Designing a Need Based Social Protection Intervention Package for Children and Adolescents Living with HIV and AIDS in Ghana—An Eclectic Perspective on Desired Social Protection Intervention Package/Framework

Background: Designing a need-based social protection intervention for children comes as comprehensive tool for addressing the overall quality of life of HIV positive children. Not much has been examined on what constitute the desired social protection framework for HIV positive children. Methods: This study was informed by a qualitative descriptive exploratory design approach. The study drew insights from the shared perspectives of 27 participants sampled from positive HIV status disclosed children—10 - 17 years, healthcare workers, Social and Development worker, HIV positive caregivers and parents from 7 ART clinics in rural and urban Brong Ahafo and Ashanti regions of Ghana. Data was collected through interviews and two focus group discussions with study participants. Drawing on the emerged themes from the transcripts, thematic content analysis was used to analyze the data using comparative thematic framework approach. Findings: The eclectic perspectives on the type of social protection policy/intervention preferred demonstrated the need for an interrelated and integrated social protection policy. This should not be designed in isolation towards addressing the child vulnerability. The study found that social protection policies aimed at addressing vulnerability levels of children should consider the dual vulnerability situation within which HIV positive children and adolescents are located. A set of unique specific tailored approach and package reflecting minimum combination social protection package to HIV positive children was considered essential for inclusion. The themes that emerged covered social policy/intervention package inclusive of a disease ending/eradication intervention package, cash transfer for children and their caregivers, free comprehensive health insurance integrating all consultancy and laboratory services charges, direct food supplements supply and nutritional support, research, target specified with evidenced-based monitoring. Counseling support and preferential treatment for children visiting ART for treatment were to be included. Conclusion: Combination social protection intervention packages remain the pathway to yielding maximum dividends on any social intervention that seeks to address the vulnerability levels of HIV positive children in Ghana. This should be designed taking into consideration the preference of the main target beneficiaries (HIV positive children) while accounting for the inclusion of the technical expertise of implementing stakeholders in the policy design from conceptualization to evaluation.

Knowledge about Sexual and Reproductive Health Services and Practice of What Is Known among Ghanaian Youth, a Mixed Method Approach

Most young person will become sexually active before their 20th birthday having to battle with early and unplanned pregnancies, unsafe abortions, maternal deaths and injuries. This study examined young person’s sexual knowledge, attitudes and practices and their levels of utilization of sexual reproductive health. Our study progresses beyond current research of reporting only sexual behaviour among youth to have insight into sexual and reproductive health update drivers yielding new empirically robust results for the Ghanaian case for sexual and reproductive health service uptake. The descriptively cross sectional design was employed in sampling 170 youth (150 surveyed and 20 Interviewed) using the stratified sampling technique together with a purposive selection of one key informant. Test of significance and associations were performed with the Chisquare test. In all 45.2% (77/170) of youth (10 - 24) had had sexual experience in life time. In respect of in-school youth, 42% (63/150) had had sexual experience whiles 70% (14/20) out-of-school youth had had sexual intercourse in life time. A total of 28.8% (49/170) of all the youth had sexual intercourse in the last six months with only 40.1 (20/49) using condom for protection. Parental discussion of contraceptive methods (29.3%) and sexual and romantic relationship (28.0%) was the least sexual and reproductive health area discussed among in-school youth. Youth knowledge of the available sexual reproductive health service was statistically associated with reproductive health service utilization (X2 = 0.00, P ≤ 0.05). A concerted effort is required from government, NGO, Civil society organizations and religious bodies to help translate youth knowledge about sexual health into responsible sexual life and protective sex.

Climate Trends of Temperature, Precipitation and River Discharge in the Abbay River Basin in Ethiopia

Projecting future changes of streamflow in the Abby River Basin (ARB) is important for planning and proper management of the basin system. The current study conducted in five stations of the Abbay river basin, and investigated the annual temperature, precipitation, and river discharge variability using the Innovative trend analysis method, Mann-Kendall, and Sen’s slope test estimator. The result showed a slightly increasing trend of annual precipitation in Assoa (Z = 0.71), Bahir Dar (Z = 0.13), and Gonder (Z = 0.26) stations, while a significant increasing trend was observed in Nedgo (Z = 2.45) and Motta (Z = 1.06) stations. Interestingly, the trend of annual temperature in Assosa (Z = 5.88), Bahir Dar (Z = 3.87), Gonder (Z = 4.38), Nedgo (Z = 4.77), and Motta (Z = 2.85) was abruptly increased. The average mean temperature has increased by 0.2°C in the past 36 years (1980 to 2016). The extreme high temperature was observed in the semi-dry zone of northern Ethiopia. During the study period, a significant declining trend of the river discharge was recorded, and the river discharge was sharply decreased from 1992 onwards. The results of the current study showed annual variability of river discharge, precipitation, and temperature of the study area of the basin that could be used as a basis for future studies.

Does Facility Based Sexual and Reproductive Health Services Meet the Needs of Young Persons? Views from Cross Section of Ghanaian Youth

The focus on facility based health setting to provide sexual and reproductive health to the youth has been tested in several settings and achieved varying results. This study examined whether facility based sexual and reproductive health services met the needs of Ghanaian youth. Adopting the descriptive cross sectional design, 170 youths between the ages of 10 and 24 were sampled. A three-stage stratified random sampling technique was adopted. The results of the study are presented using descriptive statistics. The study established that a total of 55.8% (95/170) of the youth had utilized at least one or more of a sexual and reproductive health service in life time. However, only 45.2% (43/95) of youth used or accessed sexual and reproductive health services from a facility based setting. Facility based sexual and reproductive health service provided specifically for the youth is very limited. This calls for the provision of out-of health facility services located within the communities and at strategic places while ensuring confidentiality to the youth. More rigorous research is recommended on a national scale to examine youth preference for the type of facility based and out-of-facility based sexual and reproductive health services to meet the needs of young people.

Prevalence of Unsatisfactory Pap Smear and Associated Clinical History and Diagnosis in a Tertiary Teaching Hospital in Ghana

Background: A major limitation of cervical cytology is the unsuitability of proportion of smears submitted for analysis and for cytological assessment (unsatisfactory). This study examines the prevalence of unsatisfactory Pap smear, clinical history and diagnosis in the Department of Pathology, Korle-Bu Teaching Hospital (KBTH), Ghana. Materials and Methods: A retrospective review of 15,290 cases spanning 12 years (2005-2016) was carried out at the cytology unit of the Pathology Department of the KBTH. Out of the 15,290 Pap smear records retrieved, 2347 reports were excluded leaving 12,943 for the study. All unsatisfactory smear cases were analyzed and categorized using the Bethesda 2001 System. Results are presented using descriptive statistics. Results: The overall prevalence of unsatisfactory Pap smear was 402 (3.1%). Routine screening smear accounted for 115 (0.9%);reports without clinical history and diagnosis gave 21 (0.2%) and cases with clinical history and diagnosis were 287 (2.2%). The common cause of unsatisfactory Pap smear was scanty cellularity 222 (1.72%). Patient’s history accounted for the least cause of unsatisfactory Pap smear 2 (0.02%). Conclusion: Pap smear results reported as unsatisfactory could harbor cancer malignancy. Samples should be taken by well-trained persons.

Parental Disclosure of Own HIV Status to Children in Two Ghanaian Regions;Examining the Determinants within a Child Vulnerability Context

Purpose: Parent informing children and adolescents about their own HIV infection status is crucial for harmonious and interfamilial relationship despite the associated dilemma. This study assessed the factors associated with parental disclosure of own HIV status to their biological children. Methods: The facility based cross-sectional design approach informed the recruitment of 192 HIV positive parents. This was done through a two-stage stratified (rural/urban) and random sampling technique across 7 ART clinics and hospitals in the Ashanti and Brong Ahafo regions in Ghana between June 2018 and June 2019. Data was collected through interviewer-administered structured questionnaires. Parental disclosure to children was defined as parent own verbal statement of having mentioned HIV or AIDS as the name of his/her illness to at least one of his or her biological children. The study compared weighted proportions for variables measured categorically by the use of chi-square (χ2) significant at P Results: Of the 192 HIV positive parents aged 20 to 64 years (M, SD = 38.56, 8.34), 89.1% were females, averagely having 3 children with 89.5% having only one child being HIV positive, out of which one in every four parent was without formal education. Parental disclosure to biological children was 11% while parental own status disclosure to any child under the parent’s care was 14.6%. Parental disclosure was associated with being married or living with a sexual partner (OR = 3.4;95% CI: 1.08 - 10.66, P Conclusions: Only a tenth of all HIV positive parents had told their children about their own (parents) HIV status. Parental disclosure should be encouraged and interventions designed to improve it particularly as they contribute to shaping the vulnerability context of HIV and AIDS positive children.

SPECIAL ISSUE： MIGRANT WORKERS IN THE COURSE OF URBANIZATION Migrant workers and informal employment

本文通过对广州市从事非正式就业的农民工以及珠江三角洲地区在企业工作的农民工问卷调查资料的初步统计分析，认为：第一，农民工在总体上处于一个分割并被相对隔离的、低水平的劳动市场中，但该市场内部又基本上是按照自由放任原则实现其供求平衡的。第二，这一市场进一步分化为“企业”内外的正式和非正式就业两个部分；后者又可区分为自雇与受雇就业两种类型。第三，由于企业内的正式就业者处于较为艰难的生存状态并且再生产着这种状态，农民工在正式和非正式就业的分流中，更倾向于流向非正式就业。第四，在非正式就业者中，受雇用的农民工的工作只能是一种勉强生存的手段，而自雇用的农民工则可能逐渐实现积累和向上流动，有希望获得一定的发展。

SPECIAL ISSUE： MIGRANT WORKERS IN THE COURSE OF URBANIZATION The upbringing and education of migrant workers＇ children in the Pearl River Delta

随着过去20年来中国农村劳动力向城市的大规模转移，进城务工的农民工多数都把子女留在家乡，部分子女跟随父母到了城市。无论是“留守”还是“流动”，这些农民工子女的抚育和教育问题一直都是社会和学界关心的重要问题之一。本文试图通过对2006年“珠三角”3000多名农民工的调查资料中反映的有关农民工子女的抚育和教育方式的分析，理解农民工子女“留守”家乡和“流动”到城市的影响因素，发现在控制了农民工个人和家庭因素之后，农民工来源地的区域差异仍然是影响他们的子女“留守”或“流动”的重要因素。“地区性壁垒”存在的原因和机制是一个值得进一步深入探讨的问题。

SPECIAL ISSUE： MIGRANT WORKESR IN THE COURSE OF URBANIZATION Factors influencing the migration intentions of rural workers in the Pearl River Delta

在中国城乡户籍制度存在的背景下，什么因素影响农民工选择城市户籍，做出永久性迁移的决策，是本文关注的问题。研究发现，如果以是否愿意放弃土地作为行为性永久迁移意愿的指标，那么影响农民工迁移意愿的主要因素是个体的迁移动力，是一个基于经济理性的选择；如果以是否愿意将户口迁入打工城市作为制度性永久迁移意愿的指标，那么影响农民工迁移意愿的主要因素则相对集中在地域性因素和制度合法性压力上，是农民工寻求制度保障来改变城市生活境遇的社会理性选择。在不同迁移意愿的人群中，个体迁移动力与制度合法性压力作用是不一样的。

SPECIAL ISSUE： MIGRANT WORKERS IN THE COURSE OF URBANIZATION An investigation into intergenerational differences between two generations of migrant workers

以1980年前后出生为界，中国城市农民工呈现出明显的代际差异：80后农民工拥有更多人力资本，有职业规划，求职途径较多为市场和政府，关注自己的长远发展，职业稳定性较低；他们被侵权或自己感觉被侵权的比例更高，对相关劳动法规更了解，更有维权的勇气；个人消费水平高于80前农民工，网民比例高，业余生活娱乐休闲色彩浓厚；对社会的评价和认同度相对更高，与老家的联系程度正在减弱，更愿意放弃老家田地、把户口迁入工作城市。80后农民工向企业的管理理念提出了挑战，更向城乡二元社会结构提出了挑战；农民工在取得流动权、工作权以后，理应进一步取得与城市居民完全平等的公民权。

90年代西方体育社会学面临的要求和挑战

在北美体育社会学学会(NASSS)1986年年会上,麦卡隆(MacAloon)对当代西方体育社会学提出了系统的评价和质疑,由此引起了一场热烈的讨论;近几年来,阿兰·英格汉姆(Alan lngham)、彼得·多内利(Peter Donnclly)和安德鲁·雅纳基斯(An-

Males as Partners in Family Planning Service Uptake in Ghana: A Descriptive Cross-Sectional Survey

Background: Family planning is an efficient and effective intervention that results in quick benefits for the whole family socio-economically. Differences exist in the rate of contraceptive use between male and female and male involvement of service uptake in Ghana. The objective of this study was to explore male direct involvement and or support to their partners in family planning service uptake. Methods: The study used a descriptive cross-sectional survey to sample 384 men of reproductive age (18 - 45 year) using cluster sampling to enlist participants from within the Suame Magazine light Industrial area in the Ashanti Region of Ghana. Data was analyzed descriptively using SPSS version 16. Results: Men showed very high knowledge (90%) about what constitutes Family Planning, with moderate level of involvement both active and passive involvement (56%) though only a few (38.9%) were presently adopting or using modern contraceptive. The study rather found only 14% (55) males were willing to be solely responsible and actively involved in Family Planning service. Family Planning services did not adequately meet the needs of men with the services centers remaining unavailable in the study area. Conclusion: The extent of male involvement in family planning programmes is marginally above average. Males showed appreciable knowledge of family planning options though misconceptions continued to exist. A more couple-oriented approach to family planning is needed including recruiting males as family planning providers, offering more family planning counseling for couples, and promoting female-oriented methods with men and vice versa.

Gender-health disparities: exploring the counterbalancing mechanisms of labor disadvantage and health behaviors in rural China

The health disparity associated with gender has raised attention on the rampant health inequity issues in China.This gender-health disparity is further complicated by the contrasting evidence in several substantive demographic phenomena such as the female survival paradox and female morbidity paradox.The current study pro-poses a theoretical model to reveal the counterbalancing mechanisms contributing to gender-health disparity in China.Specifically,health behaviors and labor market disadvantages are two sets of counterbalancing factors that,when considered alto-gether,reveal the true extent of gender-health disparity.Using a 2020 survey in the poverty counties in two provinces of China,the current study investigates the coun-terbalancing mechanisms in gender-health disparity through mediation and suppres-sion effects.With painful feeling and the number of chronic illnesses as depend-ent variables,this study showed that health behaviors and labor disadvantages are indeed counterbalancing mechanisms.The gender disparity in pain/chronic ill-nesses disappeared after labor disadvantages were controlled for,but reemerged in greater magnitude after health behaviors were controlled were.For chronic illnesses,the previously non-existent gender disparity emerged after health behaviors were controlled for.Were it not for women’s salubrious health behaviors,they would suf-fer worse pain and chronic illnesses than men’s.This study informs the literature of the hidden counterbalancing mechanisms in gender-health disparity,and women’s inferior position in formal and informal labor domains blocks the goal of eradicating health inequity in China.

Looking for positive viewpoints for Alzheimer's caregivers:Case evaluation of a positive energy group

Objective:As estimated in a report of global Alzheimer’s disease published by Alzheimer’s Disease International in 2015,there will be 9.9 million new patients worldwide with Alzheimer’s disease in 2015,with a new Alzheimer’s patient diagnosed,on average,every 3 seconds.Since Alzheimer’s disease is an irreversible disease,the most that can be done for Alzheimer’s patients is to merely delay the onset of disease,which to date cannot be completely cured.Therefore,even though great effort is put into caring for the patient,caregivers should not expect any substantial changes.The caring process is a dynamic process that contains negative and positive experiences.During the caring period,not only do caregivers spend a lot of effort and work very hard to help the patient,but in fact care recipients themselves also give energy to caregivers.This study attempts to take a positive energy viewpoint to explore and design a program that is suitable for Alzheimer’s caregivers.The aims of the study were as follows:(a)to explore the needs and burdens of Alzheimer’s caregivers in the treatment process of patients,(b)to design a program that meets the needs of the caregivers,and(c)to evaluate the effects of implementing a program.Methods:The study is a qualitative study employing in‐depth interviews.Interviews were conducted from September 2015 to December 2015;the interview results were reviewed and a positive energy group program was designed.Pre‐test and post‐test interviews were carried out for the program so as to evaluate the effects of the program.Results:According to the caregiver interview results,we understand the caring needs and caring process of caregivers.From the interview results,we now know that caregivers’continuous care mainly comes from positive energy in psychological,social and relationship aspects.Positive energy seems to have been affecting caregivers’caring ability and willingness.Therefore,a two‐stage group activity program was designed to provide a recollective handmade craft group and an art therapy group.Research results of the study show that when the main caregivers of Alzheimer’s patients took part in group activities,positive energy in social and relationship aspects increased for the caregiver group too.Conclusions:From these intervention programs caregivers could obtain more knowledge of patient care and these activities could effectively lighten caregivers’burdens.