Sexual reproductive health in Ghana
What’s the issue? 
Ghana’s sustained economic growth is above average for sub-saharan African but these benefits have not extended to the three regions of the north of Ghana where African Initiatives works with its partner the Community Self Reliance Centre (CSRC). The regions continue to score very low on all indicators of poverty e.g child mortality, girls in school, malnutrition, access to clean water and infrastructure development. 70% of the population in these regions are subsistence farmers living on less than $2.00 a day.
The general health of the population in these regions leaves much to be desired. Areas of most concern are accessibility to reproductive health services and the exercise of peoples’ rights especially for women and children. Discriminatory practices against women such as domestic violence and Female Genital Mutilation (FGM) are widely practiced in the area. Ghana’s Domestic Violence Act of 2007 prohibits the use of force and violence in the domestic setting. However, lack of information and awareness of rights hinders the effectiveness of its legal provisions.
The practice of FGM is also prohibited under law due to the physical and psychological damage that can be caused but again women are not able to exercise their rights. Additionally, women are not involved in decision making concerning their reproductive health; they do not make decisions concerning contraception or when they are to have children. Maternal mortality is 6%; infant mortality is 46 per 1000; post natal coverage is 51% and only 48% of women have a supervised delivery. The National Health Insurance Scheme (NHIS) was initiated in the north in 2006 but covers less than 50% of the population. There has been inadequate publicity of the scheme exacerbated by low literacy among the population and low understanding of its benefits. Making claims is perceived as problematic.
What is African Initiatives doing?
In June 2010, African Initiatives launched a new two year project to ‘improve women’s rights and access to sexual and reproductive health services’ in Ghana working with our partner the Community Self Reliance Centre (CSRC).This follows on from the successful women’s rights work already being implemented in the area with our partner CSRC, which focuses on reducing domestic violence and female genital mutilation (FGM) and women’s social and economic empowerment. It targets ten new under-served communities over two years, directly benefiting 5,990 individuals of which at least 60-70% will be women and children.
Currently, the general health of the population in the northern regions leaves much to be desired. Areas of most concern are the lack of access to health services and the exercise of people’s rights, especially for women and children. Discriminatory practices against women such as domestic violence and FGM are widely practiced in the area despite the fact they are both prohibited by law. Women are often not involved in decision making concerning their reproductive health including contraception and when they are to have children. Coupled with this, Ghana’s National Health Insurance Scheme (NHIS) covers less than 50% of the population due to lack of people’s awareness and knowledge of the scheme.
CSRC will address these issues by implementing an educational and advocacy campaign with the support of 40 volunteers in ten communities. The objective will be to increase women’s understanding of their rights within their families and their communities, and to empower women to better represent themselves now and in the future. To achieve this, CSRC will conduct a community education and awareness raising campaign on family reproductive health, including; early and forced marriage, family planning, birthing practices, pre and post natal care, HIV, AIDS and life-skills, FGM, and available services. Communities will be informed on how to access quality sexual and reproductive health services and how to register for the NHIS. Community volunteers will be trained to spread new ideas including to school children.
Rural communities will be able to access local services through health professionals, such as traditional birth attendants, community nurses, and Village Health Committees, who will receive specialised training. Our partner, CSRC will work in collaboration with the Ghana Health Service and the Ghana Education Service to help ensure it is implemented in the most effective and sustainable manner. We are extremely grateful for the support of The Body Shop Foundation for this new work – without which, it would not be possible.