title: Social Factors Influencing Child Health in Ghana.
abstract: OBJECTIVE
  Social factors have profound effects on health. Children are especially vulnerable to social influences, particularly in their early years. Adverse social exposures in childhood can lead to chronic disorders later in life. Here, we sought to identify and evaluate the impact of social factors on child health in Ghana. As Ghana is unlikely to achieve the Millennium Development Goals' target of reducing child mortality by two-thirds between 1990 and 2015, we deemed it necessary to identify social determinants that might have contributed to the non-realisation of this goal.
  
  
  METHODS
  ScienceDirect, PubMed, MEDLINE via EBSCO and Google Scholar were searched for published articles reporting on the influence of social factors on child health in Ghana. After screening the 98 articles identified, 34 of them that met our inclusion criteria were selected for qualitative review.
  
  
  RESULTS
  Major social factors influencing child health in the country include maternal education, rural-urban disparities (place of residence), family income (wealth/poverty) and high dependency (multiparousity). These factors are associated with child mortality, nutritional status of children, completion of immunisation programmes, health-seeking behaviour and hygiene practices.
  
  
  CONCLUSIONS
  Several social factors influence child health outcomes in Ghana. Developing more effective responses to these social determinants would require sustainable efforts from all stakeholders including the Government, healthcare providers and families. We recommend the development of interventions that would support families through direct social support initiatives aimed at alleviating poverty and inequality, and indirect approaches targeted at eliminating the dependence of poor health outcomes on social factors. Importantly, the expansion of quality free education interventions to improve would-be-mother's health knowledge is emphasised.
authors.affiliation: Department of Molecular Biology and Biotechnology, School of Biological Science, University of Cape Coast, Cape Coast, Ghana.|Faculty of Health and Life Sciences, De Montfort University, Leicester LE1 9BH, United Kingdom.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Quansah
authors.affiliation: Faculty of Health and Life Sciences, De Montfort University, Leicester LE1 9BH, United Kingdom.|Department of Community Health, School of Nursing, University of Ghana, Accra, Ghana.
authors.forename: Lilian Akorfa
authors.initials: LA
authors.lastname: Ohene
authors.affiliation: School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.
authors.forename: Linda
authors.initials: L
authors.lastname: Norman
authors.affiliation: Département Méthodes Quantitatives en Santé Publique (METIS), Ecole des Hautes Etudes en Santeé Publique, Rennes, France.|Ecole Doctorale Pierre Louis de Santeé Publique, Universiteé Pierre et Marie Curie (UPMC- Paris VI), Paris, France.|Meère et Enfant Face aux Infections Tropicales, Institut de Recherche pour le Deéveloppement (IRD), Paris, France.
authors.forename: Michael Osei
authors.initials: MO
authors.lastname: Mireku
authors.affiliation: Neuroscience, School of Life Sciences, University of Warwick, Coventry CV4 7AL, Uunited Kingdom.|Midlands Integrative Biosciences Training Partnership, University of Warwick, Coventry CV4 7AL, United Kingdom.
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Karikari
mesh_terms: D002648:Child; D000067576:Child Health / Q000191:economics; D016208:Databases, Factual; D003695:Delivery of Health Care; D005869:Ghana; D006291:Health Policy; D006801:Humans; D009035:Mothers / Q000193:education / Q000523:psychology; D009752:Nutritional Status; D012424:Rural Population; D012944:Social Support