Ghana

Meet Ghana’s vaccine king

Apr 22nd, 2013 1:33 PM UTC
By Guest Blogger

Dr. K.O. Antwi-Agyei at the Ghana Health Service Disease control unit vaccination cold storage facilities in Accra, Ghana. Photo: Bill & Melinda Gates Foundation

This is a guest post from the Bill and Melinda Gates Foundation, originally published on their Impatient Optimists blog.

Dr. K.O. Antwi-Agyei manages the Expanded Programme on Immunisation in Ghana, where he oversees the day-to-day work to ensure vaccines reach children across the country.

Ghana’s health care system has put a lot of its resources into vaccines. Why?
We can see a lot of achievements in reducing child deaths by investing in delivering vaccines. The returns are high, so the politicians and policy makers are convinced that it’s worth investing in vaccines. That is why at least every year within our budget we ensure that we pay for all our traditional vaccines.

Our communities have also been great because they embrace vaccination. They even testify that “Oh, our children used to die from measles. Now with vaccination, we don’t see measles.” And of course, they allow our staff into their homes. There is trust. We can now return to the communities with other vaccination campaigns. It’s marvelous.

What impact have vaccines had on the health of Ghana’s population?
Around 1974, immunisation coverage was around 1.6 percent. Today, well over 90 percent of our population is covered by immunisation services, reducing the burden of disease.

For example, measles used to be the number two killer of children. Now it’s no longer a cause of death for the past 10 years in Ghana. So a lot has been achieved through immunisations.

Last year, you were the first immunisation chief in Africa to simultaneously roll out two vaccines, one protecting children against pneumonia and the other against rotavirus. Why did you decide to do that and, and what was the result?

Our desire to reach the Millennium Development Goal to reduce childhood death was a very big motivating factor. Apart from malaria, pneumonia and diarrhea are the two highest killing diseases. So we thought, if there is no vaccine against malaria now, and there are vaccines against pneumonia and diarrhea, then it’s worth fighting. So we decided to fight the two together. We thought it would be difficult, but not an impossibility. And with careful planning, we could succeed.

How important are Ghana’s community health workers in delivering the vaccines?
They are very important. The front line health workers, they are in touch with the communities. They help improve our public health services, not only through vaccinations but also by treating minor illnesses offering family planning and providing other health-related services.

How does Ghana use data collection to improve immunisation coverage?
Data is used for making decisions. If your data is not good, then of course your decisions will also be faulty, and you won’t be able to achieve your objectives. So a lot of effort has gone into data reporting. We developed tally and register books for the basic level so that they are able to pick the necessary data on children vaccinated, and also on what vaccines have been used. We firmly believe that if you won’t use the data, then don’t collect it. So once we collect the data, we use it. If a region’s coverage is low, we immediately ask, “What is happening there?” We go and investigate and then give us feedback. Then, whatever the error is, we discuss it and correct it.

What is your long term goal for Ghana’s immunisation program?
To reach the top is difficult, but to remain at the top is even more difficult. For Ghana, our goal is to remain as a leader in the area of immunisation and to show our commitment and to develop initiatives which can spread to other areas. Whatever is happening in other countries has a bearing on us. We want to have success stories which can be shared so that together we can get rid of diseases which are killing our children and mothers.

This week is World Immunisation Week. Find out more about how ONE is supporting access to vaccinations. 

Sisterly advice on oil – start with transparency

Mar 15th, 2013 6:45 PM UTC
By ONE

Lauren Pfeifer, ONE’s Transparency and Accountability Research Assistant, shares Ngozi Okonjo-Iweala’s call for transparency and accountability mechanisms in the oil industry of Ghana.

Renowned Nigerian economist and member of ONE’s Board of Directors Ngozi Okonjo-Iweala advised Ghana on the importance of building transparency and accountability mechanisms into the DNA of its fledgling oil industry. Speaking at the John A.Kufuor Global Development Series in Accra last Friday, Okonjo-Iweala said, “My sisterly advice is that you should be uncompromising on issues of transparency and accountability in the sector.” By building transparency and accountability mechanisms into the sector, Okonjo-Iweala hopes Ghana can avoid the pitfalls of a sudden influx of revenues from natural resources.

Ngozi Okonjo-Iweala at the John A.Kufuor Global Development Series in Accra. Photo credit: www.guardian.co.uk 

Currently serving her second term as Finance Minister of Nigeria, Okonjo-Iweala cautioned Ghanaians Friday to the subtle shifts that she witnessed after Nigeria began exporting oil. After the discovery of oil in Nigeria, its well-diversified economy shifted, non-oil sectors contracted, and an entrepreneurial spirit was sapped as energies were shifted to “chasing government contracts, rather than productive investment,” she said.

Ghana’s Petroleum Revenue Management Act has been widely praised because the legislation specifies how petroleum revenue should be collected and allocated. Okonjo-Iweala implored policymakers and leaders to strengthen it further by institutionalizing transparency in contract negotiations. She encouraged the Ghanaian government to prepare thoroughly before entering into negotiations with foreign oil companies and to invest the profits in public infrastructure.

Okonjo-Iweala also stressed the importance of regional cooperation, especially with regard to infrastructure and trade. She noted that several key building blocks for development – good economic policies, good governance, and investment in infrastructure and skills – are falling into place, making the time ripe for regional development. “With these building blocks in place,” she said, “we can create a platform for the private sector to grow.”

The discovery of Ghana’s oil reserves in 2007 – now known as the Jubilee Field – is estimated at between 800 million to 1.8 billion barrels, and is expected to generate over $1 billion yearly in export revenue over the next 20 years. The new oil wealth has the potential to provide Ghana with the revenue needed to drive development and reduce poverty.

What Africa can learn from Ghana’s peaceful election

Dec 14th, 2012 8:31 PM UTC
By Dr. Sipho Moyo

Ghana is a country I’ve come to admire profoundly for its democratic credentials over the last five elections since 1992. And now, I have seen that country successfully transfer power for the sixth time in a row without an implosion. Ghana has done it again… it’s pulled off yet another peaceful election last week on December 7!

What makes this truly commendable is the fact that Ghana has maintained its reputation as an oasis of peace in a troubled region where smooth elections are not always taken for granted. Ghanaian activist and Free Africa Foundation President Professor George Ayittey highlighted a number of key factors that account for Ghana’s political maturity in an article for CNN this week.

I want to focus on three critical factors – from Professor Ayittey’s article – that Africa can learn from. These factors have helped Ghana in becoming not only the political inspiration of the continent, but the country from which we have come to expect much.

First, the existence of a free media, particularly print and broadcast media and the proliferation of FM radio stations in Ghana, has provided a precious tool for exposing problems, holding government accountable and ensuring transparent elections.

A second underpinning aspect has been the existence of a strong and vigilant civil society – enabled by freedom of association, of expression and of movement as well as the use of new technology and social media.

The third important dynamic has been the maturing of political leaders, which in the words of Professor Ayittey, was “stupendously displayed in the 2008 elections,” and has been demonstrated in this recent election where once again the difference between votes for the two leading candidates has been marginal.

Ghana concluded its elections on Sunday, and voted in President John Dramani Mahama of the New Democratic Congress, who beat his rival Nana Akufo-Addo of the New Patriotic Party.  President Mahama avoided a run-off by a whisker, garnering 50.7 percent of the votes, compared to Akufo-Addo’s 47.7 percent.

The elections were declared free and fair by the African Union, Economic Community of West African States (ECOWAS), Coalition of Domestic Election Observers (CODEO), and the US government amongst others.

However, even with an election that close, Ghana’s main opposition party will not be taking to the streets to challenge the results, in which they are sighting counting irregularities.  According to the chairman of the main opposition New Patriotic Party (NPP), Jake Obetsebi-Lamptet they will be taking their matters to the Supreme Court. Yes, in the midst of an electoral dispute, Ghana continues to bolster its image as a peaceful nation.

You really do have to admire Ghana. My sincere congratulations to Ghanaian citizens for a peaceful election.

Image credit: Kofi Akrofi

African Voices: Abdulai Shefu

Sep 5th, 2012 2:00 PM UTC
By Guest Blogger

Hello, my name is Abdulai Shefu and I am the head teacher at Duu Primary and Junior High School located in the West Mamprusi District in northern Ghana. I can say that here at school we have two major challenges: There are not enough teachers and not enough students.

Ten teachers including myself are in charge of educating 570 students from kindergarten through junior high. The staff shortage is especially acute in the lower grades: Just two teachers manage 220 kindergarteners aged 2 to 6, and a single teacher is in charge of 78 students in Class 2 (second grade). The classes are smaller in the junior high grades—just 25 in the seventh level—but that’s because so many children have left school by then.

Abdulai Shefu

In fact, in July a census counted 1,128 school-age children in the community. So about 558 are still left out there when they are supposed to be in school. But when I started teaching at Duu in 2004, enrollment was much higher. The difference? Back then, a donor-supported school feeding program drew many more students, but the program ended in 2007.

The twin problems—a teacher shortage coupled with a large out-of-school population—pose a frustrating challenge, but I am determined to make the school a success. The teacher shortage would be much worse, if we did not have the support from outside NGO partners.

But the lack of school meals affects learning as well as enrollment. Some students bring food from home, and some can buy food from vendors around the school, but many have nothing to eat. Because of the hunger, at times when you are teaching after, say, 12:30, they find it difficult to understand because there is nothing in their stomachs. You can even find some of them sleeping in class.

At the same time, the school is blessed with new kindergarten and junior high classrooms, and solar lights so the older students can study after dark, all a result of donor support. But the six primary school classrooms were built in 1987 and have had no maintenance at all in the 25 years since, not even fresh paint. The desks wobble and sometimes break because of the cracked and pitted cement floors. The floor is not good. A lot of children lose their toenails from the floor.

The cost of renovation would be around 500 cedis, or about $250, per classroom. So 500 Ghana cedis times these six classrooms would be 3,000 Ghana cedis, which is beyond our school’s capabilities.

Despite the challenges I am committed to education. I’m working on a university degree to improve my abilities for the future. For now, I earn no more than a regular teacher, and though I would prefer teaching in a classroom to running the school, I know that as head teacher I can affect many more children.

If I am a teacher, I would be teaching 45 pupils in a class. But if I’m supervising ten teachers, it means I’m supervising 45 times ten. That’s why I’m a head teacher.

Featuring contributions from African citizens who are living in communities affected by extreme poverty, ONE’s African Voices series will follow their progress to give a better understanding of the day-to-day challenges they face and also to track changes that occur over time. Find out more at one.org/africanvoices.

This post was kindly provided by the Millennium Villages Project

African Voices: Memuna Sandow

Sep 4th, 2012 3:40 PM UTC
By Guest Blogger

Before I became a district assemblywoman in 2009, I had already been working with my community for years, especially the women. But I came to realize that despite my hard work, without an official position, my ability to effect change would always be limited.

If you are not an assemblywoman, if you go to any place to say something, they will ask you, “Who are you?” But that all changed when I was elected to represent the communities of Wulugu, Silinga and Nabari at the district level. Now, any office that I want to enter, I enter, and tell them what I’ve come in for, and if they can help or they can’t, they let me know.

Memuna Sandow is an assemblywoman in West Mamprusi District, Northern Ghana.

As one of only five women in the 43-member assembly, I am especially determined to getting my voice heard. Many men in the community resist the idea of women in leadership. They believe that if a woman gets a higher position, she will not respect the husband, she will be arrogant. So because of that some men deny their women to come out and be a leader. And even though my husband supported me from the start, I endured intimidations and insults during the campaign. But the women in my community helped me to persevere.

As a member of the assembly, I meet regularly with the communities to find out what they need, and then advocates on their behalf with the government and other potential supporters. The rural communities I represents have a population of 1,700, but none of them has a health center, the schools are in poor condition and lack trained teachers, electricity is not available and water sources are inadequate, especially during the dry season.

In the next few years, I envision health facilities within easy walking distance of all, sufficient and accessible water supplies, and electricity to allow the communities to connect to the world. Nowadays, it’s computers everywhere. Without electricity, you can’t work on a computer. You use the computer to browse, to find friends, to find out what’s going on in the world, and even to find sources of support for community needs.

Education is a critical component: I want to see improved school buildings staffed by trained and committed teachers, so that all children, especially girls, can be empowered with education. Ultimately, it is women who take care of their families and communities. It is so important to empower and to educate the girl child. If a boy gets money, he goes to marry, he goes to drink. But if a girl gets money, if a girl gets good education, she will build a house for the family, she will take care of the family. She will even take care of other people that come to her.

Featuring contributions from African citizens who are living in communities affected by extreme poverty, ONE’s African Voices series will follow their progress to give a better understanding of the day-to-day challenges they face and also to track changes that occur over time. Find out more at one.org/africanvoices.

This post was kindly provided by the Millennium Villages Project

Long live Ghana: Reflecting on President John Atta Mills’ legacy

Jul 30th, 2012 11:16 AM UTC
By Dr. Sipho Moyo

ONE Africa Director Sipho Moyo reflects on the life and accomplishments of Ghana President John Atta Mills, who died last week.

When an African leader passes on, their death is never a simple, clear-cut affair. It is nearly always shrouded in secrecy or followed by a constitutional crisis in which the citizens never know exactly who is going to take over.

Not so in Ghana, where President John Atta Mills passed away last week. He was 68.

The first African country to declare independence from Britain has also become the hallmark of what an African country can achieve if it stays on a steady course of reasonable governance and is committed to serving its citizens.

Ghana has steadily become a country where institutions work and governance is conducted through these institutions rather than individuals. The fact that the death of Atta Mills has not created any constitutional crisis in Ghana is testimony to the fact that that country’s democracy has become a tradition, and no longer an experiment.

Similarly his narrow victory — elected with a margin of less than 1 percent in the 2008 election — did not set off an explosion of violence as we’ve come to expect epitomized by the post-election violence in the Ivory Coast and Kenya. Further evidence of the maturity of democracy in Ghana is how a completely seamless transition has already taken place with Vice President John Dramani Mahama stepping up to the plate.

And despite the suddenness of Mills’ death, Ghanaians have not had to worry about what will happen or who will take over in the event of death. This is all because the constitution is crystal clear, respected and above all because their institutions function.

Not many African leaders are ever admitted and die in their own national hospitals. Yet in Ghana, where government has invested heavily in the national health systems, what’s good enough for Ghanaian citizens seems to be good enough for their presidents.

For this reason, we at ONE pay tribute to President Mills for his contribution to the consolidation of this maturing democracy and for his legacy as a leader who not only oversaw the beginning of oil production in Ghana, but also pushed for transparency particularly in respect of ensuring that the nation’s oil wealth would be used for the good of the people. We urge the leaders and the people of Ghana to truly build upon, accelerate and deepen this legacy of transparency, for this is above all the aspiration of all Ghanaians and all African citizens.

Interview: GAVI’s Mercy Ahun talks Ghana’s upcoming vaccine milestone

Mar 28th, 2012 4:04 PM UTC
By Erin Hohlfelder

Last week I had the opportunity to sit down with Mercy Ahun from the GAVI Alliance Secretariat. When I first met her two years ago, she was GAVI’s Director of Program Delivery, but recently she was named GAVI’s Special Representative to GAVI-Eligible Countries. In this role, she serves as a bridge between GAVI, countries receiving GAVI support, and donors, and she works to develop customized approaches that deliver even more effective results on the ground.

ONE is really excited that in less than 1 month, Ghana will become the first country to roll out pneumococcal and rotavirus vaccines at the same time. Especially as a Ghanaian, what does this milestone mean to you?

It’s been exciting! I remember the first time I was talking to Ghana’s EPI (Extended Program on Immunization) Manager about this, and I said, are you sure you want to do this? And he said yes—we are close to achieving MDG 5 (reducing child deaths); doing this allows us to hit two birds with one stone. And when I started looking at their vaccine programs, and saw that they already had achieved high coverage levels of other vaccines, I said yes, I think the system is strong enough to do this. And I think it is important to document the process in Ghana so then others can learn from it.

I go to Ghana about six times in a year, and we have an excellent relationship not just with the EPI Manager but with other groups in the Ministry of Health and with the partners. When we’re in Ghana, you can catch the excitement. I remember that one person said to me, “It feels like the whole world is looking at us”, and to that I just think: wow.

What does a country like Ghana need to do to prepare itself for a vaccines roll out?

I think one of the most important parts is having the needed cold chain equipment for the new vaccines. Giving out two vaccines at once requires a major expansion, and Ghana planed it so that the major 10 regions in Ghana will each have the right fridges and storage units.

The Ghana Health Service also partners with WHO, UNICEF and others; together with community groups, they have developed 8 committees that are planning for this launch. There are groups focused on logistics, training, and communication which meet separately, and they also brought in a professional advertising company from the private sector to guide them. They have done a survey of local knowledge, attitudes, and practices, and they are using the findings to design appropriate messages for communities. So much is on the line that needs to be done, but things are on track.

How have you seen African leaders respond to GAVI’s work? What do they say about vaccines, and their own governments’ role in supporting them?

I think African leaders recognize the importance of immunization. President Kibaki of Kenya launched a new vaccine himself in Kenya last year. I was in Cameroon and it was the First Lady’s office which led the charge there. Ghana is expecting the President to do the launch in April.

But we also know that it’s about more than just the launch, and more than just about Presidential leadership. We know that when countries apply for GAVI support, all the ministers of health and finance need to sign the application too, because GAVI support is not for free. They need to make a commitment of their own. Since we introduced a co-financing policy in 2008, almost all countries have provided financial support for vaccines, which shows their own commitment. Come 2016, we expect that 16 countries will have a ceremony because they will be off of GAVI’s support and increasing their own contributions to immunization financing. I think it’s fantastic.

In your time working for GAVI, what have you found to be the most rewarding?

I think the most rewarding thing has been working with others. We are an alliance. We bring together the strengths of organizations from the public sector (like WHO or UNICEF), from the private sector, from foundations, and from other partners to develop immunization plans with countries. I have found that most rewarding because I think when you involve your recipient countries in the policy-development process, it is more likely to be sustainable because they feel ownership over the programs.

You and your colleagues carry a lot of responsibility at GAVI, ensuring that the world’s poorest children receive life-saving vaccinations. What do you like to do on your days off?

I have three kids—two are teenagers who are still home with me—so I like chatting with them. We are Ghanaians in Switzerland, so sometimes there are cultural challenges, and we discuss these things with each other. I like singing, dancing, attending church services. Really I try not to look at my blackberry, especially on the weekends, and enjoy myself.

Peering into Ghana’s mobile future with Mac-Jordan Degadjor

Feb 2nd, 2012 10:16 AM UTC
By ONE

Mac-Jordan Degadjor is a Ghanaian social media entrepreneur and rising star among global tech bloggers. The 26-year-old recently spoke about the positive effects of social media at the TEDxYouthInspire conference in Ghana’s capital city of Accra and was spotlighted in the Christian Science Monitor’s “Thirty Ideas from People Under 30.” We asked Mac-Jordan to explain why mobile tech advancements are important for Ghana’s economic and social growth.

Why is Ghana ready for a mobile technology boom? Are investors looking to Ghana as a market ready to advance with mobile?
Anytime I’m asked if Ghana is ready for the mobile technology boom, my answer is always YES. In Ghana, there are two major organizations providing locals with the business and technology skills they need to leverage ideas into successful mobile web companies: Meltwater Entrepreneurial School of Technology and Mobile Web Ghana.

New opportunities are showing up that make it possible for low-income economies to leapfrog other countries by adopting technologies that are suitable to their specific circumstances. I’m happy to say that Ghana is taking that bold step in adopting new mobile technologies. Take a critical look at the continent: Africa has more than 110 million Internet users, a number that is poised to grow by 2400 percent in this decade alone.

What about Ghana’s market makes it ready for mobile phone technology? How are smartphones being introduced into the market? Can bandwidth improvements keep up with the technology?

African governments are aggressively developing broadband and information/communications (ICT) policies in order to properly regulate the industry while allowing the market to work its magic. In Ghana, mobile penetration currently stands at 85.5 percent, which means that out of a population of about 25 million, there are 20 million subscribers to at least one of the country’s five active mobile networks (MTN, Vodafone, TiGO, Airtel and Expresso). These days, smartphones are being used in all areas. By 2013, Africa will have 11 undersea cables (including one in Ghana by Glo Mobile), which is likely to result in increased bandwidth and reduced cost to consumers.

From banking to agriculture, mobile technology plays a vital role in the life of the average Ghanaian. Here are two examples of how mobile or smartphones are being used in Ghana:

Esoko is an agricultural market information platform managed on the web and delivered via mobile technology in Ghana and other parts of Africa. Individuals, agri-business, and government agencies use Esoko to collect and send out market data using simple text messaging. By way of SMS, the Esoko platform provides automatic and personalized price alerts to farmers in rural areas.

The Grameen Foundation is also developing and distributing mobile phone-based applications to help the poor better manage their health, through such programs as the Mobile Technology for Community Health (MOTECH) initiative.

How are younger people in Ghana helping to push mobile advancements? As a younger person, why is tech growth so important to you and your circles?

Mobile technology is the future for Africa. In Ghana, the only way to access the Internet among the younger generation is via mobile and smartphones.

The greatest opportunity for growth will come from technological innovation and the adoption of new technologies in service sectors, such as banking, insurance, health, education and agriculture. These growths in technology are very important to me and my networks because they help shape the socioeconomic aspect of our lives and bridge the gap between people in Ghana and those in other parts of the world.

Can you describe some of the apps that could come from tech innovations that would help people in Ghana?

The catalog of mobile applications in Ghana seems to be growing by the day. We have a host of programs including mobile banking, SMS alerts for farmers and agri-business, chat functions, stock market updates and photo-sharing platforms.

When it comes to mobile apps from Africa, there’s been mention of Ushahidi, iCow and Mocality from Kenya, and Ummeli and TXTALert from South Africa. In Ghana, app providers like Nkyea, Esoko, ShopAfrica53, NandiMobile, iWallet – Dream Oval, Retail Tower and Streemio have gained a lot of popularity.

Can you describe the benefits, if any, to government transparency and democracy that mobile tech can bring to Ghana (e.g. promoting accountability, coordinating political events, and inspiring social activism)?

Universal access to affordable information is one area in which mobile technology will be of great importance in Ghana. There is widespread consensus that ICTs offer one solution to this problem, with mobile phones showing particular promise already.

In Ghana, smartphones are more affordable than computers. They require less infrastructure, do not demand much technological knowledge (users do not even have to be literate), and are very durable. With increased use of mobile phones in Ghana, citizen participation in all social aspects of life will be monitored and reported.

As a citizen journalist, the mobile phone serves as a great tool in my reporting and social activism. Bloggers in Ghana will use their mobile phones to monitor and report on the December elections later this year. This will be first time citizens have the chance to play a participatory role in the elections.

Read more from Mac-Jordan Degadjor on his blog or follow him on Twitter. He also writes for the Venture Capital for Africa blog.