USE OF THE CBMS APPROACH IN GHANA - pep-net.org...• Aim im -- acceleratinaccelerating economic growth and overall human development • Emphasis Emphasis -- poverty reduction, education,

THE USE OF THE CBMS APPROACH IN DATA THE USE OF THE CBMS APPROACH IN DATA COLLECTION IN ANALYSING THE MDGs AT THE COLLECTION IN ANALYSING THE MDGs AT THE

DISTRICT LEVEL: A CASE STUDY OF THEDISTRICT LEVEL: A CASE STUDY OF THEDISTRICT LEVEL: A CASE STUDY OF THE DISTRICT LEVEL: A CASE STUDY OF THE

DANGME WEST DISTRICT IN GHANADANGME WEST DISTRICT IN GHANA

Felix A. AsanteFelix A. AsanteCynthia Addoquaye TagoeCynthia Addoquaye TagoeCynthia Addoquaye TagoeCynthia Addoquaye Tagoe

Institute of Statistical, Social and Economic Research (ISSER)Institute of Statistical, Social and Economic Research (ISSER)University of GhanaUniversity of Ghana

Legon, GhanaLegon, Ghana

PEP Network, June 2007PEP Network, June 2007Lima, PeruLima, Peru

Presentation Presentation Outline• Introduction

• Objectives of the Paper

Th CBMS A h i Gh• The CBMS Approach in Ghana

• Progress towards the MDGs in Ghana

• The CBMS and MDGs in Dangme West District

• Challenges and Prospects

R d ti• Recommendations

IntroductionIntroduction

•• Signing of the Millennium Development Signing of the Millennium Development Declaration in September 2000 and the adoptionDeclaration in September 2000 and the adoptionDeclaration in September 2000 and the adoption Declaration in September 2000 and the adoption of the Millennium Development Goals (MDGs) of the Millennium Development Goals (MDGs)

•• Aim Aim -- accelerating economic growth and overall accelerating economic growth and overall human developmenthuman development

•• Emphasis Emphasis -- poverty reduction, education, good poverty reduction, education, good health and environmental sustainabilityhealth and environmental sustainability

•• 8 MDGs:18 targets: 48 indicators by 2015 8 MDGs:18 targets: 48 indicators by 2015

Introduction (cont’d)Introduction (cont’d)

•• Eradicate poverty and hungerEradicate poverty and hunger

•• Achieve universal educationAchieve universal education•• Achieve universal educationAchieve universal education

•• Achieve gender equality and empowerment for women,Achieve gender equality and empowerment for women,

•• Reduce child mortality Reduce child mortality

•• Improve maternal mortalityImprove maternal mortality

•• Combat HIV/AIDS Malaria and other diseasesCombat HIV/AIDS Malaria and other diseases•• Combat HIV/AIDS, Malaria and other diseases,Combat HIV/AIDS, Malaria and other diseases,

•• Ensure environmental sustainability andEnsure environmental sustainability and

•• Promote global partnership for development Promote global partnership for development

Introduction (cont’d)Introduction (cont’d)

•• Ghana’s efforts through the GPRS I (2002Ghana’s efforts through the GPRS I (2002--2005) & II (20062005) & II (2006--2009) 2009)

•• Ghana’s Decentralisation Process and Local Government StructureGhana’s Decentralisation Process and Local Government Structure•• Ghana s Decentralisation Process and Local Government StructureGhana s Decentralisation Process and Local Government Structure

•• The importance of available, appropriate and timely data (local The importance of available, appropriate and timely data (local ––national) for monitoringnational) for monitoring) g) g

•• Existing DataExisting Data-- GLSS, CWIQ, GDHS, annual reports, sector reviews GLSS, CWIQ, GDHS, annual reports, sector reviews –– MDAs, MMDAsMDAs, MMDAs-- other participatory surveys , CSOs etcother participatory surveys , CSOs etc

•• ProblemsProblemsMissing other relevant poverty indicators e g voice and exclusionMissing other relevant poverty indicators e g voice and exclusion-- Missing other relevant poverty indicators e.g. voice and exclusionMissing other relevant poverty indicators e.g. voice and exclusion

-- Irregularity of reliable data sourcesIrregularity of reliable data sources-- Focus on the macro or national level Focus on the macro or national level -- Qualitative data sources at the local levelQualitative data sources at the local levelQualitative data sources at the local levelQualitative data sources at the local level-- Isolated and do not afford the opportunity for comparison Isolated and do not afford the opportunity for comparison

Objectives of the PaperObjectives of the Paperj pj p•• Look at the use the CBMS approach in data collection in Look at the use the CBMS approach in data collection in

analysing the MDGs at the district level. analysing the MDGs at the district level. y gy g

•• Specifically, Specifically, •• to discuss the processes involved in the CBMS approachto discuss the processes involved in the CBMS approach•• to discuss the processes involved in the CBMS approach to discuss the processes involved in the CBMS approach

in Ghana,in Ghana,

•• to give an insight into Ghana’s progress towards theto give an insight into Ghana’s progress towards the•• to give an insight into Ghana s progress towards the to give an insight into Ghana s progress towards the MDGs,MDGs,

•• to compare the national MDGs with the relevant CBMSto compare the national MDGs with the relevant CBMS•• to compare the national MDGs with the relevant CBMS to compare the national MDGs with the relevant CBMS indicators used for Dangme West District, andindicators used for Dangme West District, and

t di th h ll t & d tit di th h ll t & d ti•• to discuss the challenges, prospects & recommendationsto discuss the challenges, prospects & recommendations

1.3 The CBMS Approach in Ghana1.3 The CBMS Approach in Ghana•• to generate simple and easyto generate simple and easy--toto--collect poverty indicators at the community collect poverty indicators at the community

level to inform policy makers, on a timely basislevel to inform policy makers, on a timely basis,, of the effects of policies on of the effects of policies on the standard of living of people at the community levelthe standard of living of people at the community level

•• to provide policymakers with data to be used for the prioritization of to provide policymakers with data to be used for the prioritization of projects, effective planning and monitoring of developmental programmes projects, effective planning and monitoring of developmental programmes in the various communities;in the various communities;

•• to improve capacity at the district and unit committee levels in collection, to improve capacity at the district and unit committee levels in collection, processing and analysis of data at the local levels; processing and analysis of data at the local levels;

h h fl f f d d f dh h fl f f d d f d•• to strengthen the flow of information and dissemination of poverty data to strengthen the flow of information and dissemination of poverty data from the national to the committee level; from the national to the committee level;

•• to test a locally feasible data processing system, without necessarily relying to test a locally feasible data processing system, without necessarily relying y p g y , y y gy p g y , y y gon central government resources and on central government resources and

•• to achieve the main aim of local governance which is to involve the local to achieve the main aim of local governance which is to involve the local people directly in decisions on policies which best address their needs. people directly in decisions on policies which best address their needs. p p y pp p y p

The CBMS Approach in Ghana (cont’d)The CBMS Approach in Ghana (cont’d)

•• Organisation and selection of Pilot CommunitiesOrganisation and selection of Pilot Communities-- Discussion & Choice of Dangme West DistrictDiscussion & Choice of Dangme West District

St k h ld W k h & D i f SSt k h ld W k h & D i f S•• Stakeholder Workshop & Design of Survey Stakeholder Workshop & Design of Survey Instrument Instrument

-- Discussion and Refining of Draft QuestionnaireDiscussion and Refining of Draft Questionnaire-- Discussion and Refining of Draft QuestionnaireDiscussion and Refining of Draft Questionnaire

•• Data Collection in Pilot Communities Data Collection in Pilot Communities -- Selection and Training of EnumeratorsSelection and Training of Enumerators-- Supervision of Data CollectionSupervision of Data Collection

•• Data ProcessingData Processing-- Coding, data entry and analysis done in SPSSCoding, data entry and analysis done in SPSS

•• Validation WorkshopsValidation Workshops-- Discussion of resultsDiscussion of results

•• Dissemination and Data UseDissemination and Data Use

Contents of QuestionnaireContents of Questionnaire

•• Household characteristics Household characteristics -- basic demographic characteristics of the members of a household, basic demographic characteristics of the members of a household, including age, gender and marital status. including age, gender and marital status. g g , gg g , g

•• Education Education –– levels of education and whether or not members of households are in school.levels of education and whether or not members of households are in school.

•• Political participation Political participation -- levels of household participation and voice in the country’s political levels of household participation and voice in the country’s political processes which encompass both national and district level electionsprocesses which encompass both national and district level electionsprocesses which encompass both national and district level elections. processes which encompass both national and district level elections.

•• Employment Employment –– the types of jobs available within the communities and levels of unemployment.the types of jobs available within the communities and levels of unemployment.

•• Health Health -- availability and accessibility of health facilities & common ailments prevalent in the availability and accessibility of health facilities & common ailments prevalent in the communitycommunitycommunity. community.

•• Child mortality Child mortality -- accessibility of mothers to postnatal and antenatal care and its effect on child accessibility of mothers to postnatal and antenatal care and its effect on child mortality.mortality.

H i d h lH i d h l f d lli f h h ldf d lli f h h ld•• Housing and shelter Housing and shelter –– types of dwelling for households.types of dwelling for households.

•• Lighting, water and sanitation Lighting, water and sanitation –– access to water and sanitary facilities access to water and sanitary facilities

•• Income and livelihoodIncome and livelihood -- the main sources of income for households and their expenditurethe main sources of income for households and their expenditureIncome and livelihood Income and livelihood the main sources of income for households and their expenditure the main sources of income for households and their expenditure patterns.patterns.

•• Peace and order Peace and order -- main sources of conflict within the community that may impact negatively on main sources of conflict within the community that may impact negatively on development.development.

•• Access to social and community services and programs Access to social and community services and programs -- access to community services such as access to community services such as banks, telephones or post offices and programs such as the Poverty Alleviation Fund initiated by banks, telephones or post offices and programs such as the Poverty Alleviation Fund initiated by the government to provide financial resources for smallthe government to provide financial resources for small--scale entrepreneurs within the districts. scale entrepreneurs within the districts.

Dangme West DistrictDangme West District•• Location: Location:

•• SE Ghana SE Ghana •• NW NW -- Yilo & Manya Krobo districts Yilo & Manya Krobo districts •• W W -- Akwapim North Akwapim North •• SW SW -- Tema MunicipalityTema Municipality

EE D ED E•• E E -- Dangme East Dangme East •• NE & S NE & S -- Volta River & Atlantic Volta River & Atlantic

OceanOcean•• Largest districtLargest district -- 1 442 square1 442 squareLargest district Largest district 1,442 square 1,442 square

kilometres (42%) of the region’s kilometres (42%) of the region’s land area. land area.

•• The district capital, Dodowa The district capital, Dodowa -- 25 25 km from Accra capital citykm from Accra capital citykm from Accra, capital citykm from Accra, capital city

•• Location in GAR that had the Location in GAR that had the lowest headcount poverty index in lowest headcount poverty index in 1998/991998/99

1.4 Ghana’s Progress Towards the MDGs1.4 Ghana’s Progress Towards the MDGsGoalGoal TargetTarget IndicatorIndicator On Track?On Track?

1 Eradicate extreme1 Eradicate extreme Halve extreme poverty by 2015Halve extreme poverty by 2015 Proportion below national poverty line Yes1. Eradicate extreme 1. Eradicate extreme poverty and hungerpoverty and hunger

Halve extreme poverty by 2015Halve extreme poverty by 2015 Proportion below national poverty line Yes

2. Achieve universal 2. Achieve universal primary educationprimary education

Achieve universal access to primary Achieve universal access to primary education by 2015education by 2015

Gross Primary Enrolment ratioGross Primary Enrolment ratio

Net Primary Enrolment ratioNet Primary Enrolment ratio

Yes Yes

YesYesNet Primary Enrolment ratioNet Primary Enrolment ratio YesYes

3.Promote gender 3.Promote gender equality and equality and empowermentempowerment

Eliminate gender disparity in primary Eliminate gender disparity in primary and secondary education by 2005and secondary education by 2005

Achieve equal access for boys and girls Achieve equal access for boys and girls to SS education by 2015to SS education by 2015

Ratio of females to males in primary Ratio of females to males in primary schools schools

and JSSand JSS

NoNo

YesYes

Ratio of females to males in SSSRatio of females to males in SSS NRDNRD

4. Reduce child 4. Reduce child mortalitymortality

Reduce underReduce under--five mortality by twofive mortality by two--thirds by 2015thirds by 2015

Under five mortality per 1000Under five mortality per 1000 NoNo

5. Improve maternal 5. Improve maternal h lthh lth

Reduce maternal mortality ratio by Reduce maternal mortality ratio by th t b 2015th t b 2015

Maternal mortality per 100,000Maternal mortality per 100,000 NoNohealthhealth three quarters by 2015three quarters by 2015

6. Combat HIV/AIDS, 6. Combat HIV/AIDS, malaria and other malaria and other diseasesdiseases

Halt and reverse the spread of Halt and reverse the spread of HIV/AIDS by 2015HIV/AIDS by 2015Halt and reverse the spread of Malaria Halt and reverse the spread of Malaria by 2015by 2015

National HIV prevalence rate National HIV prevalence rate

Reported cases of MalariaReported cases of Malaria

YesYes

NoNo

7. Ensure 7. Ensure environmental environmental sustainabilitysustainability

Halve by 2015 the proportion of Halve by 2015 the proportion of people without access to safe drinking people without access to safe drinking waterwater

Proportion of overall population with Proportion of overall population with sustainable access to an improved sustainable access to an improved water source water source Proportion of rural population with Proportion of rural population with sustainable access to an improved sustainable access to an improved water sourcewater source

Yes Yes Large rural Large rural urban disparitiesurban disparities

Guinea Worm infestation Guinea Worm infestation on the rise despiteon the rise despiteon the rise despiteon the rise despiteincreased accessincreased access

8. Develop a global 8. Develop a global partnership for partnership for developmentdevelopment

DealDeal comprehensivelycomprehensively withwith LDCLDC debtdebtandand makemake debtdebt sustainablesustainable inin thethe longlongrunrun

Debt service as a percentage of Debt service as a percentage of exports exports

YesYes

•• In Ghana, the proportion of the population defined as poor (¢3,708,900) In Ghana, the proportion of the population defined as poor (¢3,708,900) -- 51.7% to 39.5% to 28.5% (1991/92 51.7% to 39.5% to 28.5% (1991/92 -- 1998/99 1998/99 -- 2005/2006)2005/2006)

Extreme poor (¢2 884 700 00 (less than $1 per day)Extreme poor (¢2 884 700 00 (less than $1 per day)Extreme poor (¢2,884,700.00 (less than $1 per day), Extreme poor (¢2,884,700.00 (less than $1 per day), -- 36.5% in 1991/92 to 26.8% in 1998/98 to 18.2% in 2005/06 36.5% in 1991/92 to 26.8% in 1998/98 to 18.2% in 2005/06

•• Early 1990, girlEarly 1990, girl--toto--boy enrolment ratios in primary school of 0.83. boy enrolment ratios in primary school of 0.83. •• 1990 and 2000 0 91 and 0 95 in 20051990 and 2000 0 91 and 0 95 in 2005•• 1990 and 2000, 0.91 and 0.95 in 20051990 and 2000, 0.91 and 0.95 in 2005•• 1:1 target for 2005 not achieved but could be achieved by 2015 if current trends continue. 1:1 target for 2005 not achieved but could be achieved by 2015 if current trends continue. •• For the senior secondary level, there are no reliable data to assess the progress towards For the senior secondary level, there are no reliable data to assess the progress towards

achievement of the target. achievement of the target.

•• Reducing by twoReducing by two--thirds the underthirds the under--5 mortality is not on course. Though a lot of progress has been 5 mortality is not on course. Though a lot of progress has been made to achieve this target, the rates are still high. from 108 per 1000 in 1998 to 111 per 1000 in made to achieve this target, the rates are still high. from 108 per 1000 in 1998 to 111 per 1000 in 2003. 2003.

•• MMR decreased MMR decreased -- 740 deaths 740 deaths –– 540 per 100,000 live births in 1990 and 2000.540 per 100,000 live births in 1990 and 2000.Despite these declines there is the likelihood of not achieving the target of 246 deaths perDespite these declines there is the likelihood of not achieving the target of 246 deaths perDespite these declines, there is the likelihood of not achieving the target of 246 deaths per Despite these declines, there is the likelihood of not achieving the target of 246 deaths per 100,000 live births by 2015. 43.8% of births attended by skilled health personnel in 1995, 100,000 live births by 2015. 43.8% of births attended by skilled health personnel in 1995, increased marginally to 44 percent in 2002 and 47.1 in 2003. increased marginally to 44 percent in 2002 and 47.1 in 2003.

•• A HIV sentinel survey in 2003 in Ghana reports an estimate of 3.6 per cent among adult A HIV sentinel survey in 2003 in Ghana reports an estimate of 3.6 per cent among adult population aged between 15 population aged between 15 –– 49 years but with a significant numbers of AIDS orphans (about 49 years but with a significant numbers of AIDS orphans (about 200,000). 200,000).

•• In 2000, Ghana had a prevalence rate of 448 and the death rate of 70 per 100,000 population (all In 2000, Ghana had a prevalence rate of 448 and the death rate of 70 per 100,000 population (all ages)ages)

•• The proportion of the rural population with access to improved water sources increased from The proportion of the rural population with access to improved water sources increased from 40% in 2000 to 46.4% in 2003 and 52.0% in 2005 but guinea worm infestation is high.40% in 2000 to 46.4% in 2003 and 52.0% in 2005 but guinea worm infestation is high.40% in 2000 to 46.4% in 2003 and 52.0% in 2005 but guinea worm infestation is high. 40% in 2000 to 46.4% in 2003 and 52.0% in 2005 but guinea worm infestation is high.

1.5: The CBMS and MDGs in Dangme West District1.5: The CBMS and MDGs in Dangme West DistrictGoalGoal TargetTarget IndicatorIndicator Corresponding CBMS Corresponding CBMS

IndicatorsIndicators

1 Eradicate extreme1 Eradicate extreme Halve extreme poverty by 2015Halve extreme poverty by 2015 Proportion below national poverty lineProportion below national poverty line Average household incomeAverage household income1. Eradicate extreme 1. Eradicate extreme poverty and hungerpoverty and hunger

Halve extreme poverty by 2015Halve extreme poverty by 2015 Proportion below national poverty lineProportion below national poverty line Average household incomeAverage household incomeIncome and Economic activities of Income and Economic activities of household members; household members; Number of household members Number of household members with a job/businesswith a job/business


Achieve universal access to primary Achieve universal access to primary education by 2015education by 2015

Gross Primary Enrolment ratioGross Primary Enrolment ratio Existence of Schools/distance Existence of Schools/distance Educational materials, teachers Educational materials, teachers Elementary enrolment (6Elementary enrolment (6 12yrs);12yrs);

p yp y yy

Net Primary Enrolment ratioNet Primary Enrolment ratioElementary enrolment (6Elementary enrolment (6--12yrs); 12yrs); Secondary enrolment (13Secondary enrolment (13--16yrs); 16yrs); Educational level of household H;Educational level of household H;Household LiteracyHousehold Literacy


Eliminate gender disparity in primary Eliminate gender disparity in primary and secondary education by 2005and secondary education by 2005


Elementary enrolment (6Elementary enrolment (6--12yrs); 12yrs); Secondary enrolment (13Secondary enrolment (13--16yrs);16yrs);

ppAchieve equal access for boys and girls Achieve equal access for boys and girls to SS education by 2015to SS education by 2015

and JSSand JSS

Ratio of females to males in SSSRatio of females to males in SSS

Disaggregated along gender linesDisaggregated along gender lines


Reduce underReduce under--five mortality by twofive mortality by two--thirds by 2015thirds by 2015

Under five mortality per 1000Under five mortality per 1000 Common diseases within Common diseases within communitycommunityyy yy

Child and maternal mortalityChild and maternal mortality

Presence of health workers, Presence of health workers, hospitals, health posts etc.hospitals, health posts etc.

Distance to such facilitiesDistance to such facilities

5. Improve maternal 5. Improve maternal healthhealth

Reduce maternal mortality ratio by Reduce maternal mortality ratio by three quarters by 2015three quarters by 2015

Maternal mortality per 100,000Maternal mortality per 100,000

6. Combat HIV/AIDS, 6. Combat HIV/AIDS, malaria and other malaria and other diseasesdiseases

Halt and reverse the spread of Halt and reverse the spread of HIV/AIDS by 2015HIV/AIDS by 2015H lt d th d f M l iH lt d th d f M l i


diseasesdiseases Halt and reverse the spread of Malaria Halt and reverse the spread of Malaria by 2015by 2015

Reported cases of MalariaReported cases of Malaria


Halve by 2015 the proportion of Halve by 2015 the proportion of people without access to safe drinking people without access to safe drinking waterwater

Proportion of overall population with Proportion of overall population with sustainable access to an improved sustainable access to an improved water source water source Proportion of rural population with Proportion of rural population with

Households with sanitary toilet Households with sanitary toilet facilitiesfacilities

Households with access to safe Households with access to safe waterwaterp p pp p p

sustainable access to an improved sustainable access to an improved water sourcewater source

waterwater


In coIn co--operation with the private sector, make operation with the private sector, make available the benefits available the benefits of new technologies,of new technologies,especially for information and communicationsespecially for information and communications

Telephone lines & cellular subscribers per 100 Telephone lines & cellular subscribers per 100 population & Internet users per 100 populationpopulation & Internet users per 100 population

Availability of Electricity; Availability of Electricity; Telephones, computersTelephones, computers

1.5: The CBMS and MDGs in Dangme West District1.5: The CBMS and MDGs in Dangme West DistrictGoalGoal IndicatorIndicator Findings in Dodowa, Ningo Findings in Dodowa, Ningo

& Prampram& PrampramCorresponding CBMS Corresponding CBMS IndicatorsIndicators

h h ldh h ld1. Eradicate extreme 1. Eradicate extreme poverty and hungerpoverty and hunger

Proportion below national poverty lineProportion below national poverty line Tables 1a & b & 2Tables 1a & b & 2 Average household incomeAverage household incomeIncome and Economic activities of Income and Economic activities of household members; household members; Number of household members Number of household members with a job/businesswith a job/business


Gross Primary Enrolment ratioGross Primary Enrolment ratio Table 3Table 3 Existence of Schools/distance Existence of Schools/distance Educational materials, teachers Educational materials, teachers primary educationprimary education

Net Primary Enrolment ratioNet Primary Enrolment ratio

,,Elementary enrolment (6Elementary enrolment (6--12yrs); 12yrs); Secondary enrolment (13Secondary enrolment (13--16yrs); 16yrs); Educational level of household H;Educational level of household H;Household LiteracyHousehold Literacy



Elementary enrolment (6Elementary enrolment (6--12yrs); 12yrs); Secondary enrolment (13Secondary enrolment (13--16yrs);16yrs);

empowermentempowermentand JSSand JSS

Ratio of females to males in SSSRatio of females to males in SSS

Disaggregated along gender linesDisaggregated along gender lines


Under five mortality per 1000Under five mortality per 1000 Tables 4, 5 and Tables 4, 5 and Fi 1Fi 1

Common diseases within Common diseases within communitycommunitymortalitymortality Figure 1Figure 1Child and maternal mortalityChild and maternal mortality

Presence of health workers, Presence of health workers, hospitals, health posts etc.hospitals, health posts etc.

Distance to such facilitiesDistance to such facilities

5. Improve maternal 5. Improve maternal healthhealth

Maternal mortality per 100,000Maternal mortality per 100,000

6. Combat HIV/AIDS, 6. Combat HIV/AIDS, malaria and other malaria and other


diseasesdiseases Reported cases of MalariaReported cases of Malaria


Proportion of overall population with Proportion of overall population with sustainable access to an improved sustainable access to an improved water source water source Proportion of rural population withProportion of rural population with

Table 6Table 6 Households with sanitary toilet Households with sanitary toilet facilitiesfacilities

Households with access to safe Households with access to safe waterwaterProportion of rural population with Proportion of rural population with

sustainable access to an improved sustainable access to an improved water sourcewater source

waterwater


Telephone lines & cellular subscribers per 100 Telephone lines & cellular subscribers per 100 population & Internet users per 100 populationpopulation & Internet users per 100 population

Table 7Table 7 Availability of Electricity; Availability of Electricity; Telephones, computersTelephones, computers

1.6 Challenges1.6 Challenges•• Rapid population growth exerting pressure on existing resources.Rapid population growth exerting pressure on existing resources.

Sl t f i th d l l l f it iSl t f i th d l l l f it i•• Slow rates of economic growth and low levels of per capita income Slow rates of economic growth and low levels of per capita income resulting in an increase in the absolute number of people living in resulting in an increase in the absolute number of people living in poverty and the attendant problems of increasing ill health (e.g. the poverty and the attendant problems of increasing ill health (e.g. the rising incidence of HIV/AIDS, malaria, TB) and malnutrition. rising incidence of HIV/AIDS, malaria, TB) and malnutrition.

•• Inadequate volume of reliable and timely data for planning and Inadequate volume of reliable and timely data for planning and monitoring of progress, with the resulting difficulty in recording and monitoring of progress, with the resulting difficulty in recording and comparing trends over periods.comparing trends over periods.comparing trends over periods.comparing trends over periods.

•• Weak institutional structures and inefficient coordination, in some Weak institutional structures and inefficient coordination, in some cases, a multiplicity of institutions with overlapping roles and cases, a multiplicity of institutions with overlapping roles and esponsibilitiesesponsibilitiesresponsibilities. responsibilities.

1.7 Prospects1.7 Prospects• Goal 1: Eradication of Extreme Poverty•• The creation of a Ministry for Private Sector Development & launch of the PSIThe creation of a Ministry for Private Sector Development & launch of the PSI

G l 2 hi i l i d i• Goal 2: Achieve Universal Primary Education•• Education reform for 4 Education reform for 4 --1515•• Two years of kindergarten;Two years of kindergarten;•• Six years of primary school; andSix years of primary school; and•• Three years of Junior High SchoolThree years of Junior High School

• Goal 3: Promote Gender Equality and Empower Women•• Girls’ Education Unit in 1997Girls’ Education Unit in 1997Girls Education Unit in 1997Girls Education Unit in 1997•• Appointment of a Minister for girlAppointment of a Minister for girl--child education child education •• The establishment of the Ministry of Women and ChildrenThe establishment of the Ministry of Women and Children´́s Affairs s Affairs •• Cabinet position for the MinisterCabinet position for the Minister••••• Goal 4: Reduce Child Mortality•• More allocation to the Health sector from budget and HIPC More allocation to the Health sector from budget and HIPC •• Implementation of the CHPS & NHISImplementation of the CHPS & NHIS

Prospects (cont’d)Prospects (cont’d)

• Goal 5: Improve Maternal HealthGoal 5: Improve Maternal Health•• Implementation of the exemption policy: Implementation of the exemption policy: •• four antenatal visits and delivery to be improved to includefour antenatal visits and delivery to be improved to include•• obstetric emergencies and lifeobstetric emergencies and life--threatening, threatening, •• pregnancypregnancy--related conditions and related conditions and •• d i i f t t lit i th t f th t h t i hi h td i i f t t lit i th t f th t h t i hi h t•• reducing infant mortality in the parts of the country where poverty is highestreducing infant mortality in the parts of the country where poverty is highest

• Goal 6: Combat HIV/AIDS, Malaria and Other Diseases•• Coordination & support by Ghana AIDS Commission Coordination & support by Ghana AIDS Commission •• St ong media in ol ement s ppo ting a a eness c eation on HIV/AIDSSt ong media in ol ement s ppo ting a a eness c eation on HIV/AIDS•• Strong media involvement supporting awareness creation on HIV/AIDSStrong media involvement supporting awareness creation on HIV/AIDS•• Financial support from Government & development partners against HIV/AIDSFinancial support from Government & development partners against HIV/AIDS•• Extension of the RBM campaign to all districts in GhanaExtension of the RBM campaign to all districts in Ghana••• Goal 7: Ensure Environmental Sustainability• Goal 7: Ensure Environmental Sustainability•• Various Plans and Policies to address the challenges of natural resource management National Various Plans and Policies to address the challenges of natural resource management National

Environmental Action Plan (1990Environmental Action Plan (1990--2000), the National Land Policy etc2000), the National Land Policy etc•• Effective management of urban water to be finalized soon with private sector participation Effective management of urban water to be finalized soon with private sector participation •• Full subsidy on expanded water provision to the guinea worm endemic areasFull subsidy on expanded water provision to the guinea worm endemic areas••• Goal 8: Develop a Global Partnership for Development•• Placing policies and programmes within the integrative frameworks of regional and global Placing policies and programmes within the integrative frameworks of regional and global

networksnetworks

1.81.8 Conclusions and RecommendationsConclusions and Recommendations

•• Trends in some of the indicators (e.g. underTrends in some of the indicators (e.g. under--5 mortality rates, 5 mortality rates, maternal mortality ratios, the prevalence of HIV/AIDS and malaria) maternal mortality ratios, the prevalence of HIV/AIDS and malaria) show weak prospects of achieving the MDGs by 2015 in Ghana show weak prospects of achieving the MDGs by 2015 in Ghana unless major changes take place nowunless major changes take place nowunless major changes take place now. unless major changes take place now.

•• Significant progress has been made in the sectors of education, Significant progress has been made in the sectors of education, health and access to drinking water. If the present trends continue,health and access to drinking water. If the present trends continue,health and access to drinking water. If the present trends continue, health and access to drinking water. If the present trends continue, Ghana could reach the set goals in these areas. Ghana could reach the set goals in these areas.

•• In the specific area of the promotion of women, significant progress In the specific area of the promotion of women, significant progress has been noted in education and literacy However inequalities andhas been noted in education and literacy However inequalities andhas been noted in education and literacy. However, inequalities and has been noted in education and literacy. However, inequalities and discrimination still persist, in particular in access to economic discrimination still persist, in particular in access to economic opportunities, employment and leadership positions in public life.opportunities, employment and leadership positions in public life.

•• However, without significant commitment by government, effective However, without significant commitment by government, effective mobilisation of all stakeholders, it will be difficult to achieve these mobilisation of all stakeholders, it will be difficult to achieve these goals. goals.

1.81.8 Conclusions and Recommendations (cont’d)Conclusions and Recommendations (cont’d)

Gh ’ li i t ti ti l l th i f fGh ’ li i t ti ti l l th i f f•• Ghana’s new policy orientations, particularly those in favour of Ghana’s new policy orientations, particularly those in favour of poverty reduction and promotion of good governance, are important poverty reduction and promotion of good governance, are important indicators of progress and can better be assessed with timely and indicators of progress and can better be assessed with timely and reliable data especially at local level which the CBMS approach reliable data especially at local level which the CBMS approach ffffoffers.offers.

-- stronger commitment from government to ensure the availability of stronger commitment from government to ensure the availability of timely and reliable data to help monitor the progress towards thetimely and reliable data to help monitor the progress towards thetimely and reliable data to help monitor the progress towards the timely and reliable data to help monitor the progress towards the MDGs at the local level MDGs at the local level –– institutionalising a monitoring system like institutionalising a monitoring system like the CBMS which will help provide this information for monitoringthe CBMS which will help provide this information for monitoring

th t th i f l l t i tit ti tth t th i f l l t i tit ti t-- the strengthening of local government institutions to ensure the strengthening of local government institutions to ensure efficiency in resource management and efficiency in resource management and

-- building the capacity of the local communities to ensure theirbuilding the capacity of the local communities to ensure theirbuilding the capacity of the local communities to ensure their building the capacity of the local communities to ensure their involvement in the decision making process. By so doing, they will involvement in the decision making process. By so doing, they will also be equipped to demand accountability from local government also be equipped to demand accountability from local government units, especially for the efficient use of limited local public units, especially for the efficient use of limited local public resources.resources.resources.resources.

GRACIASGRACIAS

USE OF THE CBMS APPROACH IN GHANA - pep-net.org...• Aim im -- acceleratinaccelerating economic growth and overall human development • Emphasis Emphasis -- poverty reduction, education,

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