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Impact of Alcoholism with Persons Living with HIV in Ghana

Impact of Alcoholism



The high level of stigma and discrimination experienced by people living with HIV/AIDS can be attributed not only to prejudice among family members and community members, but also to some hospital staff.

Previous studies have shown that attitudes of some hospital staff towards people living with HIV/AIDS are influenced by fear and misconceptions about HIV transmission. Because of this there is inadequate awareness and practice of procedures to ensure staff safety against contracting HIV/AIDS.

This, to some extent, is increasing the rate of stigma and discrimination on the part of people living with HIV/AIDs(PLHIV) which has made some of them resort to dangerous activities such as alcohol abuse. Such abusive behaviour has claimed the lives of two clients within the Ga East Municipality of Ghana, and steps must be taken to ensure the same tragedy doesn’t happen again.

AFAWI Ghana aims to address the challenges faced by PLHIV as a means of understanding their plight. Only then can we effectively alleviate their struggle and curtail the problem.





This concluding chapter shows the summary of the main findings of the study and conclusions drawn from those findings. Recommendations are also expressed by the researcher based on the findings from the study.



  • Females are more vulnerable to the HIV/AIDS pandemic in the Ga East municipality than males (research demonstrated 90% female response rate versus 10% male response rate). This reaffirms assertions made by (W.H.O), World Health Organization and other social activists on HIV/AIDS.

  • The research also revealed that PLHIV are faced with stigmatization and suffer from discrimination from family members and hospital personnel. 64% report being discriminated against by family members, while 23.3% report feeling mistreated by hospital personnel.

  • PLHIV within the municipality resort to dangerous behaviors such as alcoholic intake when faced with discrimination.

  • Organizations that deal with PLHIV/AIDS within the municipality are also faced with some form of challenges- ranging from difficulties in raising money for programs to staffing problems.


Finally, the above findings prove that the hypothetical questions (statements of problems) in chapter one are true.


Building on the primary research described above, AFAWI launched a supplementary research program with the intention of identifying the familial and societal problems resulting from the stigmatization of Persons Living with HIV/AIDS. In particular, AFAWI sought to measure the extent to which Persons Living with HIV/AIDS were denied equitable access to healthcare services as a result of discrimination by medical personnel.



Stigma and discrimination negatively impact every aspect of the preventive-care-treatment continuum and greatly increase the suffering associated with HIV/AIDS pandemic. The case studies detailed here demonstrate some success in tackling stigma, discrimination, and the abuse of human rights. It also reveals evidence of real innovation when it is adapted to local circumstances and needs. Ongoing evaluation and documentation remain important.

Everyone should try to put measures in place in tackling HIV related stigma, discrimination, and human rights violations against PLHIV. Effort to do this will go a long way in slowing the impact of the pandemic in Ghana and the world at large.



The following procedures are recommended for curtailing the numerous challenges people living with HIV/AIDS are facing:


In relation to stigmatization, there needs to be media-directed efforts aimed at increasing tolerance and understanding towards PLHIV. This may include:

  • Improving the quality of life for people living with HIV through integrated care, including home-based care

  • Mobilizing religious leaders to foster respect and compassion for people living with HIV

  • Addressing broader inequalities through participatory education

  • Creating a supportive and confidential space for the discussion of sensitive topics

  • Providing comprehensive HIV treatment and AIDS care, including access to anti-retroviral therapy

  • Empowering people living with HIV to take the lead in diverse support and advocacy activities

  • Mobilizing community leaders to encourage greater openness around sexuality and HIV related issues within communities by building on positive social norms

  • Raising awareness of discrimination against PLHIV through the media.

  • Measures must be put in place within institutional settings to reduce discrimination—specifically workplaces and health services in order to de-institutionalize stigma and discrimination. This may include:

  • Mobilizing the health services to implement non-discriminatory policies.

  • Improving the quality of care for patients living with HIV through participatory work with health-care managers and providers.

  • Improving the quality of life of employees living with HIV through access to integrated care and the implementation of non-discriminatory workplace policies.

  • Promoting understanding about AIDS through the education of managers and employees

  • Ensuring that cases of discrimination are addressed and dealt with


The above recommendations will help reduce the stigma and discrimination that plague PLHIV. Promoting a more informed and nurturing environment for PLHIV will alleviate some of their hardships so they can lead happier and healthier lives.

Domestic Violence and Marital Rape in Ghana

Anchor 1

Domestic violence and marital rape affect women worldwide, however these issues are almost invisible in Ghana’s society and culture. The subject is taboo and victims are marginalized. Few organizations have published research on the subject and the media doesn’t report the daily occurrences of gender based violence.

Alliance for African Women Initiative (AFAWI) researched domestic violence and marital rape among women working in markets in the Greater Accra area. AFAWI surveyed over 500 women and over 100 men, held focus groups, and conducted interviews in order to obtain both statistical results to establish trends and in-depth qualitative information. 

Research report posted soon.

Financial Prudency and Effective Financial Management and Budgeting with Sixteen HIV Associations in Ga East District Ghana

Anchor 2

Prepared by Felicia S. Odame (Lecturer, University of Development Studies, Wa Campus)

Sponsored by Open Society for West Africa (OSIWA)


There needs to be increased transparency and prudence in the financial management of various PLHIV Support Associations. Funding agencies have increased their complaints of the inefficient financial and project management by People Living with HIV (PLHIV) Support Association in the District and have decreased funding to these vital groups. As a result, support associations have not been able to carry out their objectives. This has affected their clients (PLHIV) who are vulnerable in society and need constant care and counseling.

Also there has been an increased demand for the Persons Living with HIV/AIDS Support Association in Ga East District. It is imperative that the associations equip themselves with necessary information and skills so they are able to carry out projects and programs as effectively and efficiently as possible. But the associations also need to make sure that the funds received from funding agencies and donor partners goes to their clients (PLHIV). This survey will also give us insight into the problems and show us to where to focus the training. It will give us a baseline to measure progress before and after new techniques are implemented.


This section summarizes the major findings of the study and demonstrates the link between financial prudence, level of knowledge of financial prudence, financial management, level of budgeting, and impact on the implementation of projects in PLHIV Support Associations.

  • Financial prudence, accountability and management are key to the growth and development of NGOs. The study involved PLHIV Associations in the Ga East District of the Greater Accra Region. The study revealed that all the organizations were established after 2001; they are young with majority of them still struggling to find their feet and grow.

  • 61.5% of the organizations do not have staff with formal financial training. This possesses a big challenge to smooth running of their organizations and has made it difficult for them to win the confidence of donor organizations to be able to attract funds for their projects. Budgeting, auditing and good reporting are quite technical and requires formal training. But the organizations are still struggling to grow and are unable to engage the services of people with the requisite qualifications.

  • Although 92.3% of the organizations appear to understand the requirements of donors, they are unable to tailor their proposals in ways that would win donor support. This again boils down to the issue of qualified staff.

  • 70% of the organizations agreed that funding to PLHIV support groups has been decreasing and attributed it to the following:

    • Lack of adequate transparency and trust

    • Poor reporting on the part of support groups

    • The proliferation of fictitious PLHIV support groups

    • Leaders of the groups not being fair to their members.


Good project management skills are necessary for the effective implementation and sustainability of projects. However the study revealed that 53.8% of the organizations do not have staff trained in project management. They indicated to the researcher that they are able to manage their projects because of knowledge they have acquired during workshops.


  • Organizations should make staff development a major component of their strategy. This will encourage associations to budget for training of their staff in vital skills such as financial management, proposal writing, auditing and project management. It will go a long way to improve their activities.

  • The organizations should network with others to enable collaboration in their activities. This would enhance their activities.

  • Donors should consider building the capacities of their clients’ financial management before giving out funds. If donors are interested in a particular project they should budget for equipping the staff with vital skills for the project before releasing the funds.

  • Each organization should prioritize networking as a means of providing support services and rapidly assimilating and disseminating new information.

  • The organizations need to increase collaboration with government services to facilitate regular consultation.

Sexual Menstruation and Menstrual Management Practices Associated with Schools Girls in Ghana

Anchor 3


Since independence, successive governments in Ghana have pursued educational policies aimed at universal basic education for all citizens. These policies have moderately increased enrollment and educational participation. The quality of information pupils gain equip them with knowledge and tools with which they can plan their future even while they protect themselves from debilitating and fatal conditions such as early marriages and unwanted infection including HIV/AIDS.


Adolescence is a relatively short and transitional stage in which a child develops into and takes on roles of an adult. It is necessary to continually study and discuss the current youth's life experiences and their emerging problems related to puberty and maturation. For many reasons female adolescents are more vulnerable than any other and are biologically more susceptible to STls such as Chlamydia and gonorrhea that could facilitate the transmission of HIV (M. Asachzzon Khan 2002)

The needs of adolescents are unique and pressing but should not be considered and addressed in isolation. Their needs should be integrated into the center of family care, the resources of school and the community, and the training of health providers. All of these institutions should be sensitized to be generally sympathetic to the youth, especially the girl child.


Apart from the Government, international organizations and non governmental organizations have made it their priority to improve the quality of education and ensure access for girls and women by removing obstacles that hamper active participation. This has moderately increased enrollment particularly at the basic level but the issues of equity, retention, and participation have remained unresolved in higher levels. The gender gap widens from primary school through secondary and tertiary education and there is insufficient information about various aspects of a growing child's life (home, school, social clubs, and media) to determine the cause.


Researches have revealed that the gender gap in education is caused by many factors. In addition to poverty, which affects girls more than boys, there are social, cultural and economic factors that prevent girls from getting to school or cause them to be pushed out from school. A research conducted by FAWE Ghana (2001) revealed that one major constraint of girl-child education is the onset of menstruation because of abdominal pains, fear of soiling themselves, change in mood, and lack of appropriate toilet and water facilities.


Puberty and adolescence can be a challenging time for many girls. In most societies menarche is an indication of a girl’s developing sexuality. Johnson (2005) noted that in Western societies it is argued that society conveys conflicting messages about menarche: the beginning of womanhood sexuality, and the discouragement of sexual activity for young girls. In many societies, family and immediate community traditionally provides young people with information and guidance about sex and sexuality. In Ghana information about sex used to be formalized as part of initiation into adult roles in many ethnic groups. But in many parts of the developing world, including Ghana, recent rapid urbanization and migration have meant that families and community networks have become more widely dispersed. This may have impacted sexual socialization and education as well as on the sexual behaviors and sexuality of young people. The effectiveness of traditional family expectations and structures in shaping sexual beliefs expectations and behavior appear to have been substantially weakened with little continuity in sex education within the family and the community.


In Ghana, girls who reached menarche used to be instructed by their mothers and other females in the community in behaviors and taboos associated with menstruation. Queen mothers in the community were responsible for conducting the girls throughout puberty rites involving education in hygiene and marriage.

Menstruation is a natural event throughout much of woman’s life, yet it is a topic which is seldom openly discussed. Many women lack sufficient or accurate knowledge about it and often have misunderstanding and mistaken beliefs that have been passed on by family and communities. Many women do not understand the purpose of menstruation and what happens in their bodies during menstruation.


In-depth studies by population report (2005) found that the adolescents’ knowledge of fertility and menstruation are very poor in many countries, including Ghana. For example in Dakar, Senegal, two thirds of adolescent girls and boys aged between 15 and 19 could not identify the mid point in the menstrual cycle and the time when a woman is most likely to get pregnant. (Pop. Report 2005). In lle, Nigeria, some 40% of school girls surveyed did not know the cause and meaning of menstruation. The report further indicated that among school girls ages 12-17 in Tamil Nadu, India more than half of girls who used old cloth, napkin or only their undergarments as a menstrual product washed them only once or twice a day rather than the recommended four or five times a day. Much of what these girls had learned concerned restrictions to their mobility and behavior during menstruation and superstitions about they being ‘polluters’ of the environment.


Social change has broken down most of these social structure and studies on sexual maturation and menstrual hygiene management among school girls in Ghana. Studies elsewhere also revealed that adolescent girls have very little information about menstruation before they experience their first menstruation and this ignorance leads to worry, shyness, embarrassment, and nervousness. The study also showed a lack of adequate education about the hygienic management of menstruation and a lack of provisions for facilitating the disposal of menstrual materials. This situation is worse among rural communities in the country where information is more difficult to obtain.



Women make up about 51% of the population of the world according to the Population report (2005), contribute two-thirds of all work hours, and raise almost all of the world’s children. Educating girls lead directly to better family health, economic growth and lower rate of child mortality and malnutrition.

In other words education of girls is a simple and attainable strategy that helps overcome poverty. Education is a right for these girls. Girls as well as boys are encouraged to enroll in school, however studies show girls are at a disadvantage when it comes to retention and performance. One of the many causes of this gap is menstruation and menstrual management practices.

Recently, girls have been reaching menarche at an earlier age. In the past, girls were educated about menstruation through existing social structures, but with the changing environment girls are left to their own fate. Lack of adequate information for these girls, especially those of the rural areas, leave many girls frustrated. They often find their own solutions for managing their menstrual cycles, which are often not adequate. Most of these girls end up dropping out of schools. This raises some questions such as:

  • Is it the family ties that are breaking apart?

  • Why is the community not doing its work through the queen mothers?

  • Is the school curriculum not teaching girls sex education?

  • What are policy makers doing about these pressing issues?


It is on this note that Alliance for African Women Initiative (AFAWI Ghana) collaborated with other NGOs like FAWE Ghana , Ministry of Women and Children’s Affairs, Ghana Integrity Initiative with funding from Mama Cash Fund For Women. AFAWI conducted this research in three regions of Ghana: Brong Ahafo, Northern, and Upper East regions. AFAWI wanted to find out where the problems lie so we can team up with advocates, stakeholders, and government policy makers to find lasting solutions to the problems of menstrual and sexual management in society.



The study was both qualitative and quantitative and used both primary and secondary data. The primary source was solicited from school children, teachers, educators, opinion leaders via semi structured interviews and key informant interviews. Secondary data was gathered from journals, text books, magazines, newspapers, television news, internet, and past project documentations.




This section summarises the major findings of the study. This includes the relationship between the respondents’ demographic characteristics and sexual maturation and menstrual management practices; the knowledge of respondents about menstruation, traditions ,and customs and its relationship with sexual maturation; and menstrual management practices and management of menstruation and hygiene practices.

  • Education is an important tool in the development of every society. Age and religion were used as variables in the study of the sexual maturation and the management of menstrual practices. The respondents were in categories: 10.4% of primary school pupils and 89.6 Junior high school pupils. The study showed that menstruation does not only start with girls at Junior high school but also also at the primary school level between the average age of 9 and 13 years.

  • Out of all the boys who were interviewed, about 87% teased the girls who were menstruating. This attitude and behaviour makes the girls uncomfortable.

  • Christianity dominates in all the communities that were studied except in the Northern region where Islam was the dominant religion

  • The study revealed that as far as menstrual management practices are concerned, Christians do not prevent menstruating girls from participating in any religious activity with the churches. It preaches against pre-marital sex.

  • Islam on the other hand prevents menstruating girls from participating in the Islamic activities; menstruating women are not supposed to fast or pray during menstruation.

  • The effect of religion on the sexual maturation and menstrual management practices was seen most prevalently within the African Traditional religion.

  • The African Traditional Religion prevents menstruating women from entering the chief’s palace, entering the house of a traditional herbalist, visiting river bodies, visiting a community fetish, cooking, or going to the farm. Menstruating women are essentially segregated from the society during menstruation.

  • The findings revealed that despite all these restrictions, menstruating girls are not prevented from going to school.

  • Menstruation is not something new in the society, the study revealed that 70% of the respondents had full knowledge of menstruation. This knowledge was passed down from mothers, friends, sisters, teachers, meetings and public fora.

  • 86% of the respondents had ever menstruated, and this percentage confirmed the earlier information about the knowledge about menstruation.

  • According to the respondents, menstruation is not a positive experience; about 98% said they felt bad whenever they are menstruating because it makes them uncomfortable.

  • 66% of girls say that they report to their mother when they are menstruating. This shows the important role of mothers in the management of menstrual practices and the maturation of their young girls.


The knowledge of cultural practices affecting girls who are menstruating is not restricted to the teacher or the general public. The menstruating girls are also fully aware of the practices, especially the negative practices which have already been mentioned in the summary.


Items used in the management of menstruation include sanitary pads, toilet paper, used cloth, cotton, and wool. The study showed that toilet roll and used cloth are in high usage in the management of menstruation (48), 3% and 42.3% respectively. These items are not the best, but because of poverty they can not afford to buy sanitary pads. Those who can afford sanitary pads do not have access to these manufactured protective sanitary materials to due to factors like availability since distribution in rural areas is uncertain. Because of these factors, we found that young women often a variety of materials such as leaves, toilet paper, and pieces of sacks. These unhygienic materials may have long-term effects on their health.


The ways most of the female participants managed their menstrual cycles also compromised their quality of education.


The study again revealed that:

  • The usage of the above items is not a permanent solution and the materials needed to be changed at least twice a day

  • Menstrual symptoms include painful menstruation, heavy flow, inconsistency of the flow, and abdominal pains. Many managed these problems by taking pain killers, applying hot compresses, sleeping, lying flat on their belly, and visiting to the nearby clinic.

  • Menstruation, according to the study, is no longer considered a sickness. 70% of the participants explained that if menstruation is a sickness then every woman in this world is sick.


The study further revealed that most of the schools visited did not have facilities appropriate for menstruating girls. Many participants expressed discomfort with the current facilities. The respondents said they need facilities such as wash rooms and toilets to make them comfortable.


Many schools visited were underprivileged and lacked sufficient sanitation facilities which are vital not only during a girl's period but at all times generally. Due to inadequate water, toilet, and dumping facilities for sanitary wear at school, many menstruating girls would rather stay at home. The lack of appropriate facilities to help them manage their periods discouraged many from regularly attending school.


There was a medium of teaching sex education in most of the schools visited. It is taught in subjects like general science, life skills, and religious and moral education. But the findings revealed that these subjects do not emphasize menstrual management practices.

Sexual intercourse is well known among the respondents. 14% responded that they have had sexual intercourse while 86% declined. Participants were also fully aware of STIs, and responded that STIs can only be prevented via using condoms, sticking to one partner, and abstaining from sex until marriage.

  • Most of these diseases according to the study are curable except HIV/AIDS.

  • It was realised that the most common reason that many girls dropped out of school was not the negative cultural practices of menstruation, but rather teenage pregnancy.

  • Those who were pregnant found it difficult to return to school.

  • The study also revealed that there are no meaningful educational programmes on sexual maturation and menstrual management practices in the society.



Sexual Maturation and Menstrual Management Practices Associated with school Girls in Ghana particularly in the case study areas, (Brong –Ahafo region, Northern region. and Upper East region) is still a problem to some extent. The problem is due to the inadequate teachings the girls are receiving in school and home and is largely not due to ignorance of the girls or negative socio-cultural practices. The girls receive the information too late. The practical aspect of the lessons on sexual maturation are not taught, although the schools and families have improved in imparting knowledge to the adolescents. Another major problem is poverty, which still persists in the rural areas of Ghana. The respondents knew that sanitary pads are good and hygienic but could not afford them. Many of the respondents used unhygienic materials due to poverty and unavailability. The government and other stakeholders have yet to provide girls with school environments that are suitable for these areas, which does not make for a conducive learning atmosphere.



  • Institute program to teach girls about menstruation and sexual management practices. Education about menstruation should start at an early age before girls reach puberty so girls would be better prepared emotionally and psychologically for the experience of menstruation. This will help girls have fewer negative reactions and make them more able to care for themselves during menstruation, especially in regards to hygiene.

  • Intensify the teaching of girls about menstruation as part of adolescent and reproductive health education in our basic and secondary schools. This teaching should be part of the school curriculum and teaching should be practical. Since the study revealed that in some schools, health education is non existent, this would go a long way to improve the knowledge of girls about menstruation.

  • Provision of sanitary facilities in the schools to take care of girls who are menstruating. The current facilities available in the basic schools are inadequate, and more wash rooms are still needed for menstruating girls

  • Materials or books on menstruation should be provided for girls to read and understand the changes that occur in their bodies. The books should teach the various menstrual management and hygiene practices

  • There should be massive sensitization of the public about the traditional beliefs and practices relevant to menstruation; this will go a long way to erase the negative beliefs about menstruation within the community.

  • Mothers should also be concerned about their girls who are menstruating since the study revealed that girls talk more with their mothers. They should educate their girls about menstruation.

  • Teachers should encourage girls who are menstruating to participate in class activities and allow them to answer or ask questions while sitting. They should also encourage girls who are menstruating to report to the lady teachers in their schools.

  • Head teachers/Masters should set up a fund to take care of menstruating girls. Money from this fund can be used to buy toiletries, cotton, and other materials that can assist girls during their menstrual cycles.

  • Religious organisations that prevent menstruating girls from participating in prayer or any religious activity should be educated on the dangers involved and the effects that it has on the menstruating girls. This type of education should call for attitudinal change.

  • NGOs should try as much as possible to create programmes on sexual maturation and menstrual management practices. They should assist girls especially those with menstrual problems so as to improve their condition.

Women in the Oil Industry – Promoting Social and Economic Development in Ghana

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Prepared by Felicia S. Odame (Lecturer, University of Development Studies, Wa Campus)


More men than women work in the oil industry all over the world, however women are making rank and breaking glass ceilings and making huge impact on this previously male –dominated industry. It is upon this note that civil societies around Ghana have recognized the importance of advocating for women’s representation in the oil and gas industry. In fact many organizations have made it their mission to lobby the government for policy initiatives that will empower women out of poverty.


It is upon this that the Center for Development Partnerships has supported Alliance for African Women Initiative (AFAWI-Ghana) in their goal to encourage civil societies to advocate for women’s inclusion in Ghana’s oil industry policies. As an executive member of AFAWI, I urge policy makers to use the oil industry not just for economic development, but also for the social development of women. I believe that the government of Ghana must start creating policies that give a stronger consideration to women.

It is undisputable that the discovery of oil in Ghana carries with it significant economic and social development opportunities for the country and its citizens. Ghana’s economy will surely undergo accelerated growth and industrialization, but the potential economic boom of the oil industry also has the potential to reduce poverty and increase the standard of living for Ghanaians including women.

The oil industry will open up many employment opportunities for Ghanaians, and the government seeks to provide job-training programs for Ghanaians as outlined in the “Policy Directions” section of the Ministry of Energy’s policy framework. The government has outlined policies that promote economic development and local participation of Ghanaians in the oil industry, but policy makers in Ghana have not yet specified what specific roles women are going to play to contribute to the expected economic development the oil industry will bring to the country.


The current version of the Ghana government’s policy on the oil industry makes reference to the issue of gender, stating that “while government will provide equal opportunities for all citizens of the Republic of Ghana, the participation of women in the oil and gas industry will be actively encouraged.” This statement begs the question: exactly what kind of “active encouragement” of women is the government proposing?

Ghana government needs to consider female empowerment through education and employment opportunities in the oil industry in order to aid economic development. By improving the status of women in Ghana, the government is in turn improving the status of Ghana’s economic capacities. The reality is that women in Ghana represent far less of the formal sector workforce than men, and make up the majority of the poor, the unemployed and the informal sector workforce.


They do not always have access to the resources and education that would improve their skills and capabilities, and they are often overlooked by governmental policies that promote human development. By empowering women with the skills and training that they need to work in the oil industry, policy makers would be both creating a stable and adept workforce to support their projects, as well as eradicating poverty and social disadvantages that accompany unemployment.


It is well documented that women empowerment leads to the economic, political and social development of developing countries, and Ghana must take advantage of this opportune moment to bring women into the workforce. It is not enough for Ghana’s policy makers to simply “encourage” gender equity in the oil industry; they need to be more specific about education and training opportunities that will allow women to effectively contribute to the oil industry, and to Ghana’s development.


The oil industry has the potential to seriously improve the status of women in Ghana if government takes the appropriate steps to ensure that women are worked into its policies on local participation in the oil industry. Outlining more extensive and more specific policies for women in the oil industry would be one step closer to removing the socio-cultural impediments for women in Ghana. On a larger scale, developing countries around the world are turning their focus towards women empowerment in order to address larger issues of poverty and disease; Ghana can be one of these countries that benefit from policy-driven training and employment opportunities for women.

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