Health Education & Promotion
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MAKING HEALTH ACCESSIBLE TO THE URBAN POOR OR VULNERABLE (HEAD PORTERS). 

Introduction:

There is a complex array of cultural, political and socio-economic factors which influence the health status of the population.  Health-related vulnerability is reflected in patterns of morbidity, mortality and reproduction and is the product of simultaneous social and economic deprivation of varied forms.  Ghana revised its population policy in 1994 and incorporated new and emerging issues including the environment, gender and empowerment of women, adolescent reproductive health, sexually transmitted infections including HIV/AIDS.  There have been various attempts of integrating these population variables in all spheres of planning and development after the International Conference on Population and Development (ICPD, 1994) era.  For example, the country’s development programme is based on the Ghana Poverty Reduction Strategy (GPRS) which has replaced the Ghana vision 2020.  The goal of GPRS is to create wealth by transforming the economy to achieve growth, accelerated poverty reduction and the protection of the vulnerable and within a decentralized democratic environment.  This strategy has been adopted by the Ministry of Health, Ghana in their second Five Year Health Sector Programme of work (5 POW 11, 2002 – 2006) (Ghana Health Sector Annual Programme of Work, 2003, 1-16).

The Ghana Poverty Reduction Strategy recognizes that improving the health of the poor is crucial for reducing poverty, given the fact that ill health is both a consequence and a cause of poverty.  One of the facets of the GPRS is to ensure that all Ghanaians, irrespective of their socio-economic status or where they reside would have access to basic social services such as health care, quality education, portable water, decent housing, security from crime and violence and ability to participate in decisions that affect their own lives.

Health has been defined by various writers but in this context, health is a dynamic process that incorporates patterns of both wellness and illness.  Wellness can co-exist with disease, lack of disease does not indicate wellness. (Newman, 1986, Tripp-Gamer, 1984, 101 – 109).

Community health on the other hand, is the ability to meet the physical, socio-cultural and economic needs of constituents. (Higgs and Gustagson, 1985).  Thus, health is a process that involves the identification and promotion of patterns that result in competency and integrity.  However, this process often occurs in a partnership among interested parties and with community members. (Shutter & Goeppinger, 1996, Wallerstein & Bernstein, 1994).

It was in the context of the above principle that Community-based Center for Partners in Health (COMBACEPH) of School of Nursing, University of Ghana, Legon in partnership with JOY FM, a local multimedia broadcasting company organized a  screening programme codenamed “Easter SoupKitchen” for vulnerable group of urban dwellers called “Head Porters” (in local language “Kaya Yees) on Easter Sunday, 16th April, 2006.

The fast rate of urban growth in recent times in the developing world , including Ghana, is largely the result of poor resource distribution, population growth and decline in production in the rural areas.  This situation has led to widespread rural-urban migration and increase in the urban population, especially the capital.  Among the rural-urban drifters are young people including many teenagers seeking for jobs which are non-existent, some have home but others work and sleep in the market places, kioks, bus stations and uncompleted buildings.  These young people are actually losing the opportunity for a good home environment, consistent formal education, social guidance, adequate and regular meals and health information and services.  This makes them vulnerable to reproductive tract infections including STI/HIV/AIDS.

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Objectives of the Programme were to;

Target Population

The “Head Porters” were from various markets in the city of Accra, e.g. Makola, Agbogbloshie, Malam Atta and Nima.  These porters were mostly women between the ages of 14 – 24 years who have migrated from the northern sector of Ghana (i.e. Northern, Upper East and West) to the capital, Accra in search of jobs.  These regions are classified as ‘three of the most deprived regions of Ghana’ (GLSS, 1999).  These regions lie within the savannah belt of the country.

Setting

Afua Sutherland Park is in the center of the city of Accra, the capital of Ghana.


Health Team

The health team comprised of the staff and students (Peer-educators) of School of Nursing, University of Ghana, Legon. Students from Pharmacy Department of University of Science and Technology and West African AIDS Project to combat AIDS (WAPCAS)


Activities/Services

Services provided were mainly physical assessment like, measurement of blood pressure body mass index, examination of the eye, skin, breast, health education on family planning, adolescent health, nutrition and personal hygiene.  Drugs served out are vitamins, antihelmitics and antibiotics.  In addition, to the medical intervention, free lunch was also given out.

Common Problems

Common problems identified were skin infections, malnutrition, upper respiratory tract infections, eye infections, body aches and pains.

Achievement

On the whole, two thousand women and children were seen and few referrals were made to the nearest hospital (Ridge Hospital)


Lessons Learnt

It was realized that most of the ‘head porters’ were young people, mainly females in their teens but majority were having children.  Thus sexual and reproductive health information and services should be accessible to them.  There was also the need to organize immunization programmes for the children.

In conclusion, there is the need to make deliberate efforts to reach these very vulnerable and disadvantaged ones on a more regular basis to improve the quality of life of these head porters (Kaya Yee).  It also requires a multi-sectoral approach, involving collaboration and partnerships at various levels.  For example, the mass radio and Ministry of Women and Children.

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Health Education & Promotion | Peer Education