Serve_Health&Sanitation-Report

HEALTH & SANITATION REPORT - NOVEMBER 7, 2015 1
Health & Sanitation Project Report
Investing in Solutions
11/7/15

Written by Ernest Armah
Edited by Pauline Anaman
Table of Contents
I. SERVE Global....................................................... 3
II. Foreword................................................................ 4
III. Blood Donation Exercise ...................................... 6
IV. NHIS Registration ................................................ 7
V. Reproductive Health Counseling.......................... 9
VI. Community Health and Sanitation Durbar .........10
VII. Conclusion & Appreciation..................................11

SERVE Global
SERVE Global is a non-governmental, non-partisan, not-for-profit organization on a mission to
drastically improve the socio economic development of disadvantaged persons in society
through research, advocacy and direct interventions. SERVE is an acronym for Service for
Empowerment.
SERVE seeks to achieve true, replicable and scalable results by addressing pressing issues at the
micro-level whilst sustaining advocacy at the national level in the areas of education,
governance, psychological well-being and human development. It also conceptualizes and
executes direct intervention programs to tackle community challenges.
Most of SERVE’s direct intervention programs are geared toward youth empowerment and
community development. This year, SERVE conducted a free mental health exercise for farmers
at Narhman, a peri-urban community in the Ga East district of Accra in partnership with Korle-Bu
and Pantang Psychiatry units; awarded scholarships to four brilliant but needy students and
distributed over 65 books and stationary materials to adolescents and youths to promote
reading.

Foreword
0 percent of maternal deaths are due to lack of blood. During an interview on Multi
TV’s current affairs show PM: Express of August 2011, Mr Tetteh Carboo, Manager of
Donor Services at the Korle-Bu Blood Bank said that “Ghana has never achieved a 50
percent voluntary blood donation status, with the percentage fluctuating between
28 and 45 percent despite other African countries like Rwanda, Zimbabwe, Uganda
and Togo having achieved 100 percent status. Ghana is only able to collect 40,000
units of blood hovering around 100,000 units annually.” 1
On January 10, 2014, the Korle-Bu Teaching Hospital issued a statement to the effect that the
“current stock level (of blood) stands at sixty-two (62) processed units of blood, against the daily
requirement of two hundred (200) units of blood needed to serve the over 50 hospitals in the
Accra catchment area”.2
Availability of blood and its components is crucial for the survival of expectant mothers,
accident victims, children and patients scheduled for surgical operation. Since blood cannot be
artificially substituted and is constantly in demand, it requires frequent donation.
Unfortunately, most Ghanaians hardly donate blood. Dr Paul Mensah, Head of the Korle-Bu
Blood Bank laments that the unavailability of blood in the bank is explained by the reluctance of
Ghanaians to donate.3 Whilst we drag our feet and refuse to help out, patients in critical
conditions requiring blood transfusion including expectant and nursing mothers are left at the
mercy of luck.
We can reverse this phenomenon of apathy to blood donation. The myths, fears and religious
barriers preventing people from donating can be supplanted by a constant, unwavering
appeal emphasizing our common humanity and vulnerability; and the need to be our brother’s
keeper. We should reach a point where the decision to donate blood should be informed by an
overwhelming, abiding, moral and civic consideration for the collective good; not financial gain
and vested interests. In addition, we also have to sustain investments in primary healthcare. We
have to keep influencing people to take their health seriously by getting the right medical
information and treatment closer to them. These are social actions we can effectively execute
as a collective.
Aside the blood donation exercise we undertook, we embarked on a mission to register over 100
kids to the National Health Insurance Scheme (NHIS). This decision was informed by a desire to
ensure that healthcare reaches the unreachable. This was indeed ambitious and we were keen
1 50% of maternal mortality due to lack of blood for
transfusionhttp://edition.myjoyonline.com/pages/news/201110/74774.php
2 Blood shortage hits Korle-Bu http://www.modernghana.com/news/513054/1/blood-shortage-hits-korle-bu-blood-
bank.html
3 Ghanaians lack the culture of donating blood. http://myjoyonline.com/news/2014/January-23rd/ghanaians-lack-the-
culture-of-donating-blood-head-of-blood-bank.php
5

on making sure that the right people benefit. Thus, we were shrewd with the selection of
beneficiaries through need assessment and verification measures.
This report also includes a reproductive health exercise we conducted for adolescents and
youths in the La community. The tractability of Interventions meant to reduce teenage
pregnancy and parenthood, unsafe abortions, Human Immunodeficiency virus (HIV) and other
Sexually Transmitted Diseases (STDs) infections hinges on the approach used. The campaign to
persuade young people to hold fast to abstinence should not blind us to other realities on the
ground.
Finally, our durbar on health and sanitation in the community was necessary in light of the recent
cholera outbreak. The over 200 deaths recorded across the 10 regions of the country as a result
of the outbreak was preventable. We do not want a repeat of that.
Our health and sanitation report essentially focuses on the investments we are making in
solutions to social problems. It spells out the strategic partnerships we forged to achieve our
objectives as well as details of our interventions in the La community.
Ernest Armah
Founder & Director, SERVE Global

Blood Donation Exercise
ur primary motivations for organizing the blood donation exercise were two-fold. We
were poised to promote and encourage a culture of volunteerism, selfless service, and
participation in community development. Also, we wanted to align these intentions to
a collective, tangible, solution-focused activity. The objective to get several pints of blood to
support pregnant women, accident victims, children and other patients scheduled for surgical
operation is tangible, solution-focused and requires a collective effort.
We mobilized the youths in the La community for this purpose through engagements with youth
associations, religious and political leaders, professional groups and other non-governmental
organizations (NGOs). For some youths, this was their first time of donating blood and thus, they
were initially held back by fears of bleeding, having a swollen arm, extreme weakness, getting to
know a troubling health status and risk of sexually transmitted diseases (STDs). These fears were
effectively assuaged by personnel from the Korle-Bu Blood Bank, our partners in this exercise who
explained the processes involved and the underlying justifications thereof.
Close to 60 people turned up to donate. But some were reckoned ineligible at the testing phase
due to medical and precautionary considerations such as body mass index (BMI), high blood
pressure, no intake of breakfast, and intake of alcohol.
The goal of this exercise was to replenish the blood unit of La General Hospital which is short of
blood especially O+. Since they lack the necessary equipment and logistics, we had to invite the
National Blood Bank from Korle-Bu to conduct the exercise.
A participant about to donate blood
O

NHIS Registration
he National Health Insurance Scheme (NHIS) was conceptualized to ensure equity in
healthcare coverage by giving access to the poor and vulnerable in society to healthcare
services and protecting them against financial risk.4 But the poorest of the poor find it
difficult, if not impossible, to get on the scheme in the first place. And those who have, struggle
to renew their membership every year. Though some fall in the category of indigents, they are
not under the Livelihood Empowerment against Poverty (LEAP) programme which exempts
indigents from the payment of card processing and renewal fees.5
NHIS registration: Some parents and guardians requesting for registration forms for their wards
It is this background knowledge and understanding which informed SERVE’s decision to put 100
(we actually had 103) children, aged 0-17 years, from indigent families on the NHIS. We ensured
that this intervention went to families who really need it and had a coupon system in place to
prevent persons outside the target groups. We however accommodated about three who were
victims of parental irresponsibility.
To identify indigents in the La community, we consulted faith leaders and family heads. These
are persons who frequently interact with diverse members of the community and can
competently differentiate those in need from those in want. We evaluated the authenticity of
lists provided us by seeking the opinions of persons living in close proximity to potential
beneficiaries. Due to time constraints, we undertook this activity randomly. It is worth stating that
4 National Health Insurance Authority (NHIA). http://www.nhis.gov.gh/nhia.aspx
5 Membership of NHIS. http://www.nhis.gov.gh/membership.aspx
T

the evaluation was a good, not perfect, attempt to deliver this intervention to the poorest of the
poor.
We had a total of 103 beneficiaries for the NHIS intervention. Approximately 50% were females
followed by males with 44%. The distribution of females across the various age cohorts are nearly
even; 31.4% are between 0-5 years, 35.3% and 33.3% are between 6-11 and 12-17 years
respectively. The distribution across the cohorts in the male category are, on the contrary,
relatively wide. 21.7% are between 0-5 years whilst 45.6% represent 6-11 year olds and 32.6%
represent 12-17 year olds. The sex of six beneficiaries were unspecified as these persons
registered without filling our tracking form.
Year 0-5 Year 6-11 Year 12-17 Total
Female 16 18 17 51
Male 10 21 15 46
Not Specified 0 3 3 6
0
10
20
30
40
50
60
Numberofbeneficiaries NHIS Beneficiaries by Age & Gender

Reproductive Health Counseling
ccording to the 2013 HIV Sentinel Survey Report, 224,488 persons made up of 189,931
adults and 34,557 children are living with HIV in Ghana. The report showed a decrease
for all the age groups except for 15-19 (0.8%) and 45-49 (3.3%).6
In a culture where parents hardly educate their children on sex coupled with an era of risky
lifestyles, an avenue for a frank and educative discussion on sex cannot be overemphasized.
Through support from the Planned Parenthood Association of Ghana (PPAG), we were able to
educate adolescents and youths of La on their sexual reproductive health with the objectives of
promoting healthy lifestyles and preventing sexually transmitted diseases (STDs).
Specifically, participants were taken through the dangers of unprotected sex, various forms of
STDs and how they can and cannot be acquired, and use of contraceptives such as male and
female condoms. Close to 1,500 male condoms (140 in a box) were distributed.
A participant going through reproductive health counseling
6 Ghana Aids Commission HIV Sentinel Survey Report. http://ghanaids.gov.gh/gac1/aids_info.php
A

Community Health and Sanitation Durbar
n 2014, Ghana experienced its severest cholera epidemic in three decades, which registered
28,975 cases with 243 deaths from 130 out of the 216 districts in all 10 regions”, reports
Ghanaweb on June 22, 2015.7 That tragic incident remains a constant nudge to educate
communities on personal hygiene and sanitation. It is also crucial to streamline water, sanitations
and hygiene (WASH) interventions in the various communities.
SERVE partnered with Hope for Future Generations (HFFG), a community based NGO with focus
on women and children’s wellbeing to educate the community on sanitation and create
awareness about WASH interventions being implemented by HFFG.
One of such interventions is water access sanitation and hygiene urban poor (WASH-UP) project
sponsored by the United States Agency for International Development (USAID). Among the
activities of WASH-UP is the construction of household and public latrines at affordable prices
and promotion of hand-washing with soap.
A Representative from LADMA explaining HFFGWASH projects
7 Background of HFFG USAID program. http://www.ghanaweb.com/GhanaHomePage/NewsArchive/Gov-t-puts-in-
measures-to-contain-cholera-outbreak-363755
I

Conclusion & Appreciation
ife’s most persistent and urgent question is, “what are you doing for others”?, says Martin
Luther King Jnr. of blessed memory. Some people want to answer this question but they
do not know how. There are people who are constrained monetarily or logistically. Others
crave for a platform that will give them the opportunity to volunteer and make a
difference. Nothing truly satisfies the human heart than a positive impact in the lives of
people.
On Saturday, November 7, 2015 at the forecourt of La Presby church, we gave those who are
constrained resource-wise and those seeking an avenue to make a difference, the opportunity
to answer the question, “what are you doing for others”. Through their participation in the blood
donation exercise, NHIS registration for over 100 children from 0-17 years, reproductive health
counseling, and community health and sanitation sensitization, they answered the question.
SERVE owes the success of its direct interventions to strategic partnerships at the community
level. Making formal and informal groups in the community co-authors of a change story is
essential to the delivery and sustainability of our interventions as it ensures active participation
and ownership. And our determination to scale up our success stories makes us relentless agents
of development.
We cannot thank you, the individuals, who support us well enough. Our projects spring to life
through your generosity and belief in our determination to positively influence lives. Through your
support, a child coming from a poor family can now receive medical attention at the hospital
when sick. Through your support, we are able to raise the quality of living of persons who would
have otherwise being confined to the lowest rung of the socio-economic ladder. Through your
support, we are able to research on the most rewarding implementation designs to deliver
enduring interventions to communities.
But we aspire to do more. More support and strategic partnerships along lines of mutual interest
will propel us to attempt some of the intractable challenges in our society. Service in the best
interest of humanity per se is not enough. We need to take a step further to empower people in
the head, heart and hand to be instruments of change within their circle and the rest of society.
Though we implement in communities, we focus on people. No noble, collective social action
can endure in the absence of determined individuals to invest, nurture and defend it.
L

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