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Anthony Ofosu Linn Gould Laura Christian Joe Baranco Amy Hagopian. Karite Shea Nut Co-op. 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?
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Anthony Ofosu Linn Gould Laura Christian Joe Baranco Amy Hagopian Karite Shea Nut Co-op Hserv 544
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? Hserv 544
Ghana Hserv 544
Berekum Anthony’s home town--Obo Hserv 544
University of Ghana Anthony’s alma mater Hserv 544
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 Hserv 544
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 Hserv 544
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 Hserv 544
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%) Hserv 544
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 Hserv 544
Languages • English is the official language • 75 different languages and dialects • Largest tribal groups: Akan, Moshe-Dagomba, Ewe, Ga-Adangabe Hserv 544
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 Hserv 544
OPERATIONAL MODEL Teaching Hospital Hserv 544
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 Health Committee Hserv 544
MCH/FAMILY PLANNING HEALTH EDUCATION NUTRITIONAL REHABILITATION EPI DISEASE SURVEILLANCE ADVOCACY INTERSECTORAL COLLABORATION OPERATIONAL RESEARCH SCHOOL HEALTH CURATIVE * SPECIAL PROGRAMS MONITORING AND EVALUATION District Activities Hserv 544
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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 Hserv 544
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. Hserv 544
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 Hserv 544
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 Hserv 544
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 Hserv 544
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 Hserv 544
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) Hserv 544
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 Hserv 544
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 Hserv 544
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 Hserv 544
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 Hserv 544
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 Hserv 544
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 Hserv 544
Northern Ghana-- health problems • Child mortality is 222/1000 • Malnutrition, resistant malaria, measles, diarrhea, respiratory infections • Families can’t afford health care Hserv 544
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) Hserv 544
Our project builds on strengths • Natural environment and resources • Work and resourcefulness • Cooperative spirit • NGOs with experience in microfinance Hserv 544
More strengths • Clan-owned land distribution • Strict gender divisions leave some resources in women’s domain • Appropriate technology is available through NGOs Hserv 544
What’s the problem and the opportunity? Hserv 544
Poverty is bad for one’s health 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. Hserv 544
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 Hserv 544
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 Hserv 544
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 Hserv 544
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 Hserv 544
Conceptual Framework LA C K O F CA P I T AL L i mit ed ab ilit y t o e ngage in i nco m e gene r a ti ng a c t i v iti e s t o im p r ove l i ve li hood Poverty In s uf fi c i en t ha r ves t t o l a st ye a r r ound. La c k o f m oney to buy f ood du ri ng l ean se a son Unab l e t o pay f or cos t of hea lt h de li very ( t ran s por t and se r v i ce cos t) Ma lnu t r i ti o n P r em a t ure dea t h ( I nc r eas e I nf a n t and ch il d m o rt a lit y) L ow a c ces si b il i t y t o hea lt h se r v i ce s Co m p r o mi sed ( Inad e qua t e h e a lt h M at ern a l hea lt h f ac ilit i e s and h e a lt h I ncr e as e d M at ern a l s ta f f ) Mo rt a lit y Hserv 544
What are we going to do about it? Hserv 544
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 Hserv 544
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 Hserv 544
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) Hserv 544
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 Hserv 544
Gambaga Walewale Pigu Jayiri Gushiago Zabzugu Daboya Tinga N= 60,000 people District hospitals in the capitals Hserv 544
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 Hserv 544
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= $5,200 3bundles x 220days x 8= 5,280 0 100x8= 800 500x8= 4,000 2,256x8= 18,053 = $33,333/yr x 3 yrs Costs Hserv 544