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In rural Ghana, women face a tough time as there is little in the way of health facilities, few health workers, and the women have to farm as well as raise children and keep house. Community male elders and the younger men in the community do not pay much attention to the reproductive health problems faced by women. Providing information and education for health is the key to enable people to realize their needs and initiate joint community actions to achieve better health. However, such information needs to be disseminated in a manner, which is easily accepted by the people. The Planned Parenthood Association of Ghana has taken the approach of utilizing drama performances by their health volunteers, which tackle the real life problems existing in a village, such as a woman troubled by too much childbirth. When information is given in this way, a form rooted in traditional culture, the messages of health education are readily acceptable. Along with the support of village elders and residents, health education becomes a valuable tool to encourage joint community efforts in solving health problems. Changes are occurring. A local steering committee was set up involving all groups, including chiefs, community leaders and CBDAs. Various activities have been initiated and expanded in the community in collaboration and participation with community leaders and the residents. Some of these are home visits by CBDAs, outreach services, environmental sanitation campaigns, and income generating activities and vocational training for women., (full text)

Investment in nutritional programmes can contribute to economic growth and is cost-effective in improving child survival and development. In order to communicate this to decision-makers, the PROFILES nutrition advocacy and policy development programme was applied in certain developing countries. Effective advocacy is necessary to generate financial and political support for scaling up from small pilot projects and maintaining successful national programmes. The programme uses scientific knowledge to estimate development indicators such as mortality, morbidity, fertility, school performance and labour productivity from the size and nutritional condition of populations. Changes in nutritional condition are estimated from the costs, coverage and effectiveness of proposed programmes. In Bangladesh this approach helped to gain approval and funding for a major nutrition programme. PROFILES helped to promote the nutrition component of an early childhood development programme in the Philippines, and to make nutrition a top priority in Ghana's new national child survival strategy. The application of PROFILES in these and other countries has been supported by the United States Agency for International Development, the United Nations Children's Fund, the World Bank, the Asian Development Bank, the Micronutrient Initiative and other bodies.

From 1990 to 1994, the Benin government and the World Bank planned a pilot project that aimed to improve household food security through production and income-generating activities. Results showed that stocking (reducing losses) and selling food crops promoted access to food in villages, and the small development project--building roads and bridges--increased movement and rendered food more accessible. This pilot project resulted in a 5-year program, which incorporates nutrition in addition to the household food security objectives. The nutrition component of this program aims to reduce malnutrition through education and the empowerment of women to take charge of the problems in their village. Areas where food production does not cover the needs of the population are identified and targeted using national statistical data., (full text)

"The purpose of this paper is to begin a preliminary assessment of some reproductive health indicators within the context of family planning programs, using data from expanded Situation Analyses conducted in four recent African studies. The studies, conducted in 1994-1995, cover Senegal, Zanzibar (studied separately from Tanzania), Kenya, and Botswana....", (excerpt)

To bring about change in the lives of poor women, I set up the program working with women in urban areas (PROFEMU), and introduced gender components into program for which I am responsible, as well as working with the Senegal team to implement the gender policy in our funding and non-funding work. Some of the blockages to change on gender have been a lack of collective intervention at a national level. There are many actors, many approaches, and agencies in competition. Work pressure, changes in structures, and a lack of understanding of the new gender orientation in the field have been other problems. I set up and support women's networks, and work as a resource person with national NGOs to ensure a focus on poor women's interests. I have taken part in setting up a more gender-focused women's network, Collectif Dakar 94 - Beijing 95, and work on building women's leadership and awareness., (full text)

Society for Women and AIDS in Africa (SWAA), Mauritania, uses a multi-sectoral approach to raise awareness of the HIV/AIDS pandemic and provide assistance when needed. SWAA believes that in order to have an impact on women and development in their country they must address issues of health, education, and society. To these ends they have created a special center to provide health care and counseling to HIV-positive women and their children; they conduct health and general education sessions geared towards women; and they have formed local chapters of SWAA throughout Mauritania to provide support and information to women within their own communities. SWAA has also taken on a mass education campaign which includes the production of flyers, educational materials, and public service announcements for radio and television. For more information, please contact Mme. Sana Mint Abass, President, SWAA/Mauritanie, BP 118, Nouakchott, Mauritanie; tel: +222 564 69 (office), +222 524 04 (home); fax: +222 599 26., (full text)

I am a primary health care (PHC) coordinator working with the May Day Rural project, a local NGO involved in integrated approaches and programs with rural communities in the Ga District of the Greater-Accra region in Ghana. When we talk about the community development approach we must first and foremost recognize that we are talking about women, because in the developing world frequent childbirths mean that her burden of mortality is higher than a man's; her workload is extremely heavy--whether in gardening, farming, other household duties, caring for the sick, or the rearing of children; she has a key role in PHC and community development, because men are always looking for greener pastures elsewhere, leaving the women behind. Women's concerns are critical in most health care projects and women and children are their main beneficiaries. Why not include women in the management team, project design, implementation and evaluation processes? That is what the May Day Rural project is practicing, encouraging women's participation and creating a relationship of trust., (full text)