ghana group 5/15/02hserv 544 karite shea nut co-op l anthony ofosu l linn gould l laura christian l...
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5/15/02 Hserv 544 Ghana Group
Karite Shea Nut Co-op
Anthony Ofosu Linn Gould Laura Christian Joe Baranco Amy Hagopian
5/15/02 Hserv 544 Ghana Group
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?
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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
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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
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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
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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%)
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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
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Languages
English is the official language 75 different languages and dialects Largest tribal groups: Akan,
Moshe-Dagomba, Ewe, Ga-Adangabe
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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
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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
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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
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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
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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
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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.
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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
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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
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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
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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
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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)
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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
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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
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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
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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
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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
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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
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Northern Ghana-- health problems
Child mortality is 222/1000 Malnutrition, resistant malaria,
measles, diarrhea, respiratory infections
Families can’t afford health care
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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)
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Our project builds on strengths
Natural environment and resources
Work and resourcefulness Cooperative spirit NGOs with experience in
microfinance
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More strengths
Clan-owned land distribution Strict gender divisions leave some
resources in women’s domain Appropriate technology is available
through NGOs
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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
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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
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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
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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
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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
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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
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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
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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
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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)
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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
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Tinga
Jayiri
Gambaga
Walewale
Gushiago
Daboya
Zabzugu
District hospitals in the capitals
Pigu
N=60,000 people
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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.
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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
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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)
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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
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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
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Community Participation
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)
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Community Participation
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
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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
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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