Alhassan Siiba’s research while affiliated with Queen's University and other places

Early Learning and Childcare (ELCC) services are essential social determinants of a child’s well-being. However, many barriers exist within the ELCC climate of Canada and the United States of America (USA), limiting marginalized communities’ access to quality ELCC services. The objective of this systematic review is to investigate the barriers and facilitators that influence access to adequate ELCC for Black children and families. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 55 studies were reviewed to examine common barriers and facilitators in accessing ELCC services for Black and racialized families living in Canada and the USA. The barriers and facilitators identified were grouped into four themes: familial context, types of care, socioeconomic factors, and cultural competence. The factors of parental involvement, access to formal ELCC services, income level, parental educational level, parental employment, cultural competence, and racism emerged as either barriers or facilitators depending on their existence and direction of influence. The reviewed studies discussed the impact of parental employment, specifically, maternal employment, on whether a child is enrolled in an ELCC program. The results of this study can advise ELCC service providers and policymakers in making the ELCC climate more equitable specifically for Black and other racialized communities.

Non-communicable diseases, including cancers, are considered major health challenges in the twenty-first century and pose a disproportionate burden on many low-to-middle-income countries (LMICs). For instance, it is estimated that nearly 2000 lives are lost daily to cancer in Africa, and about 1,109,209 new cancer cases and 711,429 cancer-related deaths were reported in 2020. Without a focus on equity and prioritization of cancer from policymakers and stakeholders, cancer prevalence and mortality rates are likely to increase in Africa. In the context of LMICs, especially in sub-Saharan Africa (SSA), several structural and political challenges persist regarding the secondary prevention of cancer through timely screening, diagnosis, and treatment. Using multilevel analysis, this chapter examines the role of place in influencing the utilization of breast and cervical cancer screening in Kenya and Ghana. The results indicate that location-based variables, such as urbanity, wealth, finances, and distance, are barriers to screening. Non-location factors, such as age, education, employment, and contextual norms, were associated with breast cancer (BC) and cervical cancer (CC) screening in Kenya and Ghana. For instance, rural poor women in Kenya (OR = 0.65, 95% CI [0.46–0.93]) and Ghana (OR = 0.77, 95% CI [0.62–0.95]) were less likely to screen for BC compared to the urban poor. Similarly, rural poor women (OR = 0.63, 95% CI [0.43–0.94]) were less likely to screen for CC, whereas the urban rich (OR = 1.53, 95% CI [1.06–2.21]) were more likely to screen for CC compared to the urban poor respectively. Understanding the spatiality and role of place in cancer screening for secondary prevention in SSA is essential to enable researchers and policymakers to examine how the characteristics of individuals concentrated in places, their collective opportunities, and the socio-cultural and historical features of places where they live and play, affect their access to these essential health care services.

Climate change and non-communicable diseases (NCDs) are considered the 21st Century’s major health and development challenges. Both pose a disproportionate burden on low- and middle-income countries that are unprepared to cope with their synergistic effects. These two challenges pose risks for achieving many of the sustainable development goals (SDGs) and are both impacted by globalization through different pathways. While there are important insights on how climate change and or globalization impact NCDs in the general literature, comprehensive research that explores the influence of climate change and or globalization on NCDs is limited, particularly in the context of Africa. This review documents the pathways through which climate change and or globalization influence NCDs in Africa. We conducted a comprehensive literature search in eight electronic databases—Web of Science, PubMed, Scopus, Global Health Library, Science Direct, Medline, ProQuest, and Google Scholar. A total of 13864 studies were identified. Studies that were identified from more than one of the databases were automatically removed as duplicates (n = 9649). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a total of 27 studies were eventually included in the final review. We found that the impacts of climate change and or globalization on NCDs act through three potential pathways: reduction in food production and nutrition, urbanization and transformation of food systems. Our review contributes to the existing literature by providing insights into the impact of climate change and or globalization on human health. We believe that our findings will help enlighten policy makers working on these pathways to facilitate the development of effective policy and public health interventions to mitigate the effects of climate change and globalization on the rising burden of NCDs and goal 3 of the SDG, in particular.

Sub-Saharan Africa is undergoing an epidemiological transition driven by rapid, unprecedented demographic, socio-cultural, and economic transitions. These transitions are driving increases in the risk and prevalence of diabetes and other non-communicable diseases (NCDs). As NCDs rise, several attempts have been made to understand the individual level factors that increase NCDs risks, knowledge, and attitudes around specific NCDs as well as how people live and manage NCDs. While these studies are important, and enhance knowledge on chronic diseases, little attention has been given to the role of social and cultural environment in managing chronic NCDs in underserved settings. Using purposive sampling among persons living with Diabetes Mellitus (PLWD) and participating in diabetes programs from regional and municipal hospitals in the three underserved regions in Ghana (n = 522), we assessed diabetes management and supportive care needs of PLWDs using linear latent and mixed models (gllamm) with binomial and a logit(log) link function. The result indicates that PLWDs with strong perceived social support (OR = 2.27, p ≤ 0.05) were more likely to report good diabetes management compared to PLWDs with weak perceived social support. The built environment, living with other health conditions, household wealth, ethnicity and age were associated with diabetes management. Overall, the study contributes to wider discussions on the role changing built and socio-cultural environments in the rise of diet-related diseases and their management as many Low- and Middle-Income Countries (LMICs) experience rapid epidemiological and nutrition transitions.

We sought to determine if trust in government institutions mediate the relationship between experiences of discrimination and health care utilization during the COVID-19 pandemic. We used data from Statistics Canada’s Crowdsourcing Data: Impacts of COVID-19 on Canadians—Experiences of Discrimination. We used generalized linear latent and mixed models (Gllamm) with a binomial and logit link function as well as generalized structural equation modeling (GSEM) to determine if reported discrimination and trust were associated with difficulties in accessing health services, health care, and the likelihood of experiencing negative health impacts. We also examined if trust mediated the relationship between experiences of discrimination and these health outcomes. Our analytical sample consisted of 2568 individuals who self-identified as belonging to a visible minority group. The multivariate results indicate that experiences of discrimination during COVID-19 were associated with higher odds of reporting difficulties in accessing general health services (OR = 1.99, p ≤ 0.01), receiving care (OR = 1.65, p ≤ 0.01), and higher likelihood of reporting negative health impacts (OR = 1.68, p ≤ 0.01). Our mediation analysis indicated that trust in public institutions explained a substantial portion of the association between reported discrimination and all the health outcomes, although the effects of experiencing discrimination remain significant and robust. The findings show that building and maintaining trust is important and critical in a pandemic recovery world to build back better.

This paper examined the dynamics of urban land use and land cover change, and their implications for livelihoods in peri-urban Tamale, Ghana. The study employed household data and Landsat Thematic Mapper (TM) for 1986, Enhanced Thematic Mapper Plus (ETM +) for 2004 and Landsat 8 Operationalised Landsat Imager/Thermal Infrared Sensor (OLIS/TIRS) for 2019. The findings show that the urban expansion process witnessed a transition from agricultural livelihood to a more complex and monetised urban economy, which presented mixed impacts on the livelihoods of the peri-urban households. We argued that the horizontal expansion of urban areas into prime agricultural lands could be halted by promoting vertical development in the form of multi-storey buildings rather than the horizontal multiplication of individual housing units. Supporting the peri-urban households to diversify their livelihood portfolios by venturing into beekeeping, poultry farming, and livestock keeping, which do not require large tracts of land is recommended. ARTICLE HISTORY

Access to housing data in Ghana has been a challenge for researchers due to the lack of comprehensive data sources. However, the recent availability of big data sources has presented opportunities to bridge this data access gap. Using Greater Accra as a case, this study uses web scraping techniques to acquire publicly available housing data from two major E-commerce websites in Ghana and explores the Greater Accra Metropolitan Area's (GAMA) prevailing housing market. Spatial autocorre-lation statistics show clustering of high median prices in known high-class neighborhoods. Median prices in high-class neighborhoods were three to five times higher than median prices in the entire metropolis, highlighting high housing costs in high-class neighborhoods. This research highlights the high housing cost in GAMA, making it impossible for the average resident to afford to buy a house. Hence, a more inclusive housing strategy is needed to provide affordable housing options for all.

Parental attitude and perceptions of attributes of the built environment are important factors that influence children’s active travel to school. However, research in this emergent urban transportation field is limited in Ghana. This study seeks to overcome this limitation by examining the influence of parental attitude and perceptions on children’s active travel to school in Tamale, Ghana. The study draws primary data from a questionnaire survey, involving 842 parents and their school children. The study finds that 43% of the children live within a walking distance to school and 40.3% of them actively travel to school. Multivariate regression analyses also show that: perceiving driving to school as a more convenient travel mode, children’s preference to be driven to school by car, fear of injury from road accidents, perceived long school distance, and not encouraging active travel in schools, are significantly associated with lower likelihood of active travel. However, a greater proportion of the parents are still more likely to allow their children to actively travel to school despite their perceptions of the potential dangers on the way to school. The findings of this study generally suggest that parental attitude and perception may possibly have some significant influence on children’s active travel to school in Ghana. Thus, efforts should be made by urban planners to improve upon features of the local environment to encourage more active travel to school. As this study relied on perceptions from a cross-sectional survey, further research may also be needed to understand how objective measures of attributes of the local neighbourhood may influence active travel to school in Ghana.

Major cities in developing countries are increasingly becoming motorized. Thus, effective solutions to address the negative impacts that come with rising car-ownership are needed as part of an overall travel demand management strategy. In developed and emerging economies , shared-mobility in the form of car-sharing is becoming popular as potentially low-cost and environmentally sustainable alternative to car-ownership. Yet, our understanding of car-sharing adoption and diffusion factors in developing countries is limited. In this study, we fill this gap by examining car-sharing adoption intentions among young adults aged between 18 and 35 years in Ghana, Sub-Saharan Africa. Using structural equation modelling, we model car-sharing adoption intentions based on a framework that integrates individuals' perception of the benefits of car-sharing, attitudes towards the environment and technology, trust of stewardship in car-sharing, perception of innovativeness of car-sharing, travel expectations and socio-demographic factors. We found that pro-technology and pro-environmental attitudes correlate positively with perceived benefits of car-sharing. Perceived benefits of car-sharing, in turn, has the largest predictive effect on intentions to car-share. Other factors, including individuals' previous experience using Uber on-demand taxi services, gender, education, driver's licensure and expectation of comfortable and fast travel options, all predict car-sharing adoption intentions. While there exists an interest in both station-based and free-floating car-sharing services, more of the would-be users favour the latter than the former. Also, majority of the potential adopters (62%) would join a car-sharing service within the first 1 year of its introduction. An important finding is that dissatisfaction with existing public transit services underpins car-sharing intentions, implying that relying on car-sharing alone to meet travel needs, without a holistic strategy of providing quality and affordable public transit services, could lead to unsustainable outcomes.