Akufo Addo’s Challenge; A Public Health Perspective

The Writer

The 2016 presidential and parliamentary debate is over, and Nana Addo Dankwa Akufo-Addo obtained a landslide victory as president-elect. The NPP also won a massive parliamentary majority and is in an excellent position to form the next Government. Congratulations are due to the president-elect but also to all elected parliamentarians. Better luck to the NDC and all the losing candidates.

Winning the election is only a means to an end. Throughout the campaign period, the president-elect has told us what he wanted to do. Not just to win the election but to lead us into a sustainable developed middle-income country. Sustainable development will be a difficult goal to achieve if Ghana fails to harness a bountiful demographic dividend that she is experiencing now. Demographic dividend occurs when the proportion of working people in the total population is high because this indicates that more people have the potential to be productive and contribute to the growth of the economy. Taking advantage of the current demographic dividend will require the expansion of access to family planning for women and the youth, enabling the realization of reproductive rights, and improving adolescent sexual and reproductive health. From where I stand, this is one critical challenge to the president-elect.

Nana Addo is taking over the leadership of this country at a crucial moment. Ghana has made tremendous progress in reducing maternal mortality rates and increasing family planning uptake since the late 1990s. However, much more remains to be done. The population continues to grow at 2.5 percent per annum and deaths from induced abortion still account for over 10 percent of maternal mortality, mostly because fertility decline has stalled at between 4.0 and 4.4 children per woman since the 1990s. Uptake of modern contraception by currently married women has hovered around 20 percent since 2003. Even more worrisome is the fact that the percentage of girls aged 15 to 19 who have had children or are currently pregnant in Ghana has remained relatively unchanged at around 14 percent since 1998.

With Ghana’s total population tripling in size from around 9 million in 1970 to close to 28 million today, achieving rapid and sustained increases in the standard of living and quality of life of the majority of Ghanaians can be the greatest challenge to the new president. More resources and efforts need to be committed to increasing access to comprehensive sexuality education and sexual and reproductive health services, including family planning services for women and young people, especially, adolescent girls. This must take place alongside the dedicated pursuit of expanded free access to secondary education for all, most particularly for adolescent girls. This is one of the key promises of Nana Addo since the 2012 elections. Investment in family planning is one of the best investments the new president can lead Ghana to make.

Ghana now has its largest young adult population ever (about a third of the total population, at over 8 million in 2015). This presents a unique opportunity for the country to harness accelerated rates of social and economic development by generating significantly more resources from this productive-age population than needed for consumption. Such an outcome requires sustained, multi-sectoral actions and investments by government, the private sector, and civil society to improve the health, income earning skills, productivity and empowerment of young Ghanaians, ensure their access to credit and entrepreneurship training, and create well-paying jobs for them. However, too many young Ghanaians are currently exposed to high levels of unwanted pregnancies, sexually transmitted infections, unemployment, and underemployment. Ensuring that young people have access to sexual and reproductive health services is one of the most cost-effective means of fully harnessing the skills, energies and creativity of young Ghanaians for sustained national development. This increases their opportunities throughout their lives, starting with longer education, fewer pregnancies, a later and healthier start to child-bearing, and more opportunities to engage in income-producing activities.

It is neither smart economics nor sound ethics for Ghana to make a 13-year investment in educating a girl, only to hold back the services and information that would prevent her from having an unplanned pregnancy and dying from the complications of unsafe abortion, pregnancy, and childbirth. Neither it is beneficial to the country for the economic contributions of a 30-year-old mother of three to be undermined by three additional and unintended pregnancies, due to an unmet need for family planning. Moreover, it is a lot easier to plan for and expand infrastructural facilities, schools, health services, and agricultural production when women and couples can plan the timing and size of their families at ease. The president-elect must, therefore, begin to seriously treat family planning as a broad developmental issue and commit to increased investment in family planning programs and services. There is enough expertise in the country to help the president-elect take advantage of Ghana’s demographic devidend and deliver on the promise of sustainable development, and economic transformation for Ghana. I wish him well.

The writer, a development consultant, is the PRO of the Ghana Public Health Association and the Executive Director of the Youth Harvest Foundation Ghana. You can reach him via [email protected]