Dam-mediated flooding impact on outpatient attendance and diarrhoea cases in northern Ghana: a mixed methods study
Abstract 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 findi...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-022-14568-w |
| _version_ | 1828094203640414208 |
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| author | Winfred Dotse-Gborgbortsi Duah Dwomoh Moses Asamoah Faustina Twumwaa Gyimah Mawuli Dzodzomenyo Chengxiu Li George Akowuah Anthony Ofosu Jim Wright |
| author_facet | Winfred Dotse-Gborgbortsi Duah Dwomoh Moses Asamoah Faustina Twumwaa Gyimah Mawuli Dzodzomenyo Chengxiu Li George Akowuah Anthony Ofosu Jim Wright |
| author_sort | Winfred Dotse-Gborgbortsi |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-11T06:55:42Z |
| format | Article |
| id | doaj.art-56ff20c9d36942ecbbe4042b3e76c1b3 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-04-11T06:55:42Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-56ff20c9d36942ecbbe4042b3e76c1b32022-12-22T04:39:02ZengBMCBMC Public Health1471-24582022-11-0122111410.1186/s12889-022-14568-wDam-mediated flooding impact on outpatient attendance and diarrhoea cases in northern Ghana: a mixed methods studyWinfred Dotse-Gborgbortsi0Duah Dwomoh1Moses Asamoah2Faustina Twumwaa Gyimah3Mawuli Dzodzomenyo4Chengxiu Li5George Akowuah6Anthony Ofosu7Jim Wright8School of Geography and Environmental Science, University of SouthamptonGhana School of Public Health, University of GhanaGhana School of Public Health, University of GhanaInstitute of Statistical Social and Economic Research, University of GhanaGhana School of Public Health, University of GhanaSchool of Geography and Environmental Science, University of SouthamptonUpper East Regional Health Directorate, Ghana Health ServiceNational Headquarters, Ghana Health ServicesSchool of Geography and Environmental Science, University of SouthamptonAbstract 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.https://doi.org/10.1186/s12889-022-14568-wFloodsClimateHealth information systemsGeographic information systemsDiarrhoea |
| spellingShingle | Winfred Dotse-Gborgbortsi Duah Dwomoh Moses Asamoah Faustina Twumwaa Gyimah Mawuli Dzodzomenyo Chengxiu Li George Akowuah Anthony Ofosu Jim Wright Dam-mediated flooding impact on outpatient attendance and diarrhoea cases in northern Ghana: a mixed methods study BMC Public Health Floods Climate Health information systems Geographic information systems Diarrhoea |
| 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 | Floods Climate Health information systems Geographic information systems Diarrhoea |
| url | https://doi.org/10.1186/s12889-022-14568-w |
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