family planning clinic

Hello,

Today, our sector activity was to visit a family planning clinic about 30 minutes from our homestay village. We have discussed before in sector the various methods of birth control women and men use and the most effective ways to communicate the importance of family planning. This is an issue that is of deep concern to me so I thought I would just share what I have learned thus far about family planning in Ghana.

A few other volunteers and I recently completed a cultural presentation (the topic was up to our choosing) on the process of giving childbirth. During the process of collecting information, we learned that the majority of women are giving birth in hospitals since the national health insurance plan began about 5 years ago. It is a very good plan, with extensive coverage. It is not compulsory to join, but hospitals visits are very expensive without the plan. It is free to give birth in a gov. hospital, whereas it costs about 7 dollars to give birth with a midwife. Midwives are now a last resort and are only used if it is too late to get to the hospital. The overwhelming response we received from the women was that it was much better to give birth in a hospital because "you get more meds." It is interesting to see the contrast between the States, where midwives are gaining in popularity, and Ghana, where Westernization and technology is gaining influence. It made me wonder whether the hospital is actually better or if the perception that hospitals are better is prevalent due to the status given to "the white man" and the U.S.
During this process, we also learned that the birth rate is decreasing in Ghana. Women used to have 10 children and now, at the most, they have four. Of course, this may not be true in the North (with a Muslim influence) and in rural areas. Women did make the connection that though giving birth is free, the children still cost alot of money to raise.

There has been a shift in focusing primarily on the women to educate about family planning. This is because NGOs and the government have realized that men are the power keepers in the families and thus, control whether or not their wives can use birth control. In Ghana, there is a large campaign titled "Real Men Plan Their Families" and I am sure that I will be involved in family planning community activities in Volta. The nurse at the family planning clinic informed us that for women to get a hysterectomy, they must have the consent of their husband. We were quite confused about this because not all women are married and what if the husband is abusive or the marital situation is not good. The nurse finally understood our question and told us that if necessary, another family member can sign as the witness. In Ghana, they have the capability to perform vasectomies, but the nurse told us that she has never known a man to get one done. To Ghanian men, a vasectomy is comparable, in their eyes, to castration.

We also found out that abortion is illegal in Ghana unless the mother's life is in danger. Our Peace Corps trainer told us that many of the Peace Corps education volunteers have had young women die in their classrooms due to botched abortions. Thus it is the same situation that existed in the U.S. before abortions were legal. Women and young girls would still perform abortions, just with bottles, herbal medicines, coat hangers, etc. One of the problems is that young women cannot get family planning without a parent and thus, they do not practice family planning until after their first child or a dangerous abortion.

I am looking forward to working in Tutukpene because one of my primary responsbilities will be working at the District Clinic, working with mothers and children, and working with the youth. Much work to be done!

I will be visiting Tutukpene on Saturday for site visit and will be back for my last few days at homestay on Friday. Then the swearing in ceremony! It is all happening so fast.

tata,
Lindsey