African Journals Online
INSTITUTE OF AFRICAN STUDIES RESEARCH REVIEW

Volume 19 Number 1 2003
ABSTRACTS

Policy implications of the variations in Ghana’s Fertility Transition

Delali Badasu

Institute of African Studies, University of Ghana

Abstract

The results of three consecutive Demographic and Health Surveys (GDHS), carried out in 1986, 1993, 1998, show that Ghana's population has been experiencing a fertility transition. An analysis of the data, however, indicates that there are wide and increasing differentials in both the timing and trends in the process among geographic and socioeconomic subgroups of the population. Current Total Fertility Rate (TFR), for example, varies from around 3 to 7.

This paper examines the policy implications of the variations in the fertility transition. The transition is associated mainly with urbanization and education (particularly of mothers). The differentials are therefore explained by increasing economic inequalities among the socioeconomic subgroups of the population and the administrative regions. Policies that seek to remove the disparities in the fertility transition in the country must therefore address this underlying factor. While implementation of reproductive health/family planning programmes will have to be continued, even as the level of unmet need for contraception is still high in the population, socioeconomic development goals that seek to address such population problems must be a first priority and also be at the centre of population programmes in the country. Another policy approach will be the documentation of the details of the process at regional, district and other levels because the national averages obscure the peculiar patterns and trends presents at such levels. The quantitative data so far gathered on the various issues in reproduction in the country will also have to be supplemented by micro studies that adopt qualitative approaches to discover issues that are not captured by quantitative approaches.

Sexual behaviour and the risks of HIV/AIDS and other STDs among young people in Sub-Saharan Africa: a review

Chuks J. Mba

Regional Institute of Population Studies, University of Ghana.

Abstract

Reproductive health problems present one of the greatest threats facing youth in sub-Saharan Africa today, in addition to political and economic insecurity. Although pre-marital sex is condemned in many African societies, and young, unmarried people, especially young women, are not expected to be sexually active, the gap between expected and actual behaviour is enormous. In particular, there is almost a universal gap between age at first sexual intercourse and age at first marriage across sub-Saharan Africa. A substantial proportion of young girls are sexually active, sometimes with multiple partners. Available evidence indicates more than 50 percent of all mothers in sub-Saharan Africa are in the age group 15-19 years, and in some settings, the youth are initiated into sexual activity as early as age 12 (girls) and 13 (boys). All these have a direct correlation with reproductive health problems, including HIV infection and other sexually transmitted diseases. Governments in the region should play a leading role in putting the reality of youth sexuality into public consciousness and political agenda.

Key Words: Sexual behaviour, activity, sex, HIV, AIDS, young people, sub-Saharan Africa.

To change or not to change: obstacles and resistance to sexual behavioural change among the youth in Ghana in the era of Aids

John Kwasi Anarfi

Institute of Statistical, Social and Economic Research of the University of Ghana.

Abstract

Ghana has one of the highest levels of reported cases of HIV/AIDS in the West African sub-region. The majority of infected persons are in their twenties. Young people are particularly vulnerable to STD/HIV infection for a number of reasons. They are confronted with complex and interlinked bio-social, economic and political structures and community factors. Although they are aware of STD/HIV, they do not practice safe sex or do not use condom consistently. They are more reluctant than older ones to seek treatment for STDs partly because of the attitudes of the older people, the health care providers and the general society to adolescent sexuality or may not be able to afford services.

The paper is based on data collected from in- and out-of-school youth at the national and regional levels on their perceptions and reactions to the epidemic. Field work was done in five out of ten regions in Ghana using both qualitative and quantitative instruments. The issues covered included their current attitudes and behaviours related to HIV/AIDS, their reaction to the need for change and their perceived constraints/barriers to behaviour change.

HIV/AIDS education messages have not taken the specific concerns of the young people into consideration. Most out-of-school youth are cut off from the mainstream educational and health care facilities. Young people are receptive to AIDS-related messages when they are made part of the planning and implementation of programmes.

Attempts at initiating behavioural change in the youth must take into consideration all the complex factors. The source of, and the agents for change, must be seen to be credible and the effort must be reinforced and sustained. The problem may be of barriers than just resistance/refusal of change on the part of the youth.

Maternal mortality in Ghana: the other side

Kodjo Senah

Department of Sociology, University of Ghana

Abstract

According to recent global estimates, some 585,000 women die annually form pregnancy-related complications. Most of these deaths occur in the developing world. In Ghana, efforts to reduce the high maternal mortality rate (ranging from about 200 to 740 deaths per 100,000 live births) have given birth to the institutionalization of policies and programmes most of which derive their explanatory model form the medical perspective. However, the determinants of maternal mortality are a complex web of biology and culture. This paper presents the 'other side' of the story: a wider overview of the casual pathways by which simple interventions may produce the desired effect.

Abortion: the case of Chenard Ward, Korle Bu from 2000 to 2001

Richard W.N. Yeboah

Department of Agricultural Economics, University of Development Studies.

Monica C. Kom

Midwifery Training School, Korle Bu Hospital, Accra

Abstract

This paper examines the number of abortion cases attended to in the Chenard Ward of the Korle Bu Teaching Hospital, Accra during the years 2000 and 2001. A total of 1,935 abortion cases were handled in the year 2000 and 1,838 in 2001. Though there was a 5% decrease in the number of cases in 2001, there was an increase in ‘incomplete abortions’, which happened to be the most frequent, 78% and 83% in 2000 and 2001 respectively. The majority of the abortions were found among women in the age bracket 21-30: 58% in 2000 and 55% in 2001. There were also 63 (3.3%) and 42 (2.3%) abortions in 2000 and 2001 respectively between the ages of 41 and 50 years. These figures call for the intensification of the campaign for safer sex practices, family planning and the teaching that there is good care for those that call to the hospital early enough.

Family resources and reproductive health of girls: a focus on money and Tugbewôwô: puberty rites among the Dodome Ewes

Laetitia A.P. Hevi-Yiboe

Department of Home Science, University of Ghana.

Abstract

There has been considerable concern about the reproductive health status of girls in Ghana in recent years due to the increase in premarital sexual activities amongst the youth, socio-economic implications of teenage pregnancy and illegal abortions. The major objective of this paper is to throw some light on how proper use of family resources could help resolve the problem.  All families have certain resources such as money, time, energy, skills of members, and some community resources like schools and traditional society’s puberty rites. However, most families do not have access to enough money to meet all the needs of all family members.  Traditionally, resources are shared without due regard to needs of individual members, but rather using gender and age as yardsticks with the resultant inequalities in access; with men always getting more than their fair share and women and children not getting enough.  It is important that parents make every effort to provide the needs of their children especially the girls, so that they do not accept money from men who in turn ask for sexual favours.  In traditional societies in the past, specific rites were instituted to safeguard the reproductive health of the members. Examples of these rites were puberty rites. In Dodome, the puberty rite for girls is called Tugbewôwô but it has been suspended for some years now.  As part of these rites, girls are supposed to remain virgins till after the rites are performed.  They are taught the arts of womanhood, motherhood etc. and are prepared to take their places as women in society. Modernization has eroded most of these resources that prepared girls to become effective members of society, producing teenage single parents.  The rites served as an incentive for mothers to constantly remind their daughters of society’s expectations of them and thus they preserved their chastity.  That is no longer the case.  An exploratory study in Dodome revealed that  the majority would like tugbewôwô to be reintroduced. It is recommended that (1) families be empowered financially to be able to meet needs of members (2) that a detailed study be carried out into tugbewôwô with the aim of understanding and modernizing the rites for reintroduction in Dodome and the Ho district as a whole.  It is concluded that the time has come to seek African solutions to African problems and end the adoption of Western values.