- - -

There is no content tagged with this country

Back to the previous page

Ghana

Articles by Ghana

A healthcare worker in Ghana shows a client the Pill
14 January 2022

Ghana offers free long-term contraception in a ‘game changer’ for women’s reproductive health rights

In a major win for women’s reproductive rights, Ghana’s National Health Insurance Program has expanded to include free long-term contraception from 1 January 2022. The move will allow millions of women of reproductive age who are already covered by national health insurance to avoid paying out of pocket for family planning methods such as the implant, coil and injections. It comes after a two-year pilot study found that including family planning services in health benefits packages resulted in a greater uptake of long-term contraception and future government savings in direct care costs.   “We are excited that at long last, long-term family planning methods are included in the National Health Insurance Scheme,” said Abena Adubea Amoah, the Executive Director of the Planned Parenthood of Ghana (PPAG), an IPPF Member Association. “This means long time peace of mind for women, girls and their families with potential positive impact on their health and economic life.”   Tackling deep-rooted barriers to healthcare In late 2021, the government of Ghana launched a year-long campaign aimed at raising awareness of and preventing maternal deaths in line with Goal 3: Good Health and Wellbeing of the United Nations Sustainable Development Goals. The role of family planning in reducing preventable maternal death is well documented, with unsafe abortion being one of the leading causes. Yet, Ghana is a country where deep-rooted cultural norms and structural barriers perpetuate poor sexual and reproductive health, including high risks of maternal mortality, high numbers of sexually transmitted infections and low levels of contraceptive use. Despite making important progress in recent years, Ghana’s maternal mortality ratio is 308 per 100,000 live births, which is still well above the SDG target of less than 70 deaths per 100,000 live births by 2030.   PPAG will play an important role in supporting the government in its campaign to prevent maternal deaths and disabilities. Since 1967, PPAG has provided the people of Ghana with family planning services as well as maternal and child health care, infertility management, and voluntary counselling and testing for sexually transmitted infections including HIV and AIDS. With over 100 staff members, a team of 1,000 volunteers, and 300 peer educators, PPAG is well-positioned to deliver health services and programmes through permanent and mobile clinics in urban and rural communities across the country. The association's Youth Action Team, comprised of over 810 young people, leads a number of educational and awareness-raising activities at 1000 community-based service points across the country. 

Abena Amoah, Ghana
06 March 2020

Women in Leadership: Abena Amoah, Ghana

Ghana, a West African nation of about 30 million people, has deep-rooted cultural norms, and structural barriers that perpetuate poor sexual and reproductive health practices. Access to sexual and reproductive health education and services are often a contentious issue. Fighting for the right to bodily autonomy  Ghana's high risks rates of maternal mortality, high numbers of sexually transmitted infections, including HIV, and low levels of contraceptive use drive Abena Amoah, Planned Parenthood Association of Ghana (PPAG) executive director. She wants girls and women's reproductive choices respected, and that they have autonomy over their bodies.  Amoah says while sexual and reproductive health and rights (SRHR) has been contentious in Ghana, it is needed as often sex education is viewed as a private matter. "A lot of people still do not subscribe to providing the information openly on sexual and reproductive health, and even the service."   Having access to the right information Bringing rights into the conversation is vital as there are cultural practices which prohibit women from taking control of their lives - like early child marriage or female genital mutilation, she adds. However, ensuring young people have access to information on sexual health and rights in Ghana in the school system has led to widespread debate and misinformation in 2019. To date, Ghana's sex education policy at pre- tertiary level has focused on abstinence, but guidelines proposed in 2019 included information on contraception methods.  "It's important that the child gets to know what is available because they will get to know anyway, they will do so through the internet, radio, TV, and all that so it's better to give them the right kind of information," Amoah says. When she started working as a teacher and then in the NGO space herself, she saw the consequences of young people not having access to SRHR information, including around menstrual hygiene as well as gender-based violence. Amoah didn't learn about menstruation or SRH until she was in senior high school, and even then, it was through classmates. She remembers menstruating women at her grandfather's home having to stay in a hunt built outside the cottage. "Women would go there, and they would say they are not clean. I think no one explained to me because they thought I was too young and would not understand." Becoming more open to talking about SRHR Amoah also finds a disconnect between girls conditioned to be submissive to men, not to question cultural issues, and to never to be aggressive - but when they reach puberty, girls are then told to say no to men making sexual advances.  "They are put in a very difficult situation where it's difficult for them to act. And then we blame them [girls] when the issues come, so it was the whole social structure that for me didn't work well, and which we needed to talk about." To overcome these issues, PPAG has a strong focus on involving young people in the process of education and access to SRHR. "Getting them to understand the issues of sexual reproductive health and rights and, being the one that is leading the process of the change in attitudes and behaviour of their peers is what works. Young people listen to young people." Ultimately, Amoah wants SRHR, education information and services to become normalized, where people can confidently access PPAG services or information on their health and their rights. She also wants the secrecy around SRHR to be lifted, "so it's not something that is private, it is something that needed to be spoken about and it's something that everyone must know and be able to control.” 

cashew nut factory worker, Ghana
20 February 2020

Ghana: Expanding healthcare for young people and factory workers

Mother of six Elizabeth Adom rides a staff bus up a long, dusty dirt road, through towering pine trees, past wooden bungalows and the outward stretch of the canopy of cashew trees, to reach the cashew factory she works at in a small town in rural Ghana. Adom never planned to have six children but struggled to access the right contraception. So when Planned Parenthood Association Ghana (PPAG) along with the Danish Family Planning Association (DFPA) in 2018 began rolling out a project at the factory and in the Mim township to help women like her take control of their reproductive health, she was pleased. Both PPAG and DFPA are focused on providing sexual and reproductive health and rights (SRHR) information and service, especially for women and girls.  "I am now currently accessing family planning. It is helping me. I don't want to give birth again," Adom emphatically says, while taking a break from peeling cashews at the factory. As a former-teen mother herself, she also shares what she has learnt with her children. "[There] is the danger associated with early childbirth, your life becomes difficult, and you encounter so many challenges in your life." Helping young people  The project also targets young people in Mim, which has a population of about 30,000. Traditionally Mim was known for its timber industry, but in recent years factories have collapsed or had to undergo mass layoffs to survive, leaving many in economic hardship.  Before rolling out the project, PPAG research of young people in Mim found almost 80 per cent had very low knowledge on SRHR, despite the majority of them having had sex - of those condom use was low, as was seeking STI treatments. Beliefs about rights to access information and services around reproductive healthcare were also low. They were also uncomfortable discussing SRHR with their parents, preferring to speak to their peers.  A meaningful way to get SRHR information both to young people and the factory workers is through peer educators. Adom often meets with a colleague who has received specialised training from PPAG to educate others on SRHR.  Abena Amoah, executive director of PPAG, says in Ghana, education on sexual and reproduction health rights is generally becoming more accepted but a lot more work needs to be done.  "Traditionally, it's not said in the open," she says. "A lot of people still do not subscribe to providing the information openly on sexual and reproductive health and even providing services." The four-year project in Mim is supported by private funding.  Health facility staff throughout Mim have been trained in youth-friendly services, to make it easier and quicker to get help and information rather than facing what can be bureaucratic processes in the healthcare system in Ghana.  Patients can access comprehensive abortion care, a range of different contraception options and STI treatments. The project also works with ten schools where  clubs have been formed to discuss SRHR. The project is also gearing up to offer livelihood training so young people can be economically independent, by placing young people from Mim in long-term apprenticeships or offering skills training so they can set up their own businesses. Discussing sexual health openly  Abdul-Mumin Abukari, the PPAG DFPA Mim project officer says so far, they have seen several positive changes, including creating an environment where SRHR can be discussed openly in the community. He also finds people now realise the need for the services. "There were a lot of teenage pregnancies, there were a lot of sexually transmitted diseases, there were a lot of challenges in this community, but someway, somehow people felt that it was normal. They had accepted the situation, and they were living with it. So, the project has come to create some kind of awareness on these issues - that there's nothing normal about 13-year-olds and 14-year-olds getting pregnant." Supporting workers  At Mim Cashew, workers like Adom steam, shell, sort, peel and package the organic cashews for export. The factory has colourful PPAG posters displayed on the walls throughout.  Factory manager Matthew Porter says so far, the project has increased sensitisation amongst the workers to protect themselves and plan their lives. "People can look after themselves better and their children," he says. Jemima Akusika Hansen, HR manager at Mim Cashew, says focusing on employees' health also helps the factory.  "We think that if that is done, it will reduce absenteeism, then some of the unintended pregnancies and then STIs will be reduced." Workers also feel more comfortable in speaking about going for birth control measures at the clinics. "Now they know pregnancy is a choice. So they plan when they want to have it and when they don't want to."

Sophia Abrafi, Midwife at the Mim Health Centre, 40

“Teenage pregnancies will decrease, unsafe abortions and deaths as a result of unsafe abortions will decrease"

Midwife Sophia Abrafi sits at her desk, sorting her paperwork before another patient comes in looking for family planning services. The 40-year-old midwife welcomes each patient with a warm smile and when she talks, her passion for her work is clear.  At the Mim Health Centre, which is located in the Ahafo Region of Ghana, Abrafi says a sexual and reproductive health and right (SRHR) project through Planned Parenthood Association of Ghana (PPAG) and the Danish Family Planning Association (DFPA) allows her to offer comprehensive SRH services to those in the community, especially young people. Before the project, launched in 2018, she used to have to refer people to a town about 20 minutes away for comprehensive abortion care. She had also seen many women coming in for post abortion care service after trying to self-administer an abortion. “It was causing a lot of harm in this community...those cases were a lot, they will get pregnant, and they themselves will try to abort.”   Providing care & services to young people Through the clinic, she speaks to young people about their sexual and reproductive health and rights. “Those who can’t [abstain] we offer them family planning services, so at least they can complete their schooling.” Offering these services is crucial in Mim, she says, because often young people are not aware of sexual and reproductive health risks.  “Some of them will even get pregnant in the first attempt, so at least explaining to the person what it is, what she should do, or what she should expect in that stage -is very helpful.” She has already seen progress.  “The young ones are coming. If the first one will come and you provide the service, she will go and inform the friends, and the friends will come.” Hairdresser Jennifer Osei, who is waiting to see Abrafi, is a testament to this. She did not learn about family planning at school. After a friend told her about the clinic, she has begun relying on staff like Abrafi to educate her. “I have come to take a family planning injection, it is my first time taking the injection. I have given birth to one child, and I don’t want to have many children now,” she says. Expanding services in Mim The SRHR project is working in three other clinics or health centres in Mim, including at the Ahmadiyya Muslim Hospital. When midwife Sherifa, 28, heard about the SRHR project coming to Mim, she knew it would help her hospital better help the community. The hospital was only offering care for pregnancy complications and did little family planning work. Now, it is supplied with a range of family planning commodities, and the ability to do comprehensive abortion care, as well as education on SRHR. Being able to offer these services especially helps school girls to prevent unintended pregnancies and to continue at school, she says.  Sherifa also already sees success from this project, with young people now coming in for services, education and treatment of STIs. In the long term, she predicts many positive changes. “STI infection rates will decrease, teenage pregnancies will decrease, unsafe abortions and deaths as a result of unsafe abortions will decrease. The young people will now have more information about their sexual life in this community, as a result of the project.”

	Janet Pinamang, Mim Cashew Factory worker,.32

"It has helped me a lot, without that information I would have given birth to many children..."

Factory workers at Mim Cashew, in a small town in rural Ghana, are taking their reproductive health choices into their own hands, thanks to a four-year project rolled out by Planned Parenthood Association Ghana (PPAG) along with the Danish Family Planning Association (DFPA). The project, supported by private funding, focuses on factory workers as well as residents in the township of about 30, 000, where the factory is located. Under the project, health clinic staff in Mim have been supported to provide comprehensive abortion care, a range of different contraception choices and STI treatments as well as information and education. In both the community and the factory, there is a strong focus on SRHR trained peer educators delivering information to their colleagues and peers. An increase in knowledge  So far, the project has yielded positive results - especially a notable increase amongst the workers on SRHR knowledge and access to services - like worker Janet Pinamang, who is a 32-year-old mother of two. She says the SRHR project has been great for her and her colleagues. "I have had a lot of benefits with the project from PPAG. PPAG has educated us on how the process is involved in a lady becoming pregnant. PPAG has also helped us to understand more on drug abuse and about HIV.” She also appreciated the project working in the wider community and helping to address high levels of teenage pregnancy.  "I have seen a lot of change before the coming of PPAG little was known about HIV, and its impacts and how it was contracted - now PPAG has made us know how HIV is spread, how it is gotten and all that. PPAG has also got us to know the benefits of spacing our children." “It has helped me a lot” Pinamang's colleague, Sandra Opoku Agyemang, 27, is a mother of a six-year-old girl called Bridget. Agyemang says before the project came to Mim, she had only heard negative information around family planning. "I heard family planning leads to dizziness, it could lead to fatigue, you won't get a regular flow of menses and all that, and I also heard problems with heart attacks. I had heard of these problems, and I was afraid, so after the coming of PPAG, I went into family planning, and I realised all the things people talked about were not wholly true." Now using family planning herself, she says the future is bright for her, and her family. "It has helped me a lot, without that information I would have given birth to many children, not only Bridget. In the future, I plan to add on two [more children], even with the two I am going to plan."  

Gifty with her son, Ghana

“Despite all those challenges, I thought it was necessary to stay in school"

When Gifty Anning Agyei was pregnant, her classmates teased her, telling her she should drop out of school. She thought of having an abortion, and at times she says she considered suicide. When her father, Ebenezer Anning Agyei found out about the pregnancy, he was furious and wanted to kick her out of the house and stop supporting her education.  Getting the support she needed But with support from Planned Parenthood Association of Ghana (PPAG) and advice from Ebenezer’s church pastor, Gifty is still in school, and she has a happy baby boy, named after Gifty’s father. Gifty and the baby are living at home, with Gifty’s parents and three of her siblings in Mim, a small town about eight hours drive northwest of Ghana’s capital Accra.  “Despite all those challenges, I thought it was necessary to stay in school. I didn’t want any pregnancy to truncate my future,” Gifty says, while her parents nod in proud support. In this area of Ghana, research conducted in 2018 found young people like Gifty had high sexual and reproduce health and rights (SRHR) challenges, with low comprehensive knowledge of SHRH and concerns about high levels of teenage pregnancy. PPAG, along with the Danish Family Planning Association (DFPA), launched a four-year project in Mim in 2018 aimed to address these issues.  For Gifty, now 17, and her family, this meant support from PPAG, especially from the coordinator of the project in Mim, Abdul- Mumin Abukari. “I met Abdul when I was pregnant. He was very supportive and encouraged me so much even during antenatals he was with me. Through Abdul, PPAG encouraged me so much.” Her mother, Alice, says with support from PPAG her daughter did not have what might have been an unsafe abortion. The parents are also happy that the PPAG project is educating other young people on SRHR and ensuring they have access to services in Mim. Gifty says teenage pregnancy is common in Mim and is glad PPAG is trying to curb the high rates or support those who do give birth to continue their schooling.  “It’s not the end of the road” “PPAG’s assistance is critical. There are so many ladies who when they get into the situation of early pregnancy that is the end of the road, but PPAG has made us know it is only a challenge but not the end of the road.” Gifty’s mum Alice says they see baby Ebenezer as one of their children, who they are raising, for now, so GIfty can continue with her schooling. “In the future, she will take on the responsibly more. Now the work is heavy, that is why we have taken it upon ourselves. In the future, when Gifty is well-employed that responsibility is going to be handed over to her, we will be only playing a supporting role.” Alice also says people in the community have commented on their dedication. “When we are out, people praise us for encouraging our daughter and drawing her closer to us and putting her back to school.” Dad Ebenezer smiles as he looks over at his grandson. “We are very happy now.” When she’s not at school or home with the baby, Gifty is doing an apprenticeship, learning to sew to follow her dream of becoming a fashion designer. For her, despite giving birth so young, she has her sights set on finishing her high school education in 2021 and then heading to higher education. 

Dorcas.Amakyewaa , Mim Cashew Factory worker and peer educator, 42

"They teach us as to how to avoid STDs and how to space our childbirth"

As the sun rises each morning, Dorcas Amakyewaa leaves her home she shares with her five children and mother and heads to work at a cashew factory. The factory is on the outskirts of Mim, a town in the Ahafo Region of Ghana. Along the streets of the township, people sell secondhand shoes and clothing or provisions from small, colourfully painted wooden shacks.  “There are so many problems in town, notable among them [young people], teenage pregnancies and drug abuse,” Amakyewaa says, reflecting on the community of about 30,000 in Ghana.       The chance to make a difference  In 2018, Amakyewaa was offered a way to help address these issues in Mim, through a sexual and reproductive health rights (SRHR) project brought to both the cashew factory and the surrounding community, through the Danish Family Planning Association, and Planned Parenthood Association Ghana (PPAG).  Before the project implementation, some staff at the factory were interviewed and surveyed. Findings revealed similar concerns Amakyewaa had, along with the need for comprehensive education, access and information on the right to key SRHR services. The research also found a preference for receiving SRHR information through friends, colleagues or factory health outreach. These findings then led to PPAG training people in the factory to become SRHR peer educators, including Amakyewaa. She now passes on what she has learnt in her training to her colleagues in sessions, where they discuss different SRHR topics. “I guide them to space their births, and I also guide them on the effects of drug abuse.” The project has also increased access to hospitals, she adds. “The people I teach, I have given the numbers of some nurses to them. So that whenever they need the services of the nurses, they call them and meet them straight away.” Access to information One of the women Amakyewaa meets with to discuss sexual and reproductive health is Monica Asare, a mother of two.  “I have had a lot of benefits from PPAG. They teach us as to how to avoid STDs and how to space our childbirth. I teach my child about what we are learning. I never had access to this information; it would have helped me a lot, probably I would have been in school.” Amakyewaa also says she didn’t have access to information and services when she was young. If she had, she says she would not have had a child at 17. She takes the information she has learnt, to share with her children and other young people in the community. When she gets home after work, Amakyewaa’s peer education does not stop, she continues. She also continues her teachings when she gets home. “PPAG’s project has been very helpful to me as a mother. When I go home, previously I was not communicating with my children with issues relating to reproduction.” Her 19-year-old daughter, Stella Akrasi, has also benefitted from her mothers training. “I see it to be good. I always share with my friends give them the importance of family planning. If she teaches me something I will have to go and tell them too” she says.

International Youth Day
10 August 2018

Young people around the world are leading the way for change

All around the world, young people are leading the way for important change. From coming up with innovative ways to help classmates with their periods in Tanzania, to using music to challenge the stigma around HIV in Nepal, they are improving their communities in their own unique, brilliant ways. Here are just a few of their remarkable stories.  Frida – Uganda  Frida is 18-years-old and she is a peer counsellor at her school, where she raises awareness about unsafe abortion. She received her training from the Volunteers for Development Association (VODA), who have given her the confidence to overcome her shyness and speak in front of hundreds of people about safe sex, post-abortion care and more. As a result of her incredible work with VODA, she now hopes to become a social worker. Read Frida’s story and more.   Brook & FPA volunteers – England Current UK guidelines on relationships and sex education (RSE) haven’t changed in nearly two decades. But as of 2020, RSE will become compulsory in schools in England. Young volunteers from Brook and the Family Planning Association (FPA) have been speaking up about what they believe should be included as part of positive, effective and healthy RSE - whether that’s consent, sexting, cyberbullying, LGBTI+ issues, pornography and more. See what else they’re saying.   Akosua – Ghana  When she was younger, Akosua's sex education consisted of horror stories about the trouble she might end up in if she had sex. Now she volunteers with the Planned Parenthood Association of Ghana to promote the importance of comprehensive sexuality education for young people. She believes that rather than scaring young people into abstinence, education is what is key in order to save lives. Find out more about Akosua in her own words. Milan – Nepal Milan tragically lost both parents when he was just 10-years-old. He then found out he was HIV-positive. The discovery meant he faced a lot of discrimination from those living around him, which left him feeling humiliated and alone. But over the years Milan has been supported by the Family Planning Association of Nepal, who have helped him grow in confidence. They have even encouraged him to challenge the stigma of HIV through his love for music. Find out how he's doing that.  Alice – Tanzania  With only 2% of schoolgirls in Tanzania having access to disposable sanitary pads, many of them will try to make do with anything from cloth rags to socks, leaves or dry grass. It also means some girls skip school to avoid embarrassment. So Alice and her classmates decided to take action - they created The Pink Box, a place where girls who could spare a sanitary pad or two could donate theirs, to be distributed to those less able to afford or access them. Read more about the schoolgirls’ simple and inspiring initiative.    

Akosua Agyepong - Youth Volunteer at Planned Parenthood Association of Ghana (PPAG)
20 March 2018

Scary stories don’t save lives, Comprehensive Sexuality Education does

By Akosua Agyepong,Youth Volunteer at Planned Parenthood Association of Ghana (PPAG), IPPF member association. This was how I learnt about sex; my mother called me into her room, she was holding a newspaper in her hand. In that paper, there was a report on the rising number of cervical cancer cases in the country and then she said: “Akosua, now you are menstruating, if you sleep with any boy, you can get some of this cervical cancer.” That was the end, and then she asked me to leave. I don’t think her aim was to educate me but it was to scare me out of having sex. I believe for most youngsters in my country, that’s the reality. At home, there isn’t a discussion about sex but a horror story on the troubles sex could put you in, so that young people totally abstain. However, there are two wrongful assumptions that preachers of abstinence make. The first is the assumption that scary stories about sex would keep their virginities intact and secondly that sexuality education is all about sex and thus encourages sex. On the first assumption, we find that evidence shows that young people would have sex whether or not they hear those scary stories because sex is emotionally and hormonally driven and emotions and hormonal activity cannot be suppressed by daunting stories of death and curses. In fact, the International Technical Guidance on Sexuality Education shows how sexuality education has positively impacted the lives of young people in terms of delaying the initiation of sexual intercourse and what not to do to stay safe and healthy.  If for nothing at all, the Puritan age showed us that restricting sex to marriage and punishing pre-marital sex by fines, public shaming and even death could not suppress human emotions and pre-marital sex even in that age still persisted. UNESCO’s updated guidelines on sexuality education also disprove the claim that "sexuality education is all about sex", putting it to rest entirely. The guidance shows how sexuality education speaks to key concepts: Relationships, Values, Rights, Culture and Sexuality, Understanding Gender, Violence and Staying Safe, Skills for Health and Well-being, The Human Body and Development, Sexuality and Sexual Behaviour and finally Sexual and Reproductive Health. The instructional guide provides evidence that when young people are taken through Comprehensive Sexuality Education, they will not be learning the details of the Kama Sutra but they will have first-hand information about themselves and their health and well-being that improves their chances of becoming a successful person in future. It is a shame that many people misunderstand what Comprehensive Sexuality Education is, and are totally oblivious to its benefits to us as families, societies, nations and continents. Some individuals and organizations even go the extra mile of petitioning governments to take CSE out of school curricula. To them my final and only word is that scary stories don’t save lives, Comprehensive Sexuality Education does. Perhaps reading the UNESCO Guidance can help them understand this better.

H.E. Ambassador Takashi Shinozuka, Ambassador Extraordinary and Plenipotentiary of Japan to Morocco and Dr Latifa Mokhtar JAMAI, President of AMPF, IPPF’s Member Association in Morocco, at the JTF project launch ceremony
30 March 2017

Japan Trust Fund

The Japan Trust Fund (JTF) represents a visionary partnership that began in 2000 between the Government of Japan and IPPF. Together, we invest in programmes that prioritize health equity, gender equality, and human security for all. Traditionally a driving force behind IPPF's efforts to support the integrated HIV prevention programmes of our Member Associations in Africa and Asia, JTF has adjusted to reflect changing global health priorities. We attach importance to universal access to sexual and reproductive health and rights - an essential contributor to universal health coverage and the global development goals.     These projects have transformed the lives of people most vulnerable to HIV and high risk of maternal and child mortality. Equally, it ensures that as a donor, the GOJ’s response to HIV remains people-centred and contributes to human security.      

A healthcare worker in Ghana shows a client the Pill
14 January 2022

Ghana offers free long-term contraception in a ‘game changer’ for women’s reproductive health rights

In a major win for women’s reproductive rights, Ghana’s National Health Insurance Program has expanded to include free long-term contraception from 1 January 2022. The move will allow millions of women of reproductive age who are already covered by national health insurance to avoid paying out of pocket for family planning methods such as the implant, coil and injections. It comes after a two-year pilot study found that including family planning services in health benefits packages resulted in a greater uptake of long-term contraception and future government savings in direct care costs.   “We are excited that at long last, long-term family planning methods are included in the National Health Insurance Scheme,” said Abena Adubea Amoah, the Executive Director of the Planned Parenthood of Ghana (PPAG), an IPPF Member Association. “This means long time peace of mind for women, girls and their families with potential positive impact on their health and economic life.”   Tackling deep-rooted barriers to healthcare In late 2021, the government of Ghana launched a year-long campaign aimed at raising awareness of and preventing maternal deaths in line with Goal 3: Good Health and Wellbeing of the United Nations Sustainable Development Goals. The role of family planning in reducing preventable maternal death is well documented, with unsafe abortion being one of the leading causes. Yet, Ghana is a country where deep-rooted cultural norms and structural barriers perpetuate poor sexual and reproductive health, including high risks of maternal mortality, high numbers of sexually transmitted infections and low levels of contraceptive use. Despite making important progress in recent years, Ghana’s maternal mortality ratio is 308 per 100,000 live births, which is still well above the SDG target of less than 70 deaths per 100,000 live births by 2030.   PPAG will play an important role in supporting the government in its campaign to prevent maternal deaths and disabilities. Since 1967, PPAG has provided the people of Ghana with family planning services as well as maternal and child health care, infertility management, and voluntary counselling and testing for sexually transmitted infections including HIV and AIDS. With over 100 staff members, a team of 1,000 volunteers, and 300 peer educators, PPAG is well-positioned to deliver health services and programmes through permanent and mobile clinics in urban and rural communities across the country. The association's Youth Action Team, comprised of over 810 young people, leads a number of educational and awareness-raising activities at 1000 community-based service points across the country. 

Abena Amoah, Ghana
06 March 2020

Women in Leadership: Abena Amoah, Ghana

Ghana, a West African nation of about 30 million people, has deep-rooted cultural norms, and structural barriers that perpetuate poor sexual and reproductive health practices. Access to sexual and reproductive health education and services are often a contentious issue. Fighting for the right to bodily autonomy  Ghana's high risks rates of maternal mortality, high numbers of sexually transmitted infections, including HIV, and low levels of contraceptive use drive Abena Amoah, Planned Parenthood Association of Ghana (PPAG) executive director. She wants girls and women's reproductive choices respected, and that they have autonomy over their bodies.  Amoah says while sexual and reproductive health and rights (SRHR) has been contentious in Ghana, it is needed as often sex education is viewed as a private matter. "A lot of people still do not subscribe to providing the information openly on sexual and reproductive health, and even the service."   Having access to the right information Bringing rights into the conversation is vital as there are cultural practices which prohibit women from taking control of their lives - like early child marriage or female genital mutilation, she adds. However, ensuring young people have access to information on sexual health and rights in Ghana in the school system has led to widespread debate and misinformation in 2019. To date, Ghana's sex education policy at pre- tertiary level has focused on abstinence, but guidelines proposed in 2019 included information on contraception methods.  "It's important that the child gets to know what is available because they will get to know anyway, they will do so through the internet, radio, TV, and all that so it's better to give them the right kind of information," Amoah says. When she started working as a teacher and then in the NGO space herself, she saw the consequences of young people not having access to SRHR information, including around menstrual hygiene as well as gender-based violence. Amoah didn't learn about menstruation or SRH until she was in senior high school, and even then, it was through classmates. She remembers menstruating women at her grandfather's home having to stay in a hunt built outside the cottage. "Women would go there, and they would say they are not clean. I think no one explained to me because they thought I was too young and would not understand." Becoming more open to talking about SRHR Amoah also finds a disconnect between girls conditioned to be submissive to men, not to question cultural issues, and to never to be aggressive - but when they reach puberty, girls are then told to say no to men making sexual advances.  "They are put in a very difficult situation where it's difficult for them to act. And then we blame them [girls] when the issues come, so it was the whole social structure that for me didn't work well, and which we needed to talk about." To overcome these issues, PPAG has a strong focus on involving young people in the process of education and access to SRHR. "Getting them to understand the issues of sexual reproductive health and rights and, being the one that is leading the process of the change in attitudes and behaviour of their peers is what works. Young people listen to young people." Ultimately, Amoah wants SRHR, education information and services to become normalized, where people can confidently access PPAG services or information on their health and their rights. She also wants the secrecy around SRHR to be lifted, "so it's not something that is private, it is something that needed to be spoken about and it's something that everyone must know and be able to control.” 

cashew nut factory worker, Ghana
20 February 2020

Ghana: Expanding healthcare for young people and factory workers

Mother of six Elizabeth Adom rides a staff bus up a long, dusty dirt road, through towering pine trees, past wooden bungalows and the outward stretch of the canopy of cashew trees, to reach the cashew factory she works at in a small town in rural Ghana. Adom never planned to have six children but struggled to access the right contraception. So when Planned Parenthood Association Ghana (PPAG) along with the Danish Family Planning Association (DFPA) in 2018 began rolling out a project at the factory and in the Mim township to help women like her take control of their reproductive health, she was pleased. Both PPAG and DFPA are focused on providing sexual and reproductive health and rights (SRHR) information and service, especially for women and girls.  "I am now currently accessing family planning. It is helping me. I don't want to give birth again," Adom emphatically says, while taking a break from peeling cashews at the factory. As a former-teen mother herself, she also shares what she has learnt with her children. "[There] is the danger associated with early childbirth, your life becomes difficult, and you encounter so many challenges in your life." Helping young people  The project also targets young people in Mim, which has a population of about 30,000. Traditionally Mim was known for its timber industry, but in recent years factories have collapsed or had to undergo mass layoffs to survive, leaving many in economic hardship.  Before rolling out the project, PPAG research of young people in Mim found almost 80 per cent had very low knowledge on SRHR, despite the majority of them having had sex - of those condom use was low, as was seeking STI treatments. Beliefs about rights to access information and services around reproductive healthcare were also low. They were also uncomfortable discussing SRHR with their parents, preferring to speak to their peers.  A meaningful way to get SRHR information both to young people and the factory workers is through peer educators. Adom often meets with a colleague who has received specialised training from PPAG to educate others on SRHR.  Abena Amoah, executive director of PPAG, says in Ghana, education on sexual and reproduction health rights is generally becoming more accepted but a lot more work needs to be done.  "Traditionally, it's not said in the open," she says. "A lot of people still do not subscribe to providing the information openly on sexual and reproductive health and even providing services." The four-year project in Mim is supported by private funding.  Health facility staff throughout Mim have been trained in youth-friendly services, to make it easier and quicker to get help and information rather than facing what can be bureaucratic processes in the healthcare system in Ghana.  Patients can access comprehensive abortion care, a range of different contraception options and STI treatments. The project also works with ten schools where  clubs have been formed to discuss SRHR. The project is also gearing up to offer livelihood training so young people can be economically independent, by placing young people from Mim in long-term apprenticeships or offering skills training so they can set up their own businesses. Discussing sexual health openly  Abdul-Mumin Abukari, the PPAG DFPA Mim project officer says so far, they have seen several positive changes, including creating an environment where SRHR can be discussed openly in the community. He also finds people now realise the need for the services. "There were a lot of teenage pregnancies, there were a lot of sexually transmitted diseases, there were a lot of challenges in this community, but someway, somehow people felt that it was normal. They had accepted the situation, and they were living with it. So, the project has come to create some kind of awareness on these issues - that there's nothing normal about 13-year-olds and 14-year-olds getting pregnant." Supporting workers  At Mim Cashew, workers like Adom steam, shell, sort, peel and package the organic cashews for export. The factory has colourful PPAG posters displayed on the walls throughout.  Factory manager Matthew Porter says so far, the project has increased sensitisation amongst the workers to protect themselves and plan their lives. "People can look after themselves better and their children," he says. Jemima Akusika Hansen, HR manager at Mim Cashew, says focusing on employees' health also helps the factory.  "We think that if that is done, it will reduce absenteeism, then some of the unintended pregnancies and then STIs will be reduced." Workers also feel more comfortable in speaking about going for birth control measures at the clinics. "Now they know pregnancy is a choice. So they plan when they want to have it and when they don't want to."

Sophia Abrafi, Midwife at the Mim Health Centre, 40

“Teenage pregnancies will decrease, unsafe abortions and deaths as a result of unsafe abortions will decrease"

Midwife Sophia Abrafi sits at her desk, sorting her paperwork before another patient comes in looking for family planning services. The 40-year-old midwife welcomes each patient with a warm smile and when she talks, her passion for her work is clear.  At the Mim Health Centre, which is located in the Ahafo Region of Ghana, Abrafi says a sexual and reproductive health and right (SRHR) project through Planned Parenthood Association of Ghana (PPAG) and the Danish Family Planning Association (DFPA) allows her to offer comprehensive SRH services to those in the community, especially young people. Before the project, launched in 2018, she used to have to refer people to a town about 20 minutes away for comprehensive abortion care. She had also seen many women coming in for post abortion care service after trying to self-administer an abortion. “It was causing a lot of harm in this community...those cases were a lot, they will get pregnant, and they themselves will try to abort.”   Providing care & services to young people Through the clinic, she speaks to young people about their sexual and reproductive health and rights. “Those who can’t [abstain] we offer them family planning services, so at least they can complete their schooling.” Offering these services is crucial in Mim, she says, because often young people are not aware of sexual and reproductive health risks.  “Some of them will even get pregnant in the first attempt, so at least explaining to the person what it is, what she should do, or what she should expect in that stage -is very helpful.” She has already seen progress.  “The young ones are coming. If the first one will come and you provide the service, she will go and inform the friends, and the friends will come.” Hairdresser Jennifer Osei, who is waiting to see Abrafi, is a testament to this. She did not learn about family planning at school. After a friend told her about the clinic, she has begun relying on staff like Abrafi to educate her. “I have come to take a family planning injection, it is my first time taking the injection. I have given birth to one child, and I don’t want to have many children now,” she says. Expanding services in Mim The SRHR project is working in three other clinics or health centres in Mim, including at the Ahmadiyya Muslim Hospital. When midwife Sherifa, 28, heard about the SRHR project coming to Mim, she knew it would help her hospital better help the community. The hospital was only offering care for pregnancy complications and did little family planning work. Now, it is supplied with a range of family planning commodities, and the ability to do comprehensive abortion care, as well as education on SRHR. Being able to offer these services especially helps school girls to prevent unintended pregnancies and to continue at school, she says.  Sherifa also already sees success from this project, with young people now coming in for services, education and treatment of STIs. In the long term, she predicts many positive changes. “STI infection rates will decrease, teenage pregnancies will decrease, unsafe abortions and deaths as a result of unsafe abortions will decrease. The young people will now have more information about their sexual life in this community, as a result of the project.”

	Janet Pinamang, Mim Cashew Factory worker,.32

"It has helped me a lot, without that information I would have given birth to many children..."

Factory workers at Mim Cashew, in a small town in rural Ghana, are taking their reproductive health choices into their own hands, thanks to a four-year project rolled out by Planned Parenthood Association Ghana (PPAG) along with the Danish Family Planning Association (DFPA). The project, supported by private funding, focuses on factory workers as well as residents in the township of about 30, 000, where the factory is located. Under the project, health clinic staff in Mim have been supported to provide comprehensive abortion care, a range of different contraception choices and STI treatments as well as information and education. In both the community and the factory, there is a strong focus on SRHR trained peer educators delivering information to their colleagues and peers. An increase in knowledge  So far, the project has yielded positive results - especially a notable increase amongst the workers on SRHR knowledge and access to services - like worker Janet Pinamang, who is a 32-year-old mother of two. She says the SRHR project has been great for her and her colleagues. "I have had a lot of benefits with the project from PPAG. PPAG has educated us on how the process is involved in a lady becoming pregnant. PPAG has also helped us to understand more on drug abuse and about HIV.” She also appreciated the project working in the wider community and helping to address high levels of teenage pregnancy.  "I have seen a lot of change before the coming of PPAG little was known about HIV, and its impacts and how it was contracted - now PPAG has made us know how HIV is spread, how it is gotten and all that. PPAG has also got us to know the benefits of spacing our children." “It has helped me a lot” Pinamang's colleague, Sandra Opoku Agyemang, 27, is a mother of a six-year-old girl called Bridget. Agyemang says before the project came to Mim, she had only heard negative information around family planning. "I heard family planning leads to dizziness, it could lead to fatigue, you won't get a regular flow of menses and all that, and I also heard problems with heart attacks. I had heard of these problems, and I was afraid, so after the coming of PPAG, I went into family planning, and I realised all the things people talked about were not wholly true." Now using family planning herself, she says the future is bright for her, and her family. "It has helped me a lot, without that information I would have given birth to many children, not only Bridget. In the future, I plan to add on two [more children], even with the two I am going to plan."  

Gifty with her son, Ghana

“Despite all those challenges, I thought it was necessary to stay in school"

When Gifty Anning Agyei was pregnant, her classmates teased her, telling her she should drop out of school. She thought of having an abortion, and at times she says she considered suicide. When her father, Ebenezer Anning Agyei found out about the pregnancy, he was furious and wanted to kick her out of the house and stop supporting her education.  Getting the support she needed But with support from Planned Parenthood Association of Ghana (PPAG) and advice from Ebenezer’s church pastor, Gifty is still in school, and she has a happy baby boy, named after Gifty’s father. Gifty and the baby are living at home, with Gifty’s parents and three of her siblings in Mim, a small town about eight hours drive northwest of Ghana’s capital Accra.  “Despite all those challenges, I thought it was necessary to stay in school. I didn’t want any pregnancy to truncate my future,” Gifty says, while her parents nod in proud support. In this area of Ghana, research conducted in 2018 found young people like Gifty had high sexual and reproduce health and rights (SRHR) challenges, with low comprehensive knowledge of SHRH and concerns about high levels of teenage pregnancy. PPAG, along with the Danish Family Planning Association (DFPA), launched a four-year project in Mim in 2018 aimed to address these issues.  For Gifty, now 17, and her family, this meant support from PPAG, especially from the coordinator of the project in Mim, Abdul- Mumin Abukari. “I met Abdul when I was pregnant. He was very supportive and encouraged me so much even during antenatals he was with me. Through Abdul, PPAG encouraged me so much.” Her mother, Alice, says with support from PPAG her daughter did not have what might have been an unsafe abortion. The parents are also happy that the PPAG project is educating other young people on SRHR and ensuring they have access to services in Mim. Gifty says teenage pregnancy is common in Mim and is glad PPAG is trying to curb the high rates or support those who do give birth to continue their schooling.  “It’s not the end of the road” “PPAG’s assistance is critical. There are so many ladies who when they get into the situation of early pregnancy that is the end of the road, but PPAG has made us know it is only a challenge but not the end of the road.” Gifty’s mum Alice says they see baby Ebenezer as one of their children, who they are raising, for now, so GIfty can continue with her schooling. “In the future, she will take on the responsibly more. Now the work is heavy, that is why we have taken it upon ourselves. In the future, when Gifty is well-employed that responsibility is going to be handed over to her, we will be only playing a supporting role.” Alice also says people in the community have commented on their dedication. “When we are out, people praise us for encouraging our daughter and drawing her closer to us and putting her back to school.” Dad Ebenezer smiles as he looks over at his grandson. “We are very happy now.” When she’s not at school or home with the baby, Gifty is doing an apprenticeship, learning to sew to follow her dream of becoming a fashion designer. For her, despite giving birth so young, she has her sights set on finishing her high school education in 2021 and then heading to higher education. 

Dorcas.Amakyewaa , Mim Cashew Factory worker and peer educator, 42

"They teach us as to how to avoid STDs and how to space our childbirth"

As the sun rises each morning, Dorcas Amakyewaa leaves her home she shares with her five children and mother and heads to work at a cashew factory. The factory is on the outskirts of Mim, a town in the Ahafo Region of Ghana. Along the streets of the township, people sell secondhand shoes and clothing or provisions from small, colourfully painted wooden shacks.  “There are so many problems in town, notable among them [young people], teenage pregnancies and drug abuse,” Amakyewaa says, reflecting on the community of about 30,000 in Ghana.       The chance to make a difference  In 2018, Amakyewaa was offered a way to help address these issues in Mim, through a sexual and reproductive health rights (SRHR) project brought to both the cashew factory and the surrounding community, through the Danish Family Planning Association, and Planned Parenthood Association Ghana (PPAG).  Before the project implementation, some staff at the factory were interviewed and surveyed. Findings revealed similar concerns Amakyewaa had, along with the need for comprehensive education, access and information on the right to key SRHR services. The research also found a preference for receiving SRHR information through friends, colleagues or factory health outreach. These findings then led to PPAG training people in the factory to become SRHR peer educators, including Amakyewaa. She now passes on what she has learnt in her training to her colleagues in sessions, where they discuss different SRHR topics. “I guide them to space their births, and I also guide them on the effects of drug abuse.” The project has also increased access to hospitals, she adds. “The people I teach, I have given the numbers of some nurses to them. So that whenever they need the services of the nurses, they call them and meet them straight away.” Access to information One of the women Amakyewaa meets with to discuss sexual and reproductive health is Monica Asare, a mother of two.  “I have had a lot of benefits from PPAG. They teach us as to how to avoid STDs and how to space our childbirth. I teach my child about what we are learning. I never had access to this information; it would have helped me a lot, probably I would have been in school.” Amakyewaa also says she didn’t have access to information and services when she was young. If she had, she says she would not have had a child at 17. She takes the information she has learnt, to share with her children and other young people in the community. When she gets home after work, Amakyewaa’s peer education does not stop, she continues. She also continues her teachings when she gets home. “PPAG’s project has been very helpful to me as a mother. When I go home, previously I was not communicating with my children with issues relating to reproduction.” Her 19-year-old daughter, Stella Akrasi, has also benefitted from her mothers training. “I see it to be good. I always share with my friends give them the importance of family planning. If she teaches me something I will have to go and tell them too” she says.

International Youth Day
10 August 2018

Young people around the world are leading the way for change

All around the world, young people are leading the way for important change. From coming up with innovative ways to help classmates with their periods in Tanzania, to using music to challenge the stigma around HIV in Nepal, they are improving their communities in their own unique, brilliant ways. Here are just a few of their remarkable stories.  Frida – Uganda  Frida is 18-years-old and she is a peer counsellor at her school, where she raises awareness about unsafe abortion. She received her training from the Volunteers for Development Association (VODA), who have given her the confidence to overcome her shyness and speak in front of hundreds of people about safe sex, post-abortion care and more. As a result of her incredible work with VODA, she now hopes to become a social worker. Read Frida’s story and more.   Brook & FPA volunteers – England Current UK guidelines on relationships and sex education (RSE) haven’t changed in nearly two decades. But as of 2020, RSE will become compulsory in schools in England. Young volunteers from Brook and the Family Planning Association (FPA) have been speaking up about what they believe should be included as part of positive, effective and healthy RSE - whether that’s consent, sexting, cyberbullying, LGBTI+ issues, pornography and more. See what else they’re saying.   Akosua – Ghana  When she was younger, Akosua's sex education consisted of horror stories about the trouble she might end up in if she had sex. Now she volunteers with the Planned Parenthood Association of Ghana to promote the importance of comprehensive sexuality education for young people. She believes that rather than scaring young people into abstinence, education is what is key in order to save lives. Find out more about Akosua in her own words. Milan – Nepal Milan tragically lost both parents when he was just 10-years-old. He then found out he was HIV-positive. The discovery meant he faced a lot of discrimination from those living around him, which left him feeling humiliated and alone. But over the years Milan has been supported by the Family Planning Association of Nepal, who have helped him grow in confidence. They have even encouraged him to challenge the stigma of HIV through his love for music. Find out how he's doing that.  Alice – Tanzania  With only 2% of schoolgirls in Tanzania having access to disposable sanitary pads, many of them will try to make do with anything from cloth rags to socks, leaves or dry grass. It also means some girls skip school to avoid embarrassment. So Alice and her classmates decided to take action - they created The Pink Box, a place where girls who could spare a sanitary pad or two could donate theirs, to be distributed to those less able to afford or access them. Read more about the schoolgirls’ simple and inspiring initiative.    

Akosua Agyepong - Youth Volunteer at Planned Parenthood Association of Ghana (PPAG)
20 March 2018

Scary stories don’t save lives, Comprehensive Sexuality Education does

By Akosua Agyepong,Youth Volunteer at Planned Parenthood Association of Ghana (PPAG), IPPF member association. This was how I learnt about sex; my mother called me into her room, she was holding a newspaper in her hand. In that paper, there was a report on the rising number of cervical cancer cases in the country and then she said: “Akosua, now you are menstruating, if you sleep with any boy, you can get some of this cervical cancer.” That was the end, and then she asked me to leave. I don’t think her aim was to educate me but it was to scare me out of having sex. I believe for most youngsters in my country, that’s the reality. At home, there isn’t a discussion about sex but a horror story on the troubles sex could put you in, so that young people totally abstain. However, there are two wrongful assumptions that preachers of abstinence make. The first is the assumption that scary stories about sex would keep their virginities intact and secondly that sexuality education is all about sex and thus encourages sex. On the first assumption, we find that evidence shows that young people would have sex whether or not they hear those scary stories because sex is emotionally and hormonally driven and emotions and hormonal activity cannot be suppressed by daunting stories of death and curses. In fact, the International Technical Guidance on Sexuality Education shows how sexuality education has positively impacted the lives of young people in terms of delaying the initiation of sexual intercourse and what not to do to stay safe and healthy.  If for nothing at all, the Puritan age showed us that restricting sex to marriage and punishing pre-marital sex by fines, public shaming and even death could not suppress human emotions and pre-marital sex even in that age still persisted. UNESCO’s updated guidelines on sexuality education also disprove the claim that "sexuality education is all about sex", putting it to rest entirely. The guidance shows how sexuality education speaks to key concepts: Relationships, Values, Rights, Culture and Sexuality, Understanding Gender, Violence and Staying Safe, Skills for Health and Well-being, The Human Body and Development, Sexuality and Sexual Behaviour and finally Sexual and Reproductive Health. The instructional guide provides evidence that when young people are taken through Comprehensive Sexuality Education, they will not be learning the details of the Kama Sutra but they will have first-hand information about themselves and their health and well-being that improves their chances of becoming a successful person in future. It is a shame that many people misunderstand what Comprehensive Sexuality Education is, and are totally oblivious to its benefits to us as families, societies, nations and continents. Some individuals and organizations even go the extra mile of petitioning governments to take CSE out of school curricula. To them my final and only word is that scary stories don’t save lives, Comprehensive Sexuality Education does. Perhaps reading the UNESCO Guidance can help them understand this better.

H.E. Ambassador Takashi Shinozuka, Ambassador Extraordinary and Plenipotentiary of Japan to Morocco and Dr Latifa Mokhtar JAMAI, President of AMPF, IPPF’s Member Association in Morocco, at the JTF project launch ceremony
30 March 2017

Japan Trust Fund

The Japan Trust Fund (JTF) represents a visionary partnership that began in 2000 between the Government of Japan and IPPF. Together, we invest in programmes that prioritize health equity, gender equality, and human security for all. Traditionally a driving force behind IPPF's efforts to support the integrated HIV prevention programmes of our Member Associations in Africa and Asia, JTF has adjusted to reflect changing global health priorities. We attach importance to universal access to sexual and reproductive health and rights - an essential contributor to universal health coverage and the global development goals.     These projects have transformed the lives of people most vulnerable to HIV and high risk of maternal and child mortality. Equally, it ensures that as a donor, the GOJ’s response to HIV remains people-centred and contributes to human security.