Dam-mediated flooding impact on outpatient attendance and diarrhoea cases in northern Ghana: a mixed methods study
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Published:2022-11-17
Issue:1
Volume:22
Page:
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ISSN:1471-2458
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Container-title:BMC Public Health
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language:en
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Short-container-title:BMC Public Health
Author:
Dotse-Gborgbortsi Winfred,Dwomoh Duah,Asamoah Moses,Gyimah Faustina Twumwaa,Dzodzomenyo Mawuli,Li Chengxiu,Akowuah George,Ofosu Anthony,Wright Jim
Abstract
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.
Funder
Economic and Social Research Council
UK Research and Innovation
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference58 articles.
1. Guha-Sapir D, Vos F, Below R. Annual Disaster Statistical Review 2010: the numbers and tresnds. Brussels, Belgium: (CRED) CfRotEoD; 2011.
2. Doocy S, Daniels A, Murray S, Kirsch TD. The human impact of floods: a historical review of events 1980-2009 and systematic literature review. PLoS Curr. 2013;5. https://pubmed.ncbi.nlm.nih.gov/23857425/.
3. Smith KR, Woodward A, Campbell-Lendrum D, Chadee DD, Honda Y, Liu Q, et al. Human health: impacts, adaptation and co-benefits. In: Field CB, Barros V, Dokken D, Mach M, Mastrandrea M, Bilir T, et al., editors. Climate Change 2014: impacts, adaptation and vulnerability Part A: Global and Sectoral Aspects Contribution of Working Group II to the Fifth Assessment Report of the Inter-governmental panel on climate change. Cambridge: Cambridge University Press; 2014. p. 706–54.
4. Zarfl C, Lumsdon AE, Berlekamp J, Tydecks L, Tockner K. A global boom in hydropower dam construction. Aquat Sci. 2015;77(1):161–70.
5. Lempérière F. Dams and Floods. Engineering. 2017;3(1):144–9.
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