Our ReWoSHA (Reducing Women’s Susceptibility to HIV and AIDS) Project in Ghana: The Story So Far

The Gender Centre in partnership with 3 implementing partners/organizations (Amasachina Self Help Association (Wa), Prolink (Kadjebi) and Rural Watch (Koforidua) have since 2009 launched and implemented a project titled “Reducing Women’s Susceptibility to HIV infection as a result of Gender Inequality in Ghana. This project was conceptualized following an action-based research in high HIV infection areas in 7 regions of Ghana, undertaken by the Gender Centre, involving women living with HIV and AIDS in identifying links between prevailing patriarchal attitudes and how they impact on HIV infection. The research findings indicated that women’s acceptance of male promiscuity within marriage, polygamy, sex as a woman’s marital obligation, infertility as a woman’s fault, choice of marital partner, VAW and widow inheritance are all factors that increase women’s susceptibility to HIV infection. This project has a national, district and community level focus. Whilst Gender Centre is responsible for national level advocacy as well as capacity building of partner organizations and community level stakeholders, the implementing partners are responsible for community/district level educational programmes as well as capacity building of district/local level stakeholders. The pilot communities are Papase (Kadjebi District), Nsokwoa (Koforidua Municipality) and Manwe (Wa East District).

The main thrust of the project is to address gender inequalities that make women susceptible to HIV infection thereby reducing HIV infection rates amongst women and girls in Ghana. Strategies used include surveys, desk top studies, policy advocacy and lobbying, public education and awareness creation, community outreaches, home visits, training and publication of materials. The project works at 3 different levels; community, district and national levels.

Twenty-two (22) months into the project a lot has been achieved collectively by all project stakeholders.  The project has provided information to women and their family members, traditional & religious leaders on domestic violence, gender norms that make women vulnerable to HIV infection, laws protecting women’s rights in Ghana, HIV modes of transmission and prevention. Information on the rights of women and persons living with HIV and AIDS (PLWHA) is also disseminated to community members through workshops and celebrations (16 days of Activism and International Women’s Day). There have been significant changes occurring in 2010 as a result of work done in 2009.

A key part of this project is to work with women and men in project areas to enable them increase their understanding of women’s rights and how patriarchal attitudes can increase women’s susceptibility to HIV. In order to achieve these objectives, community members (equal numbers of men and women) have been trained as community-based prevention teams which, to date, have provided counseling and referrals to abused women. The teams have been provided trainings on the Domestic Violence Act, Children’s Act of Ghana, Marriage & Divorce Laws, Inheritance laws, in-depth training on violence against women and women’s rights etc to better equip them do their work. Community members are seeking support and information from community-based teams established in 2009 on how to address cases of abuse. Women who have been interviewed have stated that the project has given them the confidence to discuss HIV and AIDS related issues with their partners and religious leaders and chiefs are actively supporting the teams in their work by giving them platform in their churches and palace to speak on women’s rights, HIV modes of transmission and prevention as well as gender norms that make women susceptible to HIV and AIDS.

Communities in our programme areas have started dismantling patriarchal attitudes and practices that increase women’s susceptibility to HIV infection.  For instance, widowhood inheritance has been outlawed as a practice in 4 communities (Manwe, Goripie, Viehaa  and Bunaa) which are under the same paramount chief (i.e Manwe Chief) in the Wa East District. Women are feeling the impact of the project in their lives in these communities. As put by 52 year old (woman) Fatumata Issah “I am so grateful to this project because I would have been forced to marry the brother of my late husband by tradition. This man cannot take care of his two wives and 12 children and that is evident in the community but as tradition demands I would have been compelled to marry him. I thank God that this tradition has been halted in our community. It is my prayer that all of such harmful traditional practices should be discarded by our people” (Manwe).  There is also a reduction of domestic violence in the community as confirmed by the chief in his testimony “I used to receive a lot of domestic violence cases in my palace almost every day but this has reduced drastically. We now have peace in almost every home. What is important is that we are human beings with various behaviours which are difficult to change overnight. No intervention and development to me, is more important than this” (Alhaji Salia Hamidu).

The sensitization work has raised awareness not only on women’s rights but children’s rights as well. For example at one such community forum discussing violence against women and children, a girl recounted how the project has changed the way her parents interact with them. “Before this project our parents did not see us as people who could be part of the decision making process at home, we all have different roles to play. We were forced to perform certain activities in the family which we didn’t like even if it was for our good because we were forced to do so. Today most of us are happy with the way we interact with our parents and we no longer resist most of the things we are tasked to do because we see ourselves as part of the decision making process” (14 year old Saani Busa-naa – girl). Boys and girls also indicated how the level of reduction of violence in their homes has affected their well being and that parents are now able to take good care of them in school.

The project has contributed to poverty reduction in the communities. Women have been empowered with HIV prevention information particularly   skills in condom negotiation and usage which has the potential to shield them from getting HIV infection. This  also prevents unwanted pregnancies and makes it possible for couples to control their family sizes. In Papase for example, unemployed women who have attended educational programmes on the rights of women, realizing the need to engage in income generating activities mobilized themselves into groups to access micro-credits to establish their businesses. The project educates community members on the impact of HIV on a person’s health which has the tendency to diminish their ability to work and thereby sustain themselves and their children, if early treatment is not sought.

At the district level the project continued to engage the assemblies in the disbursement of the 0.5% Common Fund allocation to ensure that the funds are fully utilized. Assemblies spend their share of the fund to support PLWHA to meet some of the pressing demands as a result of opportunistic infections, anti-retroviral treatment (ART) and community sensitization. However, the CF allocation is not enough to cover the whole district hence the need to revert to 1% share of Common Fund allocation for HIV and AIDS work.

The project has created links with stakeholders including the CHRAJ, DAs, Social Welfare Departments and DOVVSU at the district level. During awareness raising activities, staff from these organizations were given the opportunity to educate community members on their functions to enable community members, especially women to access their services, which they may well not have done prior to the project’s intervention. This has helped establish relationships between the state agencies and community team members for better protection of women’s rights.

Public Awareness Raising: GC has increased awareness on the effects of gender inequality on HIV transmission through   distribution of 6 different types of posters to NGOs working on gender and HIV and AIDS.  The project also raised the awareness of the general public through airing of radio dramas in English on Unique FM (Accra),  Twi on Adom FM(Tema) and sister stations across the country as well as Sunrise FM (Koforidua). The Ewe version was aired on Volta Star FM (Ho). Gender analysis of callers during the radio programme showed 21% females and 79% males.

Questions asked during the phone-ins indicated that listeners were following the discussions with interest as it bordered on gender norms. The use of condoms within marriage as a preventive measure for HIV was debated and some callers felt the best alternative is mutual faithfulness. Though male callers accepted promiscuity on the part of men they blamed women for driving men out of their homes. The questions asked by women bordered on women accepting domestic violence as the norm. The learning from this activity is the need for continuous education on the role of gender norms in HIV and AIDS infection among women and especially the use of condoms within marriage.

For effective policy advocacy and awareness raising around the issue the Gender has so far trained 64 civil society actors in Ghana on links between domestic violence and women’s vulnerability to HIV and AIDS.

Organizational Strengthening and Capacity Building of Partners:

In order to improve the effectiveness of project implementation of GC and implementing partners, staff have benefitted from several training programmes (VAW, women’s rights and HIV and AIDS, Gender Mainstreaming, resource mobilization and fundraising, laws protecting women and children, laws on domestic violence) that have enhanced their capacity to provide similar trainings to community teams and district level stakeholders. The changes are already being felt as partners are gradually being recognized and consulted by their District Assemblies on issues related to gender and VAW having made presentations and facilitated a number of workshops involving community team members and officials of the DA. Partners no longer request the support (expertise) of GC to undertake gender sensitization work. As a result of this partnership, one of our implementing partners has mainstreamed gender into its malaria programmes.

Lessons Learnt

1. Using team members (community members) as lead facilitators in community sensitization programmes has proven to be very useful. Since the members are aware of the realities in the community, issues raised by them for discussion are not seen as foreign and responses tend to be genuine.

2. There is a clear need to provide information to women on their rights and also provide support to abused women as women report cases of abuse to team members. Hence, any project that seeks to raise issues on gender norms and domestic violence must consider making spaces and services available for counseling/supporting women with concerns.

3. In multi-ethnic communities dividing communities into sections (based on ethnicity, religion) for educational workshops has been useful in Papase where the community is large with multi-ethnic groupings.

4. The inclusion of both in and out of school youth has been useful and should be part of the criteria for selection of team members as this helps reach youth of all categories for programmes easily.

5. It is difficult to undertake HIV related work without a C.T component. Hence the project is collaborating with District Health officials to provide this service to community members.

Learning from our project areas has reinforced the need to comprehensively introduce holistic and engendered interventions towards mitigating the impact of HIV & AIDS in Ghana and move away from just applying the ABC framework.

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