Focal person in Ghana: Beatrice Sarpong, bsarpong@pdaghana.com

2016: Millenium Village Evaluation - Midterm Summary Report

Summary

This report presents the midterm findings from an impact evaluation of the Millennium Villages Project (MVP) in northern Ghana. The MVP has been designed to demonstrate how an integrated approach to community-led development can translate the international Millennium Development Goals into results.

​This is the midterm report based on the third survey round of household data (2012, 2013 and 2014), complemented by additional qualitative studies (reality check approach, interpretational lens or participatory rural appraisal study and the institutional analysis). This evaluation uses a mixed methods approach to impact evaluation, founded on a difference-in-difference design that compares changes in outcomes in the MVP areas before implementation to post-implementation, with changes in the same outcomes for an explicit control group (split into nearby and faraway controls).
Key findings:

  • Overall, the quantitative analysis finds that the project had moderately positive impacts at the midterm. The project has not yet had a sizable impact on the MDGs but several impacts are visible on other indicators of well-being. 
  • For the most part, the PRA study findings align with those of the statistical analysis, with the MVP communities appearing to show some marginal movements in (self-perceived) well-being, and no substantive reduction in poverty.
  • The RCA study, among other things, also highlights how people’s aspirations to leave farming and their need for reliable cash incomes calls into question some of the underlying assumptions behind the MVP’s means of addressing poverty. People are increasingly concerned about the unpredictability of the climate (particularly, late rains), high costs of inputs, declining soil fertility and risks; they also talk about the increasing need for cash – in contrast to a largely cashless situation observed in 2013. 
  • In terms of the institutional assessment, district officials in the three project districts appreciate what has been achieved so far under MVP, but at the same time they are concerned about the sustainability of the various initiatives when the project comes to an end.

2015: Adolescents’ Views on Sexual and Reproductive Health in Ghana’s Brong Ahafo Region

Summary

The DFID-funded Ghana Adolescent Reproductive Health Project seeks to improve adolescent reproductive health choices in Ghana’s Brong Ahafo Region (BAR). This Reality Check Approach (RCA) Study was undertaken during July-September, 2015 to provide insights into adolescents’ perceptions, attitudes and behaviours around sexual and reproductive health (SRH), based on the perceptions of adolescents themselves. 
Youth identify the parts of their bodies they like most. 
Wide range of contraceptives on display in a village drugstore.
Handwritten on a board in the urban slum.
Key Findings:
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  • Sexual activity among youth: Sexual activity in BAR is high and starts in early teens. Youth are very open to talking about sexual issues and there is no basis to suggest that talking about sex will encourage increased sexual activity.
  • Age of consent and messaging about safer sex: Clear information which is neither advisory nor moralizing needs to be provided on risks of early sexual activity, the need for safer sex and contraception, informed choice for induced abortion.
  • Reducing the financial motive for transactional sex: Innovations such as education loans targeted to particular times in the education calendar may obviate the need for girls to engage in sex for money and other support.
  • Information on correct use of contraceptives key: Contraceptive access is easy (and mostly through drugstores and dispensers) although knowledge of how they work may be sketchy especially among younger middle class. Contraceptives are used primarily to avoid unwanted pregnancies.
  • Information about STIs lacking: Generally, there was very poor understanding of STI infection routes, prevention, cure or long term consequences (especially among the middle class youth). This should be addressed with clear factual information. Even though readily available, condom use is low mainly because it is still perceived as diminishing pleasure. Use of condoms are not seen generally as a means to protect against STIs.
  • Information, advice and assistance for safe abortion: Unwanted pregnancies are prevalent across locations, and induced abortions are commonly sought. Most youth are not aware that induced abortion is legal under certain circumstance under Ghanaian Law; this lack of awareness inevitably results in unsafe practices. This suggests that there is a need to provide information about induced abortion choices, assessment of risks associated with unsafe abortion and abortion counselling services
  • Emphasise the costs of raising children and youth lifestyle in delaying pregnancy: The desire for small families and recognition of the costs of bringing up children can be capitalized on to promote contraceptive use, as well as promoting youth as a time to be cool and have fun.
  • Using the internet and popular television for adolescent SRH messages Information sourced online or through television is most trusted. Access to internet and social media is increasing and should probably be the mainstay of information dissemination. Advertisements and popular television dramas which incorporate factual information for young people to make their own choices are likely to be effective
  • Peer to peer support and education processes which emphasise informality and street credibility: Information needs to be promoted through peers or through informal means in the youths’ own spaces. Religious and traditional leaders are not regarded as sources of information although they may help in some personal crises. Where information is provided in formal settings or in the form of advice or with implied judgement it is unlikely to be valued or accessed. Posters, billboards, or other printed material such as calendars are largely unnoticed by the young. .
  • Emphasise youth friendly facilitation and approachability rather than fixed centres for youth friendly services: Gossip and stigma are widespread and prevent young people from seeking formal service provision where they might be seen by others or have to queue/wait for services. For services to be ‘youth friendly’, providers will need to reach out to youth in their own private environments and through other private means, such as online or through mobile phone technology.

2014: Millennium Villages Impact Evaluation, Baseline Summary Report 

Summary

This report presents the baseline findings from the Department for International Development (DFID)-commissioned impact evaluation of the Millennium Village Project (MVP) in Northern Ghana.

The evaluation uses a mixed methods approach to impact evaluation. RCA used to get better understanding of how the MVP affects the realities of people as well as captures any unintended consequences.

Chatting whilst pounding maize together
Key findings:
  • Participation: The baseline revealed a prevailing feeling that individuals feel they have no influence at all on local decisions and distrust ‘deals made between our chiefs and outsiders’. Concerns were voiced around individuals feeling they were only perceived as ‘vote banks’ during election periods and were cynical about the possibilities for positive change having experienced many promises of development broken.
  • Subsistence living: The RCA challenged existing rhetoric about the dignity of subsistence farmers and the need to preserve their livelihood, with the study families predominantly saying they are ‘fed up with farming’. There was an underlying recognition that waged employment or reliable self-employment reduces the stress and tension associated with the increasing riskiness of subsistence farming and also provides the liquid income required for living in increasingly commoditized communities.
  • Access to services: The study showed little participant faith in public services, suggesting much more innovative and local efforts are required. Within a health context the time, effort and costs associated with availing government health facilities meant that many did not consider using them unless they live nearby or ailments are considered ‘very serious’ or ‘critical’.
  • Family planning: counter to previous RCA studies in other locations; the study revealed that family planning was not an issue for many poor people in the participating households; there was a strong sense that women wanted to have big families. They also pointed to social pressure and that they would be teased if they space their children or be accused of being infertile if they have few. Notably the poorest and most remote village had the highest level of births and most rapidly expanding population.
  • Education: Whilst there was strong suggestion of motivation among all the participating families to send their children to school regardless of gender, there was also evidence of a pragmatic approach to investing in those with academic potential whilst recognizing that a traditional ‘academic’ focus may not be the best path for all children.
  • General change: conversations during the Reality Check indicate that the younger generation are general inclined towards a more material life than their parents. Phones, clothes, Chinese motorbikes, hair and make-up were universal aspirations among youth and children and the desire for waged employment is seems clearly interlinked with this. In all areas the pace of change is accelerating.