Making Headway: Consolidating Gains And Bridging Gaps

UNFPA Ghana 2021 Annual Report

Foreword

The COVID-19 pandemic set in at the tail end of 2019 and spiked the following year in 2020; bringing with it many reasons for countries and organizations around the world to adapt social systems to contain and be resilient to the adverse effects of the public health scourge.

In Ghana, the UNFPA Country Office continued to prioritize the interests of women and girls, as well as young people through the provision of critical information and services in the areas of maternal health, family planning, support for victims of Sexual & Gender-Based Violence and Harmful Practices, among others. The COVID-19 pandemic taught us the need to work more innovatively by using digital technology to reach more of our partners, stakeholders and most importantly, beneficiaries of our interventions.

Mr. Barnabas Yisa
Country Representative

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Chapter 1

ENDING UNMET NEED FOR FAMILY PLANNING

Globally, an estimated 214 million women including adolescents want to avoid a pregnancy but are not using an effective family planning method (WHO, 2017), contributing to many unintended pregnancies. Unmet need for family planning in Ghana remains high (30%) among married women and higher (51%) for adolescents 15-19years. Disparities in use of contraceptive remains worrying with use of modern contraceptive among married women ranging from a low of 17% in Northern region to a high of 32% in Upper East region. A functioning health system is widely acknowledged as the clear and critical determinant of countries to deliver quality contraceptive services.

During the year, UNFPA Ghana supported government and partners to provide quality contraceptive services through strengthening key blocks of the health system including— human resources/health work force, service delivery, information, and medical products.

Human resources: UNFPA supported government to build capacity of health care providers on the DMPA SC selfinject contraceptive method. The capacity building contributed to ensure that Ghana health workforce remain responsive to emerging family planning technologies and innovations in order to deliver efficient services.

`WE DECIDE’ Programme: During the year, UNFPA supported capacity building of government, civil society actors and UNFPA staff from Libera and Sierra Leone, through a WCARO programme dubbed “WE DECIDE - A Programme for Equal Opportunities and a Life Free of Violence” initiative.

Ability Fair: Persons with disabilities have the same Sexual and Reproductive Health (SRH) needs as other people. However, they often face various barriers in accessing information and services. Negative provider attitude, stigma and discrimination account for most of these barriers.

A section of participants in the training
Mr. Idrissa Ouedraogo, Gender Technical Adviser, UNFPA WCARO, delivering remarks during the training
Administration of an implant to a patient

Results

Results Recommendations

700 providers

trained to administer DMPA SC self inject contraceptive method

Results Recommendations

350 health facilities

equipped with trained health providers with the requisite competencies to provide DMPA SC and Self Injection services.

Results Recommendations

30 participants

(Civil Society and Government) equipped as trainer of trainers in issues of integrated SRHR, GBV and Disability

Results Recommendations

200 dignity kits

consisting of items such as toothbrushes, paste, sanitary pads, etc. were distributed to vulnerable adolescents girls and women

Results Recommendations

200 young people and adults

were screened for HIV and STIs. Referrals were made to those detected with medical conditions

Results Recommendations

5,250

male and female condoms altogether were distributed to vulnerable adolescents and young people

Results Recommendations

1,200 participants

including YPLWDs were reached with SGBV & SRHR information and services

Results Recommendations

1,290,816

Couple Years Protection (CYP) from UNFPA imported contraceptives

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Chapter 2

IMPROVING MATERNAL HEALTH

The Country Office continued its support to the Government of Ghana (the Ministry of Health and the Ghana Health Service) in the four MHTFfunded areas of interest, namely, EmONC, MPDSR, Obstetric fistula, and Midwifery; as well as in the UNFPA Supplies/Reproductive Health Commodities Securities/Family planning.

Following the EMONC Assessment, the GHS/MOH aims to establish the Networks of Practice with the consideration of selected EMONC facilities as model health centres in its bid to achieve UHC by 2030. UNFPA has been supporting the preparatory processes, including the development of a concept document.

Midwifery Education: Strengthening the quality of nursing and midwifery education and training is essential to improving the knowledge, skills, and competencies of midwives. A major component of pre-service training of nurses and midwives is practical sessions including Skills lab sessions. This provides student midwives an opportunity for hands-on practice with anatomical models before applying skills in real-life situations.

Preceptorship Training: A needs assessment conducted in 2016, as well as the review of the implementation of the 5-year strategic plan for nursing and midwifery funded by UNFPA pointed out a very huge gap between preservice training and practice after student nurses and midwives graduated.

Donation of Midwifery Equipment to Garden City University College
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Young Girls and Queen Mothers in Ghana pledge to end teenage pregnancy

Queen Mothers encourage adolescent girls to claim their rights and be assertive because their body belongs to them. This was at a skills building session for adolescent girls facilitated by Queen Mothers.

Results

Results Recommendations

79

obstetric fistula cases mobilized and repaired

Results Recommendations

21 midwives

awarded from the successful commemoration of the 2021 IDM

Results Recommendations

2

Midwifery Training Institutions with requisite midwifery equipment

Results Recommendations

2 OF

repair facilities upgraded towards quality surgical repairs

Results Recommendations

47

midwives with training in Life-saving skills (LSS)

Results Recommendations

30

midwifery preceptors had their capacities built

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Chapter 3

ELIMINATING SGBV & HARMFUL PRACTICES

Gender equality is a human right. Women are entitled to live with dignity and with freedom from want and from fear. This is the principle that has guided UNFPA’s work for more than 30 years. Gender-based violence and harmful practices is one of the three transformative results that UNFPA relies on to contribute to the 2030 agenda.

GBV undermines the health, dignity, security and autonomy of its victims, yet it remains shrouded in a culture of silence. It is for the above reasons that UNFPA Ghana takes a pragmatic approach in a coordinated response to GEWE as well as GBV programming.

In 2021, UNFPA continued to programme to prevent and respond to harmful practices especially child marriage. Strategic interventions were implemented at both the national and decentralised levels to review, update and advocate for gender equitable policies and frameworks, build the capacity of relevant stakeholders and enhance knowledge management and coordination. Additionally, various cohorts of community members were Results engaged using several approaches and tools to sensitize and empower them on their role in ending child marriage and all forms of SGBV.

With the national mandate to ensure gender equality and promote women and girls’ empowerment, the Ministry of Gender, Children and Social Protection through its Department of Gender and the Domestic Violence Secretariat played pivotal roles in the 2021 achievements chalked by UNFPA.

Lessons Learned

  • Use of Digital Platforms

    The use of mix methods to reach adolescent girls and other relevant stakeholders including the use of digital platforms and face to face meetings continues to facilitate the reach of many beneficiaries. Additionally, innovative platforms such as the Gender Equality Clinic and Adolescent Learning Forum provide opportunities for adolescents to exchange ideas, learn from their peers and roll out step down approaches to enhance reach.

  • Enhanced Coordination

    Supporting mandated institutions to enhance coordination using packages such as the Essential Services Package for Women and Girls Subject to Violence and other platforms such as the Child Marriage Information Portal enhances service provision and response to SGBV and HPs.

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Chapter 4

EMPOWERING YOUNG PEOPLE & ADOLESCENTS

The youth are energetic and hold the potential as future leaders and therefore possess power. It is also worth noting that, today’s youth are a vital resource of every nation which calls on the need to welcome young people’s views, initiatives and a platform to advocate on issues affecting the youth.

It is against this background, the General Assembly of the United Nations in 1999, in its resolution 54/120, endorsed the recommendation made by the World Conference of Ministers Responsible for Youth (Lisbon, August 8-10, 1998) that August 12 be declared International Youth Day (IYD). Annually on August 12, the International Youth Day is celebrated to bring youth issues to the attention of the international community and to celebrate the potential of youth as active partners in the local, regional and global society. The Focal Point on Youth selects a theme for the day often with inputs from youth organisations and members of the UN Inter-Agency Network in Youth development.

Like other partners that support youth development, the Government of the Republic of Ghana acknowledges that the youth are leaders of today, tomorrow and the future and joins the international community annually in celebrating International Youth Day. With the mandate above, Ghana’s National Youth Authority (NYA) with support from United Nations Ghana and United Nations Population Fund (UNFPA) Ghana, organised a Youth Summit to commemorate the International Youth Day 2021 to transforming food systems.

PPAG-YAM Condomize Night: This activity (Condomize night) involved two full days of active engagement on selected streets and market areas in Accra including Kaneshie market, Abbosey Okai Spare parts, Takoradi Station, Kwame Nkrumah Circle, circle main station, the Maame Dokono station, the Vienna City, the VIP station and the Tiptoe lane.

Youth Connekt Africa Summit 2021: Ghana won the bid to host the 2021 edition of Youth Connekt Africa Summit (YCA), a platform aimed at connecting youth from across Africa for continental transformation. The Summit has over the years provided opportunities to generate result-based dialogues and create strategic alliances and partnerships to enhance proactive multilateral cooperation, to support the African youth.

Condomize Night reached out to the general public, especially sexually active young people, with various SRH information
Youth Connekt Africa Summit 2021 in Ghana
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Chapter 5

UTILIZING DATA TO INFORM DEVELOPMENT PLANNING

Data and statistics are central to the development of Ghana. Without accurate and detailed data on the size, distribution and composition of the population, it is difficult to plan and implement activities, measure the achievement of socio-economic development and conduct scientific research.

Ghana has a youthful population. According to the Ghana Statistical Service, the population of Ghana has increased at an annual growth rate of 2.1 percent from 2010 to 2021 (GSS, 2021). The population of Ghana in 2021 is 30.8 million with males representing 49.3 percent and females recording 50.7 percent. Also, the population of young people is 31.2 percent (males 31.7% and females 30.8%). The national HIV prevalence in 2017 was 2.1 percent, 1.7 in 2018 and 1.6 percent in both 2019 and 2020 (GAC, 2019).

Demographic, Fertility and Mortality Status of Ghana

  • 2021 Population and Housing Census (PHC)

    The 6th round of 2021 PHC was conducted in 2021. The Census was initially scheduled to be conducted in 2020, but due to Covid 19, it was postponed to 2021. UNFPA CO has been involved technically and financially from the inception of the 2021 Census to post-census activities which are currently ongoing. The Census has been conducted and 13 general reports on age and sex, regions and districts, economic activity, difficulty and literacy etc. have been disseminated. As part of the quality assessment, CO conducted independent monitoring of the census, involving 37 Monitors with 17 from various African countries such as Niger, Kenya, Côte D’Ivoire, Togo, Ethiopia, Nigeria, and Mauritania among others.

  • Harnessing the Demographic Dividend

    The Country (CO) continued to support the Government of Ghana through the National Development and Planning Commission (NDPC) in undertaking actions to harness the Demographic Dividend (DD) by developing the Ghana Country Population Profile on National Transfer Accounts for Demographic Dividend Programming in 2020 and the National Youth Development Index, 2020 to provide evidence-based data for programming in Ghana. The final draft documents are used as reference materials for evidence-based data and designing interventions for the people of Ghana, especially young people to harness the demographic dividend. Both documents are being processed for printing.

  • Development of Medium-Term National Development and Policy Framework (MTNDPF) 2022-2025

    CO/P&D Unit participated in sector group meetings on the development of the Medium-Term National Development and Policy Framework (MTNDPF) 2022-2025 such as Population and Development and Migration. The purpose of the meeting is to solicit inputs from Development Partners to inform the development of the framework, which guides the national agenda. The framework guided the development of the CO 8th Country Programme Document (CPD). This is to ensure that the Country Programme is aligned with national priorities. The Framework is currently operational.

  • Country Programme Evaluation 2018-2022

    The CO in August 2021 commenced the 7th Country Programme Evaluation (CPE which was coordinated by the P&D Unit and the Evaluation Manager). The goal of the CPE was to demonstrate accountability to stakeholders for the results achieved, to support evidence-based decision-making, to contribute important lessons learned to the organisation's knowledge base, and to provide independent inputs to the next UNFPA country programme cycle and the strategic direction of the organisation's continued role. The UNFPA Country Office (CO), Regional Office, UNFPA Headquarters, and the Executive Board, as well as key government agencies, national partners, and development partners, including funders and UN agencies in the country, were the audience for this CPE.

  • Country Programme Document

    The CO in 2021 commenced the development of the 8th CPD. The P&D Unit was instrumental in the development of the report. The Unit led the provision of data and evidence for the CPD, the development of the Results and Resources Framework, the Costed Evaluation Plan and the summary of the 6th Country Programme. Further, the 8th CPD will guide the implementation of CO programmes from 2023-2027and ensure that the implementation of programmes is aligned to the UNFPA Strategic Plan 2022-2025 and the Medium-Term National Development Policy Framework, 2022-2025. Also, the Results and Resources Framework will be used to measure the progress of the output indicators by CO. The P&D Unit continues to provide technical inputs and address comments from the Regional Office and Headquarters.

  • 2022 Review/2021 Planning and Consultative Meeting on 8th Country Programme Document

    The UNFPA CO held an annual review, planning and consultative meeting in November 2021. The purpose of the meeting was to review planned activities with IPs for 2020, including, achievements, challenges and way forward. Also, the meeting was to review and finalise the 2022 proposed work plans of the IPs. A consultative meeting on the 8th CPD was held with implementing partners and other national partners to solicit inputs for the next CPD (8th CPD). The review and planning meeting enabled CO to identify the issues in the implementation of the programmes and plan effectively for 2022. They also resulted in resolving challenges and barriers identified during implementation. Finalised workplans were submitted and approved for implementation.

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Chapter 6

HUMANITARIAN INTERVENTIONS

Ghana, like the global community, still had to deal with the impact of the COVID-19 pandemic. Along with the pandemic were perennial floods, which affected communities in the northern zone and the Volta/Oti Regions of the country. UNFPA supported the country in various capacities, including in the area of SGBV through the Orange Support Centre. UNFPA also collaborated with the UNCT, IAWGE, Psychosocial Working Group, Youth, Communications and Gender Teams, to support the Government and people of Ghana, particularly in fulfilling its mandate areas.

In preparedness, the CO updated its Minimum Preparedness Actions Plan and prepositioned Dignity Kits and other relief items. It is also supported in conducting relevant needs assessments and monitoring exercises. The CO was flexible to offer working remotely/flexible working hours for staff who needed it, with critical staff keeping the office running as was necessary. The use of virtual platforms for meetings and the implementation of a number of activities, helped the CO to achieve more amidst the pandemic

In preparedness, it updated its Minimum Preparedness Actions Plan and prepositioned Dignity Kits and other relief items. It also supported in conducting relevant needs assessments and monitoring exercises.The CO was flexible to offer working remotely/flexible working hours for staff who needed it, with critical staff keeping the office running as was necessary. The use of virtual platforms for meetings and the implementation of a number of activities, helped the CO to achieve more amidst the pandemic.

Challenges & Lessons Learned

Results Recommendations

Funding

Limited funding and budgetary cuts limited to an extent planned support to flood victims. Fostering partnerships and mobilizing resources (proposal writing etc.) helped in overcoming some of the challenges experienced.

Results Recommendations

COVID-19

COVID-19 protocols still had to be adhered to therefore increasing cost (procurement of PPEs, hand sanitisers etc.) while having to reduce the number of people per activity/intervention. Utilising hybrid or virtual platforms presented an opportunity for the CO to fully operated and achieve results.

Results Recommendations

Partnerships

Fostering strategic partnerships and being creative in resource mobilization was pivotal in achieving more with less. The updating of Minimum Preparedness Action Plans and Contingency Plans were germane in ensuring that the CO was prepared and ready for any eventualities such as another wave of lockdown with the upsurge of COVID-19 cases during the year.

Mitigating the Effects of the Kayayei Phenomenon\

Through the Kayayei Assistance Project (KASPRO), UNFPA Ghana worked to bridge the gap created by the COVID-19 pandemic which adversely affected women and girls known as 'kayayei'. The project provided the beneficiaries with information and education about their Sexual and Reproductive Health, while giving them livelihood skills with which they could mitigate the effects of the pandemic on the main source of livelihood--head poterage--in Ghana's urban areas. The project was run with funding support from Prudential Life Insurance, Ghana (PLIG).

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