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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disease prevention are rare. Disease control related to intimate relationships is a subject that is often avoided in this society by health workers and by women and their partners. More than 70 percent of women have not discussed family planning with their spouses; it is unrealistic to expect them to raise the question of disease prevention. The chances of a woman protecting herself against sexually transmitted diseases are exceedingly small. Women’s lack of empowerment makes it unlikely that they will initiate conversations about using condoms, the only method available to prevent the spread of sexually transmitted diseases. The benefit of condom use for disease protection is not yet very usable information for the women of Kayoro village. As mobile health workers gain experience, they may be able to counsel women on how their choices of contraception should be influenced by their own determination of likely reproductive risk. Council research in several countries has shown that women are very capable of making changes and choices that reflect assessment of their personal risk. Giving women a method they could use to protect themselves from sexually transmitted diseases—without their partners’ permission—has been a priority for Council researchers. Clinical trials will soon get under way testing a microbicide women can apply vaginally to assure protection from an array of STDs. The Council is working on two versions: one would prevent, the other permit, pregnancy.
The broad definition of reproductive health also includes the concept of safe motherhood—prevention of maternal mortality associated with pregnancy and child-birth. While maternal mortality rates have plummeted around the world over the past four decades, they are still exceedingly high in the developing world—over half a million maternal deaths each year. In parts of East and West Africa, for example, the risk of maternal death during pregnancy or childbirth is over 1,000 per 100,000 live births. The rate is lower for Ghana, an estimated 740 maternal deaths for every 100,000 live births, but this is still much too high. Research has shown that an important factor in improved maternal health is the presence at delivery of a trained attendant with midwifery skills. In the Navrongo region, conversations have begun on how to immediately recognize an obstetric emergency and treat it, and there is also talk of a motorized tricycle to serve as an ambulance.
Research at the Navrongo Centre suggests that the mechanisms for increasing use of family planning and related services are not the same in this part of Africa as they are in other regions. While important, convenient distribution of contraceptive supplies to meet individuals’ needs will not necessarily be successful in societies where men are dominant and women lack bargaining power. Instead, programs should be designed to foster social legitimacy for family planning in the community by reaching out to groups of men and women, providing program information, and fostering communication.
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