• [Image: Nana Amma Oforiwaa Sam]

    Nana Amma Oforiwaa Sam

    Ghana

    Planned Parenthood Association

    “In 2007, the Government declared a state of emergency for maternal health, which made it possible for expectant mothers who have registered under the National Health Insurance Scheme (NHIS) to access free antenatal and delivery care. This was a laudable initiative but the Government also needs to make services available for women who are not giving birth by providing for free contraceptives and family planning (FP) services. If you want to address maternal health, you need a comprehensive package- including FP on the National Health Insurance scheme will help address Ghana’s high unmet need for contraceptives.”


    “About 45% of people in Ghana are under age 18, and the NHIS provides free health care services to those under 18. If you are over 18, then, you have to work to pay for services. For us it’s a good start, but not the end of the story.”


    “In 2010 when PPAG was producing a video documentary about family planning in the Kwahu South District in Ghana, we arrived in one of the communities on the first day, and people said ‘Oh! Now we have people to talk to about this problem, which we can’t talk about with anyone else.’ PPAG was recognized by the community as the only family planning service provider, the only entity that reached out to them. This is as a result of some constraints faced by the public health care system, including logistics; the government can’t reach everyone, and so try to fill the gap. PPAG reaches a good proportion of those not reached by government services.”


    “Due to funding withdrawal from USAID under the Community Based Services (CBS) project, and hence the inability of PPAG to continue its community based outreach programmes, some people for over five years had no services in some of these communities. They had no clinic in the community, and had to travel at least 20 minutes to get reproductive health care. Getting access to transport is a challenge for many people. Commercial vehicles only travel on market days. And what’s the guarantee that on that day you have the money for the services or supplies you need? So the cost is not just the product, but the cost of transportation is also a factor . In addition, the choice of method is crucial. Some people have problems with their husbands not supporting them, so they prefer the injectibles, while other women cannot visit the clinic every three months, so they prefer implants.”


    “We used to give out condoms, but now we can’t get regular supplies. So in the Kwahu South District Documentary one of the Community Based Agent remarks “The young men run to you in the middle of the night and we don’t have them, and it’s bad news”. They say, “We have to do it ‘sakora’” – without a condom. That means ‘like a bald head’ or bald-headed person. In this case, it’s a bald-headed penis! Everyone laughs at this remark, but it’s all too common that they can’t access condoms. We have to include men in our plans to address unmet need, too.”


    “Some of the communities we have worked with are showing great willingness and initiative to contribute to the family planning programme. For instance, the Chief in one community told us they had a 3-bed dwelling or facility and they wanted to use it as a clinic. They asked for help to complete the building, and asked the government to support them, so they could staff it at least once per week. The whole community, even the men, were aware of the need for a reproductive health facility and were willing to get behind or support the initiative.”