Childhood vaccination has been promoted as a global intervention aimed at improving child survival and health, through the reduction of vaccine preventable deaths. However, there exist significant inequalities in achieving universal coverage of child vaccination among and within countries. In this paper, we examine rural-urban inequalities in child immunizations in Ghana. Using data from the recent two waves of the Ghana Demographic and Health Survey, we examine the probability that a child between 12 and 59 months receives the required vaccinations and proceed to decompose the sources of inequalities in the probability of full immunization between rural and urban areas. We find significant child-specific, maternal and household characteristics on a child’s immunization status. The results show that children in rural areas are more likely to complete the required vaccinations. The direction and sources of inequalities in child immunizations have changed between the two survey waves. We find a pro-urban advantage in 2008 arising from differences in observed characteristics whilst a pro-rural advantage emerges in 2014 dominated by the differences in coefficients. Health system development and campaign efforts have focused on rural areas. There is a need to also specifically target vulnerable children in urban areas, to maintain focus on women empowerment and pay attention to children from high socio-economic households in less favourable economic times.

Globally, nearly 37 million people are living with HIV with about 70 percent of these living in Sub-Saharan Africa (SSA). Stigma and discrimination remain one of the major barriers to preventing new infections in the country. However, misconceptions about HIV/AIDS have been indicated as one of the key drivers of the disease. Efforts to prevent new infections have not been entirely successful. Therefore, this study aims to examine the trends and distribution in comprehensive knowledge of HIV and AIDS and determine the factors associated with comprehensive awareness of HIV and AIDS among adult women and men. The study relies on data from three rounds of Ghana Demographic & Health Surveys conducted in 2003, 2008 and 2014 to show trends. Logistic regression was used for multivariate analysis. The thematic mapping of HI/AIDS comprehensive knowledge was conducted using ArcGIS version 10.4 using GPS coordinates in the 2014 GDHS which contained aggregated individual characteristics and HIV knowledge scores.While comprehensive HIV and AIDS knowledge is above 50% among adult population in Ghana, the results show a significant decrease in comprehensive knowledge from 72% in 2008 to 59% in 2013. The strongest predictors for having comprehensive knowledge were found to be education; gender, marital status, locality, occupation and wealth status. The paper demonstrates that preventive activities leading to improvement in the comprehensive knowledge of HIV and AIDS in Ghana is needed. Sound knowledge about HIV and AIDS is critical for the adoption of behaviours that reduce the risk of HIV transmission. Education on HIV prevention must be expanded to improve the comprehensive knowledge of the disease.

Persons with disabilities face substantial barriers that impede their integration and participation in social and economic activities. Households with disabled members may be vulnerable to poverty due to the extra cost of living with a disability. However, there exists a knowledge gap in the magnitude of the extra cost of disabilities in sub Saharan Africa. Using data from a nationally representative household survey, this paper estimates the extra cost of disabilities in Ghana. The paper further examines the welfare effects of households with persons with disabilities. Based on the standard of living approach, we estimate the extra cost to households with a person with disability to be 26% of annual household consumption expenditures. Adjusting for the extra cost of poverty, the incidence of poverty increases from 38.5 to 52.9% amongst households with a disabled member. Our findings suggest the need to improve the efficiency of support programs to persons with disabilities to mitigate the extra costs of disabilities and reduce their vulnerability to poverty. In addition, enhancing access to economic opportunities and social services for persons with disabilities will be imperative to improve their quality of life and dignity.

Early childhood deprivations and inequalities have social and economic implications in adulthood and thus, their elimination is essential for child development. However, child-level estimates of poverty are rare in low income countries. Using data from two recent rounds of the Ghana Demographic and Health Survey, we measure the extent and sources of childhood deprivations in Ghana and examine subgroup differentials in child poverty. In addition, we examine the child quality-quantity by estimating the causal relationship between number of children and child poverty. Finally, we assess the sources of rural-urban inequalities in child poverty. We find that despite declining incidence and intensity of multidimensional child poverty, significant subgroup differentials persist in Ghana. The findings of the paper reveal that living standards is the main contributor to multidimensional poverty in early childhood in Ghana. Our findings also confirm a significant causal relationship between child quality and quantity in Ghana, there exist a positive relationship between the number of children and the intensity of child poverty in Ghana. Finally, we find that rural-urban inequalities in child multidimensional poverty in Ghana are attributable to differences in observed maternal and household characteristics between rural and urban areas. The persistence of subgroup disparities in child poverty may be detrimental to achieving equitable and inclusive growth in the country. There is the need for considerations of equity, fairness and social justice in the distribution and development of social services and economic infrastructure to ensure even distribution of social and economic opportunities and promote social mobility across groups.