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Dam-mediated flooding impact on outpatient attendance and diarrhoea cases in northern Ghana: a mixed methods study
BACKGROUND: Floods are the most frequently occurring natural disaster and constitute a significant public health risk. Several operational satellite-based flood detection systems quantify flooding extent, but it is unclear how far the choice of satellite-based flood product affects the findings of e...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9670488/ https://www.ncbi.nlm.nih.gov/pubmed/36397017 http://dx.doi.org/10.1186/s12889-022-14568-w |
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author | Dotse-Gborgbortsi, Winfred Dwomoh, Duah Asamoah, Moses Gyimah, Faustina Twumwaa Dzodzomenyo, Mawuli Li, Chengxiu Akowuah, George Ofosu, Anthony Wright, Jim |
author_facet | Dotse-Gborgbortsi, Winfred Dwomoh, Duah Asamoah, Moses Gyimah, Faustina Twumwaa Dzodzomenyo, Mawuli Li, Chengxiu Akowuah, George Ofosu, Anthony Wright, Jim |
author_sort | Dotse-Gborgbortsi, Winfred |
collection | PubMed |
description | BACKGROUND: Floods are the most frequently occurring natural disaster and constitute a significant public health risk. Several operational satellite-based flood detection systems quantify flooding extent, but it is unclear how far the choice of satellite-based flood product affects the findings of epidemiological studies of associated public health risks. Few studies of flooding’s health impacts have used mixed methods to enrich understanding of these impacts. This study therefore aims to evaluate the relationship between two satellite-derived flood products with outpatient attendance and diarrhoeal disease in northern Ghana, identifying plausible reasons for observed relationships via qualitative interviews. METHODS: A convergent parallel mixed methods design combined an ecological time series with focus group discussions and key informant interviews. Through an ecological time series component, monthly outpatient attendance and diarrhoea case counts from health facilities in two flood-prone districts for 2016–2020 were integrated with monthly flooding map layers classified via the Moderate Resolution Imaging Spectroradiometer (MODIS) and Landsat satellite sensors. The relationship between reported diarrhoea and outpatient attendance with flooding was examined using Poisson regression, controlling for seasonality and facility catchment population. Four focus group discussions with affected community members and four key informant interviews with health professionals explored flooding’s impact on healthcare delivery and access. RESULTS: Flooding detected via Landsat better predicted outpatient attendance and diarrhoea than flooding via MODIS. Outpatient attendance significantly reduced as LandSat-derived flood area per facility catchment increased (adjusted Incidence Rate Ratio = 0.78, 95% CI: 0.61–0.99, p < 0.05), whilst reported diarrhoea significantly increased with flood area per facility catchment (adjusted Incidence Rate Ratio = 4.27, 95% CI: 2.74—6.63, p < 0.001). Key informants noted how flooding affected access to health services as patients and health professionals could not reach the health facility and emergency referrals were unable to travel. CONCLUSIONS: The significant reduction in outpatient attendance during flooding suggests that flooding impairs healthcare delivery. The relationship is sensitive to the choice of satellite-derived flood product, so future studies should consider integrating multiple sources of satellite imagery for more robust exposure assessment. Health teams and communities should plan spatially targeted flood mitigation and health system adaptation strategies that explicitly address population and workforce mobility issues. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-022-14568-w. |
format | Online Article Text |
id | pubmed-9670488 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-96704882022-11-18 Dam-mediated flooding impact on outpatient attendance and diarrhoea cases in northern Ghana: a mixed methods study Dotse-Gborgbortsi, Winfred Dwomoh, Duah Asamoah, Moses Gyimah, Faustina Twumwaa Dzodzomenyo, Mawuli Li, Chengxiu Akowuah, George Ofosu, Anthony Wright, Jim BMC Public Health Research BACKGROUND: Floods are the most frequently occurring natural disaster and constitute a significant public health risk. Several operational satellite-based flood detection systems quantify flooding extent, but it is unclear how far the choice of satellite-based flood product affects the findings of epidemiological studies of associated public health risks. Few studies of flooding’s health impacts have used mixed methods to enrich understanding of these impacts. This study therefore aims to evaluate the relationship between two satellite-derived flood products with outpatient attendance and diarrhoeal disease in northern Ghana, identifying plausible reasons for observed relationships via qualitative interviews. METHODS: A convergent parallel mixed methods design combined an ecological time series with focus group discussions and key informant interviews. Through an ecological time series component, monthly outpatient attendance and diarrhoea case counts from health facilities in two flood-prone districts for 2016–2020 were integrated with monthly flooding map layers classified via the Moderate Resolution Imaging Spectroradiometer (MODIS) and Landsat satellite sensors. The relationship between reported diarrhoea and outpatient attendance with flooding was examined using Poisson regression, controlling for seasonality and facility catchment population. Four focus group discussions with affected community members and four key informant interviews with health professionals explored flooding’s impact on healthcare delivery and access. RESULTS: Flooding detected via Landsat better predicted outpatient attendance and diarrhoea than flooding via MODIS. Outpatient attendance significantly reduced as LandSat-derived flood area per facility catchment increased (adjusted Incidence Rate Ratio = 0.78, 95% CI: 0.61–0.99, p < 0.05), whilst reported diarrhoea significantly increased with flood area per facility catchment (adjusted Incidence Rate Ratio = 4.27, 95% CI: 2.74—6.63, p < 0.001). Key informants noted how flooding affected access to health services as patients and health professionals could not reach the health facility and emergency referrals were unable to travel. CONCLUSIONS: The significant reduction in outpatient attendance during flooding suggests that flooding impairs healthcare delivery. The relationship is sensitive to the choice of satellite-derived flood product, so future studies should consider integrating multiple sources of satellite imagery for more robust exposure assessment. Health teams and communities should plan spatially targeted flood mitigation and health system adaptation strategies that explicitly address population and workforce mobility issues. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-022-14568-w. BioMed Central 2022-11-17 /pmc/articles/PMC9670488/ /pubmed/36397017 http://dx.doi.org/10.1186/s12889-022-14568-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Dotse-Gborgbortsi, Winfred Dwomoh, Duah Asamoah, Moses Gyimah, Faustina Twumwaa Dzodzomenyo, Mawuli Li, Chengxiu Akowuah, George Ofosu, Anthony Wright, Jim Dam-mediated flooding impact on outpatient attendance and diarrhoea cases in northern Ghana: a mixed methods study |
title | Dam-mediated flooding impact on outpatient attendance and diarrhoea cases in northern Ghana: a mixed methods study |
title_full | Dam-mediated flooding impact on outpatient attendance and diarrhoea cases in northern Ghana: a mixed methods study |
title_fullStr | Dam-mediated flooding impact on outpatient attendance and diarrhoea cases in northern Ghana: a mixed methods study |
title_full_unstemmed | Dam-mediated flooding impact on outpatient attendance and diarrhoea cases in northern Ghana: a mixed methods study |
title_short | Dam-mediated flooding impact on outpatient attendance and diarrhoea cases in northern Ghana: a mixed methods study |
title_sort | dam-mediated flooding impact on outpatient attendance and diarrhoea cases in northern ghana: a mixed methods study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9670488/ https://www.ncbi.nlm.nih.gov/pubmed/36397017 http://dx.doi.org/10.1186/s12889-022-14568-w |
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