ghana group 5/15/02hserv 544 karite shea nut co-op l anthony ofosu l linn gould l laura christian l...

5/15/02 Hserv 544 Ghana Group

Karite Shea Nut Co-op

Anthony Ofosu Linn Gould Laura Christian Joe Baranco Amy Hagopian


Outline for our Presentation

Where are we? (Field setting, community & MOH structures)

What’s the problem or opportunity? (Needs

assessment)

What are we going to do about it? (who, what, where, how, etc)

What are our objectives? How will we implement?

(Training, supervision, problem solving, attitude and approach we bring to this.)

How will we evaluate?

Where are we?


Ghana


Berekum

Anthony’s home town--Obo


Anthony’s alma mater

University of Ghana


Ghana Gold-Coast History

Portuguese were first to settle 1471 Interest in gold, ivory, pepper, and spices Commercial rivalry between Dutch,

Swedes, Danes, French, Germans 1500’s Slavery – plantation system in American

colonies in mid 1600’s British colonialism starts in mid 1700’s


European Colonial Impacts

1752 – missionary education system 1877 – Europeans rip off gold mines 1878 – Then, cocoa plantations Serious impact of Western forces on

traditional economic and social organization


Since Independence (1957)

1957 -Multiparty parliamentary system 1964 – One party governance 1966, 1972, 1981 – Military rule 1969, 1979, 1981, 1992 – Civilian rule 1978 – Palace coup 1979- popular upheaval, violent 1983-tossed out Marxists, IMF came in


Basic Ghana Facts

Size: 92,099 sq miles (Oregon) Total population: 18.9 million Capital: Accra Religions: Protestant (28%),

Traditional beliefs (21%),

Roman Catholic (19%), Muslim (16%)


Ghana Facts* (cont)

Adult literacy: 70% Agricultural labor force: 59% Living on <$1 day: 39% Total debt: $1.5 billion Gini coefficient: 39.6 (4.2% GDP) HPI: 29.1* HDR 2001


Languages

English is the official language 75 different languages and dialects Largest tribal groups: Akan,

Moshe-Dagomba, Ewe, Ga-Adangabe


Ghana Health Statistics

Maternal mortality: 210/100,000 Infant mortality: 63/1000 Malnutrition: 10% Life expectancy: 56.6 years Access to safe water: 64% People per physician: 16,667


Teaching Hospital

OPERATIONAL MODEL

Health System

District HealthCommittee

Regional Hospital

Health Centers/Clinics

District Hospital

District Health Management Team

Regional Health Administration

Ghana Health Services

Ministry of Health Headquarters


District Health Committee

Chairman Dir of Health Svs. 2 from District

Assembly One rep each

Christian and Moslem

2 health care personnel, one of them private sector

Traditional council rep

2 “at large,” one of whom is female


District Activities

MCH/FAMILY PLANNING HEALTH EDUCATION NUTRITIONAL

REHABILITATION EPI DISEASE SURVEILLANCE ADVOCACY INTERSECTORAL

COLLABORATION

OPERATIONAL RESEARCH SCHOOL HEALTH CURATIVE * SPECIAL PROGRAMS MONITORING AND

EVALUATION


Northern Ghana

Population: 1,950,000 Northern Province: 70,383 square

km Savannah (57% of Ghana) Fire-resistant trees & bushes mixed

with grassland Rainfall 31- 47 inches Soils – not fertile, minimal nutrients


Northern Territories

Complex ethnic and religious groups Speak forms of Moshe-Dagomba

language Did not want to join independent Ghana Orientation and affinities more closely

associated with Western Sudan.


Gender Relations in N. Ghana

Marriage implies that men own women

Men own land Household unit undemocratic –

household head controls and women have disproportionate access


How did N. Ghana become poor (relative to S. Ghana)?

Started with cocoa industry (1878) Prior to cocoa, socio-economic

differences between N. and S. Ghana were narrow

Traditional subsistence-oriented, food-producing households

Traditional chieftain hierarchies


Socio-economic differentiation

between N. and S. Ghana

N. Ghanaians initially coerced south as labor reserve for cocoa plantations

Measures taken to prevent N. Ghanaians from acquiring funds to build up physical and social infrastructure

Lands were vested in state, preventing development of land market


Cocoa – Impacts of Migration in North

Food production declines Family labor no longer available New sexual division of labor Traditional patterns of authority

break down Traditional kinship systems weakened


Cocoa – Creation of

Socio-economic Hierarchy

Undifferentiated rural economy to one where access to land, capital and labor crucial

Capitalist farmer-traders rule Peasant producers

(rich, middle, poor)


Northern Ghana Government Services

Expenditure on health care biased against rural populations

Health facilities and staffing weaker

Dependent on NGO assistance to make up for lack of government services


N. Ghana Education

Educational provision and attainment weak

Originated from colonial policies – deliberate discrimination

Pattern of poor education has continued – teachers not willing to move north


N. Ghana Water

Region with greatest population without potable water

Attributable to relative remoteness and physical dispersion of settlements

Per capita cost of water supply provision has discouraged investment


Use of women’s work product

Women’s money expected to care for children – health care, food, school

Men produce for their own consumption – consumer goods such as cloth, lanterns, bicycles, zinc roofing


Food Security issues

Indigenous crops: millet, sorghum, yams, corn, legumes, leafy stuff, spices, berries

Income potential with indigenous plants Home gardening contributes to food security Threats: deforestation, urban convenience

foods Need for conservation & cultivation

Owusu, et al


Why work in Northern Ghana Province?

Modern health care system only reaches 50% of rural population

Inequality of access evidenced by high infant and maternal mortality and poor nutritional status.

Children under 5 – 19% of pop but 50% of deaths

75% are preventable


Northern Ghana-- health problems

Child mortality is 222/1000 Malnutrition, resistant malaria,

measles, diarrhea, respiratory infections

Families can’t afford health care


Current MOH Initiatives in Northern Region

Data base with all births since 1/84 Computer mapping to track family

planning practices Insecticide-impregnated

bed nets Community Health Planning

Services (CHPS)


Our project builds on strengths

Natural environment and resources

Work and resourcefulness Cooperative spirit NGOs with experience in

microfinance


More strengths

Clan-owned land distribution Strict gender divisions leave some

resources in women’s domain Appropriate technology is available

through NGOs


What’s the problem and the opportunity?


Source: Ernest Kunfaa, “Empty Pockets,” on Ghana

Narayan, Deepa and Patti Petesch. 2002. Voices of the Poor: FromMany Lands. New York, N.Y: Published for the World Bank, Oxford University Press.

Poverty is bad for one’s health


Who are we?

The Karite Shea Nut Cooperative $100,000 3-year grant from the

Mercer Foundation Will organize shea nut butter

cooperatives in 8 communities in Northern Ghana to boost income and food security and promote health


Microfinance: a primer

Provides financial services (savings, lending, and cash management) to poor

Can help people start businesses, grow businesses, and smooth over rough times

Has risks and benefits for poor people


Our partners

UNIFEM in Burkina Faso GRATIS (Ghana Regional Appropriate

Technology Industrial Service) designed new shea butter extractor

Ghana Association of Women Entrepreneurs provides training & marketing help


Needs assessment assumptions

Leaders in eight towns interested No pre-existing financing systems Partner organizations are on board We have a program plan that’s

sustainable We’re building on strengths


Poverty

Conceptual FrameworkLACK OFCAPITAL

Limited abilit y to engage ininco me generating a ctiviti esto im prove liveli hood

Unab le to pay for cos t ofhealt h deli very( transpor tand service cos t)

Prem ature dea th( Inc reas e Inf ant andchil d mort ality)

Insuffi cientharves t to last ye arround. Lack ofmoney to buy foodduring lean season

Malnu triti on

Low a ccessi bil ity tohealt h service s(Inad equate healt hfacilit ies and healt hsta ff)

CompromisedMatern al healt hIncr eased Matern al

Mort ality


What are we going to do about it?


The Idea

Worker-owned women’s co-op in 8 communities. Co-ops will produce and market shea nuts and butter. Co-op financing supports the purchase of processor

unit, the shelter, maintenance and staff. Women will earn ownership shares in the co-op, and

will elect a governing board to manage the assets. Women will have access to revenues, savings & loans Hope to create better conditions for health and

increased access health care


Karite Tree

Tree is indigenous Lives 200 years Produces at age 15 (!) Grows in southern region of the

Sahel Harvests in dry season Important to ecology, but has been

cleared away for crop cultivation


Shea Nut Butter

Seen as women’s work (that’s good!)

Butter used in chocolate, cosmetics Ghanaian nuts preferred for higher

oil content Sells on internet: 4 oz for $6.50 OR

wholesale at $1000 per metric ton • (math hint: that’s a 5100% markup)


Microfinance strategies others have learned

Offer small loans, reasonable interest

Promote savings, offer interest Organize group-based systems Provide technical assistance for

investment enterprises Organize cooperatives


Tinga

Jayiri

Gambaga

Walewale

Gushiago

Daboya

Zabzugu

District hospitals in the capitals

Pigu

N=60,000 people


Shea Processor Technology

200% increase in daily production over previous technology

New presses use 8 liters of water (vs. 160) for 85 kg of kernels

8 kg firewood (vs. 72) 30 women per press


Costs

500,000 cedis ($650) for the press

30 cents per bundle of wood Water is carried by hand Space in each community

(community donated land, labor; shelter $100)

Maintenance of the press Administration & health

educator

$ 650x8 sites= $5,2003 bundles x 220 days x 8=

5,2800

100x8= 800500x8= 4,000

2,256x8= 18,053= $33,333/yr x 3 yrs


Collateral Benefits

Water purification, pumping, and energy systems now have economic purpose

New technology reduces wood smoke exposure and need for so much firewood

Women are gathered in new spaces, providing a forum for health education

Enrolled population is easy to reach, measure

What are our objectives?


Output Objectives

Enroll women in Karite Shea Nut co-ops in 8 communities* in the Northern Ghana region• 30 women in each town by 6 months• 70 women in each town by 18 months• 100 in each town by 3 years• Monitor with: enrollment records, drop-out

rates*Gushiago, Daboya, Tinga, Pigu, Zabzugu, Walewale, Gambaga, Jayiri


Output Objectives

Establish a functional co-op structure with voting members who elect local and regional boards• Local boards elected within first year• Regional board within 15 months• Staff hired at regional level by six months• Co-op holds monthly meetings


Output Objective

Create a co-op model that is sustainable• Compared to baseline at time of enrollment,

average woman will have 20% more savings• 90% of loans taken out will be repaid on time• More than half the members report their

standard of living is “significantly improved”• Receive requests from ten other interested

communities


Output Objective

Co-op embraces health improvements as part of its mission• On average 75% of women attend the

health care portion of the monthly meetings• All health district workers and enrolled

women report they are “mostly” or “highly” satisfied with co-op health projects


Outcome Objectives

Enrolled members increase utilization of preventive health services (3 yrs)• Enrollment data compared to regular surveys

and medical records• 80% appropriately immunized• 90% have bed-nets• 10% more families practicing family planning• 75% attending monthly co-op health meetings


Impact objective

Decrease respiratory infections, acute cases of malaria, diarrhea, measles and anemia among co-op members (3 yrs)• Monitor cases reported to health station• Target 50% decrease in malaria• Target 40% decrease in anemia• Target 20% decrease in ARIs, diarrhea• 95% drop in measles cases


Impact Objectives

Improve food security & lower malnutrition• Baseline information gathered at time of enrollment;

regular follow-up surveys• Goal: spend no more than 40% of income on food• All members eat three meals a day during planting

season• No children of enrolled members below 3rd %ile of

weight-for-age• 50% lower incidence of malnutrition reported by doctors


Project Implementation

Each community co-op will elect a board

Each board sends a representative to a regional board

Executive director reports to overall board


Project Implementation

Contract with GRATIS and UNIFEM for supervision and technical expertise on micro-financing, and training of tools used by co-op.

Contract with sub-district health care worker.


ImplementationDiagram

Microfinance officer

Shea Buttermill specialist

Health Educationofficer

Technical

accountanthuman resources

Administrative

Project Coordinator one managerfor each local cooperative

DirectorKarite Shea Nut Coop Project

Karite Cooperative

Board of Directorsconsists of representatives from community boards

8 local boards

Voting members of the8 local cooperatives


Role of Health Care Worker

Attend monthly co-op meetings offering: Immunizations Baby exams Family planning (condoms) Bednets

Education (monthly):Respiratory health (ventilation in home)Nutrition (recipes)Family planning, HIV Malaria prevention (importance of bednets)


Health Care WorkerTraining and Supervision

Training in shea-nut occupational health processes (10 hrs)

Risk of respiratory infections due to fire used during shea nut processing

Risk of burns due to heated water used during processing

Orientation to co-op principles and operations (5 hrs)Supervised by the MOH

Monitoring and Evaluation


Community Participation

Working collaboratively with key women from each co-op as well as community volunteers to implement:

1. Data collection (baseline information, and on a quarterly/6 month basis)

2. Monitoring/Evaluation (reduction or increase of illness/infection, loan payment, savings)

3. Appropriate adjustments to obtain each objective



Will implement strategies to understand and monitor: Behaviors of co-op members

1. Number of women participating in co-op 2. Number of women participating in health

education classesBarriers to service utilization

1. Preventive health services (use of bednets, immunizations)

Suggestions and recommendations (eg, additional health educational training)



Community doctors and contracted health care workers will record data on:

Type/Number of health care visits Number of women attending health care

education classes Number of women utilizing preventive health

services


Short-term counts

Number of co-op meetings members attend

Number of hours of health education and care

provided to co-op members

Hours of processing per week

Amount of money earned through sales


Long-term counts

Number of women enrolled in co-op

Repayment rates, savings

Rates of ARI infection

Rates of malnutrition

Rates of increased food security

ghana group 5/15/02hserv 544 karite shea nut co-op l anthony ofosu l linn gould l laura christian l...

Documents

ghana group

s slide

basic ghana facts

obo slide

ghana goldcoast history

amy hagopian slide

social organization

gold mines