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PAPEL DÉ LA 11-6 EN EL POSTOPERATORIO DE LA CIRUCL4 DEL TERCER MOLAR INFERIOR

The major limitation of this study is the identification of rural households with HIV and AIDS due to the stigma of HIV illness. Therefore HIV-positive rural households were identified through the Association of Persons Living with HIV and AIDS (PLWHA) in three district hospitals in the Eastern Region of Ghana by consultations with health officers and AIDS counselors. This implied that only the few HIV-positive individuals who attended these health institutions were included in the study and all other HIV-positive individuals were excluded. Consequently the survey population which was purposively chosen was small. Generalization of survey findings is limited as a result of this purposive method of sampling, therefore the findings of the study cannot be generalized; the aim was to describe the management strategies of households included in the survey. The survey was cross-sectional rather than longitudinal as subjects were interviewed once due to limited time and resources. As a result the survey provided an overview of the management strategies in home gardens rather than how the management strategies in home garden changed over time in households living with HIV and AIDS. This was, however, complemented by in-depth studies.

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Information from dietary studies was self-reporting and the value depended on respondent’s truthfulness and memory. Although the method used encouraged honest recall, nevertheless some under and over reporting were likely to occur.

The survey sample was not stratified into HIV-positive and HIV-negative households during data collection due to HIV and AIDS-related stigma. These two categories were marked out during data management and analysis. In two communities, where the research was conducted, it was not easy to ensure confidentially and protect the privacy of participants as members of the communities knew households with individuals with HIV and AIDS illness. However this was not a problem in most of the communities.

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Table 3.2: Assessment of home garden management strategies among HIV-positive and HIV-negative rural households in Eastern Region of Ghana (Research Phase 2), with the objective: To assess the biodiversity in home gardens of HIV- positive and HIV-negative rural households in the Eastern Region of Ghana and its contribution to dietary diversity among these households.

Operational

objectives Expected outputs Methods, instruments and strategies for data

collection

Analysis Research Phase 2: Survey

Objective: Document differences in biodiversity in home gardens of HIV-positive and HIV-negative rural households and evaluate its contribution to dietary diversity in these households

A1: Assess and compare field and home garden cultivation in HIV- positive and HIV- negative rural households

 Differences in:

‐ field and cultivated home garden area;

‐ number of adult household members (aged 15- 65) who contribute to home garden cultivation;

‐ number of adult household members (aged 15-65) who contribute to livestock rearing;

‐ proportions with farming as main occupation

between HIV-positive and HIV- negative determined  Household survey  Semi-structured interviews Student’s t-tests and Fisher’s exact tests to uncover and explain similarities and differences

A2: Describe and compare biodiversity in home gardens of HIV-positive and HIV-negative rural households  Difference in: ‐ number of different

categories of plants species cultivated;

‐ plant species diversity; ‐ kinds of domestic livestock

and poultry reared between HIV-positive and HIV- negative households determined

 Home garden survey  Inventory of plant

species

 List of domestic livestock and poultry species in home gardens compiled  Structured questionnaire  Shannon- Wiener index  Student’s t-tests to uncover and explain similarities and differences

A3: Describe and assess contribution of home garden species to dietary diversity in HIV- positive and HIV- negative households

 Difference in:

‐ proportions that consumed the individual food groups; ‐ dietary diversity score with food items from home garden (DDS(+HG));

‐ dietary diversity score without food items from home garden (DDS(–HG)); ‐ proportions that consumed

food items from home garden between HIV- positive and HIV- negative households determined

 Household survey  Home garden survey  24-hr qualitative dietary recall  Structured questionnaire  Dietary diversity score (DDS)  Student’s t-tests and Fisher’s exact tests to uncover and explain similarities and differences

A4: Assess and evaluate the statistical

association between household dietary diversity and home garden species diversity

The degree of the association between dietary diversity score and home garden species diversity established

 Home garden survey  Inventory of plant species  24-hr qualitative dietary recall  Pearson correlation  Dietary diversity score (DDS)  Shannon- Wiener index  Correlation coefficient

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Table 3.3.1: Uncovering the effect of the interaction between household HIV status and gender of the home garden owner on biodiversity in home gardens (Research Phase 3a) with the objective: To evaluate the differences in the biodiversity in home gardens of female-headed and dual-headed HIV-positive and HIV-negative rural households and the effect on household dietary diversity.

Operational

objectives Expected outputs Methods, instruments and strategies for data

collection

Analysis Research Phase 3a: In-depth studies

Objective: Document and compare biodiversity in home gardens, labour input in home gardens and dietary diversity in female-headed and dual- headed HIV-positive and HIV-negative rural households

A1: Describe and assess field and home garden cultivation in female-headed and dual headed HIV- positive and HIV– negative rural households

 Differences in: field area cultivated; number of field

crops cultivated; - cultivated home

garden area between the four households types determined  Household survey  Case studies  In-depth interviews  Survey data stratified by household HIV status and gender of household head (female/dual- headed)  Two-way ANOVA and Fisher's protected LSD-tests to uncover and explain similarities and differences A2: Describe and

assess the biodiversity in home gardens in female-headed and dual headed HIV- positive and HIV- negative rural households  Differences in the number of: ‐ annual crops; ‐ perennial crops species; ‐ categories of crops; ‐ vegetable crop species;

‐ root and tuber crop species; fruit species; ‐ other crop species

cultivated: ‐ species diversity; ‐ kinds of domestic livestock reared; ‐ number of poultry reared; ‐ number of domestic livestock reared in the home four garden types determined

 Household survey  Home garden survey  Shannon-Wiener index  Case studies  In-depth interviews  Survey data stratified by household HIV status and gender of household head (female/dual- headed)  Two-way ANOVA and Fisher's protected LSD-tests to uncover and explain similarities and differences

A3: Describe and assess labour input in home gardens in female-headed and dual headed HIV- positive and HIV- negative rural households

 Differences in number of adult household members (aged between 15-65 years) who contributed to: cultivating; planting; weeding; - harvesting crops in the four households types

 Household survey  Case studies  In-depth interviews

 Survey data stratified by household HIV status and gender of household head (female/dual- headed)  Two-way ANOVA

and Fisher's protected LSD-tests to uncover and explain

similarities and differences

59 diversity in female-

headed and dual- headed HIV-positive and HIV–negative rural households

diversity scores of the four households types determined  24-hr qualitative dietary recall  Dietary diversity score  Case studies  In-depth interviews stratified by household HIV status and gender of household

head(female/dual- headed)

 2-way ANOVA and Fisher's protected LSD-tests to uncover and explain similarities and differences

Table 3.3.2: Exploring the biodiversity in subsistence and commercial home gardens of HIV-positive and HIV-negative rural households in the Eastern Region of Ghana (Research Phase 3b) with the objective: To explore the differences and similarities in subsistence-oriented and commerce-oriented home gardens of HIV-positive and HIV-negative rural households in the Eastern Region of Ghana and their significance in food security.

Operational objectives

Expected outputs Methods, instruments and

strategies for data collection

Analysis Research Phase 3b: In-depth studies

Objective: Describe and compare differences and similarities in biodiversity, management input used, seasonal availability of produce and consumption of home garden produce in subsistence-oriented and commerce-oriented home gardens of HIV-positive and HIV-negative households

A1: Assess and compare field and home garden cultivation in HIV- positive and HIV- negative households with subsistence oriented and commerce oriented home gardens  Differences and similarities in: - proportions that have farming as main occupation; - cultivated field area; ‐ number of years of home garden cultivation; - cultivated home garden area in the four household types determined  Household survey  Home garden survey  Case studies  In-depth interviews

 Survey data stratified by household HIV status and primary aim in home garden cultivation (subsistence-oriented/ commerce-oriented)  Chi-square tests to

uncover and explain similarities and differences  Kruskal-Wallis and Dunn’s multiple comparison tests to examine the

differences across home garden types

A2: Describe and compare biodiversity in subsistence- oriented and commerce-oriented home gardens of HIV-positive and HIV-negative households  Extent of similarity in crop composition in the four home garden types determined  Differences in: - number of individual plants; - total number of crop species; - number of annual  Home garden survey  Inventory of crop species in home gardens compiled  Inventory of crop species in home gardens compiled  Case studies  In-depth interviews

 Survey data stratified by household HIV status and primary aim in home garden cultivation ( subsistence oriented/ commerce oriented)  Species richness  Sørenson’s index of similarity  Plant count

60 food crop species; - number of

perennial food crop species; - number of non-

food crop species recorded in the four home garden types determined  Strength of the

association between function of home garden and presence of the individual crop species established.  Differences in:

- ecological indices; - species diversity; - evenness

in the four home garden types determined  Shannon-Wiener index  Kruskal-Wallis and Dunn’s multiple comparison tests to examine the

differences across home garden types

 Fisher’s exact tests to uncover and explain association between variables

A3: Assess the relationship between use of external inputs between subsistence- oriented and commerce-oriented home gardens of HIV-positive and HIV-negative households

Strength of the association between function of home garden and use of:

‐ improved planting material; ‐ chemical pesticides; ‐ chemical fertilizers; ‐ hired labour; ‐ presence or absence of fences in the four home garden types established

 Household survey  Case studies  In-depth

interviews

Fisher’s exact tests to uncover association between variables

A4: Assess and compare seasonal availability of home garden produce in subsistence- oriented and commerce-oriented home gardens of HIV-positive and HIV-negative households Differences in number of home garden crop species harvested in:

‐ rainy season only; ‐ dry season only; ‐ both rainy and dry

seasons

in the four home garden types determined  Household survey  Case studies  In-depth interviews  Kruskal-Wallis and Dunn’s multiple comparison tests

to examine the differences across home garden types  Chi-square and

Fisher’s exact tests to uncover similarities and differences

A5: Assess the consumption of a staple crop cultivated in subsistence- oriented and commerce-oriented home gardens of HIV-positive and HIV-negative households Differences in proportions that consumed a staple crop cultivated in the home garden 24-hr prior to the study determined in the four home garden types

 Household survey  24-hr qualitative dietary recall  Case studies  In-depth interviews

Fisher’s exact tests to uncover and explain similarities & differences

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Table 3.4: Evaluating the seasonal dimension of coping with food shortages in farm households living with HIV and AIDS in the Eastern Region of Ghana (Research Phase 4), with the objective: To evaluate the food insecurity of HIV-positive and HIV-negative farm households in the Eastern Region of Ghana during the post-harvest period and in the lean season.

Operational

objectives Expected outputs Methods, instruments and strategies for data

collection

Analysis Research Phase 3b: In-depth studies

Objective: Describe and compare differences and similarities in biodiversity, management input used, seasonal availability of produce and consumption of home garden produce in subsistence-oriented and commerce-oriented home gardens of HIV-positive and HIV-negative households

A1: Assess and compare field and home garden cultivation in HIV- positive and HIV- negative households with subsistence oriented and commerce oriented home gardens  Differences and similarities in: - proportions that have farming as main occupation; - cultivated field area; ‐ number of years of home garden cultivation; - cultivated home garden area in the four household types determined  Household survey  Home garden survey  Case studies  In-depth interviews

 Survey data stratified by household HIV status and primary aim in home garden cultivation (subsistence-oriented/ commerce-oriented)  Chi-square tests to

uncover and explain similarities and differences  Kruskal-Wallis and Dunn’s multiple comparison tests to examine the

differences across home garden types

A2: Describe and compare biodiversity in subsistence- oriented and commerce-oriented home gardens of HIV-positive and HIV-negative households  Extent of similarity in crop composition in the four home garden types determined  Differences in: - number of individual plants; - total number of crop species; - number of annual

food crop species; - number of

perennial food crop species; - number of non-

food crop species recorded in the four home garden types determined  Strength of the

association between function of home garden and presence of the individual crop species established.  Differences in:

- ecological indices; - species diversity; - evenness

in the four home

 Home garden survey  Inventory of crop species in home gardens compiled  Inventory of crop species in home gardens compiled  Case studies  In-depth interviews

 Survey data stratified by household HIV status and primary aim in home garden cultivation ( subsistence oriented/ commerce oriented)  Species richness  Sørenson’s index of similarity  Plant count  Shannon-Wiener index  Kruskal-Wallis and Dunn’s multiple comparison tests to examine the

differences across home garden types

 Fisher’s exact tests to uncover and explain association between variables

62 garden types

determined A3: Assess the

relationship between use of external inputs between subsistence- oriented and commerce-oriented home gardens of HIV-positive and HIV-negative households

Strength of the association between function of home garden and use of:

‐ improved planting material; ‐ chemical pesticides; ‐ chemical fertilizers; ‐ hired labour; ‐ presence or absence of fences in the four home garden types established

 Household survey  Case studies  In-depth

interviews

Fisher’s exact tests to uncover association between variables

A4: Assess and compare seasonal availability of home garden produce in subsistence- oriented and commerce-oriented home gardens of HIV-positive and HIV-negative households Differences in number of home garden crop species harvested in:

‐ rainy season only; ‐ dry season only; ‐ both rainy and dry

seasons

in the four home garden types determined  Household survey  Case studies  In-depth interviews  Kruskal-Wallis and Dunn’s multiple comparison tests

to examine the differences across home garden types  Chi-square and

Fisher’s exact tests to uncover similarities and differences

A5: Assess the consumption of a staple crop cultivated in subsistence- oriented and commerce-oriented home gardens of HIV-positive and HIV-negative households Differences in proportions that consumed a staple crop cultivated in the home garden 24-hr prior to the study determined in the four home garden types

 Household survey  24-hr qualitative dietary recall  Case studies  In-depth interviews

Fisher’s exact tests to uncover and explain similarities & differences

63

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