valentineghanem-bit/sdg-health-progress-ghana-261-districts

SDG-3 Health Progress in Ghana: Spatial Analysis of 261 Districts (2000–2030 Trajectory). LISA · Gi* · GWR · XGBoost · SHAP. # SDG-3 Health Progress in Ghana: Spatial Analysis of 261 Districts (2000–2030 Trajectory) **Author:** Valentine Golden Ghanem | Ghana COCOBOD Cocoa Clinic, Accra, Ghana **ORCID:** 0009-0002-8332-0220 **Affiliation:** Ghana COCOBOD Cocoa Clinic, Accra, Ghana **Reporting standard:** STROBE **Date:** 2026 **Status:** Manuscript in preparation ## 1. Abstract This study examines spatial variation in Sustainable Development Goal 3 (SDG-3) health progress across Ghana's 261 districts from 2000 to 2022, projecting trajectories toward the 2030 targets. A composite SDG-3 index was constructed from six sub-indicators: ANC4+ coverage, skilled birth attendance, under-5 mortality rate reduction, maternal mortality reduction, HIV incidence reduction, and TB treatment success. Spatial analysis revealed strong positive autocorrelation (Moran's I = 0.71, p < 0.001) with a pronounced north–south gradient. Greater Accra scored highest (72.4) while North East scored lowest (29.6), a 2.45-fold disparity. Machine learning identified healthcare facility density, poverty incidence, and NHIS coverage as the strongest predictors of SDG-3 progress. National composite score improved from 28.4 (2000) to 48.9 (2022), but current trajectories suggest northern regions will not meet 2030 targets without targeted intervention. ## 2. Research Question & Aims **Primary question:** What are the spatial determinants and district-level heterogeneity of SDG-3 health progress in Ghana? **Aims:** 1. Construct a validated SDG-3 composite index for 261 Ghana districts 2. Characterise spatial clustering and north–south gradient (LISA, Gi*, Moran's I) 3. Identify modifiable predictors of SDG progress using XGBoost and SHAP 4. Model GWR spatial heterogeneity in SDG-progress determinants 5. Project 2030 attainment trajectories under current trends ## 3. Methods Summary | Method | Tool | Purpose | |--------|------|---------| | Global Moran's I (queen contiguity) | esda / libpysal (Python) | Spatial autoc …