributors

Because people in rural communities speak multiple dialects and very little or no English, the Ghanaian team suggested that 1:1 conversations were the best way to communicate. The main concern was around patient contributors potentially misunderstanding the reasons for being approached or confusing the conversations as part of involvement activities with participating in research. The team therefore ensured that a translator was present for each conversation to directly translate between the Ghanaian dialect and English as spoken by the GSU team members. Each conversation started with the team outlining the reasons for approaching the patient contributor and highlighting the difference between this involvement activity and research. Only when the team was confident that the contributor fully understood the nature of the conversation and was happy to proceed, the directed conversation around their lived experiences started. The team even provided the contributors with forms to indicate their understanding of the team’s intentions, and their consent to be quoted in any kind of publication, or their pictures being taken for GSU webpages. Patients contributors consented by either signature or thumbprint and conversations were audio-recorded for analysis. When the translator was not part of GSU or the Ghanaian team, but a member of staff at the local hospital or a patients’ relative, they were reimbursed for their time and travel costs with 50 cedis. When patient contributors’ relatives acted as translators, the team experienced some difficulty with the quality of the translation due to them interpreting the patient’s answers and providing a summary in English rather than a word-for-word translation. The members of the Ghanaian team ensured that the patients contributors felt comfortable throughout the interview. This proved immensely important for the quality of the interaction. They visibly relaxed when they identified members of the Ghanaian team, who they were either familiar with due to previous treatment at their hospital or had heard of before.

The conversation was loosely structured around the focus areas as identified by the PAG and outlined above: To capture the patient contributors’ lived experiences to inform relevance, acceptability, and feasibility of the TIGER intervention. A script for this was written based on whether the contributors were previous hernia patients or currently living with hernias (Additional file 1 : Appendix 1 and 2). During the conversation, the team ensured to allow the contributors to provide as much detail about their experiences as they wanted and felt comfortable with, and only asked directed questions when necessary to address the three areas of concern.

Patient contributors’ feedback: lived experiences summarised

Summarised below are the overall topics raised by the patient contributors, as well as opinions from other relevant community members, not only addressing the three areas of concern as outlined above (study relevance, feasibility and acceptability), but providing the team with further insights into challenges and barriers of seeking healthcare and needs of rural communities. All information below stem from these conversations and represent the views and experiences of the patient contributors. It is important to note again that these conversations were not qualitative research. T herefore, no methodology was used to analyse themes. The GSU CEI Manager and Ghanaian team merely summarised common opinions and experiences as stated by the patient contributors und used these to inform the TIGER trial with respect to protocol design and trial intervention.

Relevance of study

Surgical capacity in rural areas is urgently needed.

Most rural hospitals do not have a surgeon on site at all times. Sometimes the surgeon only visits once a week or less, as they have to cover multiple hospitals in the area. Their arrival at the hospital will be announced via the local radio, information centres, churches and mosques, with patients lining up in large numbers outside the hospital and surgeons performing all kinds of surgery, no matter their specialty. More often than not, patients are being sent home or allocated a bed or any kind of free space in the hospital for several days without having had surgery, as the medical team just does not have enough capacity. This means that patients will have to either travel to the hospital multiple times whilst being ill, or that they have to stay in the hospital for several days, often sleeping on benches or the floor. This has severe consequences on the patient and their families.

Most people in rural Ghana are farmers or tradesmen, selling goods along roads to be able to feed their families. Taking time ‘off’ means that they cannot tend to their fields and most likely don’t only lose out on goods to sell, but also on harvesting and providing food for their own meals, meaning more expenditure having to buy in supplies. On top of that, patients and their family members traveling with them have to spend money they do not have on transport to and from the hospital additional to the cost of the surgery. Most patients will travel by bus, only a few with severe pain ask friends or family members with motorbikes or cars to take them. According to a Chief the team spoke to, as well as a financial officer, occasionally community leaders cover these costs when families cannot manage to save up the needed funds themselves.

Barriers to accessing healthcare: traditional medicine and alcohol are considered feasible treatment options amongst patients– whereas surgery is considered unsafe

Many communities in rural Ghana are under the impression that traditional medicine or alcohol can cure inguinal hernias or at least keep the pain at bay enough to fully function and be able to continue with their everyday life and work. Patients often live for years with a hernia - most pre-surgery patients that the team talked to have lived with their hernia for 5–10 years prior to seeing a doctor due to worrying about the cost implication, as well as potential poor outcomes of surgery. Stories about patients dying after surgery are well spread in rural communities. A more affordable, and in their opinion, safer option is traditional medicine and alcohol, even though these are arguably not cheaper than surgery when taken over many years – and only treat the symptoms, not the underlying cause.

Community leaders confirm, lack of access of safe hernia repairs poses financial burden on wider communities

After having heard about community leaders covering costs of surgery for patients within their district, the local team made arrangements to separately meet two Chiefs, a Catholic Priest, an Islamic Cleric, and an Assemblyman in the Sunyani West District in the Bono Region. Discussions with these well respected community leaders confirmed the impact that poor access to safe, affordable surgery has in these rural areas. The team was invited to meet with the Chiefs and their community elders to raise awareness of TIGER and explore their opinion on its relevance. Usually, anyone enquiring about a meeting with the Chief would be asked to follow strict rules of paying respect. However, GSU researchers were allowed to address the Chiefs directly with the help of a translator, which demonstrated the immense interest these community leaders had in finding out more about the benefits of this research for their communities. The conversations highlighted that community leaders will often use money meant to support community projects, such as fixing roads and furthering general infrastructure, for patients to be able to undergo surgery and help support their families. After explaining TIGER to them, all community leaders stated that this kind of task-shifting around hernia repairs, as well as other surgeries, would relieve a substantial amount of this burden on their communities. It was also highlighted that there is stigma attached to hernias in rural communities, with people not understanding the reasons for this condition and the impact it may have on their overall health and wellbeing. It is therefore important that the study results are shared widely in an accessible way. The relationship with these community leaders will support this dissemination and will ensure that future research can be informed by representative community members.

Acceptability of intervention: patients trust medical staff and have faith in god

When it came to addressing the matter of surgeons versus non-surgeon physicians performing the hernia repair, it became clear early on that patients will trust medical professionals and their opinion. If a surgeon vouches for a non-surgeon to have been adequately trained, the patient will not question this. In fact, most post-hernia surgery patients contributors stated that by the time they finally sought help and made their way to the hospital, they did not care who fixed their hernia, as the pain was unbearable. When prompted if they would object to someone who has not had years of surgical training undertaking their surgery, their response often was that God would guide the surgeon’s hand and that they have faith.

Feasibility of study intervention

Participating in clinical trials for the greater good of the community.

When addressing having to travel to the hospital for follow-up as a participant in the TIGER trial, it was argued that if patients travel to hospital and will be seen by a surgeon right there and then, cost implication on their families will be minimised. A second trip to the hospital for follow-up after surgery will therefore still have less impact on the family’s financial status than the current situation of having to travel multiple times or stay at the hospital for a prolonged period.

Adaptation of study protocol: inclusion of women in patient cohort

Changes to the trial protocol were made as a result of the conversations with patient contributors. For instance, initially, women were excluded from the study, but lived experiences of female patient contributors convinced the local team to change this. It was furthermore established that dissemination of relevant, accessible information about surgery and living with hernias will be crucial to ensure that communities experience the benefits of this study. The experiences in Ghana have opened up discussions at GSU about whether educational interventions may be needed to support better health in general so that the population can be provided with the knowledge and tools to help themselves.

Reflections of the research team

Traveling around Ghana and talking to patient contributors has not only informed the TIGER trial, but has made the GSU teams aware of the impact CEI may have generally on shaping and informing clinical research. After initially doubting the benefits of talking to communities that have never even heard of clinical trials, health research or CEI before, these involvement activities completely changed Prof Stephen Tabiri’s and Bernard Ofori Appiah’s mind about how they will design studies in the future.

In conversation with Bernard a few weeks after the CEI activities, he said:” Imagine an architect being [hired to design] someone’s house and then the architect […] will not get back to the person to find out what the needs of the person are and [does not] check the topography of the land and then he designs the house. At the end, the person will not be happy.

Or a tailor. You consult a tailor for a dress for a wedding. The tailor will not measure you out or interview you to find the colours you want and then he sews something for you. I believe at the end of it all, you might not be happy.

The same way research should go. At the end of it all, the benefit should be for research [and its] community focus.

So why do we design research without consulting [patients]?”

Angela Prah is a member of the UK-based PAG, having moved to the UK from Ghana to undertake a Master’s degree at the University of Birmingham. Her background is in healthcare in rural Ghana, where she worked closely as a nurse with patients and local communities. Angela’s expertise in working with local communities, having grown up in rural Ghana, was invaluable in shaping the CEI activities. Her thoughts on the TIGER trial, the relevance of working with patients in LMICs, and her feedback on what she gained from being involved with GSU are summarised below.

“Involving local communities - this being patients, their community and their caregivers - is an integral part of healthcare, however, as much as it is important in achieving optimum health, it is less considered in LMICs. The confidence a patient has in accepting to undertake a procedure, in this case a surgical procedure - be it minor or major - depends on their understanding of the whole process from pre, intra and post procedure. Being involved gives them more trust in accepting the trial intervention. TIGER trial has been a tremendous help as it would improve the use of patient-family centred approach in delivering a high quality healthcare system. This would in turn increase patient confidence in accepting procedures that would have usually been refused or delayed till they become severe.

Having the opportunity to be part of the advisory group has made an important mark in my career as a caregiver. That is, the knowledge acquired and the skills generated through the TIGER trial has enhanced my abilities to care for patients, involve them in their care and bring their community on board in the healthcare system as the primary concern of healthcare is the patient and their environment (community). This would have a transferrable impact on other healthcare givers as well. I would like to thank the TIGER trial team for choosing Ghana to be a part of the study as this would go a long way to affect positively the healthcare of Ghana, our citizens and our communities. This would inform healthcare practice in the sense that there would be a change in the way and manner we take our patients through procedures by involving them in the process.”

Summary of implications of the CEI activities

The interaction with patients in Ghana has confirmed that task-shifting and capacity-building research is crucial to support the surgical workforce in rural Ghana, has led to amendment of the TIGER study protocol and supported the research ethics application. It has furthermore allowed the team to get a glimpse at how people in certain areas of Ghana live, perceive health and disease, and their beliefs, struggles and concerns when it comes to health and seeking care. The Ghanaian team see value in involving patients and communities in future studies and have been provided with the tools to lead on this themselves. Lasting relationships with community stakeholders were established (Chiefs, politicians and religious leaders) that can be utilised for future research prioritisation, involvement throughout the research cycle, and dissemination of findings. This is providing a first step towards research being informed, led on and implemented with the help of community representatives in the Global South. A further outcome is that the experiences in Ghana helped implement other high-quality CEI activities in some of the Unit’s collaborating LMICs, with an opportunity to build on the lessons learned and share knowledge and expertise with local teams across the world. Table ​ Table3 3 outlines the top tips for CEI undertaken in Ghana and other LMICs from the UK-based researcher’s perspective.

Tips for designing CEI activities in LMICs when based in the UK

This table provides a summary of the top tips from the UK team’s perspective when designing new CEI activities in collaboration with an LMIC-based team

HIC High-income country, LMIC Low-and middle-income country, CEI Community engagement and involvement

Implementing community contributors’ feedback

The evidence base behind the TIGER proposal was solid, with other task-shifting studies having proven successful in LMICs with focus on improving health system efficiency [ 10 ]. WHO describes task-shifting as a ‘viable solution for improving health care coverage by making more efficient use of the human resources already available and by quickly increasing capacity’ [ 11 ]. The CEI activities designed for TIGER therefore aimed to confirm the relevance, feasibility and acceptability of this specific intervention focusing on hernia repairs. These are reported benefits of CEI - or PPI in the UK - with clinical trials [ 3 ]. Talking to patient contributors and community leaders in various different locations in Ghana, representing the relevant patient cohort for TIGER, has confirmed relevance, feasibility and acceptability of the study, and led to protocol changes to further increase relevance. It has furthermore highlighted the urgent need for this intervention to lessen the burden on patients, families and whole communities.

Level of involvement of community stakeholders

Designing and implementing CEI activities was a new concept for the team in Ghana. Likewise, exploring feasible ways of involving patients in an LMIC-setting was new for the UK-based team, as well. With still little evidence in the literature, especially on involving community contributors throughout the research cycle and establishing lasting relationships [ 4 ], the team set out to adapt what is accepted as best practice in the UK for local context. For this, the team used the UNICEF core standards (which were at draft stage at the time): 1. Participation, 2. Empowerment and ownership, 3. Inclusion, 4. Two-way Communication, 5. Adaptability and Localization, and 6. Building on Local Capacity [ 5 ]. CEI with research designed using these standards as a guideline is meant to contribute to the empowerment of communities to take ownership of their health by actively being involved in the research process. For this to happen, equal opportunities have to be created, ensuring that relevant stakeholders in the community get the chance and are provided with the tools to feed into aspects of the research cycle, especially marginalised communities [ 5 ]. This may mean that researchers or CEI professionals have to spend time supporting community contributors by, e.g. providing training, or where contributors live in remote locations, travelling to them to perform involvement activities, or designing activities in local language with a translator [ 8 ]. These limitations were addressed by the GSU teams, highlighting the relevance for establishing trust and good relationships with patient contributors, and the need for a skilled translator in doing so. It is important to note that these adaptations may vary in different local contexts and the way certain communities can be reached and get involved with research may depend on their skills and resources [ 5 ].

The GSU team used the GRIPP-2 framework [ 9 ] to highlight the limitations experienced when designing and undertaking the involvement activities in Ghana. Aiming to involve patients throughout the research cycle, which can reportedly have big impact on the quality and success of the study [ 12 ], the Ghanaian team was concerned about rural communities potentially not understanding the concept of research or what it means to be involved with research. This concern is often raised by GSU LMIC-based researchers, not only in Ghana. The team’s activities based on conversations with individual patient and community representatives only classify as community consultation, an entry-level involvement activity [ 13 ]. However, opening up the conversation about TIGER and exploring the patient journey has allowed the researchers to gauge how interested patients and community leaders are in ongoing involvement with GSU research, gain their trust – a step that has been reported as crucial for meaningful and sustainable engagement and involvement by other researchers, as well [ 14 , 15 ] - and establish ongoing relationships with community leaders. The Ghanaian team can now utilise these relationships for future involvement activities, potentially even aiming for involvement in research prioritisation.

This work contributes to an evidence base for CEI activities in LMICs, highlighting the process of designing these activities in collaboration with LMIC-based researchers and UK-based public contributors. This paper outlines what the GSU teams has learned and gained from talking to community stakeholders in Ghana. It also highlights the challenges and barriers, as well as solutions when involving patients in rural areas of Ghana in informing and shaping a clinical trial, with the aim to share these experiences with the wider global health research network.

Acknowledgements

A big thank you to the whole GSU team for ongoing support and providing expertise throughout the planning stage of the CEI project, here specifically (in no particular order) Mr. Aneel Bhangu, Dr. James Glasbey, Dr. Dmitri Nepogodiev, Dr. Sohini Chakrabortee, Prof Dion Morton and Prof Peter Brocklehurst, as well as Dr. Laura Nice for advice. We would also like to thank the PAG members, and patients contributors and community members in Ghana who so willingly sacrificed their time to support these activities.

Abbreviations

Authors’ contributions.

The initial activity was designed by Karolin Kroese in collaboration with Angela Prah, Stephen Tabiri, Bernard Ofori Appiah, and Ramatu Darling Abdulai. Undertaking of the activities by Karolin Kroese, Mark Monahan, Stephen Tabiri, Bernard Appiah, and Ramatu Darling Abdulai. The initial manuscript was written by Karolin Kroese with extensive support from Mark Monahan, Stephen Tabiri, Bernard Appiah and Angela Prah. The author(s) read and approved the final manuscript.

This research was funded by the National Institute for Health Research (NIHR) (16/136/79) using UK aid from the UK Government to support global health research. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK Department of Health and Social Care.

Availability of data and materials

Declarations.

Research ethics approval for the TIGER trial will be obtained once the protocol has been finalised. The activities outlined in this publication were at no stage designed to be, nor were they undertaken as research and were therefore not based on any research methodology. The main purpose, as outlined in ‘Results’, was to inform relevance, feasibility and acceptability of the TIGER trial by having conversations with those that will be affected by TIGER. These are CEI activities and the team used the CEI/PPI framework, GRIPP-2, to determine the quality. Patient and community contributors consented to participating in the CEI activities by either signature or thumb print. The Ghanaian team advised on doing this, as this meant that a significant amount of time before each conversation with the contributors was spent to explain the purpose of the conversation to follow. This allowed the team to be certain that patients and community members fully understood the reasons and intentions of the team, which was particularly important when the contributors did not speak English to eliminate concerns around miscommunication. Contributors then used their signature or thumb print to indicate clearly that they 1. Understood the intentions of the team, 2. Were happy to proceed with the activities, 3. Understood that they can say ‘No’ or refuse to provide input and feedback at any time, 4. Were happy for the conversation to be audio-recorded for note-taking purposes, 5. Were happy for their pictures to be taken and uploaded onto GSU webpages, 6. Were happy for the discussions to form part of a publication. Many did not consent to point 5. and did therefore not have their pictures taken.

Anyone named in this publication has consented by either signing a consent form, or is part of the research team and has given verbal approval.

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Addressing Contemporary Public Health Challenges in Ghana for Improved Outcomes: Getting to SDG 3

research topics on social issues in ghana

Original Research 12 December 2023 “We have nice policies but…”: implementation gaps in the Ghana adolescent health service policy and strategy (2016–2020) Emelia Afi Agblevor ,  4 more  and  Irene Akua Agyepong 1,517 views 0 citations

Original Research 14 August 2023 Why district assemblies disburse resources to district health systems for service delivery at district level in the context of decentralization: a comparative study of two districts in the Volta Region of Ghana Andrews Ayim ,  1 more  and  Nana Enyimayew 745 views 0 citations

Original Research 07 July 2023 How and why pharmaceutical reforms contribute to universal health coverage through improving equitable access to medicines: a case of Ghana Augustina Koduah 1,578 views 0 citations

Loading... Systematic Review 26 June 2023 Implementation of the Community-based Health Planning and Services (CHPS) in rural and urban Ghana: a history and systematic review of what works, for whom and why Helen Elsey ,  12 more  and  Irene Agyepong 2,890 views 0 citations

Original Research 25 May 2023 Universal coverage and utilization of free long-lasting insecticidal nets for malaria prevention in Ghana: a cross-sectional study Seth Kwaku Afagbedzi ,  6 more  and  Chris Guure 1,089 views 0 citations

Original Research 09 May 2023 Continuity of care among diabetic patients in Accra, Ghana Veronica Awumee  and  Samuel Kennedy Kangtabe Dery 1,026 views 0 citations

Original Research 09 May 2023 Making districts functional for universal health coverage attainment: lessons from Ghana Humphrey Cyprian Karamagi ,  9 more  and  Francis Chisaka Kasolo 962 views 0 citations

Loading... Original Research 13 April 2023 District-level analysis of socio-demographic factors and COVID-19 infections in Greater Accra and Ashanti regions, Ghana Alex Barimah Owusu ,  2 more  and  Edwin Takyi 2,299 views 0 citations

Original Research 09 February 2023 Maternal factors and child health conditions at birth associated with preterm deaths in a tertiary health facility in Ghana: A retrospective analysis Seth Kwaku Afagbedzi ,  2 more  and  Henrietta Taylor 1,380 views 0 citations

Loading... Original Research 03 February 2023 Influencing factors of work stress of medical workers in clinical laboratory during COVID-19 pandemic: Working hours, compensatory leave, job satisfaction Gang He ,  2 more  and  Houzhao Wang 2,468 views 3 citations

Original Research 22 December 2022 Estimation method for distance cost to access medical services: Policy and patient privacy implications in Taiwan Siao-Jing Guo ,  1 more  and  Chia-Feng Yen 1,679 views 0 citations

Original Research Frontiers in Public Health The role of community engagement towards ensuring healthy lives: A case study of COVID-19 management in two Ghanaian municipalities 711 views 0 citations

  • Thursday, April 4, 2024
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Government must expand social interventions to reduce inequality—CSOs

Accra, Jan. 20, GNA – A group of Civil Society Organisations (CSOs) haS called on government to consider expanding the various social intervention schemes to curb the worsening inequality in the country.

It also wanted government to address issues of corruption that had characterised some of the interventions to ensure they reached the targeted beneficiaries to make the expected impact.

The CSOs made the call at a multi-stakeholder forum on the Commitment to Reducing Inequality in Ghana, in Accra.

The forum, jointly organised by OXFAM, SEND-Ghana and the CSOs Platform on SDG, was to share and discuss findings of the 2021 Commitment to Reducing Inequality(CRI) report released by OXFAM in November last year.

It was also to make policy proposals and secure commitment to alleviate and address the widening inequality gap in the present COVID-19 context.

Dr George Domfe, Senior Research Fellow, Centre for Social Policy Studies, University of Ghana, said Ghana had made significant stride in terms of economic growth over the last couple of years culminating in the reduction of the inequality gap in the country.

Despite the progress, Dr Domfe said more Ghanaians continued to live in extreme poverty.

He said expanding the numerous social intervention programmes, especially the Livelihood EmpowermentAgainst Poverty (LEAP) programme, by increasing the amount given to the beneficiaries, as well as roping in more disadvantaged people, would go a long way in alleviating the plight of more vulnerable persons and help bridge the inequality gap.

“Ghana is not doing well at all in social interventions. We are not spending so much in that area if you compare us to the other African countries and I think government can do better to cushion a lot of poor people and help bridge the gap,” he emphasised.

Ghana currently is implementing more than 40 different social protection interventions to reduce poverty and bridge the inequality gap in the country.

These interventions include the LEAP, the Ghana School Feeding Programme, the National Health Insurance Scheme, the Capitation Grant, the Free Senior High School (FSHS), Free School Uniform, Free Exercise books and the Labour-Intensive public works.

Figures from research conducted by OXFAM showed that in the decade up to 2016, Ghana saw 1,000 new US dollar millionaires created, while nearly one million were pushed into poverty.

Ghana is currently ranked 3rd in West Africa as the most committed country to reducing inequality.

In Africa, it ranks 20th and 121st globally.

Professor Godfred A. Bokpin, Economist at the University of Ghana Business Schools, noted that the country had performed poorly when it came to labour, especially in addressing unemployment.

While advising government to review the country’s current tax regime, especially in the informal sector, he urged it to tackle issues of unemployment.

Data from the GSS indicates that unemployment rate in Ghana has almost tripled in little more than a decade and more than 1.55 million people, or 13.4 per cent of the country’s economically active population are out of work.

Professor Bokpin, therefore, encouraged the government to show more commitment in the agriculture sector, which employed more of the country’s labour force, to curb the phenomenon.

Mr Vitus Azeem, Chairman, Tax Justice Coalition, advised government to prioritise the collection of property tax to rake in more revenue and reduce the tax burden on the ordinary Ghanaian.

Ms Harriet Nuamah Agyemang, Senior Progamme Officer, SEND-Ghana, appealed to government to ensure enough allocation and disbursement of budgetary allocation to the health sector, to expand the infrastructural needs to achieve the Univeral Health Coverage agenda by 2030.

The Commitment to Reducing Inequality (CRI) Index is a multidimensional index, which ranks 158 countries on policy performance to reduce inequality through public services, progressive taxation and labour rights.

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On Sept. 24, 2022, Global Citizen Festival: Accra lit up the iconic Black Star Square, with some of the world’s leading artists, world leaders, business leaders, philanthropists, and Global Citizens coming together to drive change in the mission to end extreme poverty NOW. 

The Global Citizen Festival campaign culminated in $2.4 billion mobilised to help end extreme poverty — including more than $440 million earmarked exclusively to support initiatives to end extreme poverty in Africa. 

But as well as this, it was a crucial moment to bring together young Ghanaians to take action for girls, for the planet, and to create change. 

In the run up to Global Citizen Festival: Accra, we hosted a series of events to engage young people in Ghana and empower them to take action on the issues they care about most. From beach cleanups , to a Festival of Cultures, to popups with sustainable fashion designers, to a youth forum that culminated in a petition to Ghana’s government highlighting the changes young Ghanaians want to see — Global Citizens got involved in their hundreds. 

At these events, we took the opportunity to ask young Ghanaians what issues matter most to them, and what action they want to see to drive real, lasting change in their lives and the lives of their communities. Here’s what they said. 

Youth Unemployment

Regina Buabeng is a student of Regional Maritime University in Accra. She wants to see more action taken to combat youth unemployment, which is a huge issue both in Ghana and across the continent. You can find out more about why youth unemployment is such a significant issue across Africa by taking our quiz . 

research topics on social issues in ghana

Ghana’s youth unemployment rate, according to a 2021 census , is at an all-time high of 13.4% — almost three times higher than in 2010. It’s a worrying trend for soon-to-be graduates like Buabeng, who we caught up with at a beach cleanup we hosted with Plastic Punch Ghana at Regional Maritime University on Sept. 10. 

“Thinking about all the money my parents have spent on my education and going out being unemployed makes me feel bad,” she told Global Citizen.

Anita Laryea is an auditor based in Accra and she wants to see more action taken to improve sanitation in Ghana — just like Global Citizen Festival: Accra headliner, Stonebwoy , who is also Ghana’s global ambassador for sanitation . 

According to UNICEF, there is still no urban sanitation strategy in Ghana , meaning that various efforts to improve sanitation aren’t being effectively monitored or coordinated. The capital, Accra, continues to battle annual floods which affect lives, health, properties, and businesses. This flooding is partly attributed to the changing climate, but also the issue of improper disposal of waste — with waste, much of it plastic, blocking existing drainage systems. 

research topics on social issues in ghana

“You walk around town you see someone drinking water and the person just throws it on the streets,” Laryea said, when we spoke with her at the beach cleanup on Sept. 10. “Some people make rubbish in their houses and throw it in the gutters. It causes the flooding.”

The rains in May and June this year left many parts of Accra and Kumasi flooded, bringing into question the cities’ climate resilience plans. 

Frances Quayson highlighted corruption in Ghana’s police service as an issue he wants to see addressed. A survey, released in July 2022 by the Ghana Statistical Service, named the Ghana Police Service as the most corrupt institution in Ghana . 

research topics on social issues in ghana

“I work in the media and I have been seeing them taking money anytime I travel from Accra to Takoradi,” Quayson said. “If somebody wants to do something bad they can easily pay and do it.”

Economic Crisis

Kwaku Kumi, the owner of Gold Coast Tokota, a manufacturer of made-in-Ghana footwear, is concerned about the exchange rate in Ghana and what it means for the financial security of Ghanaians. The continuous weakening of the country’s currency against the US dollar has made it one of the worst-performing currencies in the world , according to Bloomberg. 

research topics on social issues in ghana

Kumi told us: “I am doing business in Ghana now and, trust you me, the dollar rate is not helping us. It’s not easy to operate a business in Ghana. I am still in business because I am taking that leap of faith that things will change.”

Eugenia Tenkorang, a local journalist, wants to see more action taken to tackle poverty and the impact it’s having on Ghanaians' lives. 

In 2022, around 3.4 million people in Ghana are living in extreme poverty — meaning on less than $1.90 a day — and the vast majority of these ( about 3.1 million ) live in the country’s rural areas. 

But while extreme poverty in the country is falling, there are many ways poverty can be experienced beyond the extreme poverty criteria of living on less than $1.90 a day — including being deprived of health, education, living standards, and more. 

research topics on social issues in ghana

According to a 2020 report from the Ghana Statistical Service and the UN Development Programme (UNDP), around 2 in 5 Ghanaians are identified as poor beyond monetary deprivations — or an estimated 14 million Ghanaians who are “ multi-dimensionally poor ”. 

As Tenkorang added: “The level of poverty, which is seen in almost all spheres, really gets to me.” 

“Personally, I know a woman who grew up in poverty,” she continued. “She got married and raised all her three children in poverty. The kids have graduated, but have not gotten employed yet. And so, these children, whose parents were looking forward to a brighter future for them, have grown up to continue the poverty cycle.”  

Global Citizen Asks

Demand Equity

5 Key Issues That Matter Most to Young People in Ghana

Oct. 11, 2022

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7 serious social problems in Ghana and their solutions: be in the know

Like other developing countries in Africa, Ghana faces multiple issues. Its contemporary society is highly influenced by rapid social and technological changes. These changes can no longer be solved using traditional approaches. It is time to think about new solutions to various social problems in Ghana.

social problems in Ghana

A social problem is any condition or situation that adversely affects many people in a country. It disrupts the normal functioning of society. There are multiple social problems in Ghana. Some can be resolved easily, while others are more complex to solve.

Serious social problems in Ghana and their solutions

The social problems experienced by most Ghanaians today tend to form a chain. One challenge often leads to another.

Main social problems in Ghana in 2022

Below is a list of social problems in Ghana and their solutions.

1. Unemployment

Unemployment refers to the share of the labour force without work but are available for and seeking employment. The rate of unemployment in Ghana in 2020 was 4.70%, a 0.05% increase from 2020.

research topics on social issues in ghana

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The Ghanaian Times reports that about 1.74 million people, which is equivalent to 13.4% of the total working population of 13 million aged 15 years and above.

The rate of unemployment can be attributed to numerous factors, including the prevailing economic recession, corruption , slow economic growth, and a sharply increasing population.

2. Corruption

What is Ghana struggling with?

One of the most pressing social problems in Ghana in 2022 is corruption. The same is being experienced in multiple African nations.

For a long time, Ghana has earned a significant amount of cash from its natural resources, including gold, manganese, bauxite, and diamonds. Unfortunately, a considerable portion of these resources goes down the cesspool created by corruption.

This means that despite the nation being naturally endowed, resources benefit a few and leave the rest in poverty. The country has many institutions and departments where one cannot receive service without bribing the officers.

research topics on social issues in ghana

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3. Illiteracy and inaccessibility of quality education

Education is an important tool for development in any country. In Ghana, the quality of education is lagging behind. While there have been a few positive developments in the sector, much is desired.

The Ghanaian educational sector faces multiple challenges, especially in rural areas. The basic facilities in public schools are in deplorable states and inadequate. Besides, the human resources to fill the minimum criteria of a school are inadequate.

Many children, especially those from resource-poor settings, do not go to school or drop out early. As a result, the level of illiteracy is quite high.

What is Ghana struggling with?

According to Oxfam , approximately 24.2% of the Ghanaian national population lives below the poverty line. Numerous people, especially on the northern side of the nation, earn less than one American dollar a day.

Although the country is blessed with the resources needed to end extreme poverty and bridge the disparities between the rich and poor, it is failing to do so because of corruption.

research topics on social issues in ghana

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5. Forest encroachment and desertification

Ghana is among the tropical countries that have suffered the most from deforestation in recent years. Shocking results show the forest cover has shrunk up to five times in one century.

The increasing human population has also encroached on land that should otherwise be left for forests and wildlife. Forest encroachment and desertification have led to climate change, especially long episodes of drought.

6. Rural-urban migration

Many young Ghanaians move from their rural homes to urban areas looking for jobs. In the capital city of Accra , for instance, the population has doubled since the ’90s.

Young people perceive urban areas to be the epicentre of economic opportunities and exciting modern lifestyles. Some of the challenges of rural-urban migration are poor housing conditions due to congestion in the cities, increased crime rates, and deterioration of the rural economy leading to chronic poverty.

research topics on social issues in ghana

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7. Lack of well-defined child welfare practice systems

What are some of the economic problems facing Ghana?

Child rights and gender-based violations are pretty common in the country. Many would expect that in 2022, children's welfare is prioritised. Unfortunately, that is not the case.

The nation has poorly defined child welfare practices . In fact, it lacks a clear definition of what child abuse is. This makes it hard for social workers to fully protect the rights and freedoms of children and women.

The existing social service agencies often fail to meet the needs of the populations they serve due to a lack of clear policies and guidelines. The problem is further aggravated by poverty and corruption.

Solutions to social problems in Ghana in 2022

How can Ghana solve the problems explored above? Below are feasible measures that can be enacted to resolve the challenges.

Solving unemployment in Ghana

The high rate of lack of jobs can be solved in the following ways.

research topics on social issues in ghana

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  • The government should provide better financial support to technical institutions in the country. The demand for hands-on skills outdoes the supply, so the government should encourage young people to pursue technical courses.
  • A youth-programmed fund should also be initiated to fund start-up businesses for the youth.
  • The relevant authorities should also address the monster of corruption. If addressed, funds to expand the economy and create jobs will be availed.
  • Additionally, the government should facilitate the export of human capital to get qualified Ghanaians job opportunities overseas.

Solving corruption

What are some of the social issues?

The government can implement the following anti-corruption measures.

  • Make reforms in public administration and finance management. This should be coupled with strengthening the mandate of auditing bodies and agencies.
  • Providing rewards and incentives to citizens who report corruption cases.
  • Creating pathways that empower citizens with relevant tools and knowledge to engage and participate in their government.
  • Promoting transparency and access to information.
  • Creating, funding, and strengthening agencies that prosecute corruption cases.

research topics on social issues in ghana

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Solving illiteracy and inaccessibility of quality education

Illiteracy and inaccessibility of quality education can be resolved in the following ways.

  • Ensuring the education sector is well-funded.
  • Every child has the right to an education in a safe and healthy setting, so basic education should be made mandatory for all.
  • Setting up programs that ascertain students transition from different levels of study to the highest where they earn the right skills.

Solving poverty in Ghana

The country can resolve poverty in the following ways.

  • Ensuring all children access quality education.
  • Ensuring basic health care for all.
  • Prevent child marriages and promote proper child welfare practices.
  • Supporting environmental programmes.
  • Improving childhood nutrition.

Solutions to forest encroachment and desertification

Forest encroachment and desertification be solved in the following ways.

  • Sensitising all citizens about the dangers of forest encroachment and desertification to society.
  • Running tree planting programmes in communities.
  • Resettling people who have settled in forest zones and giving stringent punishments to those who encroach on these areas.

research topics on social issues in ghana

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Rural-urban migration

Rural-urban migration can be solved in the following ways.

  • Creating employment opportunities in rural areas.
  • Promoting agriculture in rural areas.
  • Improving transport and communication network services.

Solving poor child welfare practice systems

Child welfare practice systems should be improved in the country. Policies on children's welfare should be updated, and terms should be defined clearly.

list of social problems in ghana

What is the meaning of a social problem?

A social problem is an issue that affects many people within a society. It arises from fundamental faults in the structure of a society.

What are the social problems in Ghana?

The social problems in Ghana include rural-urban migration, unemployment, forest encroachment and desertification, corruption, poverty, illiteracy, and inaccessibility of quality education.

What are 5 social problems?

The five pressing social problems in Ghana are unemployment, poverty, corruption, rural-urban migration, and the inaccessibility of quality education.

What are some of the social issues?

research topics on social issues in ghana

Fine girl in trouble: Hajia4Real allegedly arrested in the UK over $8m fraud, man drops full details

Some of the social problems in the world are unemployment, poverty, corruption, rural-urban migration, forest encroachment and desertification, and inaccessibility of quality education.

What are some of the economic problems facing Ghana?

Some of the economic challenges facing Ghana are unemployment, corruption, state-society gap, inconsistent economic policies, poor human capital development, poor health system, and crime and terrorism.

What is Ghana struggling with?

Ghana is struggling with unemployment, corruption, inaccessibility of quality education, poverty, forest encroachment and desertification, rural-urban migration, and poor child welfare practice systems.

What are examples of social problems?

Examples of social problems are corruption, unemployment, poverty, inaccessibility of quality education, forest encroachment and desertification, rural-urban migration, and poor child welfare practice systems.

There are several pressing social problems in Ghana. Most of them can be solved by implementing stringent government policies and measures.

READ ALSO: 25 profitable business ideas in Ghana in 2022 listed and explained

research topics on social issues in ghana

Climate activists challenge TotalEnergies CEO at COP27

Yen.com.gh recently published a list of profitable business ideas in Ghana in 2022. The high unemployment rate among Ghanaian youths is worrying. One way of solving the menace is turning to self-employment.

People of all ages can start and run successful businesses in the country. Before starting any venture, do a feasibility study to ascertain whether it is profitable.

Source: YEN.com.gh

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Research: How Women Can Build High-Status Networks

  • Carla Rua-Gomez,
  • Gianluca Carnabuci,
  • Martin Goossen

research topics on social issues in ghana

Companies can help women overcome common obstacles they face when trying to forge powerful professional ties.

Despite the potential career benefits of building high-status networks, research has long shown that women face greater obstacles in establishing these networks compared to men. The authors’ research , published in the Academy of Management Journal, not only underscores what we know about the unique challenges women face in building high-status networks; it also offers a strategic roadmap for overcoming these challenges. By understanding and leveraging the power of shared social connections, women as individuals can navigate around systemic biases and forge valuable professional ties that propel their careers forward. For organizations committed to gender equality, their study provides a clear directive: Invest in building network sponsor programs that recognize and use the distinct pathways through which women can achieve high-status connections.

In the context of career advancement, the notion that “It’s not what you know, but who you know” holds some truth. However, for many women, this concept presents unique challenges. Despite the potential career benefits of building high-status connections within an organization, research has long shown that women face greater obstacles in establishing such connections compared to men. Our research , published in the Academy of Management Journal, offers new insights into this persistent challenge, and we share some of those insights in this article.

research topics on social issues in ghana

  • CR Carla Rua-Gomez  is an assistant professor of management and organization at SKEMA Business School, Université Côte d’Azur (GREDEG). She received her PhD from Università della Svizzera italiana (USI) in Switzerland. Her research interests revolve around innovation, social networks, and gender inequality. Carla is particularly interested in understanding how workplace dynamics perpetuate or limit gender inequality within research-intensive corporations.
  • GC Gianluca Carnabuci is a professor of organizational behavior at ESMT Berlin. He is also the holder of the Ingrid and Manfred Gentz Chair in Business and Society. His research and teaching focus on how informal networks shape the flow of information and knowledge within organizations, and how that affects the productivity of leaders, teams, and organizations.
  • MG Martin Goossen is an assistant professor in the Department of Management of Tilburg University. His research focuses on the role of individual employees in the R&D activities of high-technology firms.

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ScienceDaily

Talking politics with strangers isn't as awful as you'd expect, research suggests

Many of us avoid discussing politics with someone who holds an opposing viewpoint, assuming the exchange will turn nasty or awkward. But having those conversations is far more gratifying than we expect, a new research paper suggests.

Across a series of experiments involving hundreds of U.S. adults, a team of scientists found that individuals underestimate the social connection they can make with a stranger who disagrees with them. The findings are published in Psychological Science, a journal of the Association for Psychological Science.

These low expectations may help to explain why people think those on the opposite side of the political spectrum have more extreme views than they actually do, behavioral scientists Kristina A. Wald (University of Pennsylvania), Michael Kardas (Oklahoma State University), and Nicholas Epley (University of Chicago) wrote in an article about their research.

"Mistakenly fearing a negative interaction may create misplaced partisan divides," they wrote, "not only keeping people from connecting with each other but also keeping people from learning about each other and from each other."

The experimenters found evidence, through experiments conducted online and in person, that people prefer to avoid hot-button issues, especially with people who disagree with them. People also tend to advise their friends and relatives to avoid such conversations.

But Wald, Kardas, and Epley believed people would find discussing their political differences to be a more positive experience than expected, at least partly because people fail to appreciate the extent to which conversations are informative and draw people closer together.

To test their theory, they asked nearly 200 participants in one experiment for their opinions on divisive political and religious topics, such as abortion and climate change. The researchers then divided the participants into pairs and assigned them to discuss one of these topics. Some participants were told in advance whether their partners agreed with them or not, but others entered the discussions unaware of their partners' views.

All the participants reported how positively or negatively they expected the conversation to be, then engaged in the discussion while being video recorded. Afterward, the participants rated their sentiments about the dialogue. Research assistants also viewed the videos of the conversations and evaluated them across several dimensions.

As predicted, the participants underestimated how positive their conversation experience would be, but this tendency was largest when they disagreed with their partner. Participants in this disagreement condition also underestimated the similarities in their opinions. Coders who watched the videos of these conversations confirmed that participants tended to stay on topic, and that the conversations were consistently positive whether the participants agreed or disagreed.

In another experiment, the researchers tested their hypothesis that people underestimate how the process of conversation itself -- actual back-and-forth dialogue -- connects people. To do so, they randomly assigned participants to discuss a divisive topic they agreed or disagreed on, but they also randomly assigned participants to either have a conversation about the topic in a dialogue format or to simply learn of their partners' beliefs on the topic in a monologue format. In the monologue format, each person separately recorded themselves talking about their opinion and then watched the other person's recording.

Overall, the participants underestimated how positive their interactions would be, especially when they disagreed with their partner, the researchers noted. But this tendency was especially strong when people actually had a conversation with their partner rather than simply learning of their beliefs in a monologue. The social forces in conversation that draw people together through back-and-forth dialogue are not only powerful, but they appear to be even more powerful than people expect.

The researchers cautioned that their experiments involved participants talking with strangers; the experiments did not reveal how disagreements unfold among family and friends. Still, they said their findings illustrate the benefits of talking and listening to others rather than typing and broadcasting in debates on social media.

Our reluctance to discuss our differences denies us some positive social interactions, the authors concluded.

"Misunderstanding the outcomes of a conversation," they wrote, "could lead people to avoid discussing disagreements more often, creating a misplaced barrier to learning, social connection, free inquiry, and free expression."

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Journal Reference :

  • Kristina A. Wald, Michael Kardas, Nicholas Epley. Misplaced Divides? Discussing Political Disagreement With Strangers Can Be Unexpectedly Positive . Psychological Science , 2024; DOI: 10.1177/09567976241230005

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Inflation, Immigration Rank Among Top U.S. Issue Concerns

Worry about illegal immigration and terrorism has increased most over past year among 14 issues rated.

research topics on social issues in ghana

WASHINGTON, D.C. -- Amid the heightened numbers of migrants entering the United States at the Southern border and discord in the Middle East, Americans have grown more anxious about immigration and terrorism over the past year. At the same time, with the inflation rate down from 2023, public concern about that issue has eased. Nevertheless, more Americans still say they worry about inflation than any of 13 other issues rated in the new survey.

Gallup finds a slightly different rank-order of concerns with its “most important problem facing this country" question. For the second straight month, immigration leads Americans’ unprompted answers about what most ails the nation, with inflation also figuring prominently.

Six Issues Worrisome to Majority of Americans

Gallup asks Americans to rate their concern about a variety of national issues each March as part of its Environment poll. This year’s survey, conducted March 1-20, asked respondents about 14 different issues, most of which have been tracked regularly since 2001.

The 55% of Americans who worry “a great deal” about inflation is just slightly above the percentages concerned about five other domestic issues that are troubling to majorities of Americans. These are crime and violence (53%), hunger and homelessness (52%), the economy (52%), the availability and affordability of healthcare (51%), and federal spending and the budget deficit (51%).

Another four issues are highly concerning to less than half but at least four in 10 Americans: illegal immigration (48%), drug use (45%), the Social Security system (43%) and the possibility of future terrorist attacks in the U.S. (43%).

In addition, fewer than four in 10 worry a great deal about the availability and affordability of energy (37%) and the quality of the environment (37%). Race relations (35%) and unemployment (33%) garner the least concern, with about a third highly worried about each.

Immigration Is Americans’ Top Unprompted Concern

Gallup also measures Americans’ views of national concerns monthly by asking them to name, unprompted, what they believe is the most important problem facing the country today. This question format is asked before the list of issue concerns in the survey and yields a slightly different conclusion, finding immigration ranking ahead of inflation. Overall, 28% of Americans, the same as in February and the most for any issue, name immigration as the top problem. That essentially ties the 27% reading from July 2019 as the highest since Gallup started compiling mentions of immigration in 1981.

Mentions of government and poor leadership, combined, rank second (at 19%), while the economy in general is next with 14%, followed by inflation at 11%.

Despite being among the highest-rated concerns when asked about directly, poverty and homelessness (6%) and crime (3%) are further down the list in top-of-mind mentions.

Immigration, Terrorism Concerns Rose Over Past Year; Inflation, Economy Waned Slightly

Americans grew less concerned about two economic issues over the past year: the economy in general (down eight points) and inflation, specifically (down six points).

Both declines most likely reflect the near halving of the inflation rate over this period, from 6% just before the start of last year's poll to 3.2% prior to this year's.

Meanwhile, public concern about two of the 14 issues rated in the poll -- illegal immigration and the possibility of future terrorist attacks in the U.S. -- has grown.

The percentage worried a great deal about illegal immigration has increased seven percentage points, from 41% in March 2023 to 48% today. This mostly reflects a near doubling of concern among Democrats, from 14% to 27%. Concern has edged slightly higher among independents (rising from 39% to 44%), while it has been steady at a high level among Republicans (74% in 2023 and 73% today).

Although migrant border crossings are down from the record-smashing numbers experienced in December, they remain much higher than they were before 2021, with February’s crossings the highest on record for that month.

Concern about future terrorist attacks also has grown by seven points since last year, from 36% to 43%, with increases seen among all party groups. However, overall concern about the issue still doesn’t match the higher levels of concern it garnered in 2015 (51%), 2016 (48%) and the early 2000s (49%).

The public's elevated concern about terrorism may partly stem from FBI Director Christopher Wray’s recent warnings to Congress about an increased potential for terrorist attacks in the U.S. In testimony before Congress, he said the risk of terrorism has increased significantly since Hamas’ attack on Israel last year, given the backlash against the United States’ position on the resulting conflict. This intersects with public concern about illegal immigration, as Wray also reported that some migrant smuggling networks have ties to ISIS and other terrorist organizations.

Republicans Much More on Edge Than Democrats About Issues

Substantial differences in concern about issues are seen by political party, with Republicans much more likely than Democrats to worry a great deal about most of the issues. The gap is particularly wide for federal spending and the deficit (49 points), illegal immigration (46 points), and inflation (37 points).

Democrats are more concerned than Republicans about four of the 14 issues, by relatively modest margins: race relations (with a 25-point gap), the quality of the environment (20 points), the availability and affordability of healthcare (17 points), and hunger and homelessness (nine points).

Given the potential importance of political independents to deciding this year’s presidential election, the candidates may want to note that this group’s top issue concerns are hunger and homelessness (59%), inflation (55%), the availability and affordability of healthcare (53%), and crime and violence (52%). Like Republicans, independents are least concerned about race relations, followed by the environment.

On the unaided Most Important Problem question, fully half of Republicans (52%) cite immigration as the nation’s top problem, making it their primary unprompted concern.

Immigration also ranks as the top issue among independents, mentioned by 21%, although this is closely matched by the government, at 19%. Democrats are most likely to cite aspects of government and U.S. leadership (28%), including Donald Trump, with immigration second (12%).

Bottom Line

As the presumptive presidential nominees make their cases to voters, Americans may be most interested in what they have to say about inflation, crime, immigration, and the economy more broadly. They may also want to know what the next president will do to ensure that important aspects of the nation’s safety net for citizens are intact, with majorities expressing high concern about hunger and homelessness and access to affordable healthcare.

Immigration’s status as the most prominent top-of-mind issue for Americans signals that a major segment of the electorate is acutely focused on this issue.

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Regions & Countries

6. teachers’ views on the state of public k-12 education.

Overall, teachers have a negative view of the U.S. K-12 education system – both the path it’s been on in recent years and what its future might hold.

The vast majority of teachers (82%) say that the overall state of public K-12 education has gotten worse in the last five years. Only 5% say it’s gotten better, and 11% say it has gotten neither better nor worse.

Pie charts showing that most teachers say public K-12 education has gotten worse over the past 5 years.

Looking to the future, 53% of teachers expect the state of public K-12 education to be worse five years from now. One-in-five say it will get better, and 16% expect it to be neither better nor worse.

We asked teachers who say the state of public K-12 education is worse now than it was five years ago how much each of the following has contributed:

  • The current political climate (60% of teachers say this is a major reason that the state of K-12 education has gotten worse)
  • The lasting effects of the COVID-19 pandemic (57%)
  • Changes in the availability of funding and resources (46%)

Elementary school teachers are especially likely to point to resource issues – 54% say changes in the availability of funding and resources is a major reason the K-12 education system is worse now. By comparison, 41% of middle school and 39% of high school teachers say the same.

Differences by party

A dot plot showing that, among teachers, Democrats are more likely than Republicans to say the current political climate is a major reason K-12 education has gotten worse.

Overall, teachers who are Democrats and Democratic-leaning independents are as likely as Republican and Republican-leaning teachers to say that the state of public K-12 education is worse than it was five years ago.

But Democratic teachers are more likely than Republican teachers to point to the current political climate (65% vs. 54%) and changes in the availability of funding and resources (50% vs. 40%) as major reasons.

Democratic and Republican teachers are equally likely to say that lasting effects of the pandemic are a major reason that the public K-12 education is worse than it was five years ago (57% each).

K-12 education and political parties

A diverging bar chart showing that about a third or more of teachers trust neither party to do a better job on a range of educational issues.

We asked teachers which political party they trust to do a better job on various aspects of public K-12 education.

Across each of the issues we asked about, roughly a third or more of teachers say they don’t trust either party to do a better job. In particular, a sizable share (42%) trust neither party when it comes to shaping the school curriculum.

On balance, more teachers say they trust the Democratic Party to do a better job handling the things we asked about than say they trust the Republican Party.

About a third of teachers say they trust the Democratic Party to do a better job in ensuring adequate funding for schools, adequate pay and benefits for teachers, and equal access to high quality K-12 education for students. Only about one-in-ten teachers say they trust the Republican Party to do a better job in these areas.

A quarter of teachers say they trust the Democratic Party to do a better job in shaping the school curriculum and making schools safer; 11% and 16% of teachers, respectively, say they trust the Republican Party in these areas.

Across all the items we asked about, shares ranging from 15% to 17% say they are not sure which party they trust more, and shares ranging from 4% to 7% say they trust both parties equally.

A majority of public K-12 teachers (58%) identify with or lean toward the Democratic Party. About a third (35%) identify with or lean toward the GOP.

A bar chart showing that Republican teachers more likely to say they trust neither political party to handle many aspects of K-12 education.

For each aspect of the education system we asked about, both Democratic and Republican teachers are more likely to say they trust their own party to do a better job than to say they trust the other party.

However, across most of these areas, Republican teachers are more likely to say they trust neither party than to say they trust their own party.

For example, about four-in-ten Republican teachers say they trust neither party when it comes to ensuring adequate funding for schools and equal access to high quality K-12 education for students. Only about a quarter of Republican teachers say they trust their own party on these issues.

The noteworthy exception is making schools safer, where similar shares of Republican teachers trust their own party (41%) and neither party (35%) to do a better job.

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Report Materials

Table of contents, ‘back to school’ means anytime from late july to after labor day, depending on where in the u.s. you live, among many u.s. children, reading for fun has become less common, federal data shows, most european students learn english in school, for u.s. teens today, summer means more schooling and less leisure time than in the past, about one-in-six u.s. teachers work second jobs – and not just in the summer, most popular.

About Pew Research Center Pew Research Center is a nonpartisan fact tank that informs the public about the issues, attitudes and trends shaping the world. It conducts public opinion polling, demographic research, media content analysis and other empirical social science research. Pew Research Center does not take policy positions. It is a subsidiary of The Pew Charitable Trusts .

IMAGES

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    research topics on social issues in ghana

  2. (PDF) The extent to which social media has impacted education in Ghana

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  4. Social Sciences

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  6. Corruption in Ghana: Causes and Suggestions for A Corrupt-Free Society

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VIDEO

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  1. Mental health and disability research in Ghana: a rapid review

    The objective of this rapid review was to explore the current evidence base for mental health and disability research in Ghana. The PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist was followed. Online databases were used to identify primary studies, systematic reviews, meta ...

  2. Social challenges of adolescent secondary school students in Ghana

    Students experience a myriad of challenges during this period. Unfortunately, research on adolescent students in Ghana has focused on their academic, behavioural and health challenges (Akwei, Citation 2015; Glozah, Citation 2013, Citation 2015). Research on adolescent students' social challenges in Ghanaian secondary school context is limited.

  3. Unravelling the Health Inequalities in Ghana: An Intersectional

    Intersectionality theory has recently been applied in health research in addressing the complex interlocking social axes of differentiation. Several studies have focused on both single and across country health inequalities in the global North, less is known about health inequalities in the global South. This paper analyses health inequalities by examining how different social groups ...

  4. Contemporary social problems in Ghana

    The challenge of ageing in rural and urban Ghana / Steve Tonah. Widowhood rites in Ghana : a study among the Nchumuru, Kasena and the Ga / Joana Brukum, Alice Pwamang and Steve Tonah. Changing trends in Ghanaian funeral celebrations : a case study of the Ga Mashi Traditional Area, Accra / Juliana Naa-Dedei Attoh.

  5. PDF Social problems and social work in Ghana: Implications for sustainable

    people. It is designed to support people burdened with varying degrees of social problems to function better within society. Meaningful and sustainable development cannot take place in societies afflicted with a host of social problems which receive no meaningful interventions. Ghana is beset with a myriad of social problems that call for ...

  6. Health and social needs of older adults in slum communities in Ghana: a

    Older adults living in developing countries, face various challenges regarding their health and social needs. These challenges are even more profound among older adults living in slum areas in developing countries, because of poor living environments [1,2,3,4] and humans are influenced by the environment.Rural-urban migration has resulted in the emergence of slums in the large cities of most ...

  7. Unmasking the factors behind Socio-economic inequalities in Ghana

    Williams Ohemeng - Ghana Institute of Manage ment and Public Administration (GIMPA) Unmasking the factors behind Socio-economic inequ alities in Ghana. This study uses the recent household ...

  8. Factors influencing the approach to community development in Ghanaian

    The community's capacity, weak social ties among the residents, and nature of the project undertaken were the factors that determined the approaches taken. The basis for the approach used in CD should be the characteristics of the communities and how they facilitate the successful implementation of projects.

  9. A systematic review of social media research in Ghana: gaps and future

    The emergence of internet-based communities, popularly known as social media, has transformed communication drastically. Due to its importance, scholars have written on the subject within the Ghanaian context. However, the literature remains fragmented without knowledge of its current state, gaps, and opportunities for future research.

  10. Science as a Development Tool in Ghana: Challenges, Outcomes ...

    Ghana is a West African country with a population of 28.8 million (UNDP 2018) and a gender ratio of 50.147 percent female and 49.853 percent male in 2018 (World Bank data). Footnote 1 It was the first sub-Saharan African country to gain independence from Britain in 1957, and it is an ethnolinguistically diverse society, with about 44 indigenous languages.

  11. Scoping review of community health participatory research projects in Ghana

    In addition, three local journals (Ghana Medical Journal, Ghana Social Science Journal, and Ghana International Journal on Mental Health) were searched. The search terms used are provided in Table 1. Studies published on CHPR projects in Ghana between January 1950 and October 2021, or which had a participatory component, were included in this ...

  12. Social Work in Ghana: A Participatory Action Research Project Looking

    Special attention would be paid to get information about social problems and social work interventions, the western nature of practice and education in most non-western host countries and the ...

  13. (PDF) Exploring the role of social studies as a school subject in

    This study seeks to explore what the 2010 and 2020 social studies curriculum - Ghana, needed to have had in them both contents and pedagogy wise in order to inculcating in its learners, national ...

  14. Social Work Practice in Ghana: Changing Dynamics, Challenges ...

    Abstract. Social Work is described as a helping profession since it is a professional practice that provides services aimed at helping societies work better for their people. It is also designed to assist people with varying degrees of social problems function better within society. While social work started in the pre-independence era as the ...

  15. ISSER Launches Ghana Social Development Outlook 2022 Report

    The launch of the Ghana Social Development Outlook 2022 report showcases ISSER's commitment to producing research that informs policy decisions and contributes to the nation's development. The report's comprehensive analysis of key social issues and its policy recommendations provide valuable insights for stakeholders to make informed decisions ...

  16. Social problems and social work in Ghana ...

    Social Work practice is a helping profession that provides services aimed at assisting societies work better for their people. It is designed to support people burdened with varying degrees of social problems to function better within society. Meaningful and sustainable development cannot take place in societies afflicted with a host of social problems which receive no meaningful interventions.

  17. Community engagement and involvement in Ghana: conversations with

    Methods. As this kind of larger scale involvement of community stakeholders with research was a novel way of working for the team in Ghana, a reflective approach was taken to outline step-by-step how the GSU team planned and undertook these involvement activities with 31 hernia patients, two Chiefs (community leaders), a community finance officer and a local politician in various locations in ...

  18. Addressing Contemporary Public Health Challenges in Ghana ...

    In 1978, Ghana was a participant in the Alma-Ata meeting on primary health care and was an early adopter of its ideals. However, like most developing countries it has made efforts to strengthen public health as a way of ensuring the conditions in which its people can be healthy and productive. The evolution of the public health in the country involved core assessments, policy development, and ...

  19. Government must expand social interventions to ...

    Dr George Domfe, Senior Research Fellow, Centre for Social Policy Studies, University of Ghana, said Ghana had made significant stride in terms of economic growth over the last couple of years culminating in the reduction of the inequality gap in the country. Despite the progress, Dr Domfe said more Ghanaians continued to live in extreme poverty.

  20. ghana

    About Pew Research Center Pew Research Center is a nonpartisan fact tank that informs the public about the issues, attitudes and trends shaping the world. It conducts public opinion polling, demographic research, media content analysis and other empirical social science research. Pew Research Center does not take policy positions.

  21. 5 Key Issues That Matter Most to Young People in Ghana

    Corruption. Frances Quayson highlighted corruption in Ghana's police service as an issue he wants to see addressed. A survey, released in July 2022 by the Ghana Statistical Service, named the Ghana Police Service as the most corrupt institution in Ghana . Frances Quayson works in media industry in Ghana. Image: Betty Kankam-Boadu for Global ...

  22. 7 serious social problems in Ghana and their solutions: be ...

    Main social problems in Ghana in 2022. Below is a list of social problems in Ghana and their solutions. 1. Unemployment. Unemployment refers to the share of the labour force without work but are available for and seeking employment. The rate of unemployment in Ghana in 2020 was 4.70%, a 0.05% increase from 2020. Read also.

  23. Research: How Women Can Build High-Status Networks

    Summary. Despite the potential career benefits of building high-status networks, research has long shown that women face greater obstacles in establishing these networks compared to men. The ...

  24. Teens are spending nearly 5 hours daily on social media. Here are the

    4.8 hours. Average number of hours a day that U.S. teens spend using seven popular social media apps, with YouTube, TikTok, and Instagram accounting for 87% of their social media time. Specifically, 37% of teens say they spend 5 or more hours a day, 14% spend 4 to less than 5 hours a day, 26% spend 2 to less than 4 hours a day, and 23% spend ...

  25. Problems students are facing at public K-12 schools

    Major problems at school. When we asked teachers about a range of problems that may affect students who attend their school, the following issues top the list: Poverty (53% say this is a major problem at their school) Chronic absenteeism - that is, students missing a substantial number of school days (49%) Anxiety and depression (48%) One-in ...

  26. Talking politics with strangers isn't as awful as you'd expect

    Summary: Individuals underestimate the social connection they can make with a stranger who disagrees with them on contentious issues, a new research paper suggests. Share: FULL STORY. Many of us ...

  27. 4. Challenges in the classroom

    Elementary and middle school teachers: 68% each among elementary and middle school teachers say they have to deal with behavior issues daily, compared with 39% of high school teachers. A third of elementary and 29% of middle school teachers say they have to help students with mental health every day, compared with 19% of high school teachers.

  28. Inflation, Immigration Rank Among Top U.S. Issue Concerns

    These are crime and violence (53%), hunger and homelessness (52%), the economy (52%), the availability and affordability of healthcare (51%), and federal spending and the budget deficit (51%). Another four issues are highly concerning to less than half but at least four in 10 Americans: illegal immigration (48%), drug use (45%), the Social ...

  29. Views of the US education system among public K-12 teachers

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