Aaron Kobina Christian

Land tenure arrangements are widely recognized as a determinant of agricultural productivity and household food security. Yet, most empirical studies treat this relationship as spatially uniform, overlooking how agro‐ecological contexts may shape its nature and direction. This study examined whether the relationship between land tenure type and household food security differs across Ghana's agro‐ecological zones. Drawing on data from the Ghana Living Standards Survey (GLSS 7), conducted among 14,009 households from 2016 to 2017, an analytical sample comprising 7439 households with access to agricultural land was selected. Survey‐weighted partial proportional odds models with tenure‐by‐zone interactions were used to test whether this relationship varied across the Coastal, Forest, and Savannah agro‐ecological zones. Overall, 28.7% of households were food secure, with considerable variation across the Forest (35.7%), Coastal (25.1%), and Savannah (17.5%) zones. In the pooled model, purchased (odds ratio [OR] = 0.61, p = 0.018), rented (OR = 0.63, p = 0.003), free‐use (OR = 0.69, p = 0.002), and distributed land (OR = 0.69, p = 0.002) were associated with lower odds of food insecurity relative to inherited land. Associations between tenure type and food insecurity differed significantly across zones ( χ ² (12) = 40.20, p < 0.001), supporting the study's hypothesis. The difference was clearest, and held under all alternative specifications, for sharecropped land, which was associated with lower odds of food insecurity in the Savannah zone (OR = 0.31 to 0.44) but higher odds of severe food insecurity in the Coastal zone (OR = 2.30, p = 0.016). Rented land was associated with lower odds of food insecurity in the Savannah zone (OR = 0.40, p < 0.001) but not in the Coastal or Forest zones, while associations for free‐use and distributed land did not differ across zones. These findings suggest that policies aimed at strengthening land tenure–food security relationships should be context‐specific, reflecting the different institutional and environmental contexts in which households operate. This applies in Ghana and in other low‐ and middle‐income countries with plural tenure systems across contrasting farming environments.

Ample research explores marital structures' impact on children's nutrition, yet results are mixed, and pathways remain underexplored. In this study, we examine the effect of marital structure on children's nutritional status while estimating the mediation and moderation effects of household size and women's empowerment, respectively. We analyzed the latest Demographic and Health Survey data from 24 sub-Saharan African countries to evaluate the odds of stunting, anaemia, and underweight in children from polygynous households compared to those with single mothers and monogamous caregivers, using multinomial logit regression. Children from polygynous households were more likely to be anaemic, stunted, and underweight. Children of empowered monogynous mothers were associated with lower risks of malnutrition, whereas an increase in household size amplified childhood malnutrition in single and polygynous families. Wealth and sanitation also influenced childhood nutrition, with poorer households and those lacking proper sanitation experiencing worse nutritional outcomes. This study underscores the complexity of the maternal structure and children's outcomes and suggests interventions that seek to improve children's nutrition status should factor mother's empowerment and household size as key influencers.

Background: Obesity in adults is defined as an individual with a body mass index (BMI) of 30 kg/m ² or higher. The disease is one of the leading risk factors for noncommunicable diseases (NCDs), which accounts for 2.8 million deaths per year globally. Despite efforts to reduce obesity, the levels are still high, particularly in low‐ and middle‐income countries. In Ghana, obesity has been on the rise over the past few decades, especially among women. The health and economic burden of obesity cannot be underestimated, and efforts must be made to identify factors that are associated with the condition. This study sought to determine the levels, trends, and factors associated with obesity among women in Ghana. Methods: Data for the study came from four waves of the Ghana Demographic and Health Survey (GDHS) from 2003 to 2022. The analysis involved women aged 15–49 years. Their obesity status was categorized into a binary outcome of “1” for those who are obese (BMI = 30+ kg/m ² ) and “0” otherwise (BMI 2 ). Binary logistic regression was performed on the data to ascertain the factors that are associated with obesity among women for each of the years separately. Results: In all, 15,467 women, aged 15–49 years, were included in the analysis. Out of this, 13.7% were obese (BMI = 30+ kg/m ² ). In terms of trends in obesity prevalence across the various years, the results showed an increase in obesity from 9.9% in 2003 to 23.0% in 2022. From the regression results, the common factors associated with obesity for each of the years included being an urban resident, having a tertiary education, and being in the richest household. Conclusions: The results showed that being an urban dweller, having a tertiary level of education, being in the richest household, and being a resident of regions in the north of Ghana are associated with obesity. Therefore, policies aimed at reducing obesity in Ghana should intensify public health education, particularly among urban dwellers and wealthy individuals, to engage in healthy lifestyles. The less educated members of the population should also be educated to avoid behaviors that will put them at risk of obesity. Local authorities should create an environment, particularly in high‐class neighborhoods, that offers easy access to healthy foods and places for physical activities.

Background: This study explores how non-communicable diseases (NCDs), social capital, and government grants (social grants) influence subjective well-being (SWB) among individuals aged 40 and older in rural South Africa. Understanding gender differences in these relationships provides insights for improving public health interventions in resource-constrained settings. Methods: Data from 2,432 participants in the HAALSI Wave 3 study were analyzed to examine the predictors of SWB using regression models. Key covariates included age, education, marital status, employment, wealth, religion, social capital, and social grants. Interaction effects between NCDs, social capital, and social grants were evaluated, with gender-stratified analyses to explore disparities. SWB scores were computed, and statistical significance was assessed at various thresholds. Results: About a third of the sample had hypertension (58%), one-fifth had diabetes (20%), and nearly two-fifths had depression (36%). Having an NCD) was significantly associated with lower subjective wellbeing (β = −0.855, p < 0.001), with a slightly stronger negative effect observed among women than men. Older age (particularly 80+), and lower education were also associated with reduced wellbeing. Social capital did not moderate the negative impact of NCDs, as individuals with NCDs reported similarly low wellbeing regardless of high or low social capital. However, access to social grants showed some buffering effect: individuals with NCDs and high social grants reported better wellbeing outcomes compared to those with NCDs and low grants, particularly among males. Health insurance coverage was positively associated with wellbeing across all groups. Conclusions: These findings suggest that while NCDs significantly reduce wellbeing, social capital alone may not mitigate this burden, whereas targeted material support through grants may offer partial protection, particularly for men. We recommend the development of NCD financing strategies within the public healthcare funding schemes.

Non-communicable diseases (NCDs) are a public health challenge in Zambia. This is driven by economic transitions, urbanization, and lifestyle changes. This study examines how NCDs cluster and relate to socioeconomic factors such as education, income, and employment. Using data from the 2017 Zambia WHO STEPS survey (N = 4,302 adults, mean age: 36.57 years), Latent Class Analysis identified NCD risk profiles, and multinomial logistic regression assessed their associations with socioeconomic determinants. Three NCD risk groups emerged: Low-Risk (12.0%), Intermediate-Risk (64.3%), and High-Risk (23.7%). The Low-Risk group maintained healthy lifestyles. The Intermediate-Risk group, the most prevalent, showed borderline metabolic indicators and occasional unhealthy behaviours. The High-Risk group exhibited multiple risk factors, including obesity, hypertension, diabetes, and substance use. Males had 22.8 times higher odds of being in the High-Risk group than females. Surprisingly, higher education increased the odds of being in the Moderate- and High-Risk groups. NCD prevention in Zambia requires risk-stratified strategies: primary prevention for Intermediate-Risk groups and intensive intervention for High-Risk populations. Critical policy actions include taxing tobacco, alcohol, and unhealthy foods; expanding universal screening; integrating NCD care into primary health systems; and addressing urbanization, cultural practices, and healthcare disparities.

Hypertension remains a primary contributor to avoidable mortality and impairment. This study aimed to examine the association between household food insecurity (HFI), another public health concern, and hypertension among women farmers in peri-urban and rural communities in Ghana. Self-reported hypertension status, blood pressure measurement, and HFI were assessed using data on 430 women from a cross-sectional survey. We examined the odds of hypertension in women experiencing different categories of food insecurity while controlling for other known factors. Close to 74% (n = 319) of respondents belonged to households that were food-secure with 26% (n = 111) in food-insecure households. At the time of the survey, about a fifth of the participants (19%) reported to have ever been diagnosed with hypertension and 22% were living with high blood pressure (i.e., systolic: 140 mm Hg or higher and diastolic: 90 mm Hg or higher). Living in a rural community compared to a peri-urban community was associated with lower odds of living with high blood pressure. Older women were more likely than younger women to report having known hypertension and living with high blood pressure. Dangbe women were less likely to have high blood pressure than women from other ethnic groups. An increase in physical/morbidity activity was associated with a decreased likelihood of high blood pressure among food-insecure women. This study buttresses the importance of hypertension awareness among older women, particularly, in urbanizing communities, and the need to explore mediating factors through which ethnicity may influence living with high blood pressure.

Although hypertension and diabetes are known to increase cardiovascular disease risk, the influencing and underlying factors remain unclear. To examine the mediating effect of location of residence and the moderating effects of recommended lifestyle practices in the hypertension/diabetes and cardiovascular disease nexus. Data were drawn from 4,563 participants in Steps 1 and 2 of the 2020 World Health Organization's STEPS survey in Cabo Verde, with a subsample of 2,436 individuals completing Step 3. A logit regression model was employed to examine the correlations of cardiovascular disease, while structural equation modeling and interaction analysis were used to identify mediators and moderators within the explored relationships. Living with hypertension and diabetes were both observed to increase the likelihood of having a cardiovascular disease [Coeff. (RSE), 0.46, (0.12), p < 0.001; 1.26, (0.14), p < 0.001, respectively]. We identify urbanicity as a potential mediator through which hypertension/diabetes leads to a cardiovascular disease and waist circumference as a moderator of hypertension/diabetes-cardiovascular nexus. These findings add to the toolset of public health practitioners and policymakers in formulating policies and interventions aimed at managing cardiovascular diseases, particularly in developing nations.