TO
KAYORO
Bringing Reproductive Health to a Village in Ghana
MARGARET CATLEY-CARLSON
POPULATION COUNCIL
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FROM TO KAYORO Bringing Reproductive Health to a Village in Ghana
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In Kayoro: very poor,
isolated, male dominated, and pronatalist The other "Cairo"—Kayoro—is a
settlement located in one of the poorest areas of the world, in northern Ghana close to
the border with Burkina Faso. It is an hour’s rough jeep ride on unpaved roads from
Navrongo, where the Population Council has been working with the Ghanaian government to
study health and related issues since 1994. Navrongo is the only town nearby with
electrification, telephone service, and paved roads. Kayoro is a patrilineal/patriarchal
society headed by a chief, who is paramount along with nine other chiefs. The Kayoro
population is traditional, agrarian, rural, isolated, and impoverished. Over 80 percent of
adults are illiterate. Kayoro villagers are definitely among the one billion people
globally who live on the equivalent of less than $1 per day.
In Kayoro, male dominance is assured by marriage custom and one-third of families are polygynous. Many women marry in their teens and there is a large age difference between spouses. Women are viewed—and view themselves—as the property of males. Domestic power relationships assure male control over family resources and health-seeking decisions; in fact, all decisionmaking abilities are vested in males. Religion is traditional and includes ancestor worship. Soothsayers control the access to ancestors.Of course, only men can consult soothsayers. The society is pronatalist and women have on average more than five children in their lifetime. With high levels of infant and child mortality, about one in four children do not see their fifth birthday. Infectious diseases and diseases of malnutrition are prevalent. Although immunization has had its successes, many can remember measles epidemics that wiped out all of the children within certain families. Children are seen as one of the main purposes of life, essential to carrying on the ancestral lineage. Women without children are seen as being punished by the gods and ancestors. Wifebeating is common, expected, and sanctioned. In such a poor society, can integrated reproductive health and family planning services be made available? Can they reach women who have little or no personal mobility? In such a strong traditional society, where marital and kinship customs diminish the reproductive autonomy of individuals, what kinds of policies are needed to legitimize family planning services? How can women with so little power exercise the reproductive rights Cairo said was their birthright?
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