Appropriate governance and financing model for household solid waste management in Ghana: implications for public health
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Date
2018-11
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KNUST
Abstract
ABSTRACT
Waste management is an important developmental issue globally, especially in Lower Middle-income countries like Ghana. In Ghana, it appears the key challenge in household solid waste management is appropriate governance and financing. This study assessed utilization of solid waste management (SWM) services in Ghana, the financing mechanisms, governance structure for managing solid waste and the willingness-to-pay for improved SWM services as an integral attribute of sustainable financing mechanism for SWM services in Ghana. This was a cross-sectional multi-center study and conducted in Ghana from January to August 2017, among 1560 households in four regional capitals in Ghana; Accra, Takoradi, Kumasi and Tamale. Data were collected using a structured questionnaire and an in-depth interview guide for clients, waste management service providers and key informants from the Assemblies. Logistic regression models were used to determine the factors associated with utilization of household solid waste management services and the predictors of willingness-to-pay for household solid waste management services in Ghana. The current governance structure was found to be weak; not inclusive, role conflict among, Municipal and District Assemblies, (MMDAs), staff and other actors, absence of public health dimension, and a single source funding (user charges). The overall level of utilization of SWM services was 55%, with difference across study sites; 53.9%, 53.2%, 70% and 42.9% in Takoradi, Tamale, Accra and Kumasi respectively (p<0.001). Other ways of house hold waste disposal methods included drop-off at communal container sites (21.7%) and burning or putting in dug pits (21.8%). Overall, 53.7% of the households were willing to make additional payment of (GHC10- GHC50) for improved services, with difference across study sites; 54.5%, 53.1%, 61.7% and 46.6% in Takoradi, Tamale, Accra and Kumasi respectively. User charge was mainly the available payment system and was fraught by default
payments and inability to collect revenue. Utilization of household SWM services was associated with age, educational level, marital status, occupation, type of accommodation, type of residence, economic status and duration of stay at residence. Compared to those with no formal education, having tertiary education was associated with higher odd of utilization of SWM services (adjusted odds ratio aOR, = 1.60; 95% confidence interval CI, = 1.01-2.60). Urban residency was associated with higher odds of utilizing household SWM services compared to residing in a peri-urban area (aOR, =2.80; 95% CI, and 1.55-6.69). Willingness-to-pay for improved solid waste management was also predicted by educational level, marital status, type of employment and region of residence. Compared to women who had no formal education, having senior high school (aOR, 95%CI; 2.53; 1.48-4.30], post-secondary (aOR, 95% CI=1.97; 1.08, 3.60] and tertiary education (aOR, 95%CI; 3.30, 1.91, 5.69) were associated with higher odds of willingness-to-pay for improved SWM services. This study provides important evidence on important attribute for the establishment of appropriate governance and financing structure that facilitate willingness-to-pay for improved SWM services. Findings would contribute to efforts at finding sustainable ways for solid waste management service delivery in Ghana. It is therefore recommended that the proposed model for SWM is adopted and piloted in one of the metropolis for improved solid waste management.
Description
A thesis submitted to the department of health policy, management and economics, school of public health, college of health sciences in fulfilment of the requirements for the Award of the Degree of (Doctor of Philosophy in Public Health)