Ghana both urban and rural areas. These difficulties areconcentrated

Ghana has waste management difficulties that extend from the state to the local municipalities, andrefuse of all shapes and sizes is a common site in both urban and rural areas. These difficulties areconcentrated and complicated by population pressures in the few heavily populated cities of which Accra is the most prominent. The capital and largest city of Ghana is Accra, which has an urban population of 2.27 million (Ghana Statistical Service, 2017) and keeps growing daily.The confluence of poor governance and human factors (such as indiscriminate dumping) has resulted in a city environment characterized by choked drains, clogged gutters, and garbage piles heaped in the open.Only 30% of all houses have toilets that actually flush. Only 1 in every 5 houses has functioning indoor plumbing. The public latrines that have been built to accommodate these disparities are overused and often shared by 10 or more people (AMA Report, 2016).Accra is currently divided into 16 waste collection zones each contracted to different waste management firm responsible for collecting and disposing solid waste. Collection of solid waste from these zones has been delegated to the private sector. The AMA ….that is in charge of…concentrates on supervision of waste collection, monitoring of the public-private partnership, and management of final disposal points.  Approximately 20% of the population receives weekly house-to-house collection. Accra generates between 1500-1800 tons of waste per day, but it has the capacity to collect only 1200 (66%) tons per day. At all the various levels of waste management, (sorting, collection, transportation, and disposal) there exist disruptions that pose a threat to the environment and public health.Outside of the home, health risks are no better. When disposal facilities are not accessible or haveoverflowed, residents will dispose of their waste in open spaces and surface drains. If drainage channelsbecomes blocked with solid waste, water cannot drain from streets. Blocked drains and standing water pools are a contributing factor in the endemic status of Malaria. Malaria accounted for 53 percent of all reported diseases at Ghana outpatient facilities in 2016, and is the leading cause of morbidity in Accra.Insufficient communal facilities has led to open defecation along beaches, drains, and open spaces. In this environment there is a tendency for fecal material to become intermixed with household refuse. Street runoffs also become a potential source for human infection when drains become contaminated with fecal matter. Poor sanitation practices are also a cause of cholera. Cholera, an acute intestinal infection caused  Vibrio cholera, infects humans through contaminated food and water. It is considered a preventable disease persons perish needlessly. About 18% of households in greater Accra region (mostly low-income households) burn their waste. This burning contribute to outdoor air pollution. Leachants from burned refuse enter the groundwater. Leaching of refuse into water, particularly from household products like batteries, is a very pressing concern during the rainy season. Many neighborhoods are situated in low-lying areas which are susceptible to floods. Contamination of surface water in these flood prone areas raises the risk of exposure. This explains the statistically significant association between cholera prevalence and density of refuse dumps. The burning of domestic waste has been associated with respiratory illness. Households that are serviced inconsistently by waste collection companies sometimes burn their waste.  In these households, respiratory diseases are more common in mothers and children.