FOREWORD
Ghana’s End Decade Report has been prepared in accordance with guidelines provided by UNICEF Headquarters to globally assess progress of work on the follow-up action to the World Summit on Children held in 1990.
The end decade report serves as Ghana’s input into the preparatory process of the UN General Assembly Special Session on the World Summit for Children scheduled for September 2001.
The report has been prepared by the Ghana National Commission on Children with the support of UNICEF Ghana and Save the Children (UK) Ghana Office with inputs from Government agencies, private sector, civil society and NGOs as well as with the participation of children. It gives an overview of actions that have been taken in the country to achieve the goals and objectives of the Summit Declaration and Plan of Action. Being the first country to ratify the Convention on the Rights of the Child soon after its adoption, Ghana immediately developed a National Programme of Action, which set the framework for the implementation of the goals of the World Declaration and Plan of Action.
The preparation of this report has afforded us the opportunity to determine the situation of the Ghanaian child and assess progress made at the end of the decade and also identify strategies and resources needed for the achievement of further goals in the new millennium.
The report has also brought to the fore, the need to establish public and private sector partnerships at community level, sectoral linkages at national level and global alliances at the international level to address the needs of the Ghanaian child.
It is our expectation that this report will also serve as an input for UNICEF to identify strategies to accelerate progress, tackle existing problems and initiate actions to address emerging issues in order to afford every child the opportunity to develop his or her potential.
Mrs. T. Alberta Quartey
Chairman, GNCC
GHANA’S NATIONAL REPORT
ON
THE FOLLOW – UP TO THE WORLD SUMMIT FOR CHILDREN
- DECEMBER 2000 -
TABLE OF CONTENTS
List of acronyms......
1.Introduction and Background
1.2 Follow-up Actions to the WSC and Preparation of the NPA
1.3 Mechanisms Established for Periodic Review of Progress
1.4 Mid-Decade Review
1.5 Report Submitted under Article 44 of the CRC
2. Process Established for the End-Decade Review
3. Action at the National Level
3.1 Preparation and Implementation of the NPA
3.2 National Plans, Programmes and Policies
3.3 Assessment of National Budgetary Commitments in Support of the Plan Of Action on the Rights of the Child
3.4 Social Mobilisation
3.5 Data Collection, Analysis, and Publication
3.6 Research and Development
4. Specific Actions for Child Survival, Protection and Development
4.1 Implementation and Monitoring of the CRC
4.2 Child Health
4.3 Food and Nutrition
4.4 Maternal Health and Family Planning
4.5 Protection of Children within the Family
4.6 Basic Education and Literacy
4.7 Children in Especially Difficult Circumstances
4.8 Protection of Children During Armed Conflict
4.9 Children and the Environment
4.10 Alleviation of Poverty and Revitalisation of Economic Growth
5. Lessons Learnt
5.1 Key Factors that have Inhibited Progress for Children
5.2 Key Factors that have Enabled Progress for Children
6. The Way Forward
List of acronyms
AIDSAcquired Immune Deficiency Syndrome
ARHAdolescent Reproductive Health
ARIAcute Respiratory Infection
CBRCommunity Based Rehabilitation
CHRAJCommission for Human Rights and Administrative Justice
CRCConvention on the Rights of the Child
CSPSCentre for Social Policy Studies
CWCChild Welfare Clinics
CWIQCore Welfare Indicators Questionnaire
CWSACommunity Water and Sanitation Agency
CWSPCommunity Water and Sanitation Program
DADistrict Assembly
DDPDistrict Development Plans
DHMTDistrict Health Management Team
DHSDemographic and Health Survey
DSWDepartment of Social Welfare
DWM31st December Women’s Movement
ECDEarly Childhood Development
EFAEducation for All – Year 2000 assessment
EU European Union
fCUBEFree Compulsory Universal Basic Education
FGMFemale Genital Mutilation
GAPVODGhana Association of Private and Voluntary Organisations for Development
GESGhana Education Service
GEU Girls Education Unit
GLSSGhana Living Standards Survey
GNCCGhana National Commission on Children
GOGGovernment of Ghana
GWCLGhana Water Company Limited
GWEPGhana Guinea Worm Eradication Program
GWSCGhana Water and Sewerage Corporation
HDSHuman Development Strategy
HIVHuman Immuno Deficiency Virus
ICJCRInternational Club of Journalists on Children’s Rights
ICMMS Infant, Child and Maternal Mortality Survey
IPECInternational Program for Elimination of Child Labour
JSSJunior Secondary School
MCH/FPMaternal and Child Health and Family Planning
MESWMinistry of Employment and Social Welfare
MICSMultiple Indicator Cluster Survey
MLGMinistry of Local Government
MMSWMinistry of Mobilisation and Social Welfare
MOAMinistry of Agriculture
MOE Ministry of Education
MOFMinistry of Finance
MOFAMinistry of Food and Agriculture
MOHMinistry of Health
NACOBGhana Narcotic Control Board
NCWDNational Council on Women and Development
NDFPNational Development Policy Framework
NDPCNational Development Planning Commission
NFEDNon-Formal Education Division
NGOsNon-Governmental Organisations
NPANational Program of Action
NPCNational Planning Commission
ORTOral Rehydration Therapy
PHCPrimary Health Care
RBMRoll Back Malaria
RCCRegional Co-ordinating Council
RESPONSEResponding to the Needs of Street Children
RSGCReport on the State of the Ghanaian Child
SCSave the Children
SHEPSchool Health Education Program
SSSSenior Secondary School
STISexually Transmitted Infection
STMEScience Technical Mathematical Education
TBATraditional Birth Attendant
TFRTotal Fertility Rate
UNDPUnited Nations Development Program
UNFPAUnited Nations Population Fund
UNHCRUnited Nations High Commission for Refugees
UNICEFUnited Nations Children’s Fund
WAJUWomen and Juvenile Unit
WDPAWorld Declaration and Plan of Action
WHOWorld Health Organisation
WSCWorld Summit for Children
1
1.Introduction and Background
1.1 A member of then ruling Provisional National Defence Council (PNDC), Mr. Justice D. F. Annan, headed Ghana’s delegation to the World Summit for Children (WSC) in 1990.
1.2 Follow-up Actions to the WSC and Preparation of the NPA
In 1991, as a follow-up to the WSC and the ratification of the Convention on the Rights of the Child (CRC), a multi-sectoral task force was set up to draw up the National Programme of Action (NPA). The task force included representatives from the following institutions: Ghana National Commission on Children (GNCC), National Council on Women and Development (NCWD), National Development Planning Commission (NDPC), Ministry of Finance (MOF), Ministry of Education (MOE), Ministry of Health (MOH), Ministry of Agriculture (MOA), Ministry of Mobilisation and Social Welfare (MMSW), Ministry of Local Government (MLG), Ghana Water and Sewerage Corporation (GWSC), Secretariat of the Committees for the Defence of the Revolution, 31st December Women’s Movement (DWM)and the Ghana Association of Private and Voluntary Organisations for Development (GAPVOD). The main co-ordinating body, GNCC, provided the secretariat for the task force, with technical and financial assistance from the United Nations Children’s Fund (UNICEF). A group of consultants, under the supervision of the task force, prepared the first draft after which the task force and the consultants provided input for the second and third drafts. Finally, the third draft received inputs from the United Nations Development Programme (UNDP), United Nations Population Fund (UNFPA), World Health Organisation (WHO), and the World Bank before the NPA – ‘The Child Cannot Wait’ was completed in 1992.
1.3 Mechanisms Established for Periodic Review of Progress
A series of planned activities were to take place on a regular basis to institutionalise a continuous process of policy supervision, monitoring and assessment of progress of the NPA. It was planned that information gathered at the grassroot, district, regional, and national levels would feed into one another, culminating in an annual progress report on the NPA. Activities planned included: information dissemination and discussions at grassroot level, annual meetings, monitoring of child related development activities and discussions at public fora at the district level. These interactions would provide data for annual Regional Co-ordinating Council (RCC) meetings. At this level, the RCC’s sub-committee on children would identify areas of success and weakness in implementation, and assistance needed from government. Finally, at the national level, discussions at semi-annual meetings of the Cabinet Sub-Committee would be presented to the Cabinet from which the annual progress report on the NPA would be developed. It was envisioned that this process would take some time to be fully established. A trial run was therefore planned for 1993 and an on-going process to be embarked upon during the 1995-96 year.
In order for the above process to be achieved and maintained, a system for gathering information on monitoring indicators was established within the NPA. The indicators were divided into three distinct categories: input indicators, e.g. budget allocations; output indicators, e.g. immunisation coverage; and impact indicators, e.g. mortality rates which reflect the cumulative effects of programme activities as well as other general socio-economic factors. During the preparation of the NPA, existing information was utilised to develop a baseline on which future progress could be assessed. Where data was conflicting, unreliable, or obsolete it was planned that surveys would be commissioned between 1992 and 1994 to fill the gap. The ongoing monitoring of input and output indicators was planned to be undertaken by the responsible ministry/agency as part of its regular information gathering activities, and emphasis was placed on the integration of communities and districts, into these sectoral monitoring systems. With regard to the assessment of impact, it was proposed that a National Social Survey be commissioned every five years (1996-7 and 2001-2).
The above monitoring indicators were also planned to provide information for two other reporting processes - the mid-term evaluation of the NPA in 1997 and the biennial Report on the State of the Ghanaian Child (RSGC). The GNCC was made responsible for the RSGC. A further review of progress would be an updated 1995 Government of Ghana (GOG)/UNICEF Situation Analysis of Children and Women. This proposed monitoring framework for the NPA related directly to the nine major goals of the NPA, which were also based on the seven major goals for the survival, protection and development of children by the year 2000 outlined in the World Declaration Plan of Action (WDPA). However, majority of the activities and mechanisms planned for reviews of progress did not take place, due mainly to lack of capacity and change of policy emphasis.
1.4 Mid-Decade Review
In 1995, a mid-decade review was undertaken to monitor progress made towards achieving the Mid-Decade Goals. MOH and UNICEF undertook a national survey to assess the status of the goals. The review revealed that there had been mixed success in terms of achieving the mid-decade goals. Many of the indicators in the survey indicated significant rural and urban disparities, with the urban areas having an advantage.
Some success had been achieved in the areas of education, water and sanitation as well as breast-feeding. Basic education improved, with 63% of children of the recommended age entering primary one. The net primary school enrolment ratio increased from 67 in 1990 to 70 in 1995, and the gross primary school enrolment ratio increased from 83 in 1990 to 96 in 1995, with little overall difference between boys and girls. The percentage of people with access to safe drinking water rose from 49% in 1990 to 65% in 1995, and safe sanitary disposal increased from 27% to 32% in the same period. There were increases in the 1988 levels of exclusive breast-feeding (up to four months) from 2% to 19% and timely complementary feeding from 57% to 63%, with continued breast-feeding at 94% in 1995.
However, immunisation coverage of children, with a mid-decade goal of 80% was only 42% in 1995. Tetanus toxoid coverage was 64%, a coverage below the 80% goal. Salt iodisation was significantly low with iodated salt consumption in 1995 at only 0.3%, compared to the mid-decade goal of universal coverage. Knowledge and control of Acute Respiratory Infections (ARI) was also found to be low with only 24% of mothers aware of the symptoms that indicate that a child should be taken to an appropriate health care provider. The use of oral rehydration therapy (ORT) and continued feeding as part of the programme to control diarrhoeal diseases was only 24% as compared to the mid-decade goal of 80%. The proportion of children receiving vitamin A supplements was only 0.2% compared with the mid-decade goal of 80%.
The findings and recommendations of the survey were disseminated with the hope that they would provide policy makers, planners and programme managers with reliable, factual, and up-to-date information on specific areas critical to the survival and development of children.
1.5 Report Submitted under Article 44 of the CRC
The first Ghana Report to the UN Committee on the Rights of the Child (under Article 44 of the CRC), due in 1992, was prepared by GNCC on behalf of the GOG and submitted in November 1995. The NPA was completed in 1992 with a focus on setting up structures for its implementation. The setting up of structures, combined with political changes led to delays in preparation and late submission of the report. The lateness of the first report has led to a rescheduling of all subsequent reports.
The report highlighted various barriers to Ghana’s commitment to children such as certain cultural practices and the high proportion of youth. It also highlighted that despite measures being taken to harmonise national laws with the CRC, for example, child protection laws and provisions in the 1992 Constitution, problems of implementation often occurred due to lack of resources. The report noted that although the GNCC had carried out many activities and taken advantage of events in order to publicise the CRC, these had not made the desired impact. The Ghanaian adult behavioural pattern and traditional attitudes remained major obstacles. Issues of child abuse and discrimination notably food allocation were also focused on. Steps taken to ensure the best interest of children, their right to life, survival and development, and activities implemented to encourage respect for children’s views were highlighted, as were measures taken to ensure civil rights and freedoms for children. Another problem identified was the issue of children having access to inappropriate information, for example, ‘adult films’, due to lack of law enforcement. Concerning welfare service provision for children, legislation on family and alternative care, the problems of unregulated ‘private’ fostering system in Ghana and the increasing number of street children were focused on. With regard to education, the report highlighted the increase in total enrolment and the number of primary and Junior Secondary Schools (JSS), especially in rural areas. However, it also outlined inequalities in educational provision in terms of region, gender, and rural and urban, the decline in per capita spending on education, and the high cost of education for some parents. With reference to health care, the report highlighted the high cost of health care for the poor and lack of facilities for disabled children, and noted that although there was increased provision of health care for children through Child Welfare Clinics (CWC), child health problems were still prominent. The report drew attention to the low levels of water and sanitation provision in rural areas, and stark disparity in provision between rural and urban areas. It also highlighted that despite special protection measures for children in emergency situations, in conflict with the law, or in exploitative situations, problems existed in terms of child labour, sexual abuse and exploitation through customary practices.
The Committee reviewed the report with Ghana’s delegation in May 1997, issuing concluding observations and offering a number of suggestions and recommendations. The committee observed a number of achievements especially, the establishment of GNCC in 1979, adoption of the NPA, development of a new constitution in 1992, which includes specific provisions relating to children’s rights and the establishment in 1992 of the Commission on Human Rights and Administrative Justice (CHRAJ), which is also involved in the crusade for the protection of children. The Committee recognised two principal factors that were impeding the implementation of the convention - the economic situation in Ghana and certain traditional practices and customs, especially with regard to the girl-child.
The Committee went on to outline principal areas of concern. These included the following:- several provisions of the law were incompatible with the principles of the CRC; insufficient co-ordination between government bodies dealing with the welfare of children; weak institutional and financial status of the GNCC; lack of a systematic mechanism to monitor progress in all areas covered by the CRC and limited capacity to collect and process data. Others were persistent discrimination against some groups of children; poor attitudinal patterns despite nation-wide educational programmes on the CRC; use of corporal punishment and the absence of laws prohibiting mental and physical torture; inadequacy of existing laws in protecting "adopted" children; the number of, lack of data on, and violence towards, children living and/or working on the streets; persistence of malnutrition and rapid spread of HIV/AIDS. Others were persistence of traditional attitudes and harmful practices; the right to free basic education not yet fully and equally implemented and other educational problems; difficulties faced by refugee children in securing basic education, health and social services; insufficiency of measures to prevent and combat economic exploitation of children; absence of information concerning sexual abuse; and administration of juvenile justice, violation of children’s rights in detention centres, low age of criminal responsibility and inadequacy of existing alternative measures to imprisonment.
2. Process Established for the End-Decade Review
The End-Decade Review has been co-ordinated by the GNCC. Each of the relevant government ministries and agencies comprising MOH, Department of Social Welfare (DSW), Department of Births and Deaths, Statistical Service, MOE, Ghana Water Company Limited (GWCL) and the Community Water and Sanitation Agency (CWSA) provided data and information on areas relevant to their sectors. Non-governmental organisations (NGOs) and other civil society organisations have made contributions to particular sections of the review. In addition, an analysis of legislation reforms which had been undertaken since the adoption of the NPA, was carried out to establish progress made in that area.