MDG Report (24-10-13)

2010
POPULATION & HOUSING CENSUS REPORT
MILLENNIUM DEVELOPMENT
GOALS IN GHANA
Ghana Statistical Service
July, 2013
Copyright 2013 Ghana Statistical Service
Prepared by:
Eric Osei-Assibey
Steve Kwasi Grey
ii
Preface and acknowledgements

Ghana, like many other developing countries, relies mainly on survey and population census
data for planning at the national and the sub-national levels. Characteristics of the population
such as age, sex, education and occupation are obtained from census data and complemented
by other relevant indicators from national sample survey data. The 2010 Population and
Housing Census, which is the fifth census to be conducted in the country was, therefore,
implemented to provide data for effective planning at all levels.
The success of the 2010 Population and Housing Census, including the preparation of
analytical reports and monographs, has been a collaborative effort of the Government of
Ghana, various Development Partners (DPs) and the people of Ghana. Local consultants from
research institutions and universities in Ghana were engaged to prepare the national and
regional analytical reports including six monographs using the 2010 Census data. In order to
strengthen the report writing capacities of the Ghana Statistical Service (GSS) and
Ministries, Departments and Agencies (MDAs) which are engaged in population-related
activities,, professional staff of GSS and these MDAs were paired up with consultant writers
to prepare these reports.
The monograph on Tracking the progress towards MDGs in Ghana, is one of the six
monographs, that have been prepared from the 2010 Population and Housing and is meant to
inform policy makers on how far the country has gone in achieving each of the eight
Millennium Development Goals. The report focuses on seven out of the eight goals and about
18 indicators. Issues of youth and child labour have also been discussed in the report because
of the emerging interest of policy makers and development partners on this matter. All
indicators are disaggregated by sex, region and urban/rural residence as far as possible to
enable data users to have the full benefit of the report.
The report indicates that Ghana has made great progress in achieving the MDGs but
substantial amount of work needs to be done in order to achieve many of the goals by 2015.
The report points out that while significant progress has been made in some key MDG targets
such as poverty eradication, education and access to safe water, a lot needs to be done with
respect to under-five, infant and maternal mortality as well as sanitation.
The Ghana Statistical Service wishes to thank the United Nations Development Programme
(UNDP) for providing funds for the preparation of this monograph and the United Nations
Population Fund (UNFPA) for the lead role it played in mobilizing resources from the UN
System and from other DPs for the 2010 PHC. Our appreciation also goes to Mr. Steve Gray
and Dr. Eric Osei-Assibey for the dedication and competence they demonstrated during the
preparation of this report.
Dr. Philomena Nyarko

Government Statistician
iii
Table of Contents
Preface and acknowledgements ............................................................................................... iii
List of Tables ............................................................................................................................. v
List of Figures ........................................................................................................................... vi
List of Acronyms ................................................................................................................... viii
Chapter One: Introduction ........................................................................................................ 1
Chapter Two: National Context ................................................................................................ 2
2.1 Sources of data ............................................................................................................ 4
Chapter Three: Tracking Progress towards Achieving MDGs in Ghana ................................. 6
Goal 1: Eradicate extreme poverty and hunger ...................................................................... 6
Goal 2: Achieve universal primary education ...................................................................... 17
Goal 3: Promote gender equality and empower women ...................................................... 23
Goal 4: Reduce child mortality ............................................................................................ 30
Goal 5: Improve maternal health .......................................................................................... 35
Goal 7: Ensure environmental sustainability ....................................................................... 41
Goal 8: Develop a global partnership for development ...................................................... 57
Chapter Four: Conclusion and Recommendations ................................................................. 65
4.1 Introduction ............................................................................................................... 65
4.2 Decent and Sustainable Employment Generation ..................................................... 65
4.3 Universal Basic Education ........................................................................................ 66
4.4 Promoting Gender Equality and Women Empowerment .......................................... 66
4.5 Maternal and Infant Mortality ................................................................................... 66
4.6 Improving Sanitation ................................................................................................. 67
4.7 Reliable ICT services ................................................................................................ 68
4.8 Data for Planning, Monitoring and Evaluation ......................................................... 68
Reference ................................................................................................................................. 69
Appendix .................................................................................................................................. 71
iv
List of Tables
Table 3.1:
Table 3.2:
Table 3.3:
Table 3.4:
Table 3.5:
Employment sector by locality and sex .................................................................. 7

Unemployed population by age group, 1960-2010 .............................................. 12
GER and NER in primary school by sex and locality 2000 and 2010 ................. 18
Literacy status of population 15-24 by sex and locality, 2000 and 2010 ............. 21
Ratio of females to males in primary, secondary and tertiary education by
locality................................................................................................................... 25
Table 3.6: Gender parity in education, 2009/10 and 2010/11................................................ 25
Table 3.7: Trends in women participation in public life, 2000-2011 .................................... 28
Table 3.8: Under-five mortality rate by region and period of computation........................... 32
Table 3.9: Three Best Performing Regions in 2010 .............................................................. 37
Table 3.10: Region requiring attention .................................................................................... 37
Table 3.11: Proportion of population using improved and unimproved water source by
locality and region................................................................................................ 44
Table 3.12: Trends in national coverage of improved sanitation, 2008-2011 ......................... 45
Table 3.13: Proportion of population using toilet facility by locality, 2000 and 2010 ............ 47
Table 3.14: Proportion of the population with access to improved (WC) sanitation by
locality and region................................................................................................. 47
Table 3.15: Proportion of households by tenure/holding arrangements by locality,
2000 and 2010 ....................................................................................................... 53
Table 3.16: Number of persons per sleeping rooms by locality, 2010 .................................... 55
Table A1: MDG goals and targets tracked ............................................................................ 71
Table A2: Unemployment rate by sex, locality and region ................................................... 72
Table A3: Employment rate by sex, locality and region ....................................................... 73
Table A4: Proportion of own account and contributory family member in total
employment 15 years and older by sex, locality and region ................................. 74
Table A5: Under-five mortality rate by region and period of computation ........................... 75
Table A6: Maternal births and deaths by age group .............................................................. 75
Table A7: Ratio of females to males in primary, secondary and tertiary education by
locality and region, 2000 and 2010 ....................................................................... 76
Table A8: Classification of improved and unimproved water sources .................................. 77
Table A9: Percentage of urban population using unimproved water and sanitation ............. 77
Table A10: Improved and unimproved water sources by region ............................................. 78
Table A11: Classification of improved and unimproved sanitation facility ............................ 78
Table A12: Proportion of population using toilet facility by locality ...................................... 79
Table A13: Proportion of households by ownership type by locality ..................................... 79
List of Figures
Figure 3.1: Employment to population ratio, 2000 and 2010 by sex and locality ................... 7
Figure 3.2: Employment to population ratio by region............................................................ 8
Figure 3.3: Proportion of own account and contributing family worker by sex and locality .. 9
Figure 3.4: The proportion of own account and contributing family worker by region ........ 10
Figure 3.5: Unemployment rate of young people aged 1524 years by locality ................... 11
Figure 3.6: Unemployment rate of young people aged 1524 years by region ..................... 13
Figure 3.7: Proportion of children aged 7-14 who are employed by locality ........................ 15
Figure 3.8: Proportion of children aged 7-14 who are employed by region .......................... 16
Figure 3.9: Net and Gross enrolment ratio in primary school, 2010 ..................................... 18
Figure 3.10: Net and Gross enrolment ratio in primary school, 1990 -2010 ........................... 18
Figure 3.11: NER in primary school by region, 2000 and 2010 .............................................. 19
Figure 3.12: GER in primary school by region 2000 and 2010 ............................................... 20
Figure 3.13: Youth literacy status by locality and region ........................................................ 22
Figure 3.14: Ratio of females to males in primary, secondary and tertiary education by
locality................................................................................................................. 24
Figure 3.15: Share of women in paid employment by locality, 2000 and 2010 ...................... 26
Figure 3.16: Share of women in paid employment by region, 2000 and 2010 ........................ 27
Figure 3.17: Proportion of women in senior management position in public and private
occupations ......................................................................................................... 28
Figure 3.18: Under-five mortality rate by sex ......................................................................... 31
Figure 3.19: Under-five mortality rate by region..................................................................... 31
Figure 3.20: Infant mortality rate by locality and sex .............................................................. 33
Figure 3.20: Infant mortality rate by region............................................................................. 33
Figure 3.21: Maternal mortality ratio by locality..................................................................... 35
Figure 3.22: Maternal mortality ratio by region ...................................................................... 36
Figure 3.23: Skilled birth attendants (SBA) at birth by wealth quintile (1998 -2008) ............ 38
Figure 3.24: Problems in accessing health facilities ................................................................ 39
Figure 3.25: Proportion of population using an improved water source, 2000 and 2010........ 42
Figure 3.26: Proportion of population using water from the various improved and
unimproved water sources .................................................................................. 43
Figure 3.27: Proportion of population using unimproved water source .................................. 43
Figure 3.28: Proportion of the population with improved and unimproved water source
by region ............................................................................................................. 44
Figure 3.29: Proportion of the population with access to improved and unimproved
sanitation by locality, 2000 and 2010 ................................................................. 46
Figure 3.30: Improved and unimproved toilet facilities ......................................................... 46
sanitation by locality, 2000 and 2010 ................................................................. 48
Figure 3.32: Proportion of the population disposing liquid waste by method of disposal ...... 49
Figure 3.33: Proportion of population disposing solid waste by method ................................ 49
Figure 3.34: Percentage of population living in slums (type of accommodation), 2010 ......... 52
Figure 3.35: Proportion of urban population without access to improved water sources........ 53
Figure 3.36: Proportion of urban population without access to improved sanitation ............. 54
Figure 3.37: Proportion of the urban population in number of sleeping rooms
households occupy .............................................................................................. 55
Figure 3.38: Fixed telephone lines per 100 population............................................................ 59
vi
Figure 3.39: Trends in national fixed lines subscriptions 2003-2012 ...................................... 59

Figure 3.40: Mobile phone subscription per 100 population by sex and locality .................... 60
Figure 3.41: Mobile phone subscription per 100 population by region and sex...................... 61
Figure 3.42: Internet usage per 100 population ....................................................................... 62
Figure A1: Unimproved water source by region ................................................................... 77
Figure A2: Unimproved water and sanitation 2000 and 2010 ............................................... 78
vii
List of Acronyms
AIDS
APR
BECE
BOG
CHPS
CWSA
DPs
E-LEAP
EPA
EPI
FCUBE
GDHS
GDP
GER
GLSS
GMHS
GOG
GPI
GPRS
GSS
HIV/AIDS
ICSE
ILO
IMF
IMNCIs
IMR
IPEC
LEAP
M&E
MOFEP
MOH
MMR
MOWAC
MPs
NDPC
NEPAD
NER
NGOs
NHIS
ORS
PLWAs
PMMP
PMP
PMTCT
SADA
SFP
STEPP
UN
UNDP
WFCL
WHO
Acquired Immune Deficiency Syndrome

Annual Progress Report (Various Issues on the Implementation of the GPRS)
Basic Certificate of Examination
Bank of Ghana
Community Health Planning Services
Community Water and Sanitation Agency
Development Partners
Emergency Livelihood Empowerment Against Poverty
Environmental Protection Agency
Expanded Program of Immunisation
Free Compulsory Basic Education
Ghana Demographic and Health Survey
Gross Domestic Product
Gross Enrolment Ratio
Ghana Living Standards Survey
Ghana Maternal Health Survey
Government of Ghana
Gender Parity Index
Growth and Poverty Reduction Strategy
Ghana Statistical Service
Human Immuno Virus/Acquired Immune Deficiency Syndrome
International Classification of Status of Employment
International Labour Organisation
International Monetary Fund
Integrated Management of Neonatal and Childhood illnesses
Infant Mortality Rate
International Programme for the Elimination of Child Labour
Livelihood Empowerment Against Poverty
Monitoring and Evaluation
Ministry of Finance and Economic Planning
Ministry of Health
Maternal Mortality Ratio
Ministry of Women and Children Affairs
Members of Parliament
National Development Planning Commission
New Partnership for Africas Development
Net Enrolment Rate
Non-governmental Organizations
National Health Insurance Scheme
Oral Rehydration Solution
People Living with HIV Aids
Prevention of Maternal Mortality Programme
Maternal Mortality Programme
Prevention of Mother-to-Child Transmission
Savannah Accelerated Development Authority
School Feeding Programme
Skills Training and Employment Placement Programme
United Nations
United Nations Development Programme
Worst Forms of Child Labour
World Health Organisation
viii
Chapter One
Introduction
The Millennium Development Goals come from the Millennium Declaration, signed by 189
countries, including 147 heads of State and Government, in September 2000. Building on the
United Nations global conferences of the 1990s, the United Nations Millennium Declaration
of 2000 marked a strong commitment to the right to development, to peace and security, to
gender equality, to the eradication of the many dimensions of poverty and to sustainable
human development. The goals represent a partnership between the developed countries and
the developing countries "to create an environment - at the national and global levels alike which is conducive to development and the elimination of poverty. This is what has become
known as the eight Millennium Development Goals (MDGs), including 21 time bound targets
and 60 indicators.
The specific aim of the MDGs is to eradicate extreme poverty and hunger, achieve universal
primary education, promote gender equality and empower women, reduce child mortality,
improve maternal health, combat HIV/AIDS, malaria and other diseases, ensure
environmental sustainability, and develop global partnerships for development. Since 2000,
when the goals were launched, Ghana has committed to all the goals and implemented
policies that are in line with its broader Medium-term Development Frameworks such as
Ghana Poverty Reduction Strategy I & II and the Ghana Shared Growth and Development
Agenda. Progress towards the attainment of the MDGs has been reported periodically since
2002 in many national documents including the Annual Progress Report on the
implementation of the Medium-term Development Frameworks and the biannual special
MDG report prepared by the National Development Planning Commission, with support from
the UNDP, Ghana.
The overall assessment of Ghanas progress toward the MDGs reveals that, while progress
has generally been positive, performance has been mixed across indicators, regions and
localities. While significant progress has been made in some key MDG targets such as
poverty eradication and food security, education and access to safe water, the overall pace of
progress, based on current trends, is insufficient to achieve many of the MDGs such as underfive, infant and maternal mortalities as well as access to improved sanitation by the target
date of 2015.
The main purpose of this report is to track the progress towards achieving the MDG goals
based on new data from the latest population census, the 2010 Population and housing
Census (PHC). For comparison purposes, the 2010 PHC data was complemented with the
past censuses, particularly the 2000 PHC and, where available, reference is also made to
similar national surveys such as the GDHS and the various rounds of the GLSS. It is also
noteworthy that because of the data limitations, the report focuses on only targets whose
indicators are captured in the PHC questionnaire. In this regard, the report is limited to seven
goals (i.e., MDGs 1, 2, 3, 4, 5, 7 and 8) and about 18 indicators. The report also has special
discussion on youth and child labour. All indicators are disaggregated by sex, region and
urban/rural residence as far as possible. The rest of the paper is organised as follows: Section
II presents the national development context and a brief review of the status of MDG in
Ghana. Section III tracks the progress of the selected targets and indicators. Section IV
concludes with recommendations on the way forward.
1
Chapter Two
National Context
According to the 2010 Population and Housing Census (PHC) report, Ghanas population
stood at 24,658,823 at the time of the 2010 census. The country has ten administrative
regions and 170 districts. Ghana has one of the highest GDP per capita in West Africa and is
ranked as a Lower-Middle Economy by the World Bank. The country has a diverse and rich
resource base with gold, cocoa, timber, diamond, bauxite, and manganese being the most
important source of foreign trade. In 2007, an oilfield which could contain up to 3 billion
barrels of light oil was discovered. Although oil and gas exploration in Ghana dates back to a
century, it is this latest discovery and many more afterward that have catapulted the country
to be counted among the league of oil producing countries across the globe. Yet, in spite of
the abundance of natural resources, a quarter of the population lives below the poverty line.
However, the country has made considerable progress in reducing poverty over the last two
decades. Successive nationally representative living standards surveys conducted between
1992 and 2006 (respectively, GLSS3 in 1991/2, GLSS4 in 1998/9 and GLSS5 in 2005/6)
suggest that monetary poverty (measured by the level of per capita consumption) has
significantly reduced. The number of poor went down from 7.9 million people (or 52 percent
of the population at that time) in 1992 to 6.3 million people in 2006 (or 29 percent of the
population at that time). With the rapid economic growth since the last survey in 2006, it is
likely there is a further poverty reduction. Structurally, Ghanas economy has undergone
some significant transformation over the last couple of years. Ghanas economy which until
2006 was dominated by agriculture is now led by service accounting for about 51% of
national output. Agriculture accounts for about 30% (although about 55% of employed are
engaged in the sector) while industry trail with only 19% of total national output. The
informal economy accounts for about 86% of total employment while gold and cocoa remain
the leading export earnings. This is expected to change with the commencement of oil
production in commercial quantities in 2010.
Various policy frameworks that have been adopted since the adoption of the Millennium
Declaration, 2000 can largely explain the above development outcomes. The Ghana Poverty
Reduction Strategy (GPRS I), 2003 2005, the Growth and Poverty Reduction Strategy
(GPRS II), 2006 2009 and the on-going Ghana Shared Growth and Development Agenda
(GSGDA 2010-2013) are the most notable ones. The GPRS I focused on the macroeconomic
stability, production and gainful employment, human resource development and provision of
basic services, vulnerable and excluded, and good governance. The GPRS II also emphasizes
continued macroeconomic stability, human resource development, private sector
competitiveness, and good governance and civic responsibility. The GSGDA is anchored on
seven main themes: sustainable macroeconomic stability; enhanced competitiveness of the
private sector; accelerated agricultural modernisation and natural resource management; oil
and gas development; infrastructure, energy and human settlements development; human
development; and transparent and accountable governance.
Within/amidst the context described above, the country has been touted as one of the best
performing countries in the sub-region likely to achieve many of the MDG targets by the year
2015. However, as previously mentioned, this performance has been mixed and the country is
2
completely off-track in achieving some of the important indicators on non-monetary poverty.

In what follows, we briefly describe the progress the country has made so far towards
achieving the MDGs by 2015 based on the previous national surveys preceding the 2010
PHC and as reported in the latest report, the 2010 MDG monitoring report on Ghana.
Out of the seven MDG goals (except Goal 6) that this paper focuses on, the performance of
Ghana over the years has generally been mixed with considerable work still to be done on
some of the goals. The 2010 MDG report indicates that MDG 1A target of halving extreme
poverty and MDG7B of halving the proportion of people without access to safe drinking
water have been achieved ahead of time. MDG1C of halving proportion of people who suffer
from hunger; MDG2 of achieving universal basic education; MDG3 of eliminating gender
disparity in school for both boys and girls; MDG4 of reducing under-five mortality; MDG6
of halting and reversing the spread of HIV/AIDS and malaria; MDG8 of ensuring debt
sustainability are found to be on track of potentially or probably achieving the targets. Five
targets MDG1B of achieving full and productive employment and decent work; MDG3 of
achieving equal share of women in wage employment in non-agriculture sector; MDG5 of
reducing maternal mortality; and MDG7 target of reversing the loss of environmental
resources and address the problem of sanitation are unlikely to be achieved.
According to the MDG (2010) report, Ghana is largely on track in achieving the MDG 1
target of reducing by half the proportion of the population living in extreme poverty at the
national level and in rural and urban areas. Although current data on poverty is not available,
trends in economic growth suggest a further decline in poverty between 2006 and 2010.
However, poverty is quite endemic in the three northern regions to the extent that it would be
a difficult hurdle for these regions to reduce extreme poverty by a range between 11.7
percentage points in the Northern Region and 41.8 percentage points to reach the target of
halving extreme poverty by 2015.
With regard to MDG2, the report shows that Universal primary education in Ghana is on
track to achieving both the gross and net enrolment targets by 2015. The country has five
years to increase GER and NER by 5.1 and 11.5 percentage points respectively to reach the
target with intensification of much more effort in the area of capitation grant, school feeding
programme and free school uniform. Four regions namely Western, Central, Brong Ahafo
and Upper West have already achieved the 100 percent GER ahead of time while Northern
Region is not far from the target. Ashanti, Eastern, Greater Accra, Upper East and Volta
regions have GER below the national average and therefore require a bit more attention to
help them to attain the target in 2015. Only two regions, Central and Western have NER
above the national average indicating that the eight other regions require particular policy
attention to fast improve NER to facilitate the attainment of the target within the next
remaining five years. The country needs to do much more to improve the primary school
completion rate considering the distance 13.7 percentage points from the target.
On MDG 3 target of ensuring gender parity especially at the Primary and Junior High school
(JHS) levels, the report indicates that Ghana is on track in achieving both targets, although
primary level parity has stagnated at 0.96 since 2006/07. Gender parity at JHS which
increased slightly from 0.91 in 2006/07 to 0.92 in 2007/08 has also remained at that level in
2008/09 and 2009/10. On the other hand, the parity at the KG has declined slightly from 0.99
in 2006/07 to 0.98 in 2008/10. Regarding gender equality and empowerment, progress
towards increasing the number of women in public life suffered a setback with the reduction
of the number of women elected into Parliament during the 2008 elections declining from 25
3
to 20. This had reduced the proportion to below 10 percent, and puts Ghana under the
international average of 13 percent. Access of women to wage employment in nonagricultural sector has remained quite weak undermining the countrys quest to promoting
gender equality and women empowerment.
The country has made significant progress in achieving the MDG 4 target of reducing both
infant and under-five mortality rates by two-thirds by 2015. However, as the 2010 MDG
report indicates, with the average rate of reduction it will be a challenge to achieve the MDG
target for 2015 of 41 per 1000 live births unless greater effort is made to scale-up and sustain
the recent child survival interventions which have brought about the current improvement in
these indicators. The MDG 5- Improve Maternal health- is way off-track. The MMR at 164
per 100,000 live births in 2010 Ghana is unlikely to attain the target of reducing by three
quarters the maternal mortality ratio between 1990 and 2015, despite the introduction of free
maternal health in 2008 and other similar interventions.
The MDG target of reducing by half the proportion of people without access to improved
water has been achieved ahead of time. The report suggests that the slow progress in
improving environmental sanitation and the continue loss of forest cover and the slow pace of
decline in the proportion of urban population living in slum areas remain a big challenge. The
forest cover is continuously being depleted with the cost of environmental degradation (lands,
forest, fisheries) pegged at about 10 percent of GDP in 2010. Even though access to improve
sanitation has been increasing over the years, Ghana is unlikely to achieve the MDG target
for sanitation. Efforts should therefore be accelerated to quicken the pace of policy
implementation rolled out to improve the situation. There is also the urgent need to effect
attitudinal and behavioural change in the people through extensive educational and awareness
creation programmes.
Lastly, Ghana continued to sustain the progress under MDG 8 of dealing comprehensively
with the domestic debt burden and ICT development. The 2010 MDG report indicates that
the total ODA inflows declined in 2010, and ODA as a percentage of GDP has not shown any
consistent trend over the years. The portfolio of aid inflows continued to be dominated by
project aid. Project aid constitutes the highest percentage of total ODA received from 2003 to
2010. This is followed by budget support aid. With regard to ICT penetration in the country,
mobile phone subscription has since 2000 increased significantly, according to the report.
Mobile cellular phone subscription jumped from about 0.67 per 100 inhabitants in 2000 to 63
per 100 inhabitants in 2009. According to the National Communication Authority (NCA), the
total subscription stood at 17.4 million at the end of 2010, which represented a penetration
rate of about 71.5 percent. This has been facilitated by the increase in the number of service
providers and the expansion in the network coverage across the country. Like the cellular
phone, internet usage has expanded rapidly since 1995, although its rate of increase has been
slower. With virtually only isolated cases of internet access in 1995, usage has increased
dramatically to about 5.3% of the population in 2009.
2.1
Sources of data
The main source of data for this assessment is the 2010 PHC. The data were generated from
the responses to the questionnaire administered to the household population. The 2010 PHC
is the fifth census conducted in Ghana since independence. Previous post-independence
censuses were conducted in 1960, 1970, 1984 and 2000. The 2010 PHC was carried out with
reference to 26Th September 2010 as the Census Night. Enumeration was completed in
4
November 2010 and data processing ended in May 2012. Since the census questionnaire was
not specifically designed to solicit information for the assessment or tracking of progress on
the MDGs, it was challenging to get appropriate responses to cross tabulate so as to monitor
progress on the MDGs. Since the MDG goals were set in 2000, data from the 2000 PHC
were also used so as to provide a basis for comparison with the information obtained from the
2010 census. Institutional data were resorted to essentially for comparison purposes. Some
of the data were from the various round of the Ghana Living Standards Survey (GLSS),
World Bank and IMF global monitoring reports on the MDGs, Africa MDG reports, and
various Ghana MDG reports produced by the NDPC and the UNDP.
It has to be noted that it is only eighteen (18) out of the sixty (60) indicators that have been
reported on in this paper, as these are the only ones covered in the PHC data set. The census
is therefore, not a very comprehensive source to turn to for a holistic assessment of the
performance of the MDGs. Notwithstanding these challenges, the recourse to the use of
census data for an exercise like this, which is a pioneering endeavour in Ghana, has revealed
significant insights into some of the indicators, particularly at sub-national levels.
The use of census data also posed a few challenges especially with regard to definition of
terms and concepts. For example, while one of the indicators requires data on slums, the
census did not specifically designate any settlement as a slum. To be able to report on this
indicator using the census data will require that a working definition is adopted for what
dwelling units the authors consider as constituting a slum settlement. The alternative was to
use the proxy for a slum as explained in the official MDG indicators.
Chapter Three
Tracking Progress towards Achieving MDGs in Ghana
The discussions that follow examine the progress made in only those indicators listed under
the various goals of the MDGs using as a primary source data from the 2010 PHC. Where
there are comparable data for the 2000 PHC, these are used to show trends. Some
administrative records and survey data are also used where possible to see whether there is
any consistency or departure from the results obtained from the census data. At the end of the
discussion of the indicators under each of the goals, the key policy measures and challenges
are presented.
Goal 1: Eradicate extreme poverty and hunger

Target 1B: Achieve full and productive employment and decent work for all, including
women and young people
Indicators1.5: Employment-to-population ratio
Employment to population ratio is the proportion of a countrys working age population that
is employed. The indicator provides information on the ability of an economy to provide
employment. It monitors the degree to which the labour force is utilized in the economy and
therefore serves as a measure of the success of strategies to create jobs for the population.
Moreover, according to ILO (2008), the ratio, both in its level and change over time, can be
viewed in connection with economic growth to determine the extent to which economic
growth is pro-employment growth and, in connection, pro-poor. While a higher share
indicates a greater proportion of the population that could be working does work, a low ratio
indicates that a large share of the population is not involved directly in market-related
activities. The indicator is computed by dividing the total number of employed person 15
years and above by the population of the same age group.
The 2010 PHC data indicate that out of the 15,208,425 population 15 years and older,
10,243,476 are employed. This makes employment to population ratio 67.4 percent.
Compared to the 2000 PHC (66.9%), employment to population ratio has increased only
marginally by about one percentage point in a decade (Figure 3.1). This should be a matter of
concern to policymakers since the result is indicative of the fact that not much employment
opportunities have being created for the countrys labour force despite the numerous
government initiatives, the expansion of the private sector and the sustained economic growth
over the last decade or so.
Figure 3.1: Employment to population ratio, 2000 and 2010 by sex and locality
80.0
70.0
66.9
67.4
69.0
72.4
69.3
64.9
65.6
60.7
Percentage
60.0
73.3
62.3
50.0
2000
40.0
2010
30.0
20.0
10.0
0.0
All localities
Male
Female
Urban
Rural
Source: Ghana Statistical Service, 2000 and 2010 Population and Housing Census
On the other hand, one could argue that although the increase is marginal, for the fact that the
proportion has increase or even stayed the same while actual population has increased
suggests that there is an expanding labour market at least that commensurate with the growth
in the employable population. In any case, the thorny issue is how sustainable and the
potential of these jobs to lead to reduced working poor. While elsewhere these ratios of
employment to population will be considered as high and impressive, we should note that the
ratio only measures quantity, but not quality. It is important that if employment is being used
as a tool to poverty reduction then considerations should be given to the quality and the
decency of these jobs. Confirming this concern, Table 3.1 shows that a greater majority of the
employed are within the private informal sector (86.2%). In the sections that follow, we will
examine the decency and the vulnerability of these jobs in much detail.
Table 3.1: Employment sector by locality and sex
All
employment
sector
Public
(Gover
nment)
Private
Formal
Private
Informal
SemiPublic/
Parastatal
NGOs (Local
and
International)
Other
International
Organisations
10,243,476
5,005,534
5,237,942
6.2
8.1
4.5
6.8
9.7
4.1
86.2
81.2
91.0
0.1
0.2
0.1
0.5
0.7
0.3
0.0
0.1
0.0
0.2
0.3
0.1
0.7
1.0
0.4
0.1
0.1
0.0
0.1
0.1
0.0
0.3
0.4
0.3
0.0
0.0
0.0
All ages
Total
Male
Female
Urban
Total
5,125,635
9.4
11.2
78.5
Male
2,477,284
12.1
16.0
70.5
Female
2,648,351
6.9
6.7
85.9
Rural
Total
5,117,841
3.1
2.5
94.0
Male
2,528,250
4.2
3.6
91.7
Female
2,589,591
2.0
1.4
96.3
Source: Ghana Statistical Service, 2010 Population and Housing Census
The 2010 PHC also show that employment to population ratios are higher in rural (73.3%)
than in urban areas (62.3%). However, a higher proportion of the employed rural workforce
is in the private informal sector 94 percent as against 78.5 percent in urban areas.
Furthermore, only 3.1 percent and 2.5 percent of the rural workforce is employed in either
public formal or private formal respectively, while in urban areas, the corresponding figures
are 9.4 percent and 11.2 percent for public and private formal sectors.
With regard to regional variations, there appears not to be any substantial disparities in
employment to population ratio across the regions, except that the gap has narrowed in the
last decade. The three northern regions have the highest employment to population ratios and
experienced the highest growth rate ranging from 7.1 percent for Northern and Upper West
Regions to 29.8 percent for Upper East region between the period 2000 and 2010. The
Ashanti Region which recorded the lowest employment to population ratio of 64.8 percent
also experienced a decline of 5 percent. The greatest decline, however, was in the Western
Region, declining from 70.5 percent in 2000 to 66.3 percent in 2010, a percentage fall of four
percent. This result, no doubt, has a positive implication for poverty reduction in the three
northern regions which happen to be the poorest regions in the country and have the slowest
progress towards achieving MDG target for Goal 1. For instance, while all seven other
regions have exceeded the Goal 1 target, the three northern regions have target deficits of not
less than 20 percent in moving out of the upper poverty line and more than 30 percent in
moving out of the lower poverty line (extreme poverty) according to the GLSS 5 data
(2005/06 reported in 2010 Ghana MDG report). Therefore, the increasing employment ratios
in the region will, all else being equal, will increase the income levels of the people (Fig 3.2).
Figure 3.2: Employment to population ratio by region

80.0
70.0
Percent
60.0
70.5
68.6
67.0
68.2
65.3
66.3 66.1
69.2
67.0
68.2
61.4
64.8
73.4
71.5
72.0
71.8
67.3
67.3
62.8
55.3
50.0
40.0
2000
2010
30.0
20.0
10.0
0.0
Western
Central
Greater
Accra
Volta
Eastern
Ashanti
Brong
Ahafo
Northern Upper East
Upper
West
Indicator 1.7: Proportion of own account and contributing family workers in total
employment
While monitoring employment ratios provides a good starting point to assess the health of
labour markets in the country, it is essential to consider decent work deficits and the quality
of work among the employed. In the current situation where the employment to population
ratio is way above 65 percent in the country, the issue that arises is how secured, decent,
sustainable and dignifying these employments are. According to the International Labour
Organization (ILO), Decent Work involves opportunities for work that is productive and
delivers a fair income, security in the workplace and social protection for families, better
prospects for personal development and social integration, freedom for people to express
their concerns, organize and participate in the decisions that affect their lives and equality of
opportunity and treatment for all women and men. On the contrary, Vulnerable worker is a
category of workers who are less likely to have formal work arrangements, and are therefore
more likely to lack decent working conditions, adequate social security and voice through
effective representation by trade unions and similar organizations. Vulnerable employment is
often characterized by inadequate earnings, low productivity and difficult conditions of work
that undermine workers fundamental rights, and do not allow workers to live a life of human
dignity in the security of employment that is often absent in the informal sector.
The indicator to monitor this is unpaid or contributing family workers and own-account
workers as a percentage of total employment. They also sometimes fall in the category of the
working poor. That is, even though they are deemed to be working, such workers still fall
below the national poverty line. According to International Classification of Status of
Employment (ICSE), own account workers refer to those who, working on their own account
or with one or more partners hold the type of jobs defined as a self-employment jobs and
have not engaged on a continuous basis any employees to work for them. People engaged in
own account and contributing family jobs are deemed vulnerable because they are more
likely to lack relevant elements associated with decent work as mentioned above.
Figure 3.3: Proportion of own account and contributing family worker
by sex and locality
100.0
90.0
80.0
85.4
Percent
70.0
80.6
80.6
72.4
71.4
60.0
50.0
90.0
63.7
59.4
40.0
2000
46.5
2010
30.0
20.0
10.0
0.0
Both
Male Female
Urban
Both
Male Female
Rural
Both SexesMale Female

National
According to the 2010 PHC results, majority of employments in the country are vulnerable.
The data show that out of 10,243,476 employed people in the country, 7,413,025 are
vulnerable. In other words, 7 out of every 10 Ghanaian workers (72.4%) are vulnerable
workers (Figure 3.3). This clearly shows that most of the informal sector employment, which,
as mentioned earlier, employs over 86 percent of the nations workforce, generally lacks
social protection, fair income and dignity.
Although there appears to be a downward trend in the rate of vulnerable employment over the
years, it is marginal. According to the various rounds of GLSS data, the rates declined
marginally from 82.5 percent to 75.4 percent between 1991 and 2006 (2010 MDG report). A
comparison of the 2000 and 2010 census data also indicates a similar pattern as it declined
only less than three percentage points from 2000 (74.9%) to 2010 (72.4%). Moreover, Figure
3.3 shows that female workers (80.6%) are more likely to be vulnerable than their male
counterparts (63.7%), and this is even worse if the female worker is in a rural locality. In
general, rural workers are more likely to be vulnerable as shown in Figure 3.4. With regard to
regional variations, the Greater Accra, Ashanti and Western regions have rates that are below
the national average while all the others are above with Upper West, Upper East and
Northern regions with figures above 78 percent, according to Figure 3.5. This result suggests
that vulnerability is highly related with poverty as the three northern regions have the highest
incidence of poverty in the country.
Regions
Figure 3.4: The proportion of own account and contributing family worker by region
Upper West
87.4
Upper East
87.6
Northern
86.1
Volta
83.1
Brong Ahafo
80.8
Eastern
80.4
Central
78.1
Western
74.5
Ashanti
71.4
Gt. Accra
54.1
0
87.6
87.4
87.2
82.8
78.6
2010
76.6
2000
75.3
71.2
66.9
52.2
20
40
60
80
Percent
10
100
The implication of these results suggests that the increasing number of Kayayei, street
vendors or streetism, shoeshine boys and hawkers should be a matter of great concern not
only to policy makers, but also the international community and civil society if the nation is
to attain the MDG goal on decent employment and poverty.
Youth Unemployment
Target: In Cooperation With Developing Countries, Develop And Implement Strategies For
Decent And Productive Work For Youth.
Indicator: Youth Unemployment Rate
In recent times, youth unemployment has been a growing concern to policy makers,
international community and civil society. Youth unemployment has the potential to bring
about social upheaval and brutal revolution as evident in the recent Arab Spring. In the light
of this, the MDG Goal 8, Target 16 stipulates that in cooperation with developing countries,
develop and implement strategies for decent and productive work for youth. The indicator to
monitor this is the unemployment rate of young people measured as the number of people
aged 1524 years who are unemployed divided by the number of people in the labour force of
the same age group. The rationale is to monitor the degree to which the youth labour force is
utilized in the economy and therefore serves as a measure of the success of strategies to
create jobs for the youth.
Figure 3.5: Unemployment rate of young people aged 1524 years by locality
25.0
22.5
20.0
18.2
Percent
16.7
15.0
12.9
12.2
2000
10.0
8.0
2010
5.0
All Localities
Urban
Rural
Locality
The 2010 PHC data indicate that youth unemployment rate in the country is 12.9 percent as
against the national unemployment rate of 6.2 percent. There is, however, a decline of about
four percentage points from the 2000 PHC youth unemployment rate of 16.7 percent (Figure
3.5). What is of great concern is the share of youth in the national unemployment rate. Table
3.2 shows that more than 70 percent of the unemployed in Ghana can be found in the 15- 29
years age group with those within 15-24 constituting about half of it.
11
Figure 3.5 shows that youth unemployment in 2010 (like all previous censuses) is much
higher in urban localities (18.2%) than in rural areas (8%). The data, however, show no
substantial variation in rates for males and females, although females (13.5%) in all localities
are more likely to be unemployed than their male counterparts (12.1%) (see Appendix 3).
Table 3.2: Unemployed population by age group, 1960-2010
Age Group
1960
1970
1984
2000
2010
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65+
40.1
23.7
12.8
7.4
4.7
3.4
2.3
1.8
1.1
1.1
1.6
39.8
31.9
13.7
6.4
3.4
2
1.4
0.9
0.5
0.4
0.6
37.7
36.8
13.7
4.6
2.2
1.3
1
0.7
0.5
0.4
1.1
17
19.1
14.2
9.9
7.8
6.5
5.4
4.3
2.9
3
9.8
1.1
33.3
41.6
12.0
4.9
2.4
1.3
1.1
0.8
0.5
0.9
Source: Central Bureau of Statistics, 1960, 1970, 1984 Censuses and

Ghana Statistical Service, 2000 and 2010 Population and Housing Census
All regions except the three northern regions registered a double-digit youth unemployment
rates according to the 2010 PHC data. Figure 3.6 indicates that while Greater Accra Region
recorded the highest of 18.1 percent of its economically active youth being unemployed,
Northern region registered the least youth unemployment rate of 5.8 percent in the country.
The high rates in the big, well-endowed cities and regions compared to the poor ones may be
attributed to the surge in rural-urban migration of young people in search of unavailable jobs,
particularly from the northern parts of the country to the south. It is also significant to note
that the only region where the youth unemployment rate increased was Western region,
increasing from 13.3 percent in 2000 to 14.0 percent. All the others registered a substantial
decline with Upper West region leading the way by falling from a high of 22.6 percent in
2000 to a low of 6.2 percent in 2010. It may be likely that a large number of unemployed
youth in the region might have moved out to other regions to seek employment and were
therefore not available during the census to be enumerated. Sometimes people who are not
working may deliberately report themselves as employed so as not to be tagged as being lazy.
12
Figure 3.6: Unemployment rate of young people aged 1524 years by region
18.1
Greater Accra
24.0
15.8
Ashanti
17.8
15.1
16.2
Eastern
14.0
14.7
Regions
Central
Western
13.3
Brong Ahafo
10.2
Volta
10.0
14.0
2010
13.4
12.5
8.1
Upper West
2000
18.4
6.4
Upper East
22.6
5.8
Northern
-
5.0
11.2
10.0
15.0
20.0
25.0
30.0
Percent
Key Policy Measures and Challenges

Government recognising the critical concern and the developmental challenges pose by youth
unemployment, has rolled out a number of policy interventions and initiatives to address the
problem in recent times. Initiatives and guiding principles have been taken in the recent past
to increase access and participation in the workplace by the youth such as the National Youth
Volunteer Programme by the Ghana National Service Scheme; the establishment of the
Youth Venture Capital Fund; the enactment of a new Labour Law (Act 561) to ensure a more
flexible labour market environment; the enactment of the Disability Act to address the
employment needs of young persons with disabilities and the enactment of a demand-driven
law for technical and vocational education. Moreover, the various growth and development
frame-works such as Growth and Poverty Reduction Strategy Programmes (GPRSP I&II) and
the Ghana Shared Growth and Development Agenda (GSGDA, 2010-2013) all came out with
specific policy initiatives to promote youth employment. For instance, the GPRS II blueprint expected that general policy initiatives such as the pro-poor decentralization and good
governance reforms, the Rural Enterprise Project, Alternative Livelihood Programme, the
Village Infrastructure Project (VIP) and projects implemented by the Social Investment Fund
(SIF) would support and enhance employment opportunity for the youth.
13
One key intervention in the country to reduce the growing unemployment among the youth is
the National Youth Employment Programme (NYEP). The NYEP was created in October
2006 to address the country's youth unemployment with the aim of empowering Ghanaian
youth so they could add positively to the socio-economic and sustainable development of the
nation. This has made it easier for some unemployed youth to find jobs in sectors such as,
agriculture, education, forestry, resource mobilization, health (auxiliary nursing), waste and
sanitation and internship. The current GSGDA also supports this initiative with an enhanced
form of NYEP by expanding the modules to include Youth in Agriculture Programme and the
establishment of ICT trainers programme to train SHS graduates in ICT applications (e. g.
repair of mobile phones and other related gadgets). The governments creation or
establishment of Special Development Areas to reduce Poverty such as the Savannah
Accelerated Development Authority (SADA) and Central Regional Development
Commission (CEDECOM) are strategies to provide productive jobs for the youth.
There is also a complete government supported private initiative, Local Enterprise and Skills
Development Programme (LESDEP) aimed at training the unemployed youth to acquire
viable skills that will eventually make them self-employed through a specialized hands-on
training, within the shortest possible time in their localities. Launched in 2011, LESDEP is
registered under the auspices of the Ministry of Local Government & Rural Development,
and trainings are implemented in collaboration with the Ministry of Employment and Social
Welfare and other government agencies.
Finally, cognisant of the effect of the lack of a policy framework with which stakeholders
could work to achieve the objectives of youth development in the country, government
launched a National Youth Policy on the International Youth Day in August, 2010 to address
such challenges. The national youth policy is intended to address challenges such as lack of
education, skills training; inadequate labour market information, unemployment and
underemployment and also include the provision of opportunities for government to engage
the youth and other stakeholders in meaningful partnership to develop appropriate
interventions and services for youth empowerment.
Challenges
These initiatives and programmes notwithstanding, a number of challenges remain in tackling
the growing youth and graduate unemployment in the country. The following are some of the
challenges:
The rapid increase in youth population (with people age between 15-24 constituting
more than 20 percent of the countrys population) and increasing more than fourfold
over the last forty years
Failure of the economy to generate sufficient employment outlets.
Moreover, there is an apparent mismatch. Education and training have no link to the needs of
the important sectors of the economy; the shrinking of Ghanas industrial and manufacturing
base due partly to the influx of foreign products particularly from China.; the shrinking of
public sector employment opportunities coupled with a relatively slow growth of the private
sector; and the lack of a coherent national employment policy and comprehensive strategy to
deal with the employment problem.
14
Reduce child labour

Target CCA 19: Elimination of child labour1
Indicator: Proportion of Children under Age 15 who are working
The world Summit on Sustainable Development in 1995 directed that countries should take
immediate and effective measures to eliminate the worst forms of child labour (WFCL) as
defined in International Labour Organization Convention No. 182, and elaborate and
implement strategies for the elimination of child labour that is contrary to accepted
international standards. Child labour refers to children who are employed in an economic
activity for pay, profit or family and is measured by the number of children aged 7-14 who
are employed, divided by the number of children of the same age group in the population.
This phenomenon is pervasive across the globe particularly in Africa, and for that matter
Ghana, where children as young as seven years work as domestic labourers, porters, hawkers,
miners, quarry workers, fare collectors, and in agriculture, particularly cocoa growing areas
and in fishing communities. The results from the 2010 population census indicate that more
than half a million children (594,642) aged 7-14 years, representing 12.6 percent of that
population, are employed.
Figure 3.7: Proportion of children aged 7-14 who are employed by locality
25.0
20.6
20.0
19.8
Percent
15.4
15.0
12.6
2000
10.0
7.9
2010
4.3
5.0
All Localities
Urban
Rural
Percent
Figure 3.7 shows that children in rural localities (19.8%) are more likely to be employed than
their counterparts in urban areas (4.3%). The prevalence of child labour in rural areas could
be due to the fact that the capacity to enforce minimum age requirements for schooling and
work is lacking, as well as, poverty. This is confirmed by Figure 1.8 below which shows that
the less well-endowed regions in the country had a much higher incidence of child labour
than the other regions. It averages about 30 percent in the three northern regions with the
Northern region registering the highest of 34.6 percent.
Additional socio-economic common country assessment (CCA) indicators (UN, 2003)
15
Figure 3.8: Proportion of children aged 7-14 who are employed by region
45.0
40.0
2000
35.0
2010
39.8
37.7
34.6
27.8
30.0
Percent
25.9
25.0
25.8
20.0
15.0
14.7
11.7
10.0
5.0
3.4
7.3
5.2
12.4
10.0
9.9
8.8
14.5
9.0
7.0
11.4
15.1
0.0
Greater
Accra
Ashanti
Western
Eastern
Central
Volta
Brong
Ahafo
Upper
East
Upper
West
Northern
Regions
Moreover, while the 2010 PHC data indicate a reduction of about 18.6 percent change from
the 2000 level, regions such as Central, Volta, and Upper West regions actually recorded an
increase in child labour rates by 11 percent, nine percent and 7.8 percent respectively.
Although, the Greater Accra Region recoded the largest decline in child labour rate of more
than 70 percent, the decline (35%) recorded in Upper East seems to have a greater impact
because of the prevailing high rate.
It is well acknowledged that children work for a multiplicity of reasons, the most important
being poverty. In developing countries, though children are not well paid and are sometimes
exploited, they still serve as major contributors to family income and towards their education.
Furthermore, schooling problems also contribute to child labour, whether the inaccessibility
of schools (due either to proximity or affordability) or the lack of quality education which
spurs parents to allow their children to enter into more profitable ventures. Rigid traditional
and cultural factors as well as migratory issues in rural and cocoa growing communities have
all been mentioned as some of the causes why children work (Sahel and West Africa Club
Secretariat/OECD, 2011). Government has recognised these problems and has initiated a
number of interventions and programmes to address child labour as an integral part of
national development policies by creating an enabling environment and setting-up effective
and relevant national child protection systems.
Ghana has formally adopted the three International Labour Organization (ILO) Conventions
on child labour. In addition, it has signed a memorandum of understanding with ILO to
launch a programme under the International Programme for the Elimination of Child Labour
(IPEC). Ghana laws also forbid child labour. Section 87 of the Children's Act, 1998 (Act 560)
forbids any person from employing a child in exploitative labour, or in any engagement that
deprives the child of its health, education or development. Section 88 prohibits anyone from
employing any child at night that is between the hours of eight o'clock in the evening and six
16
o'clock in the morning. Section 89 and90 of the Act allow children above the age of 13 to
engage in light work, and those aged over 15 in non-hazardous work.
Challenges
While substantial legislation and programmes are now in place, legal enforcement remains a
challenge, particularly in the rural areas. With high poverty and poor schooling opportunities,
child labour is still prevalent and sometimes a survival strategy to cope with deprivation.
Thus, there is still a lack of consensus with the definition of what constitutes child labour
even within the international community, making immediate abolishment or enforcement
difficult. A case in point is that in areas/situations where children may have to work to
support their schooling or care for incapacitated or ailing guardian/parents, complete and
immediate abolishment may be precarious or counterproductive.
Goal 2: Achieve universal primary education

Target 2.A: Ensure that, by 2015, children everywhere, boys and girls alike, will be able to
complete a full course of primary schooling.
Indicators
2.1 Net enrolment ratio in primary education
2.2 Proportion of pupils starting grade 1 who reach last grade of primary
2.3 Literacy rate of 15-24 year-olds, women and men
Indicator 2.1: Net enrolment ratio in primary education
Net primary enrolment rate (NER) in primary education is the number of children of official
primary school age (as defined by the Ghana Education Service) who are enrolled in primary
education as a percentage of the total children of the official school age population. The
indicator is used to monitor progress towards the goal of achieving universal primary
education, identified in both the MDGs and the Education for All initiative. It shows the
proportion of children of primary school age who are enrolled in primary school. NER refers
only to children of official primary school age while Gross Enrolment Rate (GER) includes
children of any age. A high NER denotes a high degree of enrolment in education by the
official school-age population. NER below 100 percent provides a measure of the proportion
of school age children who are not enrolled at the primary level. It is important to note,
however, that this difference does not necessarily indicate the percentage of students who are
not enrolled, since some children might be enrolled at the secondary school level. When the
NER is compared with the GER the difference between the two ratios highlights the
incidence of under-aged and over-aged enrolment.
17
Table 3.3: GER and NER in primary school by sex and locality 2000 and 2010
Both sexes
Boys
Girls
Urban
Boys
Girls
Rural
Boys
Girls
2000
GER
NER
80.8
61.4
82.3
61.8
79.2
60.9
92.1
70.7
93.4
71.5
90.8
70.0
73.5
55.4
75.5
56.0
71.5
54.8
2010
GER
NER
111.5
74.6
112.4
74.2
110.6
75.0
116.0
81.8
115.9
81.6
116.1
81.9
107.8
68.6
109.7
68.3
105.9
69.0
The 2010 PHC data indicate that the NER for children in the age group 6-11 in primary
school is 74.6 percent (Table 3.3). While this figure is a marked improvement over the 2000
PHC, which was 61.4%, it is marginally lower than the institutional NER released by the
Ghana Education Service (GES). As shown in Figure 3.9, the institutional data from GES in
themselves show a declining trend of NER, dropping from 88.5 percent in 2008/09 to 77.9
percent in 2010/11 academic year. The two results therefore show a slow progress towards
achieving the MDG target of 100 percent universal primary education by 2015. In contrast,
Figure 3.10 indicates that the GER has been rising steadily from 79.5 percent to 96.4 percent
in 2010/11, itching closer to the 100 percent target. The 2010 PHC results, however, show a
much higher GER of 115.5 percent, creating a wide gap with the NER. The wide gap
suggests that increasingly over-aged enrolments at the primary school level are increasing,
indicating a growing participation in the education system. However, the declining NER
which provides an indication of the extent to which children are enrolling in school at their
correct ages may have implications for the likelihood of children not staying in school and
dropping out particularly if they do not enroll at their correct ages.
Figure 3.9: Net and Gross enrolment ratio in primary school, 2010
120.0
112.4
111.5
110.6
Percentage
100.0
80.0
74.2
75.0
74.6
60.0
GER
40.0
NER
20.0
0.0
Boys
Girls
Pupils
18
Total
Figure 3.10: Net and Gross enrolment ratio in primary school, 1990 -2010
120
100
96.4
Percent
80
77.9
72
60
NER
45.2
40
GER
MDG Target
20
Linear (NER)
0
Source: Ministry of Education

Ghana Statistical Service, 2010 Population and Housing Census
At the locality level, the 2010 PHC results indicate that enrolment in rural areas is much
lower than in the urban areas. While NER in urban areas is 81.8 percent, rural areas
registered 68.6 percent. Both localities, however, registered significant progress over a 10
year period as urban NER increased by 11 percentage points while rural NER increased by
about 13 percentage points over the 2000 PHC results.
Figure 3.11: NER in primary school by region, 2000 and 2010
90.0
80.0
71.6
70.0
Percent
60.0
72.2
64.1
72.3
68.4
63.3
63.4
58.4
75.4
76.4
70.4
81.6
76.4
70.2
67.2
82.8
72.3
74.6
61.4
50.0
40.0
30.0
36.6
32.6
32.1
20.0
10.0
0.0
Northern
Upper
West
Brong
Ahafo
Upper
East
Volta
Central
Western
Eastern Ashanti Greater

All
Accra regions
2000
Region
19
2010
Figure 3.12: GER in primary school by region 2000 and 2010

140.0
120.0
Percent
100.0
107.6
112.3
112.6
113.1
114.3
116.0
116.1
116.2
Western
Greater
Accra
Ashanti
Central
Volta
Eastern
119.6
111.5
90.5
80.0
60.0
40.0
20.0
0.0
Northern
Upper
West
Brong
Ahafo
Regions
Upper All regions

East
2000
2010
Indicator 2.3: Literacy rate of 15-24 year-olds, women and men

There has been a significant improvement in youth literacy status since 2000. A comparison
of the 2000 and the 2010 PHC results shows that the proportion of illiterate youth has
decreased more than half, dropping from 29.3 percent in 2000 to 14.3 percent in 2010. The
reduction appears the same for both men and women. In terms of literacy status on specific
local and international languages, Table 3.4 shows that significant progress have been made
in literacy in local languages only, increasing from 1.8 percent in 2000 to 5.0 percent in 2010
(a growth of about 177%). Surprisingly however, literacy in English among men registered a
slight decline of three percent over the 10 year period. Similarly, while literacy in English
and Ghanaian language among male recorded a slight decline, that of their female
counterparts recorded a substantial increase from 40.3 percent to 52.1 percent over the period,
representing about 30 percent increase. Literacy in other international languages including
French also witnessed a marked improvement of 100 percent over the 2000 rate, increasing
from 0.8 percent in 2000 to 1.6 percent in 2010.
20
Table 3.4: Literacy status of population 15-24 by sex and locality, 2000 and 2010
Literacy status
Not literate
Both sexes
Male
Female
English only
Both sexes
Male
Female
Ghanaian language only
Both sexes
Male
Female
English and Ghanaian language
Both sexes
Male
Female
English, French, Ghanaian
language and other
Both sexes
Male
Female
All
localities
29.3
24.1
34.5
2000
Urban
Rural
17.6
12.8
22.1
41.2
34.9
47.7
All
localities
14.3
11.7
16.8
23.6
24.7
22.5
28.0
28.9
27.1
19.1
20.6
17.6
1.8
1.7
2.0
1.6
1.3
1.8
44.5
48.8
40.3
0.8
0.8
0.7
2010
Urban
Rural
7.8
5.5
9.9
22.2
18.8
25.7
23.9
23.9
23.9
26.4
26.3
26.4
20.8
21.1
20.5
2.0
2.0
2.1
5.0
4.4
5.6
3.8
3.2
4.3
6.6
5.9
7.3
52.0
56.0
48.2
36.9
41.8
32.0
55.2
58.5
52.1
59.7
62.8
56.9
49.7
53.5
45.8
0.9
0.9
0.8
0.7
0.7
0.6
1.6
1.5
1.7
2.3
2.3
2.4
0.7
0.7
0.8
Note: 2000 data does not include French
Figure 3.13 shows that youth literacy rate in Ghana is much higher in urban localities
(92.2%) than in the rural areas (77.8%), giving credence to the fact that illiteracy is associated
with poverty and underdevelopment. While the youth in urban localities often have easy
access/proximity to schools, the same cannot be said about the youth in rural and deprived
localities. The regional results indicate that regions of low level of development and high
poverty rates tend to have lower literacy rates. While the national literacy rate among the
youth according to the 2010 PHC data is 85.7 percent, those of the three northern regions
range from 54.1 percent (Northern), 71.2 percent (Upper West) to 73.6 percent (Upper East).
21
Figure 3.13: Youth literacy status by locality and region

Upper West
71.2
Upper East
Rural
Urban
73.6
All localities
Northern
54.1
Brong Ahafo
83.9
Ashanti
91.6
Eastern
92.0
Volta
86.6
Greater Accra
93.7
Central
92.6
Western
88.0
All regions
85.7
-
20.0
40.0
60.0
80.0
100.0
120.0

The broad policy objectives outlined in the Ghana Shared Growth and Development Agenda
(GSGDA) on education are aimed at producing a well-educated, skilled and informed
population capable of transforming the key sectors of the economy for wealth creation and
poverty reduction. At the level of primary education, key policy related issues to be addressed
include the low perception of quality of teaching and learning outcomes, the removal of
geographical disparities to support the reduction of overcrowding by providing enough
schools for the growing school-age population, low teacher motivation and supervision, and
inadequate supply of teachers in classrooms especially in deprived districts, etc.
Whilst significant efforts have been made by Government and its development partners
particularly towards achieving the universal primary education in the country over the years
through improved access, financing and the provision of infrastructure and facilities, the
progress towards MDG target of NER has been slow and unlikely to be achieved by 2015.
The continued decline in the Net Enrolment Ratio (NER) in primary education is worrying
and requires critical attention and appropriate policy measures are needed to reverse the
trend. Beyond the implementation of the Free Compulsory Basic Education (FCUBE) policy
over the last two decades or so, some of the key policy interventions and strategies that are
being implemented and that seemed to explain the recent high rates of GER include the
following:
22
Capitation grant which is intended to encourage participation in basic education and

increase school attendance rate.
The school feeding programme: The objectives of the school feeding programme are
to increase school enrolment, attendance and retention; and to reduce short-term
hunger and malnutrition among school children in deprived communities across the
country.
Provision of free school uniform and exercise books: Like the Capitation Grant the
objective of providing of school uniforms is to enhance enrolment and retention of
children in schools, particularly children from poor households.
Construction/Rehabilitation of School Classrooms: Measures to construct new
classrooms and rehabilitate those dilapidated have been intensified in recent times.
New schools are been built to reduce the number of schools under trees.
Challenges
Despite the above policy interventions, access and quality education issues remain a matter of
national concern as evidenced by the increasing number of children out of school and
persistently low educational outcomes. Inadequate education infrastructure and high and
increasing cost of education at all levels, as well as low teacher motivation that dampens
morale and commitment are some of the challenges confronting broadening access to the
remaining out of school children at their correct age.
Goal 3: Promote gender equality and empower women

Target 3.A: Eliminate gender disparity in primary and secondary education, preferably by
2005, and in all levels of education no later than 2015
Indicators
3.1 Ratios of girls to boys in primary, secondary and tertiary education
3.2 Share of women in wage employment in the non-agricultural sector
3.3 Proportion of seats held by women in national parliament
Indicator 3.1: Ratios of girls to boys in primary, secondary and tertiary education
This indicator measures the equality of opportunity, fairness and efficiency of education,
measured as a ratio of the number of enrolled girls to enrolled boys in primary, secondary and
tertiary education (also known as the gender parity index), regardless of ages. Education is
one of the most important aspects of human development. It is widely acknowledged that
eliminating gender disparity at all levels of education would help to increase the status and
capabilities of women and reduce feminisation of poverty (GSGDA, 2010). Female education
is also an important determinant of economic development. The emphasis on girls is because
girls are more likely than boys to suffer from limited access to education, especially in rural
areas and/or where families have to make difficult choices in situations of limited resources
or low income. This situation is even worse at higher levels of education as it is well
acknowledged that in most developing countries girls potentially face additional hurdles in
accessing and remaining within the educational ladder, particularly in the later grades as
daughters assume additional burdens within the home and are more susceptible to harassment
from male pupils/students and teachers as well as forced early marriage.
Figure 3.14 shows that the Gender Parity Index (GPI), according to the 2010 PHC data,
reduces as one moves higher on the educational ladder. GPI at the primary level is 0.95,
23
which is for every 100 boys in school there are 95 girls while secondary school and tertiary
level are 0.88 and 0.71 respectively. Trend analysis shows that the GPI has reduced by one
percentage point when compared with the 2000 PHC data, indicating slow progress towards
achieving the MDG target of 1.00 GPI. However, substantial progress has been made at the
tertiary level where the GPI has increased from 0.58 in 2000 to 0.71 in 2010. This increase
may indicate the beginning of a positive trend in increased enrollment of female students
compared with male students at the tertiary level, and thus a positive development for the
countrys quest for equitable and universal education for all children.
A comparison of GPI in urban and rural localities shows that it is lower at all levels of
education in rural localities ranging from 0.9 in primary, 0.78 in secondary and 0.6 at tertiary
levels as against 1.01, 0.97 and 0.73 respectively in urban areas.
Figure 3.14: Ratio of females to males in primary, secondary and tertiary education
by locality
1.20
1.01
1.00
0.95
0.97
Secondary
0.90
0.88
0.80
Ratio
Primary
Tertiary
0.73
0.71
0.78
0.60
0.60
0.40
0.20
0.00
Total
Urban
Rural
Localities
Although the variations at the regional level are generally small, the Greater Accra region has
a GPI at primary of 1.04, secondary school 1.02 and tertiary (0.84), whereas the Northern
region has the lowest GPI at all levels with primary being 0.88, secondary 0.71 and tertiary
0.47 (Table 3.5). A comparison with the 2000 PHC results suggests that while Western,
Central, Northern and Upper Western regions recorded increase in primary school enrolment,
Volta and Eastern regions recorded a decline of three and one percentage point respectively.
However, all the regions saw an increase in both secondary and tertiary enrolments. Northern
(22%) and Upper East (18%) regions registered the most impressive increase at the secondary
school level while the Greater Accra (21%) and Volta (20%) regions recorded the highest at
the tertiary level.
24
Table 3.5: Ratio of females to males in primary, secondary and tertiary education
by locality
2000
2001
Primary
Secondary
Tertiary
Primary
Secondary
Tertiary
Western
0.95
0.82
0.64
0.96
0.87
0.71
Central
0.95
0.83
0.65
0.96
0.95
0.67
Greater Accra
1.04
0.98
0.63
1.04
1.02
0.84
Volta
0.96
0.8
0.49
0.93
0.8
0.69
Eastern
0.94
0.81
0.59
0.93
0.86
0.75
Ashanti
0.88
0.66
0.97
0.92
0.69
Brong Ahafo
0.97
0.94
0.79
0.53
0.94
0.82
0.62
Northern
0.82
0.58
0.35
0.88
0.71
0.47
Upper East
0.9
0.74
0.48
0.91
0.87
0.49
Upper West
0.95
0.8
0.49
0.95
0.86
0.54
Table 3.6 shows trends in GPI since 2009 computed with data from Ministry of Education.
While the GPI obtained from the institutional data depicts similar results as the population
census at both primary and secondary school levels, female enrolment at tertiary level shows
rather wide disparity (Table 3.6). At the basic education sub-sector GPI is highest at the
lower levels in education. There was no change in the GPI for Kindergarten, which currently
stands at 0.98 as in the previous year. At the primary level, GPI increased marginally to 0.97
after it had stagnated at 0.96 since 2006/07 (MOE, 2008). This increase suggests a positive
trend in the enrolment of female pupils compared to male pupils at the primary level. With
regard to JHS, the GPI climbed to 0.93 in 2010/11 after a period of stagnation at 0.92. The
limited progress in GPI in recent years at the basic education level suggests that if parity is to
be achieved, a concerted and targeted strategy is required to close the gap in access at all
levels.
Table 3.6: Gender parity in education, 2009/10 and 2010/11
Educational level/year
2009
2009/10
2010/11
0.98
Target
(2015)
1.00
Progress Towards
target
Stagnated
GPI at KG
0.99
0.98
GPI at Primary
0.96
0.96
0.97
1.00
Slow Progress
GPI at JHS
GPI at SHS level
0.92
0.92
0.93
1.00
Slow Progress
0.84
0.85
0.87
1.00
Significant progress
Female enrollment in
Tertiary level
Female enrollment in Public
Universities
Female enrollment in
Polytechnics
Female enrollment in TVET
44.3
44.7
45.4
50%
Significant progress
37.4
32.4
33.3
40%
Slow Progress
29.7
30.2
32
40%
Slow progress
44.3
44.7
44
50%
Stagnated
Source: Ministry of Education, 2012
25
Indicator 3.2: Share of women in wage employment in the non-agricultural sector

The share of women in wage employment in the non-agricultural sector is the share of female
workers in the non-agricultural sector expressed as a percentage of total employment in the
sector2. The indicator measures the degree to which labour markets are open to women in
industry and service sectors, which affects not only equal employment opportunity for
women but also economic efficiency through flexibility of the labour market and, therefore,
the economys ability to adapt to change. However, labour markets, particularly in
developing countries, remain strongly segregated. According to United Nations (2003), in
many countries, productive work under conditions of freedom, equity and human dignity is in
short supply, and this disproportionately affects women. Women are much more likely than
men to work as contributing family workers, without their own pay, and in the informal
sector (as previously shown). As the rationale behind this MDG indicator envisages, as
economies develop, the share of women in non-agricultural wage employment becomes
increasingly important. A higher share in paid employment could secure for them better
income, economic security and well-being.
The 2010 PHC data show that there are large variations between women and men in nonagricultural employment in Ghana. Figure 3.15 indicates that the share of women in paid
employment stands at 32.7 percent, only increasing marginally from the 2000 PHC figure of
30.1 percent. This result therefore suggests slow progress towards the attainment of the MDG
target. It also indicates that women are not taking advantage, or are not able to take
advantage, of the growing opportunity in the formal sector employment and are more likely
than men to engage in informal activities, subsistence and/or unpaid work in the household.
Figure 3.15: Share of women in paid employment by locality, 2000 and 2010
35.0
30.0
33.7
32.7
30.1
30.6
29.0
28.5
Percent
25.0
20.0
15.0
2000
10.0
2010
5.0
All Localities
Urban
Rural
Locality
The non-agricultural sector includes industry and services. The Ghana Statistical Services follows
the International Standard Industrial Classification (ISIC) of All Economic Activities which defines
industry to include mining and quarrying (including oil production), manufacturing, construction,
electricity, gas and water. Services includes wholesale and retail trade; restaurants and hotels;
transport, storage and communications; financing, insurance, real estate and business
services; and community, social and personal services.
26
Since 2000 the share of women in paid employment has increased among those in urban
localities, from 30.6 percent to 33.7 percent but has declined in rural areas from 29.0 percent
to 28.5 percent accentuating the disparity between rural and urban areas. At the regional
level, with the exception of Northern Region, all the regions registered positive growths of
womens share in paid employment with the Central Region recording the highest percentage
increase of 15 percent. Northern Region however, witnessed a fall of about 6.4 percent to
27.7 percent in 2010 from the 2000 figure of 29.6 percent. See Figure 3.16.
Figure 3.16: Share of women in paid employment by region, 2000 and 2010
40.0
35.0
32.7
30.0 30.1
Percent
25.0
32.4
33.9
33.1
31.5 32.4
32.6
31.1
28.1 28.1
25.7
33.6
29.4
32.8
32.6
30.3
30.4
29.6
27.7
33.5
33.3
20.0
15.0
10.0
5.0
0.0
All region Western
Central
Greater
Accra
Volta
Eastern
Ashanti
Brong
Ahafo
Northern
Upper
East
Upper
West
2000
Region
2010
Indicator 3.3: Proportion of seats held by women in national parliament

Womens representation in parliament is one aspect of womens opportunities in political and
public life, and it is therefore linked to womens empowerment. It is against this backdrop
that the indicator, proportion of seats held by women in national parliament, introduced to
measure womens presence in leadership and decision making that will not only promote
gender equality and empower women, but also influence an effective and transformative
participation.
Although the 2010 PHC does not specifically capture this indicator, it gives an important
signal of the extent of women participation compared to their male counterparts at the senior
level management positions in both public and private works. Figure 3.17 shows that more
females are more likely to work in management positions than their male counterparts as
more than half (50.3%) of the senior level management positions in the country are occupied
by women. However, there are wide disparities in the type of occupation concerned. While
over 77 percent of managers in hotels and restaurants are by women, only 18 percent of Chief
Executive Officers (CEOs) or managing directors, production managers and ICT managers
are women. With regards to legislators and senior public officials, women constitute 40.6
percent. In the case of elementary occupations (such as labourers, street vendors and food
preparation assistants), however, women make up about 65 percent. This result clearly
27
suggests that not only are women more likely to be engaged in the service industry such as
hotels, restaurants and retail and wholesale, but also far outnumber their male counterparts in
menial and elementary occupations.
Figure 3.17: Proportion of women in senior management position in public
and private occupations
Occupation at the Management Level
Hotel and restaurant managers
77.5
Retail and wholesale trade managers
50.8
Legislators and senior officials
40.6
Sales marketing and development managers
37.7
Professional services managers
34.6
Business services and administration
31.9
Manufacturing mining construction and
23.9
Managing directors and chief executives
17.8
Production managers in agriculture forestry
17.7
Information and communications
17.7
Other Services
15.8
National
50.3
-
20.0
40.0
60.0
80.0
100.0
Percentage
Available institutional data from Ministry of Women and Childrens Affairs (MOWAC)
suggest that the progress towards increasing the number of women in public life is slow, and
shows a declining trend. Table 3.7 shows that the proportion of seats held by women declined
from 10.9 percent between the periods 2004-2006, to 8.3 percent between the periods 20082011.
Table 3.7: Trends in women participation in public life, 2000-2011
Sector
Members of Parliament
Ministers of State
Deputy Ministers
Regional Ministers
Deputy Regional Ministers
Cabinet Ministers
State Board and Council
Members
Constitutional Review
Commission
Total
Female
200
33
31
10
19
2
5
0
2000-2004
Percent
of total
10
6.1
16.1
0
5
20
1
2
20
10
Source: MOWAC, 2011
28
Total
230
29
39
10
10
2004 2008
Percent
of total
25
10.9
4
13.9
10
25.9
0
0
Female
4
2
40
Total
Female
230
35
28
10
19
7
4
1
2008-2011
Percent of
total
8.3
20
14
10
7
19
205
3
4
48
42.9
21.1
23.41
22

Empowering women and gender mainstreaming into socio-economic development of the
country has received enormous attention since the Affirmative Action adopted in the Beijing
Conference in 1995. Government thus continues to honour its international obligations and
commitments to women, notably, the implementation of the Beijing Platform for Action; the
Convention on the Elimination of All Forms of Discrimination against Women (CEDAW);
ECOWAS, EU and the Commonwealth Policies, plans and programmes on gender equality.
Key policy strategies and programmes of action that have been developed to empower
women and ensure gender equality in government development frameworks include:
Development and implementation of affirmative policy action for women

Creation of a special fund to support the participation of women in national and
district level elections.
Instituting measures to ensure increasing proportion of women government
appointees in District Assemblies.
Sustenance of public education, advocacy and sensitization on the need to reform
outmoded socio-cultural practices, beliefs and perceptions that promote gender
discrimination.
Development of leadership training programmes for women to enable, especially
young women, to manage public offices and exercise responsibilities at all levels
Strengthening of institutions dealing with women and children.
The ongoing medium term policy framework, GSGDA (2010-2013), has some strategies
aimed at slowing the feminization of poverty. These include promoting the economic
empowerment of women through access to land, labour, credit, markets, information,
technology, business services and networks. Other areas covered are social protection
including property rights, promoting the social empowerment of women through access to
education, (especially secondary, vocational/ technical and tertiary education, non-formal
education, opportunities for continuing education for school drop-outs; and scholarships).
Finally, there are avenues for creating access to health/reproductive health services and
rights, legal aid, social safety nets, social networks and adoption of affirmative action
policy/law to increase participation of women in sectors of leadership and decision-making
(40%) minimum of women representation.
The setting up and the continuous existence of the Ministry of Women and Childrens Affairs
(MOWAC), no doubt, underline the commitment of Government to carry through these
policies. The MOWAC was set up with the mandate of initiating or formulating policies to
promote gender mainstreaming across all sectors that will lead to the achievement of gender
equality and empowerment of women and to facilitate the survival, development and growth
of children.
Challenges
Although, there have been gradual improvements in womens public life and empowerment,
significant challenges still remain for womens participation in access to education
particularly at the secondary and tertiary levels, governance and access to economic
resources. Low female enrolment at secondary and tertiary levels poses a challenge to
womens participation in decision-making at higher levels and their involvement in
employment in wage employment and higher level occupations. With regard to governance,
there is inadequate women representation and participation in public life. Perceived
29
discrimination and harassments in election campaign processes for female candidates, low
limited resources and lack of requisite educational qualification are but a few factors that
hamper womens participation in public life (GSGDA, 2010). Moreover, the dominance of
women in the informal private sector, mainly engaging in contributory or unpaid family work
or menial jobs is a matter of concern. This poses a challenge to the development of a policy
to end the feminisation of poverty. Last but not least, socio-cultural practices, norms, and
societal attitudes tend to discourage women from engaging in wage employment and some
occupations such as commercial driving, welding, auto-mechanics etc. Moreover, certain
socio-cultural practices such as early marriages, customary fostering, female ritual servitude
(Trokosi) and puberty rites still remain a challenge to girl-child education.
Goal 4: Reduce child mortality

Target 4.A: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate
Indicators
4.1 Under-five mortality rate
4.2 Infant mortality rate
4.1 Under Five Mortality Rate
The under-five mortality rate remains a major public health concern to governments and the
international community. This is because it captures more than 90 percent of global mortality
among children under the age of 18 (United Nations, 2003). It is the probability (expressed
as a rate per 1,000 live births) of a child born in a specified year dying before reaching the
age of five. The rationale of this indicator is the fact that it measures child survival and
reflects the social, economic and environmental conditions in which children (and others in
society) live, including their health care and vulnerability to diseases (United Nations, 2003).
In other words, and more simply, the under-five mortality rate is used to identify vulnerable
populations, particularly where data on the incidences and prevalence of diseases (morbidity
data) are not readily unavailable.
Results from the 2010 PHC, in combination with similar data collected from 2000 PHC and
GDHS show a marked decline in under-five mortality. Under-five mortality declined from
167 per 1000 live births in 2000 to 90 per 1000 live births in 2010, about 46 percent decline.
The decline notwithstanding, the result indicates that the country appears off-track in
achieving the MDG target of 39.9 per 1000 live births in 2015 as the progress is worryingly
slow.
Under-five mortality is lower in urban than rural areas. The results from the 2010 PHC
indicate that under-five mortality in rural areas is 90 deaths per 1000 live births compared to
83 deaths per 1000 live births in urban areas. Male children experience higher mortality than
female children. Figure 3.18 shows that under-five mortality rates for male and female
children in urban areas are 92 and 76 deaths per 1000 live births, respectively. Similarly,
under-five mortality rates for male and female children in rural areas are 98 and 82 deaths per
1000 live births, respectively (sourced from the 2010 PHC NDA on mortality, Chapter 10).
30
Figure 3.18: Under-five mortality rate by sex

No. of Deaths Per 1000 live births
120
100
83
98
92
90
76
80
82
Urban
60
Rural
40
20
0
Both Sexes
Male
Female
Variations in under- mortality by region are also quite marked. The under-five mortality
varies from 72 deaths per 1,000 live births in Greater Accra to 128 deaths in the Upper West
Region. Poverty appears to explain the probability that a child will die before the age of five
as the three northern regions and the Central Region, the four most deprived regions in the
country, have mortality rates higher than the national average.
Figure 3.19: Under-five mortality rate by region
Upper West
128
Upper East
117
Northern
116
Central
94
Volta
87
Brong Ahafo
87
Western
82
Ashanti
80
Eastern
75
Greater Accra
72
0
20
40
60
80
100
120
140
No. of Deaths Per 1000

A comparison with the 2000 PHC indicates that under-five mortality rate has reduced in all
the regions in Ghana. Table 3.8 shows that the largest decline was recorded in the Greater
Accra region, reducing by about 110 percent while Upper East region recorded the lowest
decline of approximately 40 percent. The table also indicates that the 2010 PHC results
31
appear to be consistent with the 2008 GDHS as the two show almost a similar pattern
described above.
Table 3.8: Under-five mortality rate by region and period of computation
Region
Western
Central
G/Accra
Volta
Eastern
Ashanti
B/Ahafo
Northern
U/west
U/East
2000
census
DHS
2003
DHS
2008
2010
census
161
163
152
174
144
146
164
199
226
179
106
102
113
129
94
116
95
148
191
96
65
106
56
57
88
79
86
139
90
146
82
94
72
87
75
80
87
116
117
128
Sources: Ghana Statistical Service, *2000 Census ** DHS 2003, ***2008 and ****2010 Census
Indicator 4.2: Infant mortality rate

The infant mortality rate measures the number of infants dying before reaching the age of one
year per 1,000 live births in a given year. In other words, it measures the probability of an
infant dying between birth and the first birthday. Like the under-five mortality, it also reflects
the social, economic and environmental conditions in which children (and others in society)
live, including their health care.
Infant mortality rate stands at 59 deaths per 1000 live births per the 2010 PHC results. This
shows a decline in the last ten years from 90 deaths per 1000 live births in 2000. The last
GDHS (2008) report, however, indicates a 50 per 1000 live births over the survey period.
Although these results show the country has made a substantial progress towards achieving
the MDG target of 26 per 1000 live births by 2015, achieving the said target remains a big
challenge. Figure 3.20 shows that the probability that a child will die before their first
birthday is higher in rural areas than in urban areas (60 deaths per 1000 live births compared
with 55). In addition, a male child is more likely to die before year one than their female
counterparts. The infant mortality rates of male and female in urban areas are 60 and 49
deaths per 1000 live births, respectively. In rural areas, infant mortality rates for male and
female are 65 and 53 deaths per 1000 live births, respectively (Figure 3.20).
32
No. of deaths per 1000 live births
Figure 3.20: Infant mortality rate by locality and sex

70
55
60
60
60
65
49
50
53
40
30
Urban
20
Rural
10
0
Both Sexes
Male
Female
Sex
At the regional level, like under-five mortality, substantial variation exists in infant mortality.
Greater Accra has the lowest infant mortality at 48 deaths per 1000 live births, whereas
Upper West has the highest infant mortality at 81 deaths per 1000 live births (Figure 3.20).
No. of deaths per 1000 live births
Figure 3.20: Infant mortality rate by region

90
81
80
73
70
60
50
48
50
53
55
57
58
Volta
Brong
Ahafo
74
61
40
30
20
10
0
Greater Eastern Ashanti Western
Accra
Central Northern Upper

East
Upper
West
Region

The government, in close partnership with development partners (DPs), has implemented a
number of priority interventions to reduce by two-thirds mortality among both infants and
children between 1990 and 2015. Recognising the stagnation in the child survival indicators,
Ghana adopted a new Child Health Policy and Child Health Strategy in 2006. The Child
Health Policy outlines the key interventions to be scaled up along the continuum of care and
33
focuses on improving access to, quality of, and demand for essential services. The strategy
also includes recent new technologies such as low osmolarity oral rehydration solution (ORS)
and zinc for the management of diarrhoea, and introduction of new vaccines such as 2nd dose
measles vaccine, pneumococcal vaccine and rotavirus vaccine through the national Expanded
Program of Immunisation (EPI) programme.
Moreover, the government recognising the fact that about 40 percent of all deaths that occur
before the age of five are due directly and indirectly to under-nutrition, making it the single
most important cause of child mortality, has rolled out a number of initiatives including the
2007 Program of Work (POW) and the draft 5YPOW III (2007-2011) 3 . The Ministry of
Health (MOH) and the Ghana Health Service (GHS) spearheaded the launch of Imagine
Ghana Free of Malnutrition, a multi-sectoral strategy that addresses malnutrition as a
developmental problem in the context of the Ghana Poverty Reduction Strategy and the
second Five Year Program of Work (5YPOW). Specifically, the MOH and GHS, with the
support of DPs, have expanded over the last several years core health and nutrition services
(i.e. immunization, vitamin A supplementation, deworming etc.) that affect nutritional and
health status of children, mainly through the rapid delivery approach.
Challenges
Though child survival has improved as a result of high impact healthcare services and
economic progress, the current data suggest that one in eleven Ghanaian children dies before
they reach the age of five from largely preventable childhood diseases. There are still
challenges that need to be addressed. These include:
Funding: The inability to sustain the funds used to support programmes under EPI
which requires enormous donor support. Again, more innovation is required in the use
of existing resources, in addition to sustaining resource mobilization and allocation to
the child health programme.
Low coverage of comprehensive health and nutrition services: Despite several
interventions to expand the scale of health services, many reports have complained
that essential health services including intensive health and nutrition education with
necessary inputs (e.g. LLINs) have not been delivered at a scale large enough to bring
desirable outcomes at the regional or national level. A GHS report indicates that
many programs/project supported by DPs cover just a few communities in each
district, if any.
Inadequate human resources and skills within the health system to improve the poor
quality of care;
Uncoordinated activities of Neonatal, Postnatal and Child illness: Lack of integrated
Management of Neonatal and Childhood illnesses (IMNCIs), skilled deliveries, and
postnatal care;
Under reporting of child deaths and inadequate national data to provide complete and
reliable information on child health.
The last Multiple Indicator Cluster Survey (MICS, 2006) report indicates that most of childhood
deaths are caused by preventable or treatable health conditions: the main causes of childhood deaths
are malaria (26%), pneumonia (18%), diarrhoea (18%), and neonatal factors (38%).
34
Goal 5: Improve maternal health

Target 5.A: Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio
Indicator 5.1: Maternal mortality ratio
The maternal mortality ratio is the number of women who die from any cause related to or
aggravated by pregnancy or its management (excluding accidental or incidental causes)
during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective
of the duration and site of the pregnancy, per 100,000 live births. This indicator remains one
of the greatest concerns for the country as far as achieving the MDG target is concerned. The
progress towards the target has been slow and completely off track. Although considerable
progress has been made as various health survey results indicate a fall from a high of 740 per
100,000 live births in 1990 to 451 per 100,000 live births in 2008 (Ghana Health Sector
Review, 2009). The results from the 2010 PHC cast further doubt on achieving the MDG
target. Figure 3.21, based on 2010 PHC, shows that the maternal mortality ratio (hereinafter
referred to as MMR) stands at 485 deaths per 100,000 live births. With less than three years
to 2015, this result indicates a reduction of about 60 percent to 70 percent will be required to
reach the MDG 2015 target of 185 deaths per 100, 000 live births.
Although the census did not ask questions on the causes of maternal deaths, several studies
relate it to pregnancy related complications such as severe bleeding (hemorrhage),
hypertensive diseases, infections and abortions (Ghana Health Sector Review, 2010 ). The
issue is if health workers and government are aware of the causes, why is the country missing
this MDG 5 target. Even a more critical issue is whether the modest gains achieved so far
have been evenly/equitably distributed across different geographical settings and socioeconomic groups such as poor and non-poor individuals, rural and urban localities and age
groups, etc.
Figure 3.21: Maternal mortality ratio by locality
Deaths Per 100,000 live births
7000.0
6000.0
5670.7
5000.0
4000.0
National
3000.0
Urban
2000.0
Rural
1000.0
735.1
565.7 379.7
358.6 509.5 499.2
990.4 960.9
485.2
0.0
12-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 Total
Age group
35
The 2010 PHC results give a startling revelation about the variation of MMR across the agegroups. Though not too surprising, the highest incidence of death occurs between the ages of
12 and 14 as the results indicate 5671 deaths per 100,000 live births, more than ten times
higher than the national rate (Figure 3.21). This age group, however, has the least number of
pregnancy related deaths and live births of 52 and 917 respectively (see Appendix 6). The
data further show that the risk of death increases for women aged above 40 years. The second
highest age group more likely to die from pregnancy related complication is women aged
between 45 and 59. With regard to rural-urban variation, the results appear almost evenly
distributed across the two localities, although deaths in rural areas appear slightly above that
of urban areas, and particularly so for those aged 12-14 and those aged 50-54 years
At the regional level, the disparities are much wider. The MMR ranges from 355 deaths per
100,000 in the Greater Accra Region to 802 deaths per 100000 in the Upper East Region.
Closely following the Upper East Region is the Volta Region which stands at 701 deaths per
100,000. (Figure 3.22) This latest result on Volta Region is not surprising since it confirms
many reports from Ghana Health Service that suggest a worrying trend from the region in
recent times (Ghana Health Sector Review, 2010), particularly in the area of Antenatal Care
(ANC) and Skilled Birth Attendance (SBA).
Figure 3.22: Maternal mortality ratio by region
Upper East
802
Region
Volta
706
Eastern
538
Northern
531
Central
520
Upper West
466
Western
435
Brong Ahafo
422
Ashanti
421
Greater Accra
355
0
100
200
300
400
500
600
700
800
900
Per 100,000 per live births

Antenatal care (ANC) from health professionals (nurses, doctors, midwives or community
health officers) is one of the most important ways of reducing maternal mortality. Data from
the 2008 GDHS indicates that 15 percent of all pregnancies develop complications and
36
become emergencies. Thus, early identification can help for it to be managed to avoid
needless death. However, the 2010 Ghana Health Sector Review Report indicates that the
coverage of pregnant women who received at least one antenatal care visit nationwide
dropped by about 5 percentage points, from 95.0 percent in 2008 to 90.6 percent in 2010. As
mentioned previously, according to the report, even more worrying is women in the Volta
Region, as it recorded the lowest coverage at 70.9 percent in 2010; almost 20 percentage
points lower than the national average. Although, the percentage of Volta women seeking
ANC from health professional has remained the lowest in the country for some time now
(GDHS, 2008), the recent sharp drop-out rates should be a matter of concern since that could
be explaining the high maternal deaths recorded in the 2010 PHC. Table 3.9 below indicates
regions that are performing better compared with regions that need attention in the efforts at
curbing the increasing maternal deaths in the country.
Regions of excellence and regions Requiring Attention
Introducing the regions of excellence and regions requiring attention concepts, the 2010
Ghana Health Review report indicates that although no single region stood out as the most
excellent performer, different regions had presented the most positive trends for different
indicators notably, Upper West, Eastern and Western Regions (see Table 3.9 below).
Table 3.9: Three Best Performing Regions in 2010
Penta 3
(%)
ANC
Supervised
deliveries
(%)
Most positive trend
0.0
4.2
25.6
National trend
-5.0
-1.6
5.6
MDG 5:U/West R
-8.8
-1.0
25.6
EPI: Eastern R
0.0
-3.4
-1.5
OPD: Western R
-2.1
4.2
-1.4
Source: 2010 Ghana Health Sector Review Report
FP
acceptor
rate (%)
1,8
-24.5
-13.8
1.8
-39.0
Institutional
MMR
(%)
-40.9
-3.5
-40.9
41.2
-7.4
OPD per
capita (%)
45.7
10.0
25.0
16.0
45.7
However, in line with our earlier observations, the regional analysis indicates that Volta
region is one region that requires most attention (Table 3.10). A number of Volta Regions
indicators showed a negative trend from 2009 to 2010. Furthermore, Volta Region generally
ranked low in performance compared with the other 9 regions.
Table 3.10: Region requiring attention
Most negative trend

National trend
Volta Region
Trend rank (1 is highest)
Performance rank
Penta 3
ANC
Supervised
deliveries
FP
acceptor
rate
Institutional
MMR
OPD
per
capita
-16.0 %
-5.0 %
-14.1 %
9/10
9/10
-20.2 %
-1.6 %
-20.2 %
10/10
10/10
-15.2 %
5.6 %
-15.2 %
10/10
10/10
-39.0 %
-24.5 %
-19.0 %
5/10
7/10
60.5 %
-3.5 %
50.3 %
9/10
9/10
-0.1 %
10.0 %
0.2 %
9/10
8/10
Source: 2010 Ghana Health Sector Review Report
The coverage in Volta Region of Penta 3, ANC and supervised deliveries, institutional MMR
and OPD per capita were among the lowest in Ghana. The analysis suggests that Volta
Region may require special attention going forward in stemming maternal death in Ghana,
37
and as the report recommends, there is an urgent need for specific support to Volta Region in
order to identify the causes of deteriorating performance.
Causes of Maternal Mortality: Does poverty matter?
Various studies have shown that womens wealth status is one of the determinants of
receiving skilled care during pregnancy. An analysis of the GDHS (2008) data suggests that
in 2008, at national level, 57 percent of births received skilled assistance, however, births to
women in the poorest quintile had approximately three (3) times less access to skilled care
compared to their richest counterparts (Figure 3.23). A substantial increase in the SBA
coverage was observed across all the wealth groups between the two surveys. However, the
coverage gap in accessing skilled care by the poorest and the richest remained wide.
Figure 3.23: Skilled birth attendants (SBA) at birth by wealth quintile (1998 -2008)
94
100
90
81.7
80
64.8
Percent
70
60
50
50
2003
40
30
2008
24.2
20
10
14.6
10.6
9.8
17.1
48
Poorest
Poorer
Middle
Richer
Richest
0
Wealth Quintile
Source: Ghana Statistical Service, 2003 and 2008 Ghana Demographic Health Survey
A further analysis of the data relating to problems women encounter in accessing health
facilities, confirms the fact that poverty plays a critical role in womens decision to seek
medical treatment or ANC. Women respondents of the 2008 demographic health survey
reported that the greatest problem they face in accessing healthcare for themselves was
getting money for treatment (45.1%). Other problems cited were concerns that no drugs were
available (45%), followed by concerns that no providers were available (44%) and the
distance to health facility (26%) (Figure 3.24).
38
Figure 3.24: Problems in accessing health facilities

Getting permission to go for treatment
Not wanting to go alone
18.4
Concern no female provider available
21.5
Having to take transport
25
Distance to health facility
25.9
Concern no provider available
43.5
Concern no drugs available
44.9
Getting money for treatment
45.1
0
10
15
20
25
30
35
40
45
50
Source: Ghana Statistical Service, 2008 Ghana Demographic Health Survey
Again, information gap, including inadequacy of information, incomplete or inaccurate

information, is more prevalent among poor women and/or in relatively deprived communities.
The lack of information available to women about signs of complications in pregnancy, and
access to basic laboratory services, particularly in the Northern and Upper West regions,
affect the quality of antenatal care (MAF, 2010). In the Northern and Upper West regions,
only six in ten pregnant women, and two in three have access to urine testing and blood
testing respectively (GDHS, 2008). These are against the national average of 90 percent
access to these services. This suggests that taking blood and urine samples were less likely to
be performed among poorest women.
A study by Overboscha, et al. (2004) that investigated the determinants of antenatal care use
in Ghana, seems to be consistent with the problems outlined above. The study finds that
standard of living, cost of consultation and in particular travel distance to the provider have a
significant impact on the demand and sufficiency of antenatal care. In addition, pregnant
women with more schooling have a higher propensity to seek sufficient antenatal care from
all providers, while women of higher poverty tend to use less antenatal care from less
expensive providers. Their findings suggest that adequate antenatal care use in Ghana can be
promoted effectively by extending the supply of antenatal care services in the rural area, by
general education policies and by specific policies that increase reproductive health
knowledge.
It is important to note, however, that in Ghana there is too much emphasis on the supply side
of health services delivery. Although, very often, health workers are swift to mention what
they call the Three Ds or the Three Delays that result in maternal death, not much attention
has been given to all the Ds. The Three Ds relate to the delay in making a decision to go to
the health facility, the delay in getting to the facility and the delay in the facility itself. The
first two Ds which border on the demand side of health delivery do not often receive enough
attention as the last D. To a large extent most of the deaths are avoidable. Yet it will depend
on the knowledge available to the woman involved and the family in general to make the
39
right and quick decision during pregnancy. Information on such factors as outlined above is
particularly important in understanding and addressing the barriers women may face in
seeking care during pregnancy and at the time of birth. These are a clear case of demand
deficiency issues. Much as the supply side of the health delivery process is crucial to stem the
tide of maternal mortality, the demand side issues should also receive an equal amount of
attention. It should be noted that access to a health facility is not the same as use. A pregnant
woman may have access or be very close to a hospital but can decide to voluntarily exclude
herself because of certain socio-cultural or religious beliefs she or her family harbours.
Demand driven factors that have recently been identified as key factors affecting delivery in
facilities are poor staff attitude and unsatisfactory facilities, transportation, next to cultural
and other barriers (Ghana Health Sector Review, 2010). Thus, addressing maternal health
issues in the country should be holistic.
Recognising that the target year of 2015 to achieve the MDGs is close, and the fact that
Ghanas maternal mortality rate continues at an unacceptably high level, the government with
support from the development partners has introduced a number of interventions within the
framework of GPRS II and the ongoing GSGDA (2010-2013). Specific to GSGDA, the
following policy measures have been outlined to improve access to quality maternal, child
and adolescent health services:
re-introducing certificate midwifery training and ensuring midwifery service in CHPS
compounds;
providing comprehensive emergency obstetric care (including blood transfusion,
ambulances) at the district level; providing basic emergency obstetric care at all
health centers;
scaling up community case management and strengthening high rapid impact
delivery (HIRD) for U5M & MM and malnutrition; and instituting essential newborn
care.
ensuring safe blood and blood products transfusion; intensifying the implementation
of strategies to reduce maternal mortality;
continuing the implementation of the free health care for pregnant women including
deliveries;
continuing training and upgrading of skills of people engaged in traditional maternal
health service delivery in deprived areas,
sensitizing the public on entrenched negative cultural beliefs associated with maternal
health, increasing coverage of community based management of childhood diseases
and nutrition and scaling up implementation of essential nutrition actions. The
remaining measures are:
strengthening community/facility growth promotion including school feeding
programme; supplementary feeding for malnourished children under five years of age
and pregnant and lactating women; equipping district hospitals and health centers to
handle obstetric emergencies, strengthening referral services for childhood and
maternal emergencies and other essential services, and strengthening adolescent
health service programmes at school, clinic and community levels.
Challenges
These policies notwithstanding, maternal mortality ratio is unacceptably high and achieving
the MDG 5 target by 2015 is almost impossible. But we can work to reduce this unacceptable
40
high rate and save the lives of our mothers. In order to do this, there are persistent policyrelated issues that need to be addressed. These include:
Inadequate maternal health, particularly at the district level as well as investments
in Community Health Planning Services and related Primary Health Care
infrastructure and systems within the context of the Ouagadougou Declaration.
Lack of skilled health workers, supply of equipment, logistics, staff
accommodation, transportation and ambulance services and poor quality of care at
facilities.
Poor transportation and limited referral opportunities: Referrals still remain a
problem in many districts. Although a national ambulance service has been
introduced, it is said to be expensive (and probably not yet able to ensure district
based services).
Proximity: Barriers to access to critical health services by families and
communities, mainly due inadequate financial capabilities of families or mothers,
long distance to the health facility and low female literacy rate as well as poor
health-seeking behaviours among the poor and socio-cultural factors such as
mens influence in healthcare decision making.
Low coverage of the NHIS: The NHIS does not cover the cost of conveying
women in labour to the facilities. The fact that the additional costs of transporting
the women in labour together with the responsible TBA to the nearby hospital or
health facility is not covered may be one of the major factors explaining the
reluctance of mothers to deliver at the facility
Going Forward
There is no doubt that urgent attention and interventions are needed to reduce maternal deaths,
if the 2015 target is to be achieved or appreciably reduced. The issue really has not been
policies or strategies to stem the tide but what we refer to as impact action that will produce
measurable results at the grass roots. The recent Ghana MAF 2010 report observes, among
others, that there are a number of policy documents, strategic plans and review reports on
maternal health. However, implementation has almost always stalled, leading to minimal
impact on the MMR. There exist several long and short term measures including the
expansion of midwifery school intake, redistribution of midwives, lifesaving skills training,
CHPS and free delivery that have been instituted to increase supervised deliveries (Ghana
MAF, 2010); yet current reports indicate a rise in rate from the regions. It is in this light that
there is the need to redirect focus and strategy towards a more action oriented and demand
focused solutions to complement the already existing policies and strategies. A bottom-up
approach from the district health centres should be the way to go. Issues such as
transportation, information and socio-cultural inhibitions that are region specific should
receive immediate attention (details of these are discussed at the recommendation sections).
Goal 7: Ensure environmental sustainability

Target 7.C: Halve, by 2015, the proportion of people without sustainable access to safe
drinking water and basic sanitation
Indicators: 7.1
Proportion of population using an improved drinking water source
41
Ghana has made considerable progress towards achieving the MDG target of halving the
proportion of population without sustainable access to safe drinking water. A recent UNDP
Ghana report (2012) indicates that Ghana is on course to achieve the MDG target of reducing
the proportion of Ghanaians without access to improved water sources to 22 percent by 2015,
and indeed may even exceed it. The indicator measures the percentage of the population who
use any of the following types of water supply for drinking: piped water, public tap, borehole
or pump, protected well, protected spring or rainwater. Improved water sources do not
include vendor-provided water, bottled water, tanker trucks or unprotected wells and springs.
According to UN (2003), the indicator, improved water sources, is based on the assumption
that improved sources are more likely to provide safe water, and that unsafe water is the
direct cause of many diseases in developing countries (see appendix for the detailed
classification of improved and unimproved water source).
The 2010 PHC result appears consistent with the previous survey result on improved water
source, although progress seems to be slowing. Figure 3.25 shows that the proportion of the
population with access to an improved source stands at 76.4 %, representing an increase of
one percentage point from the 2000 PHC surveys figure of 75.3 %. However, a comparison
with the GDHS (2008) results (83.8 %) indicates a sharp decline of about 7.4 percentage
point. The concern is that if this apparent decline is not checked, Ghanas high hope of
achieving this target may be dashed.
Figure 3.25: Proportion of population using an improved water source, 2000 and 2010
100
80
2000
89.7
90
82.6
2010
75.3 76.4
70.2
Percent
70
64.1
60
50
35.9
40
30
29.8
24.7 23.6
17.4
10.3
20
10
0
Improved, all Unimproved,
localities
all localities
Improved,
urban
Unimproved,
urban
Improved,
rural
Unimproved,
rural
Water Source
A detailed analysis of the improved water sources indicates, however, that a greater majority
of the population (50%) still rely on bore-hole/pump/tube well (34%) or public tap/standpipe
(16%) water sources while approximately 40 percent of the population has access to pipe
borne water either within dwelling (17%) or outside dwelling (23%). The latter result on the
pipe-borne indicates a reduction from the 2000 PHC results, which stood at about 48 percent.
Regarding unimproved water sources, Figure 3.36 shows that River/Streams dominate with
46 percent while Sachet water comes second with about 29 percent. A significant proportion
of the population still depends on Unprotected well (10%) or Dugout/Pond/Lake (8%).
42
Figure 3.26: Proportion of population using water from the various improved and
unimproved water sources
Improved water source
Protected well
8%
Rain
water
1%
Protected spring
1%
Pipe-borne
inside dwelling
17%
Borehole/Pump/Tube
well
34%
Pipe-borne
outside
dwelling
23%
Public
tap/Standpipe
16%
Figure 3.27: Proportion of population using unimproved water source

Dugout/Pond/Lak Other
e/Dam/Canal
1%
8%
Bottled water
1%
Satchet water
29%
River/Stream
46%
Tanker
supply/Vendor
provided
4%
Unprotected
spring
Source: Ghana Statistical Service, 2010 Population and Housing1%
Census
Unprotected well
10%
The data further show that urban dwellers experienced a fall in access to improved water
source (from 89.9 % to 82.6 % in 2000 and 2010 respectively) largely on account of a surge
in sachet water usage which is an unimproved source (Figure 3.27). This suggests a cause and
effect it could be that lack of access to an improved source means people are increasingly
using sachet water. However, the proportion of rural dwellers using unimproved water source
(29.8 %) remains much greater than their urban counterparts (17.4 %) (Table 3.11).
43
Table 3.11: Proportion of population using improved and unimproved water source
by locality and region
Improved Water
Urban
Rural
82.6
70.2
88.2
59.4
80.0
76.5
69.7
62.0
81.5
60.9
81.5
65.7
93.2
83.2
91.0
68.3
85.9
60.8
92.2
86.7
95.0
87.9
Region
All region
Western
Central
Greater Accra
Volta
Eastern
Ashanti
Brong Ahafo
Northern
Upper East
Upper West
Unimproved Water
Urban
Rural
17.4
29.8
11.8
40.6
20.0
23.5
30.3
38.0
18.5
39.1
18.5
34.3
6.8
16.8
9.0
31.7
14.1
39.2
7.8
13.3
5.0
12.1
With regard to regional variations, the Volta (67 %), the Northern (68.4 %) and the Greater
Accra (69 %) regions are way below the national average (Figure 3.28). The Greater Accra
Region, in particular, witnessed the greatest deterioration in access to improved water sources
as the proportion of the population with access to improved water fell by about 22 percent
between 2000 and 2010). However, the Northern Region recorded the most impressive
growth rate of about 24 % during this period. The region with the highest access to improved
water is the Ashanti Region, recording about 89.2 %, followed by Upper West (89.1 %), and
then Upper East (87.8 %).
Figure 3.28: Proportion of the population with improved and unimproved
water source by region
120.0
100.0
32.2
31.6
31.0
28.5
27.5
21.9
21.7
78.1
78.3
10.9
10.8
87.8
89.1
89.2
Percent
80.0
12.2
60.0
40.0
67.8
68.4
69.0
71.5
72.5
20.0
0.0
Region
44
Unimproved
Improved
Proportion of population using an improved sanitation facility

Sanitation continues to pose a serious challenge to the country. It is believed that poor
sanitation costs the economy of Ghana about $290 million per year according to a desk study
carried out by the Water and Sanitation Program (WSP, 2012). This sum is the equivalent of
US$12 per person in Ghana per year or 1.6 percent of the national Gross Domestic Product
(GDP). Although, some progress has been made over the last few years, this has been slow,
and the MDG target of 53 percent of the population having access to an improved sanitation
facility by 2015 appears unlikely to be achieved. According to data from the Sanitation
Directorate of the Ministry of Local Government and Rural Development, the national
coverage for improved sanitation stood at 14 percent as at 2011, after stagnating at 13 percent
for three consecutive years (see Table 3.12). The implication of this is an additional one
million, two hundred thousand people will need to have access to or use an improved
sanitation facility each year till the target date of 2015. Put differently, the gap suggests that
there must be approximately five times increase in coverage to be able to achieve the MDG
target (UNDP, 2012).
The results from the 2010 PHC appear to confirm the above results. Using the UN MDG
approved definition for improved sanitation; the proportion of the countrys population with
access to improved sanitation is 13.6 percent. The improved sanitation is referred to as the
percentage of the population with access to facilities that hygienically separate human excreta
from human, animal and insect contact. (Appendix 13 shows the classification of improved
and unimproved sanitation). Facilities such as sewers or septic tanks, pour-flush latrines and
simple pit or ventilated improved pit latrines are assumed to be adequate, provided that they
are not public, according to the World Health Organization and United Nations Childrens
Funds Global Water Supply and Sanitation Assessment 2000 Report. To be effective,
facilities must be correctly constructed and properly maintained. The rationale is that good
sanitation is important for urban and rural populations, but the risks are greater in urban areas
where it is more difficult to avoid contact with waste.
Table 3.12: Trends in national coverage of improved sanitation, 2008-2011
% of popn with access to improved sanitation
services
2008
13
2009
13
2010
13
2011
14
40
40
40
40
Estimated proportion of solid waste generated

properly disposed off (major towns and cities)
Source: Sanitation Directorate of the Ministry of Local Government and Rural Development, 2011
Using a very conservative definition of improved sanitation to be access to private water

closet (WC), Figure 3.29 shows the entire population with access to an improved sanitation
facility, is 14 percent compared with 8.4 percent in 2000. The remaining unimproved
sanitation facilities, constituting about 86 %, include public toilet (32%), no facility, bush or
beach (24%), pit latrine (19%) and KVIP (10%).
45
sanitation by locality, 2000 and 2010
120.0
100.0
80.0
60.0
91.6
82.7
98.5
86.4
75.7
Unimproved sanitation
97.3
Improved sanitation
40.0
20.0
0.0
8.4
All
17.3
Urban
2000
1.5
Rural
13.6
All
24.3
Urban
2.7
Rural
2010
Figure 3.30: Improved and unimproved toilet facilities

W.C.*
14%
Public toilet**
32%
Pit latrine**
19%
Bucket/Pan**
1%
KVIP **
10%
Bush/beach/No
facility**
24%
Note: * indicates improved facility, **indicates unimproved facility
Compared to the 2000 PHC data, improved sanitation has only increased slightly by over five
percentage points over a decade. With regard to usage of unimproved sanitation facilities, the
use of Pit latrine and Bucket/pan have reduced substantially from 22.3 percent and 3.6
percent in 2000 to 19.5 percent and 0.6 percent in 2010 respectively (Figure 3.30). However,
the proportion of the population with no facility or that defecate in bushes or at the beaches,
those using KVIP and Public toilets increased between the one to three percentage points
from the 2000 figures. In the rural areas, Table 3.13 shows that only about 2.7 percent of the
46
population used W.C. as against 24 percent of their urban counterparts. The results further
indicate that the use of KVIP and Public toilets has increased in both urban and rural areas
while the use of Bucket/pan is almost phasing out in both localities. It is also significant to
note that more than 38 percent of the rural population do not have any toilet facility at all or
defecate in the bushes or at the beaches an increase of six percentage points from 2000.
Table 3.13: Proportion of population using toilet facility by locality, 2000 and 2010
2000
Urban
Rural
11.3
32.8
All
localities
24.4
8.4
22.3
6.6
3.6
28.9
17.3
12.4
9.7
6.4
35.8
1.5
30.0
4.2
1.4
23.6
6.5
0.2
6.8
0.2
100.0
100.0
All
localities
23.4
No facilities (bush/beach/field)
W.C.
Pit latrine
KVIP
Bucket/Pan
Public toilet (WC/KVIP/Pit/Pan etc)
Facility in another house
Other
Total
2010
Urban
Rural
10.8
38.2
13.6
19.5
9.7
0.6
31.8
24.3
13.5
12.6
1.1
37.3
2.7
25.7
6.7
0.2
26.1
6.3
0.2
N.A
0.4
N.A
0.4
N.A
0.4
100.0
100.0
100.0
100.0
The differences are even more pronounced at the regional levels. For example, Table 3.14
shows that while the two most populous regions, the Greater Accra (32.3 %) and Ashanti
(22.3%) recorded the highest access to improved sanitation, the three northern regions,
Northern (1.5%), Upper East (2.4%) and Upper West (2.2%), recorded rates that were far
lower than the national average. In fact, the Northern Regions access to improved sanitation
actually deteriorated from the 2000 figure of 1.9 percent. The regions that recorded the
largest improvement were the Volta, the Brong Ahafo and Eastern regions.
Table 3.14: Proportion of the population with access to improved (WC) sanitation
by locality and region
Region
All Regions
Western
Central
Gr. Accra
Volta
Eastern
Ashanti
Brong Ahafo
Northern
Upper East
Upper West
All
2000
Urban
Rural
8.4
7.0
4.8
24.6
2.4
4.0
11.9
2.8
1.9
2.0
2.1
17.3
15.6
10.5
26.6
6.9
9.5
21.9
6.2
4.0
7.4
7.4
1.5
2.1
1.4
10.2
0.7
1.2
1.3
0.8
1.1
1.0
0.9
All
2010
Urban
Rural
13.6
12.2
8.4
32.3
5.2
7.9
22.3
5.6
1.5
2.4
2.2
24.3
25.4
14.5
34.0
12.3
15.1
33.8
10.6
3.5
8.5
9.2
2.7
2.7
3.2
15.9
1.6
2.5
4.8
1.7
0.6
0.8
0.8
47
Growth
Rate
(2000
&2010)
61.5
75.1
75.1
31.2
116.6
96.8
88.1
101.3
-22.3
20.5
3.9
As previously mentioned, it is noteworthy that the definition for improved sanitation has so
far been restricted narrowly to access to WC in order to be consistent with the previous
reports. However, if we are to go strictly by the WHO definition as previously mentioned
(and also as outlined in Appendix 13), the 2010 PHC data suggest that improved sanitation is
actually itching closer to the 2015 MDG target. Defined as the population with access to WC,
KVIP and Pit latrine, provided they are not public, improved sanitation is 42.8 percent, an
increase of about six percentage points from the 2000 figure, as shown in Figure 3.31 below.
The improvement was largely attributed to the phasing out of bucket/pan latrines and the
increase in KVIP in the urban areas, as no significant change was recorded in the rural areas.
Figure 3.31: Proportion of the population with access to improved and
unimproved sanitation by locality, 2000 and 2010
120.0
Percent
100.0
80.0
60.0
62.7
60.5
57.2
64.3
49.7
64.9
Unimproved
40.0
20.0
37.3
39.5
35.7
42.8
50.3
Total (2000)
Urban
(2000)
Rural
(2000)
Total (2010)
Urban
(2010)
Improved
35.1
0.0
Rural
(2010)
Locality
Liquid and Solid Waste Disposal

A further examination of the 2010 PHC data reveal that the disposal of liquid and solid
wastes still remain a great challenge for the country. Figure 3.32 shows that more than 67
percent of the population disposed of their liquid wastes either throwing them onto the
street/outside (30.8%) or onto their compounds (36.3%). As a matter of fact, only about 26
percent of the entire population throws their liquid wastes into either the gutter (16.1%) or the
drainage into gutter (9.6%) while the remaining six percent throw the waste into the sewage
or the soak away system.
48
Figure 3.32: Proportion of the population disposing liquid waste by method of disposal
40.0
36.3
35.0
30.8
Percent
30.0
25.0
20.0
16.1
15.0
9.6
10.0
5.0
3.2
3.2
0.7
Other
Through the
Through
Through
Thrown into Thrown onto Thrown onto
sewerage drainage into drainage
gutter
the
compound
system
a pit (soak system into a
street/outside
away)
gutter
Method of liquid waste disposal
Regarding solid waste disposal, more than 50 percent of the population disposed off it either
by dumping them in an open space (39.2%) or by dumping them indiscriminately (11.2%). A
container dumping and collection by waste collectors, which mainly occurred in the urban
areas, were 21.2 percent and 12.8 percent respectively. A significant proportion of the
population also burned (10.8%) or buried (3.6%). (Figure 3.33)
Figure 3.33: Proportion of population disposing solid waste by method
45.0
39.2
40.0
Percent
35.0
30.0
25.0
21.2
20.0
15.0
10.8
11.2
Burned by
household
Dumped
indiscriminately
12.8
10.0
5.0
1.0
3.6
Other
Buried by
household
Collected
Public dump
(container)
Public dump
(open space)
Method of solid waste disposal


Several policy interventions have been introduced in the last decade or so by government
with support from its development partners to improve access to safe water and sanitation in
both urban and rural areas of the country. Access to safe water, sanitation and the observation
49
of good hygiene practices for improving the health status of the people is of critical concern
to Government. The Government believes that a healthy population is not only an asset by
itself, but also facilitates sustained poverty reduction and socio-economic growth.
The policy objectives of the erstwhile GPRS II and the current GSGDA are to address issues
such as the following: inadequate access to quality and affordable water; poor water resource
management; inadequate access to sanitation facilities and poor sanitation service delivery;
inaccessible and unfriendly environmental, water and sanitation facilities; poor environmental
sanitation; poor hygiene practices and inadequate hygiene education; and inadequate
financing of environmental sanitation services. Ministry of Water Resources, Works and
Housing (MWRWH) working through the Community Water and Sanitation Agency
(CWSA) in the rural areas and the Ghana Water Company in the urban areas have been put in
place to ensure the realisation of governments policy on water and sanitation. With regard to
the provision of safe drinking water, huge investments have been made to either build or
rehabilitate water treatment plants at the district and regional levels which have improved
significantly water delivery system in the country. Several NGOs and DPs have been in the
forefront of providing boreholes and public stand pipes in many rural communities
particularly in the northern parts of the country.
Access to improved sanitation has also received even greater attention in recent times. This
includes initiatives such as the MDG Acceleration Framework (MAF) for Sanitation in order
to fast track the attainment of MDG 7C by 2015; the Coastal Development Programme aimed
at keeping the coastal line clean; the establishment of the Urban Environmental Sanitation
Project, involving the construction of primary storm water drains in various places across the
country to improve sanitation and ensure sustainable environment; and the introduction of
Sanitation Guards under the National Youth Employment Programme to assist Environmental
Health Officers in intensifying education and enforcing sanitation laws.
Challenges
Although the MDG target on access to an improved water source appears to be on track, the
increase from 2000 is marginal and there is also a possible indication of a decline given the
2008 GDHS results. This should be a matter of critical concern to the Government. In
particular, the fast pace of urbanisation and the need to meet the growing demand for water
for consumption, industry and commerce, remain a challenge. There also exist substantial
regional variations in access to safe water which needs to be addressed.
The challenges facing the countrys bid to meet the MDG 7 target on sanitation is enormous
and require an urgent multi-stakeholder action plan to address them. Lack of toilet facilities
in most homes across the country is a major challenge despite an increase in KVIP in the last
decades. Open defecations (known popularly as free range) at landfills, in gutters and
along the beaches, particularly among the rural poor have become serious health hazards.
A major problem with waste management in Ghana, specifically in the regional capital cities
like Accra and Kumasi is the lack of appropriate dumping sites. In Accra, in particular, whilst
rubbish continues to pile-up at open landfill sites in the Weija-Oblogo disused quarry and the
Teshie-Nungua site, residents around Kwabenya protest the construction of a new managed
facility. Moreover, lack of resources and logistics compound the problem in most of the big
cities particularly Accra and Kumasi. There are not enough waste containers or waste
vehicles - the metropolitan assemblies are simply overwhelmed with the amount of refuse
being generated and indiscriminately disposed of. It is acknowledged that whilst institutions
50
such as Zoomlion are assisting to clean up, the delays in clearing up piled-up refuse and the
attitudes of residents were hampering effective garbage disposal efforts.
In sum, the challenges facing access to improved sanitation including solid waste disposal
include the following:
poor development planning/poor infrastructure (population growing faster than waste
management development)
inadequate funding for logistics, infrastructure and landfills
attitudes of the general public towards sanitation
ineffective coordination of sanitation delivery agencies at the regional and district
levels.
Target 7.D: By 2020, to have achieved a significant improvement in the lives of at least 100
million slum dwellers
Indicators 7.10: Proportion of urban population living in slums
UN-Habitat (2003) defines a slum household as a group of individuals living under the same
roof who lack one or more (in some cities, two or more) of the following conditions: security
of tenure, structural quality and durability of dwellings, access to safe water, access to
sanitation facilities and sufficient living area. The indicator is intended to provide an
overview of the share of urban population living in conditions of poverty and physical and
environmental deprivation. According to UNO (2008), the actual proportion of people living
in slums is measured by a proxy, represented by the urban population living in households
with at least one of the four characteristics: a) lack of access to improved water supply; b)
lack of access to improved sanitation; c) overcrowding (3 or more persons per room); and
dwellings made of non-durable material.
Ghanas progress towards achieving the MDG target 7 on reducing the proportion of the
urban population living in slums, remains slow. The increase in population, the rapid rise in
rural-urban migration, limited supply of land, and regulatory frameworks that do not address
the needs of the urban poor has led to an increase in the creation of slums (NDPC, 2011).
According to the 2010 census, the urban population grew to 12.5 million showing a growth
rate of 4.2 percent per annum during 2000 to 2010. While this rapid urbanisation is occurring,
it is estimated that Ghanas housing backlog or deficit currently stands at about 1.7 million
units with the most vulnerable being the urban and rural poor. The MWRH further estimates
that about 43 percent of urban dwellers in Ghana live in slums with 1.3 million living in
Accra alone. In 2001, the slum population for Ghana was estimated at five million people
growing at a rate of 1.83 percent per annum scattered in all the major cities in the country and
was projected to reach 5.8 million by 2010. In terms of its share of the total population, the
proportion of people living in slums in Ghana has declined consistently from 27.2 percent in
1990 to about 19.6 percent in 2008 (NDPC, 2011). In what follows, based on the latest 2010
PHC, we assess the slum and housing situation in Ghana, using the various proxies for slum
as described above.
51
Proportion of Urban Population without Access to Secure Housing4

The indicator is intended to provide an overview of the share of urban population living in
conditions of poverty and physical and environmental deprivation. One of the proxies for a
slum is the proportion of urban population living in dwellings made of non-durable material
or in makeshift houses. According to the 2010 PHC data on type of dwelling units, about six
percent of the urban population live in houses classified as huts, improvised home (kiosk
/container), quarters attached to a shop or uncompleted building. Figure 3.34 shows that the
Upper West (13.3%), the Volta (12.7%) and the Greater Accra (9.1%) regions have the
highest proportion of slum populations as per type of accommodation, while the Eastern
(2.5%) and Ashanti regions (3.0%) have the least. This is based on the dwellings
categorization mentioned earlier. However, according to MWRH (2011), the population with
access to secure housing will increase by only six percent by 2020, and therefore if the
current pattern continues, a significant proportion (about 14%) of the population will still be
living in slum housing by 2020.
Figure 3.34: Percentage of population living in slums (type of accommodation), 2010
All localities
5.9
Upper East
13.3
Volta
12.7
Greater Accra
9.1
Region
Northern
5.7
Upper West
4.6
Western
3.6
Brong Ahafo
3.5
Central
3.3
Ashanti
3.0
Eastern
2.5
-
2.0
4.0
6.0
8.0
10.0
12.0
14.0
Percent
In terms of tenure security or house holding arrangements, about 23 percent of urban

population live in houses which can best be described as rent free (21.2%), perching (0.5%)
or Squatting (0.4%).
The Ghana Statistical Services (GSS) defines a secure house in Ghana as a structurally separate
and independent place of abode such that a person or group of persons can isolate themselves from the
hazards of climate such as storms and the sun. However, this type of housing is only a small
proportion of dwelling units in the country which is broadly defined as a specific area or space
occupied by a particular household and therefore need not necessarily be the same as a house.
4
52
Table 3.15: Proportion of households by tenure/holding arrangements by locality,

2000 and 2010
Type
2000
Urban
Rural
2010
41.4
Owning
All
localities
57.4
Renting
22.1
35.8
9.9
31.1
45.0
13.5
Rent free
19.5
21.6
17.6
20.8
21.2
20.3
Perching
1.0
1.2
0.8
0.5
0.5
0.4
Squating
Other
N.A
N.A
N.A
N.A
N.A
N.A
0.3
0.2
0.4
0.2
0.1
0.1
100.0
100.0
100.0
100.0
100.0
100.0
Total
71.7
All
localities
47.2
Urban
32.7
Rural
65.5
Note: Data not collected in 2000 on squatting and other
Proportion of Urban Population without access to Improve water supply or Improved

Sanitation
According to the 2010 PHC data, 17.4 percent of the urban population does not have access
to improved water sources. The situation has actually deteriorated over the last 10 years with
10.3 percent not having access in 2000. By this definition, the Greater Accra Region has the
largest number of its urban population living in slums as about 30 percent do not have access
to improved water sources (Figure 3.35).
Figure 3.35: Proportion of urban population without access to improved water sources
35.0
30.3
Unimproved water 2000

30.0
Percent
25.0
20.0
20.4
17.4
16.9
15.0
10.0
18.5
14.1 17.8
11.8
10.3
8.1
5.0
7.8
5.0
4.4
6.8
Upper
West
Ashanti
18.5
20.0
14.2
11.1
9.0
7.6
5.5
3.7
0.0
All
Regions
Upper
East
Brong
Ahafo
Western Northern
Volta
Region
53
Eastern
Central
Greater
Accra
If lack of access to improved sanitation is used as a proxy for slum, the proportion of the
urban population living in slum conditions is even higher. Approximately 50 percent of the
urban population has no access to improved sanitation such as WC, private KVIP and Pit
latrine (Figure 3.36). By this definition, about 86.4 percent and 81 percent of Northern and
Upper East regions urban population live in slum conditions while for the Greater Accra,
Eastern and Ashanti regions this is a little over 40 percent.
Percent
Figure 3.36: Proportion of urban population without access to improved sanitation

100.0
90.0
80.0
70.0
60.0
50.0
40.0
30.0
20.0
10.0
0.0
2000
76.1
2010
49.7
42.3
42.8
43.5
50.2
50.5
All
Greater Eastern Ashanti Western Central
Regions Accra
55.1
Volta
81.0
86.4
58.5
Brong
Ahafo
Upper
West
Upper Northern
East
Region
Number of Persons per Room

The 1996 United Nations Conference on Human Settlements stressed on the number of
person per room as a measure of provision of sufficient living space and avoidance of
overcrowding, particularly in the urban areas. Moreover, crowding, or housing density, is a
key measure of housing quality. Also housing, apart from being shelter, often functions as an
important place for social interaction and caring for children, thus ensuring respite from,
social instability, insecurity and violence. The three most commonly used measures of
crowding are persons per room, floor area per person and households per dwelling unit. The
number of persons per room indicator is calculated by dividing the number of people who
live in the household by the total number of rooms they occupy. A low indicator denotes low
crowding (density), and it is considered overcrowding if there are three or more persons per
room.
54
Table 3.16: Number of persons per sleeping rooms by locality, 2010
All sleeping rooms

One room
Two rooms
Three rooms
Four rooms
Five rooms
Six rooms
Seven rooms
Eight rooms
Nine rooms or more
All
localities
4.4
3.1
4.8
6.2
7.2
8.2
9.0
9.7
10.4
12.3
Urban
Rural
4.0
3.0
4.7
5.9
6.7
7.6
8.5
9.2
10.1
12.1
4.9
3.2
5.1
6.5
7.6
8.6
9.4
10.1
10.7
12.4
The 2010 PHC results indicate that on the average more than three people sleep in one room
nationwide (Table 3.16). The ratio appears to be lower in the urban areas (1:3) than in the
rural area (1:3.2). However, in terms of numbers, Figure 3.37 shows than more than 45.8
percent of the urban population belongs to households that occupy only one sleeping room.
The proportion significantly reduces as the number of households occupying more than one
room increases. For example, while households occupying two bedrooms constitute about 26
percent of the urban population, only 7 percent are in four bed rooms.
Percent
Figure 3.37: Proportion of the urban population in number of sleeping rooms

households occupy
50.0
45.0
40.0
35.0
30.0
25.0
20.0
15.0
10.0
5.0
-
45.8
All
Urban
25.9
Rural
11.4
7.0
One
room
Two
rooms
Three
rooms
Four
rooms
3.8
2.3
1.2
Five Six rooms Seven

rooms
rooms
No. of sleeping rooms

55
0.8
1.7
Eight
Nine
rooms rooms or
more

The implications of the rapid urbanization in the cities of Ghana, particularly Accra and
Kumasi, is that governments and City Authorities will have difficulty of mobilizing adequate
resources for development in order to reduce slum and shanty towns expanding so that the
contribution of the cities towards economic growth, social development and alleviation of
poverty will be strengthened. This therefore requires concerted efforts on the part of
government and city authorities as well as all stakeholders to formulate policies that will have
a lasting solution to the problem. It is in light of this that the Government of Ghana has
introduced a number of interventions and initiatives to try to curb slumming in the big cities
and to introduce affordable housing units across the country to close the huge housing deficit
the country is facing. The specific policy objectives for housing in the Ghana Shared Growth
and Development Agenda (GSGDA) include: (i) Increase in access to safe, adequate and
affordable housing; (ii) Improve housing delivery in rural areas; (iii) Upgrade existing slums
and prevent the occurrence of new ones.
To achieve the above set objectives, a National Housing Policy which has an overall goal of
providing adequate, decent and affordable housing that is accessible and sustainable with
infrastructural facilities using private enterprise, with government as facilitator or partner
where appropriate has been prepared and is ready for submission to Cabinet. Furthermore, the
Ministry of Water Resources Works and Housing with support from the UN-Habitat is in a
process of launching a report known as the Ghana Housing Sector Profile that provides
information and an in-depth understanding of the structure and functioning of the housing
sector and the role housing policies play in influencing housing markets and the provision of
affordable housing options.
Again, in order to ensure sustainable urban development through the upgrading of slum areas,
the government initiated The Slum Upgrading Facility (SUF) in collaboration with the UNHabitat in 2008. The SUF operated under the premise that slums can be upgraded
successfully when slum dwellers are involved in the planning and design of upgrading
projects and able to work collaboratively with a range of other key stakeholders. This policy
intervention was immediately followed by the SUF establishing two Local Finance Facilities
(LFFs) in 2009, which was managed under a joint secretariat called the Ghana Slum
Upgrading Facility Secretariat located at the Institute of Local Government Studies. The two
facilities have a series of projects that are being evaluated to ascertain their financial viability
prior to approval for implementation.
Finally, some of the specific government interventions in the affordable housing scheme
include the Government of Ghana Affordable Housing Programme comprising 4720 housing
units which are at various stages of completion at Borteyman, Kpone, Asokore-Mampong,
Koforidua, Tamale and Wa. The projects have been funded from HIPC and SSNIT sources.
To date the total amount of money expended on all six (6) project sites is about GH70.0
million of which GH40.0 million is from HIPC sources and GH30.0 million loan facility
from SSNIT.
Challenges
In spite of these government efforts, progress towards improving significantly the lives of
slum dwellers by 2015 is very slow. The situation does not seem to be abating and conditions
in slum areas in the country appear to be deteriorating with poor sanitation conditions, lack of
access to potable water and spiraling makeshift housing units and squatters spreading in the
56
countrys big cities. The challenges facing slum dwellings today are many, but we will focus
on three, namely, institutional challenges, inadequate housing and poor utility service
provision. We explain these in detail below:
Institutional: The institutional challenges identified include weak enforcement of

development control and planning regulations. Because of this weak institutional and
regulatory framework, which often affect the management of land and planning,
migrants settle anywhere for a long time without being noticed by the City
Authorities, and they multiply in number until their existence begins to pose social
and developmental challenges to the city and its inhabitants and the nation as a whole.
This has created a situation where planning in the city is done mostly after
development had taken place with forced ejections and demolitions. The
ineffectiveness of the town and city planning agencies have been attributed to
inadequate qualified and motivated staff to carry out their mandates of ensuring
orderly development of the city.
Housing: Difficulty in land acquisition and high cost of building materials as well as
lack of financing have been identified as the major constraints slum dwellers and
developers alike face. This situation does not compare favourably with the large
household sizes in the slum communities, making it difficult for the city authorities to
control slum growth since without the slum the people virtually have no alternative
accommodation.
Utility Service Provisions: The city authorities also face real challenge in their quest
to ensure efficient supply of utilities like water, electricity, sanitation and roads to the
slum communities due to their unauthorized locations and weak structures, as well as
illegal connections and inaccessibility.
Goal 8: Develop a global partnership for development

Target 8.F: In cooperation with the private sector, make available the benefits of new
technologies, especially information and communications
Indicators:
8.14: Telephone lines per 100 population
8.15: Cellular subscribers per 100 population
8.16: Internet users per 100 population
Ghana has experienced a phenomenal growth in Information Communication Technology
(ICT) penetration in every facet of the economy - business, education, governance and
agriculture - over the last two decades. The speed with which ICT is developing and its
impact on socio-economic activities cannot be overemphasized as it is constantly growing in
importance in terms of its contribution to GDP, and employment (mostly the youth). The
drivers of the ICT industry currently are the mobile phones and internet services. According
to the National Communication Authority (NCA), as at August 2012, the total cellular/mobile
voice subscriber base in Ghana stood at 24,438,983, which is 98 percent of the Ghanaian
population estimated at 25million. Moreover, the subscribers of internet service have been
growing in leaps and bounds over time. It stood at11 percent or 1,296,047 in 2009, rising to
16 percent in 2010. By 2011 there were over four million subscribers (a rate of 21%),
according to the NCA.
57
The importance of these ICT indicators as tools for monitoring progress towards MDG, Goal
8 stem from the fact that effective communication among those involved in the development
process is not possible without the necessary infrastructure (UNDP, 2003). It is widely
acknowledged that personal computers and telephone lines allow people to exchange
experiences and learn from each other, enabling higher returns on investment and avoiding
problems of duplication or missing information. The use of ICT can make Governments more
transparent, thereby reducing corruption and leading to better governance. Moreover, ICT can
not only help people in rural areas find out about market prices and sell their products at a
better price, but also it can also help to overcome traditional barriers to better education by
making books available online and opening the door to e-learning. The following therefore
assesses the countrys progress towards the ICT target of Goal 8 using the three indicators,
fixed telephone lines, cellular/mobile phones subscribers and internet subscribers per 100
population.
Indicator 8.14: Fixed telephone lines per 100 population
The indicator is measured as the total fixed telephone lines divided by the population and
multiplied by 100 (UN, 2003). According to the 2010 PHC, the total number of households
with fixed line is 127,694, implying that the number of fixed telephones (if we assumed that
each household will have one fixed telephone line) per 100 population is 0.53. This minimal
rate appears to be in line with figures recently released by NCA. According to NCA, fixed
line subscriptions continued to decline, reaching 270,761 in August 2012, from over 289,000
in February 2012 (see Figure 3.39). With the estimated population of 25 million, it means
fixed lines per 100 subscriptions are just 1.08. The discrepancy with the PHC figure may be
due to the fact that the NCA figure includes both commercial telephone lines (i.e., in offices
and institutions) and households while the PHC data captured only the latter. Figure 3.38
shows that fixed line usages are almost non-existence in the rural areas as only 0.12 of fixed
lines per 100 population are available. The declining trend is, however, not too surprising as
it is much more convenient and easy, if not cheaper, to own mobile phone now than fixed
lines. The decline, may therefore be attributable more to a replacement of the fixed line in
households with cellular phones which serve peoples needs better than the fixed lines which
are fast becoming irrelevant in homes.
58
Figure 3.38: Fixed telephone lines per 100 population

1.00
0.93
0.90
No. of fixed lines per 100
0.80
0.70
0.60
0.53
0.50
0.40
0.30
0.20
0.12
0.10
0.00
All localities
Urban
Rural
Locality
Figure 3.39: Trends in national fixed lines subscriptions 2003-2012
Total subscription
450,000
No. of subscribers
400,000
386,060
350,000
300,000
267,389
292,400
250,000
270,761
200,000
152,938
150,000
100,000
50,000
0
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012*
Source: National Communication Authority

Note: * means data up to August 2012
Indicator 8.15: Cellular/mobile phone subscribers per 100 population

This is computed by dividing the total cellular subscribers by the population and multiplying
by 100. As previously mentioned, mobile phone penetration is almost 98 percent in the
59
country. However, this does not necessarily mean over 24 million Ghanaians have mobile
phone lines, because some individuals have more than one mobile line, while others do not
have. This is somewhat manifested by the fact that the 2010 PHC data show a far less
penetration rate. Figure 3.40 indicates that mobile phone subscription per 100 population as
at 2010 is 33 percent. This figure is higher among males (36%) than their female counterparts
(30%). The figure also reveals that rural penetration (19 per 100) is far less than in urban
areas (46 per 100).
Figures 3.40: Mobile phone subscription per 100 population by sex and locality
No. of users per 100
60
46
50
40
30
33
48
43
36
30
19
20
Both sexes
23
15
Male
Female
10
All localities
Urban
Rural
Localities
The disparities in mobile usage are much more pronounced at the regional level. While the
Greater Accra Region has 56 subscriptions per 100 population, the Northern Region has only
14 subscriptions per 100 inhabitants. It is also noteworthy that although the Upper East
Region comes next to the Northern region with only 14.5 subscription per 100 inhabitant, it is
the only region where mobile penetration is higher among female (10.6 subscription per 100)
than males (6.9 subscription per 100) (See Figure 3.41).
60
Figure 3.41: Mobile phone subscription per 100 population by region and sex
53.9
Greater Accra
37.4
42.3
39.8
Ashanti
28.3
Western
32.5
28.3
Central
Region
59.1
56.4
31.7
36.7
35.3
28.7
34.0
31.3
Eastern
24.5
Brong Ahafo
Female
30.5
Male
27.5
23.0
Volta
All sex
29.0
25.9
12.9
Upper East
10.4
6.9
Upper West
10.4
Northern
0.0
10.0
19.7
16.2
14.5
17.6
14.0
20.0
30.0
40.0
50.0
60.0
70.0
Percent
Indicator 8.16: Internet users per 100 population

Like the previous indicators, internet users per 100 population is computed by dividing the
total number of Internet users by the population and multiplying by 100. Although, internet
usage access has experienced enormous growth, the rate of penetration remains very low.
According to the 2010 PHC, internet subscription per 100 population stood at 5.3 (see Figure
3.42 below). Here again, urban usage surpasses rural usage by more than seven percentage
point. Internet usage among females (3.8 subscriptions per 100) also appears to be much less
than among their male counterparts (6.9 subscriptions per 100). The difference becomes
greater for those in the urban areas. It is significant to note, however, that although the
penetration appears much lower, it is consistent with data for Sub Saharan African where
internet usage per 100 population is 6 as at 2008, that is, about one in almost 17 people are on
line in developing countries (African Economic Outlook, 2012) Moreover, a distinction has
to be made between subscribers and usage. Nowadays with the advent of mobile internet, one
does not have to subscribe before having access or using internet. It is also important to note
that access does not necessarily mean usage as people may have access but do not use. In any
case, the rate might be much greater if these two are taken into consideration.
61
Figure 3.42: Internet usage per 100 population

14.0
12.0
12.0
9.1
No. of users per 100
10.0
8.0
6.0
6.9
6.5
Urban
3.8
4.0
2.0
All localities
5.3
Rural
1.8
1.4
0.9
Both sexes
Male
Female
Sex

The Government of Ghana and other agencies including development partners and the private
sector have over the years made several strides in initiating policies to develop the ICT
infrastructure so as to bridge the digital divide between Ghana and the developed world. The
main policy objectives for the information communication technology in GSGDA (2010- 13)
are the promotion of rapid development and deployment of the ICT infrastructure,
strengthening of the institutional and regulatory framework for managing the ICT sector, the
promotion and use of ICT in all sectors of the economy. Key policy interventions in recent
times include the following:
The Ghana National ICT Development Policy (ICT4D) has been developed and
passed by Parliament in 2003. It is a policy statement aimed at realizing the vision to
transform Ghana into an information-rich knowledge-based society and economy
through the development, deployment and exploitation of ICTs within the economy
and society. The ICT policy has four year rolling plans and an operational life span of
between 15 to 20 years. The 14 priority areas of the Policy concentrate on promoting
rapid ICT physical infrastructure development, modernize agriculture and facilitate
development of the private sector.
Another prominent intervention is the development of a national fibre optic network

called Voltacom Project by the nations power hub; the Volta River Authority. A
consolidated national gateway monitoring system was installed in 2010. This was
done by Ministry of Communication through the National Communication Authority
(NCA). The system was to help the sector accelerate the development of mobile
telephony throughout Ghana and also create the environment for a competitive terrain
to enhance the delivery of affordable ICT services. Under this sector, the Ministry
supervised the implementation of the 2nd phase of the Fibre Backbone Project.
The government in conjunction the National Information Technology Agency (NITA)

pursued the e-Government network infrastructure project aimed at creating a platform
for the use of shared services among the MDAs nationwide. It helped to facilitate
62
communication within Government. In this regard, 8 communication masts were

constructed to facilitate the deployment of WIMAX.
Again, the Kofi Annan ICT Centre of Excellence which is a joint Ghana/India project
was established in 2003, through a partnership between the Government of Ghana and
the Government of India. It is a state-of-the-art facility working to stimulate the
growth of the ICT Sector in the Economic Community of West African States
(ECOWAS) and provides an enabling environment for innovation, teaching and
learning as well as practical research on the application of ICT4D in Africa to
produce the human capacity needed for the emerging ICT Industry in Ghana and the
Sub-region.
The recently introduced Subscriber Identity Module (SIM) Card Registration is also
another milestone achievement in the ICT sector. It involves the implementation of
the policy on national registration of SIM Cards and at the end of June 2011, 85
percent of Ghanaian phone users have been properly registered.
Introduction of the Mobile Number Portability (MNP): MNP, implemented in July

2011 by NCA, is a system that allows mobile phone users to move from one mobile
network to another and still retain their original number.
National Digital Broadcasting Migration - The National Digital Broadcasting

Migration Implementation Committee has been inaugurated and the ministry is
monitoring its activities to ensure the smooth migration process from analogue to
digital terrestrial broadcasting in line with international standards. Ghanas
compliance to international technical standards will be adopted by December 2014
ahead of the International deadline of 2015. The completion of the digital
broadcasting migration will lead to improved choice and quality of service for
consumers including better picture and sound quality, and more programme channels
on one frequency. Since the channel will run on one frequency there will be spectrum
release which will be resold for other telecom service. This will promote spectrum
dividend for future use and generate a new revenue stream for government.
Challenges
Notwithstanding these, various initiatives and massive investments in ICT infrastructure by
government and its partners, the sector is still faces a number of challenges. These include the
following:
Poor service delivery in recent times: the frequent network or connection lost by
major mobile phone operator services remains a major concern by the regulator,
NCA, and the general public.
Inadequate penetration or expansion of internet services to SHS and JSS across
the country.
Lack of capacity at the NCA: The regulator, the NCA, improving and building its
capacity to be more visible and credible and acquired the regulatory skills to
effectively guide the growth of the sector.
The regulator should intervene in the Internet market to engender dynamism to
promote growth of the industry. The Internet market should be made competitive
63
so as to attract adequate foreign investment, buy-ups and mergers as epitomised in

the mobile telephone market.
Unavailability of standards for mast construction.
Infrastructure to bring access to rural areas, including for example electricity for
charging phones/ computers etc and infrastructure to bring internet and to increase
mobile phone coverage.
64
Chapter Four
Conclusion and Recommendations
4.1
Introduction
Ghana has made considerable progress in achieving the MDG. Yet substantial challenges
remain to achieve most of the target by 2015. The overall assessment of Ghanas progress
toward the MDGs reveals that, while progress has generally been positive, performance has
been mixed across indicators, regions and localities. While significant progress has been
made in some key MDG targets such as poverty eradication, education and access to safe
water, the overall pace of progress, based on current trends, is insufficient to achieve many of
MDGs such as under-five, infant and maternal mortalities as well as improved sanitation
facilities by the target date of 2015. With only just about two (2) years to the target year, a lot
more efforts are needed to reduce the current worrying levels of some of these targets. It is
well acknowledged that most of these targets, no matter the interventions by government and
other stakeholders, will not be achieved by 2015. In what follows we discuss some policy
recommendation that will be needed to improve on the targets discussed so far in this report.
4.2
Decent and Sustainable Employment Generation
Since the start of the Structural Adjustment Programme, the emphasis of governments has
been on how to grow Ghanas economy. The belief is that higher economic growth will
engender higher incomes because of high employments that will ensue. The reality however
is that the unprecedented growth rates like the periods of the SAP in the 1980s and in recent
times had failed to create decent employment for Ghanaians. The quality of growth and the
distributional effect of the growth process are critical, if the unemployment in the country,
particularly among the youth, and the vulnerable nature of many jobs within the informal
sector are to reduce.
In particular, government must see productive and decent employment generation as the best
and sustainable means of alleviating poverty in Ghana. Consequently, treating employment
generation as a core of government policies must be a priority. This calls for a review of
current macroeconomic and sectoral policy with the introduction of targeted and more
employment oriented initiatives to reverse the problem of weak employment friendly growth.
Measures to sustain macroeconomic stability must be complemented with targeted
interventions towards the promotion of private sector development. This includes rapid
infrastructural development, review of external trade policies to support the growth of
domestic manufacturing enterprise, and measures to ensure the flow of affordable credit to
SMEs.
Again, there should be strategies for promoting more decent and sustainable jobs in both the
formal and informal economies. This should include supporting selected industrial products
to be produced domestically in labour-intensive environment (e.g. construction and building
materials, agricultural equipment, motor vehicles, etc); value addition and processing of
primary products rather than exporting in their raw state, expanding technical and vocational
education and training systems like ICCESS and Competency Based Training (CBT) to
provide resources (inputs); and offering technical support for SMEs, as well as promoting
entrepreneurial development.
65
4.3
Universal Basic Education
The slowdown of enrolment growth at all levels of basic education reflects the significant
challenge the education sector faces in expanding access to the remaining out of school
children and meeting the universal basic education target of MDG 2. Alternative approaches
need to be devised to enroll this hard to reach group. This involves strengthening the
capitation grant, expanding coverage of the school feeding programme to other deprived
areas, providing free school uniform and exercise books; construction/rehabilitation of
schools and classrooms, particularly those under trees, and ensuring the full implementation
of the FCUBE programme to ease some of the cost of educational expenses on parents and
guardians. And also improving access to schools (and understanding why pupils dont
attend). On infrastructure and safety -emphasis should be on separate toilet facilities for boys
and girls etc; and finally ensuring properly qualified staff and that teaching staff are present,
improved quality of teaching.
4.4
Promoting Gender Equality and Women Empowerment
Over the last two decades or so women empowerment and gender mainstreaming into socioeconomic development of the country has received enormous attention. However, significant
challenges still remain for womens participation in access to education particularly at the
secondary and tertiary levels, governance and top management positions. The low share of
women in non-agriculture wage employment and their underrepresentation in national
Parliament and other political and senior management level positions require stronger policy
effort to improve gender equality and promote women empowerment. Introducing such
support scheme as tax rebate for employers who offer the mandatory three month paid
maternity leave for women as stipulated in the Labour Act (Act 651) will help promote
access to wage employment by women. In addition, political parties must be encouraged to
reserve a proportion of safe parliamentary seats for only women to compete as a means to
getting more women into Parliament. That will in turn facilitate the appointment of more
women into government. Besides, government must increase its commitment in promoting
womens involvement in decision making at the local level by appointing more women to the
DCE/MCEs positions.
Moreover, women empowerment should also go beyond politics and a lot more emphasis
should be put on economic empowerment as well. In particular, access to finance, is one area
where most women have been marginalised and excluded. This is because financial
imperfections, such as information and transactions costs, may be especially binding on the
poor women who lack collateral and credit histories. Lack of inclusive financial system
suggests that poor women may be forced to rely on an alternative high cost informal credit
market or on their own internally generated meagre resources. Thus, their ability to invest in
their childrens education, build profitable enterprises, or actively participate in and benefit
from the growing opportunities is limited. Therefore ensuring that women have equal access
to affordable finance will enhance income earning capacity, and they will generally enjoy an
improved quality of life.
4.5
Maternal and Infant Mortality
The maternal mortality rate in the country today is unacceptable and unnecessary. It therefore
requires a doubling of efforts from government and all stakeholders. A national Action
Campaign should be declared around the themes that were recently suggested by Ghana MAF
66
(2010) which are likely to have a greater impact on maternal health both within the short-run
and the long-run. These three key interventions are family planning (FP); skilled delivery
services (SD); and emergency obstetrics and neonatal care (EmONC). It has recently
emerged that despite the focus on FP in recent past, the number of FP acceptors decreased by
almost 25 percent in 2010 compared to 2009, and in 2010 it was at 23.5 percent (Ghana
Health Review, 2010). FP is an essential component of the strategy to reach the MDGs, and it
is recommended that education on family planning should be stepped up as a medium to long
term measure and to introduce a FP indicator in the monitoring framework.
Moreover, transportation, distance and emergency referrals still remain a problem in many
districts. The majority of hospitals across the country do not have ambulance services.
Although it is well acknowledged that regional and district hospitals are well equipped to
handle complicated labour cases, the main issue is how to timely transport women in labour
to these facilities. Although the national ambulance service has been in place for some time
now, its coverage is not only limited and unable to ensure district based services, but also it is
said to be too expensive for poor families to bear. Additionally, the EmONC is being
implemented in all 10 regions, but according to the Health Sector Review (2010), it is not yet
at full complement of required resources (midwives, equipment). It is therefore recommended
that in order to accelerate the achievement of MDG 5 by 2015, the ambulance services should
be scaled up and made available in all district hospitals.
There is also an urgent need to carry out studies into the factors underlying voluntary selfexclusion that lead to low institutional deliveries, and adopt best local practices to encourage
institutional deliveries. More specifically, research should focus on demand other than only
on the supply side. Particularly, careful empirical analysis of why ANC, SBA and FP
indicators have substantially decreased in some regions and districts such as Volta Region.
While we discuss reducing maternal deaths as Goal 5, it invariably links up with Goal 4
which is reducing Child Mortality. Women who attend ANC frequently and are delivered in a
health facility assisted by skilled health personnel will be more likely to have a healthy child
and have access to the routine national immunization for both mother and child. Thus efforts
to encourage women to visit their health facilities and maternal health campaign in general
should have a positive ripple effect on infant mortality rate. Besides, awareness creation to
promote healthy and nutritious infant food, exclusive breast feeding in the first six months
and immunization campaign should be intensified.
4.6
Improving Sanitation
The challenges facing the countrys effort at meeting the MDG 7 target on sanitation are huge
and require urgent multi-stakeholder action plan to address them. The country continues to
face unhygienic conditions such as poor toilet facilities, liquid and solid waste disposal
challenges as a result of poor development planning/poor infrastructure, inadequate funding
for logistics, infrastructure and landfills and ineffective coordination of sanitation delivery
agencies at the regional and district levels. Ghana therefore needs to improve on its strategies
to expedite the progress towards MDG 7, especially sanitation. At the current pace of
increase in the use of improved sanitation, the number of people in Ghana who would be
without improved toilet facilities will be 18.7 million by 2015. Ghana has also developed
another MAF for Sanitation in order to fast track the attainment of MDG 7C by 2015, dabbed
Go Sanitation Go (GSG). The three key strategic intervention areas identified for
improving basic sanitation under the MDG Acceleration Framework (MAF)are, scaling-up
67
Community-Led Total Sanitation (CLTS) country-wide, implementing decentralised

treatment/disposal systems incorporating harvesting/re-use of biogas, and rolling out targeted
Micro-finance credit scheme for household latrine construction. Government and
development partners should work together to mobilise resources for the implementation of
MAF for sanitation and other interventions.
There is also the urgent need to effect attitudinal and behavioural change in the people
through extensive educational and awareness creation programmes of maintaining healthy
lifestyles and good sanitary conditions.
4.7
Reliable ICT services
Although the country has witnessed a phenomenal growth in ICT usage, the nature of
services provided by some of the telecom companies needs to be greatly improved. There is
the need for the National Communication Authority to sign performance based agreements
with these providers on month by month basis to ensure value for money for the growing
users. And penalties should be imposed if such contracts are not observed to deter them from
taking their unsuspecting clients for granted and ensure improved services.
4.8
Data for Planning, Monitoring and Evaluation
Finally, improved data and monitoring tools are crucial for devising appropriate policies and
interventions needed to achieve the MDGs. Although some progress is being made, reliable
statistics for monitoring development remain inadequate in the country. There is therefore the
need for a more conscious effort on the part of government and development partners to take
keen interest in investing in the production and publication of regular, accurate and timely
data and statistics to facilitate effective planning, monitoring and evaluation of policy
interventions and the progress towards MDGs and beyond. Building such capacity for an
effective data gathering and M&E demands increased and well-coordinated financial and
technical support from government and development partners.
68
Reference
Ghana MAF (2010) Country Action Plan for Maternal Health, 2010, United Nations
Ghana MAF (2011) Go Sanitation Go: Country Action Plan for Sanitation, 2011, United
Nations
Government of Ghana (2011) Implementation of the Ghana Shared Growth and
Development Agenda 2010-2013: 2010 Annual Progress Report, National
Development Planning Commission
Government of Ghana, (2005) Growth and poverty Reduction Strategy (GPRS II), 20062009, Volume 1: Policy Framework
Ghana Government, (2010) Ghana Shared Growth and Development Agenda 2010-2013
Environmental Protection Agency (2007) Ghana Environment Sector Study (GESS) Accra
GSS (2007) Pattern and Trends of Poverty in Ghana 1991-2006, Ghana Statistical Service
ILO (2009) Guide to the new Millennium Development Goals Employment Indicators,
including the full set of Decent Work Indicators International Labour Office,
Geneva, available at http://www. Ilo.org/trends
NDPC (2010) 2008 Ghana Millennium Development Goals Report, Republic of Ghana
Overbosch, G. B., Nsowah-Nuamah, N. Van Den Boom, G and Damnyag, L. (2004),
Determinants of Antenatal Care Use in Ghana, Journal African Economics, 13: 277301
Sparreboom and Baah-Boateng (2011) Ghana Economic Growth and Better Labour
Market outcomes, but challenges remain in Sparreboom and Albee (ed.) Towards
Decent Work in sub-Saharan Africa: Monitoring MDG Employment Indicators ,
International Labour office, Geneva
UNICEF (2010) Analysis of Out of School Children in Ghana: Ghana Demographic and
Health Survey, GDHS 2003-2008
United Nations (2011) The Millennium Development Goals Report 2011, United Nations,
New York
Unite Nations Development Group (2003) Indicators for Monitoring the Millennium
Development Goals: Definitions, Rationale, Concepts and Source Document No.
ST/ESA/STAT/SER.F/95, New York
69
West Africa Club Secretariat / OECD (2011) Emerging good practice in combating the
worst forms of child labour in West African cocoa growing communities Paper No.
SWAC/OECD2011, Available at:
http://www.oecd.org/swac/publications/49069653.pdf
World Bank (2011) Tackling Poverty in Northern Ghana, World Bank, Washington D.C.,
March 2011
70
Appendix
Table A1: MDG goals and targets tracked
Goals and Targets

Indicators for monitoring progress
(from the Millennium Declaration)
Goal 1: Eradicate extreme poverty and hunger
Target 1.B: Achieve full and productive
1.5 Employment-to-population ratio
employment and decent work for all, including 1.7 Proportion of own-account and contributing
women and young people
family workers in total employment
Goal 2: Achieve universal primary education
Target 2.A: Ensure that, by 2015, children
2.1 Net enrolment ratio in primary education
everywhere, boys and girls alike, will be able to 2.2 Proportion of pupils starting grade 1 who reach
complete a full course of primary schooling
last grade of primary
2.3 Literacy rate of 15-24 year-olds, women and men
Goal 3: Promote gender equality and empower women
Target 3.A: Eliminate gender disparity in primary 3.1 Ratios of girls to boys in primary, secondary and
and secondary education, preferably by 2005, and
tertiary education
in all levels of education no later than 2015
3.2 Share of women in wage employment in the nonagricultural sector
3.3 Proportion of seats held by women in national
parliament
Goal 4: Reduce child mortality
Target 4.A: Reduce by two-thirds, between 19s90 4.1 Under-five mortality rate
and 2015, the under-five mortality rate
4.2 Infant mortality rate
Goal 5: Improve maternal health
Target 5.A: Reduce by three quarters, between 5.1 Maternal mortality ratio
1990 and 2015, the maternal mortality ratio
Target 5.B: Achieve, by 2015, universal access to
reproductive health
5.4 Adolescent birth rate
Goal 7: Ensure environmental sustainability
Target 7.C: Halve, by 2015, the proportion of
7.8 Proportion of population using an improved
people without sustainable access to safe drinking
drinking water source
water and basic sanitation
7.9 Proportion of population using an improved
sanitation facility
Target 7.D: By 2020, to have achieved a
7.10 Proportion of urban population living in slums
significant improvement in the lives of at least
100 million slum dwellers
Goal 8: Develop a global partnership for development
Target 8.F: In cooperation with the private sector, 8.14 Fixed telephone lines per 100 inhabitants
make available the benefits of new technologies, 8.15 Mobile cellular subscriptions per 100
especially information and communications
inhabitants
8.16 Internet users per 100 inhabitants
71
Table A2: Unemployment rate by sex, locality and region

Western
Central
Greater Accra
Volta
Eastern
Ashanti
Brong Ahafo
Northern
Upper East
Upper West
Total
All localities
Urban
Rural
All localities
Urban
Rural
All localities
Urban
Rural
All localities
Urban
Rural
All localities
Urban
Rural
All localities
Urban
Rural
All localities
Urban
Rural
All localities
Urban
Rural
All localities
Urban
Rural
All localities
Urban
Rural
All localities
Urban
Rural
Both Sexes
Male
Female
5.9
8.8
3.8
5.7
7.5
4.1
8.3
8.4
6.6
4.1
5.8
3.3
5.7
7.6
4.2
6.9
8.5
4.6
4.3
6.4
2.7
3.7
7.7
2.1
3.4
7.7
2.3
4.1
11.5
2.9
5.8
8.0
3.5
48.5
48.6
48.3
44.6
44.8
44.2
46.9
47.1
44.0
45.1
45.5
44.8
44.6
45.0
44.1
41.3
41.1
42.1
41.9
40.7
44.1
45.7
47.2
43.5
46.2
46.1
46.4
44.9
45.3
44.6
44.8
44.9
44.4
51.5
51.4
51.7
55.4
55.2
55.8
53.1
52.9
56.0
54.9
54.5
55.2
55.4
55.0
55.9
58.7
58.9
57.9
58.1
59.3
55.9
54.3
52.8
56.5
53.8
53.9
53.6
55.1
54.7
55.4
55.2
55.1
55.6
72
Table A3: Employment rate by sex, locality and region

Employment Rate
Both Sexes
Western
Central
Greater Accra
Volta
Eastern
Ashanti
Brong Ahafo
Northern
Upper East
Upper West
Total
Male
Female
All localities
94.1
94.4
93.8
Urban
91.2
91.2
91.2
Rural
96.2
96.5
95.9
All localities
94.3
94.5
94.2
Urban
92.5
92.6
92.4
Rural
95.9
96.1
95.7
All localities
91.7
92.1
91.3
Urban
91.6
91.9
91.2
Rural
93.4
94.1
92.6
All localities
95.9
96.1
95.8
Urban
94.2
94.3
94.1
Rural
96.7
96.9
96.6
All localities
94.3
94.8
93.9
Urban
92.4
92.6
92.2
Rural
95.8
96.3
95.3
All localities
93.1
94.1
92.1
Urban
91.5
92.7
90.4
Rural
95.4
96.1
94.8
All localities
95.7
96.3
95.0
Urban
93.6
94.4
92.8
Rural
97.3
97.7
96.9
All localities
96.3
96.6
96.0
Urban
92.3
92.8
91.8
Rural
97.9
98.1
97.6
All localities
96.6
96.7
96.6
Urban
92.3
92.6
92.1
Rural
97.7
97.7
97.7
All localities
95.9
96.1
95.7
Urban
88.5
89.2
87.9
Rural
97.1
97.3
97.0
All localities
94.2
94.6
93.7
Urban
92.0
92.5
91.5
Rural
96.5
96.8
96.1
73
Table A4: Proportion of own account and contributory family member in

total employment 15 years and older by sex, locality and region
Locality
Total
Western
Central
Greater Accra
Volta
Eastern
Ashanti
Brong Ahafo
Northern
Upper East
Upper West
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Both
sexes
(%)
72.4
59.4
85.4
71.2
58.0
80.1
75.3
65.8
83.2
52.2
51.0
65.1
82.8
70.7
88.5
76.6
65.3
84.6
66.9
57.1
81.5
78.6
68.8
85.8
87.2
73.1
92.3
87.4
71.0
91.4
87.6
60.0
92.1
Male (%)
Female (%)
63.7
46.5
80.6
61.3
42.1
73.4
64.5
50.8
75.6
38.0
36.6
52.5
76.8
60.7
84.2
69.3
53.2
79.8
56.9
44.3
75.3
73.1
60.1
81.9
84.4
65.7
91.4
84.3
63.1
89.5
84.7
50.5
90.3
80.6
71.4
90.0
81.4
73.1
87.4
84.5
78.3
89.8
66.1
65.0
77.7
88.1
79.4
92.3
83.6
75.7
89.6
76.6
69.3
87.7
84.0
76.6
89.8
89.9
80.6
93.2
90.2
78.2
93.0
90.3
68.9
93.7
74
Table A5: Under-five mortality rate by region and period of computation
Region
Western
Central
G/Accra
Volta
Eastern
Ashanti
B/Ahafo
Northern
U/west
U/East
2000
census*
DHS
2003**
DHS
2008***
2010
census
****
161
163
152
174
144
146
164
199
226
179
106
102
113
129
94
116
95
148
191
96
65
106
56
57
88
79
86
139
90
146
82
94
72
87
75
80
87
116
117
128
Sources: Ghana Statistical Service, *2000 Census ** DHS 2003, ***2008 and ****2010 Census
Table A6: Maternal births and deaths by age group

Number of live
births in the last
12 months
Total
12-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
623,700
917
40,307
126,417
167,306
130,724
92,751
41,898
14,742
8,638
Number of
female
deaths in last
12 months
33,347
1,311
2,647
3,350
3,809
4,821
4,636
4,714
3,858
4,201
Pregnancy
related
Deaths
MMR
3,026
52
228
480
600
666
463
308
146
83
485.2
5670.7
565.7
379.7
358.6
509.5
499.2
735.1
990.4
960.9
75
Table A7: Ratio of females to males in primary, secondary and tertiary education
by locality and region, 2000 and 2010
All regions
Western
Central
Greater Accra
Volta
Eastern
Ashanti
Brong Ahafo
Northern
Upper East
Upper West
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Primary
0.96
1.02
0.91
0.95
1.03
0.91
0.95
1.01
0.92
1.04
1.05
0.96
0.96
1.02
0.93
0.94
1.02
0.91
0.97
1.02
0.92
0.94
1.00
0.90
0.82
0.90
0.76
0.90
0.99
0.88
0.95
1.04
0.92
2000
Secondary
Tertiary
0.84
0.58
0.94
0.62
0.72
0.5
0.82
0.64
0.95
0.69
0.72
0.58
0.83
0.65
0.93
0.71
0.76
0.57
0.98
0.63
1.00
0.64
0.81
0.51
0.80
0.49
0.90
0.56
0.76
0.45
0.81
0.59
0.93
0.59
0.73
0.60
0.88
0.66
0.97
0.68
0.76
0.60
0.79
0.53
0.90
0.52
0.70
0.53
0.58
0.35
0.68
0.40
0.48
0.29
0.74
0.48
0.89
0.59
0.67
0.43
0.80
0.49
0.91
0.53
0.75
0.47
76
Primary
0.95
1.01
0.9
0.96
1.01
0.92
0.96
1.00
0.93
1.04
1.05
0.97
0.93
1.01
0.90
0.93
1.00
0.88
0.97
1.02
0.92
0.94
0.99
0.90
0.88
0.94
0.86
0.91
0.96
0.89
0.95
1.07
0.93
2010
Secondary
Tertiary
0.88
0.71
0.97
0.73
0.78
0.6
0.87
0.71
0.97
0.76
0.78
0.52
0.95
0.67
1.02
0.71
0.88
0.54
1.02
0.84
1.03
0.83
0.89
1.04
0.80
0.69
0.88
0.75
0.75
0.59
0.86
0.75
0.95
0.78
0.76
0.65
0.92
0.69
0.98
0.68
0.79
0.75
0.82
0.62
0.91
0.66
0.72
0.43
0.71
0.47
0.78
0.49
0.65
0.42
0.87
0.49
0.96
0.58
0.83
0.40
0.86
0.54
0.98
0.49
0.82
0.61
Table A8: Classification of improved and unimproved water sources

Improved water sources
Unimproved water sources
Household connection
Borehole
Protected dug well
Protected spring
Public standpipe
Unprotected well
Unprotected spring
Bucket
Rivers or ponds
Vendor-provided water
Tanker truck water
Bottled (& sachet) water
Source: UNDP, 2003

Table A9: Percentage of urban population using unimproved water and sanitation
All Regions
Western
Central
Greater Accra
Volta
Eastern
Ashanti
Brong Ahafo
Northern
Upper East
Upper West
Unimproved water
2000
2010
10.3
17.4
5.5
11.8
14.2
20.0
7.6
30.3
17.8
18.5
11.1
18.5
8.1
6.8
16.9
9.0
20.4
14.1
3.7
7.8
4.4
5.0
Unimproved sanitation
2000
2010
60.5
49.7
64.5
50.2
65.9
50.5
52.8
42.3
69.3
55.1
59.7
42.8
54.9
43.5
63.0
58.5
88.9
86.4
84.8
81.0
79.0
76.1
Figure A1: Unimproved water source by region
77
Figure A2: Unimproved water and sanitation 2000 and 2010

100
90
80
70
60
50
40
30
20
10
0

Unimproved sanitation 2000
Unimproved sanitation 2010
Table A10: Improved and unimproved water sources by region

2000
Western
Central
Greater Accra
Volta
Eastern
Ashanti
Brong Ahafo
Northern
Upper East
Upper West
Improved
71.6
79.6
88.5
60.6
70.5
82.4
67.5
55.1
91.8
86.3
2010
Unimproved
28.4
20.4
11.5
39.4
29.5
17.6
32.5
44.9
8.2
13.7
% Growth
Rate
Improved Unimproved
71.5
28.5
78.1
21.9
69.0
31.0
67.8
32.2
72.5
27.5
89.2
10.8
78.3
21.7
68.4
31.6
87.8
12.2
89.1
10.9
-0.3
-1.9
-22.0
11.8
2.8
8.3
16.0
24.1
-4.4
3.2
Table A11: Classification of improved and unimproved sanitation facility

Improved Sanitation Facilities
Unimproved Sanitation Facilities
Flush or pour-flush to piped sewer system,

piped sewer system and pit latrine
Ventilated improved pit latrine (VIP)
Composting toilet
Flush or pour-flush to elsewhere
Source: UN, 2003
78
Pit latrine without slab or open pit

Bucket
Hanging toilet or hanging latrine
No facilities/bush/field (open
defecation)
Table A12: Proportion of population using toilet facility by locality
No facilities (bush/beach/field)
WC
Pit latrine
KVIP
Bucket/Pan
Public toilet (WC/KVIP/Pit/Pan etc)
Facility in another house
Other
Total
All
localities
23.4
8.4
22.3
6.6
3.6
28.9
6.5
0.2
100.0
2000
Urban
Rural
11.3
17.3
12.4
9.7
6.4
35.8
6.8
0.2
100.0
32.8
1.5
30.0
4.2
1.4
23.6
6.3
0.2
100.0
2010
All Urban Rural
localities
24.4
10.8 38.2
13.6
24.3
2.7
19.5
13.5 25.7
9.7
12.6
6.7
0.6
1.1
0.2
31.8
37.3 26.1
N.A
N.A
N.A
0.4
0.4
0.4
100.0
100.0 100.0
Table A13: Proportion of households by ownership type by locality
Owned by household member

Being purchased (e.g. mortgage)
Relative not a household member
Other private individual
Private employer
Other private agency
Public/Govt ownership
Other
Total
All
localities
57.4
1.1
12.5
19.3
4.1
0.4
2.0
3.1
100.0
2000
Urban
Rural
41.4
1.6
13.3
30.1
5.1
0.6
3.3
4.6
100.0
71.7
0.7
11.7
9.7
3.3
0.2
0.8
1.9
100.0
79
All
localities
52.7
0.8
15.6
26.3
1.5
0.4
2.2
0.4
100.0
2010
Urban
Rural
39.7
1.1
16.2
37.3
1.6
0.5
3.1
0.5
100.0
69.1
0.6
14.8
12.5
1.4
0.2
1.0
0.3
100.0

MDG Report (24-10-13)

Uploaded by

Copyright:

Available Formats

MDG Report (24-10-13)

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

MDG Report (24-10-13)

Uploaded by

Copyright:

Available Formats

2010

POPULATION & HOUSING CENSUS REPORT

Copyright 2013 Ghana Statistical Service

Preface and acknowledgements

Dr. Philomena Nyarko

Employment sector by locality and sex .................................................................. 7

Figure 3.39: Trends in national fixed lines subscriptions 2003-2012 ...................................... 59

Acquired Immune Deficiency Syndrome

completely off-track in achieving some of the important indicators on non-monetary poverty.

Goal 1: Eradicate extreme poverty and hunger

Figure 3.2: Employment to population ratio by region

Northern Upper East

Both SexesMale Female

Source: Central Bureau of Statistics, 1960, 1970, 1984 Censuses and

Key Policy Measures and Challenges

Reduce child labour

Additional socio-economic common country assessment (CCA) indicators (UN, 2003)

Goal 2: Achieve universal primary education

Source: Ghana Statistical Service, 2010 Population and Housing Census

Source: Ministry of Education

Eastern Ashanti Greater

Figure 3.12: GER in primary school by region 2000 and 2010

Upper All regions

Indicator 2.3: Literacy rate of 15-24 year-olds, women and men

Figure 3.13: Youth literacy status by locality and region

Source: Ghana Statistical Service, 2010 Population and Housing Census

Key Policy Measures and Challenges

Capitation grant which is intended to encourage participation in basic education and

Goal 3: Promote gender equality and empower women

Source: Ghana Statistical Service, 2010 Population and Housing Census

Source: Ghana Statistical Service, 2010 Population and Housing Census

Source: Ministry of Education, 2012

Indicator 3.2: Share of women in wage employment in the non-agricultural sector

Indicator 3.3: Proportion of seats held by women in national parliament

Occupation at the Management Level

Hotel and restaurant managers

Retail and wholesale trade managers

Legislators and senior officials

Sales marketing and development managers

Professional services managers

Business services and administration

Manufacturing mining construction and

Managing directors and chief executives

Production managers in agriculture forestry

Information and communications

Source: MOWAC, 2011

Key Policy Measures and Challenges

Development and implementation of affirmative policy action for women

Goal 4: Reduce child mortality

Figure 3.18: Under-five mortality rate by sex

No. of Deaths Per 1000

Indicator 4.2: Infant mortality rate

No. of deaths per 1000 live births

Figure 3.20: Infant mortality rate by locality and sex

No. of deaths per 1000 live births

Figure 3.20: Infant mortality rate by region

Central Northern Upper

Key Policy Measures and Challenges

Goal 5: Improve maternal health