For women in Ghana, increased migration for farm work coupled with the socio-economic fallout of the COVID-19 pandemic are worsening problems of access to reproductive health.
These are the findings of a new study led by Jemima Baada, PhD student in Western's department of gender, sexuality and women's studies.
This is a major issue as the west African nation's trade economy may be forged on exporting gold, cocoa and oil, but everyday life for the general population highly depends on agriculture. A national strategy sees workers migrate regularly for farming jobs around the country, and in recent years women have become permanent players in the sector.
But when relocating to unfamiliar communities, these women farmers lose the informal support of extended families and neighbours, and that exacerbates the lack of health-care services, says Baada.
Jemima Baada
"Before migrating, you could always have a neighbour or a friend or an extended family member give you support or even a ride in their vehicle. But after migrating, some of these women have trouble fully developing support networks in their migration destinations, so it's really difficult to rely on some of those forms of help that they previously enjoyed in their home region," said Baada.
Ghanaian women have long had a limited role in family-planning decisions, and the trend towards travelling for work has added to the challenge, says Baada. According to a 2018 report by the World Health Organization, maternal mortality in Ghana stands at 319 per 100,000 live births, compared with a global average of 12 per 100,000 for developed countries. Though hard data is not available, Baada and her collaborators say their research suggests these rates are even worse for migrant women farmers.-
Isaac Luginaah, Western's Canada Research Chair in Health Geography, stressed that geography is the greatest determinant in access to and use of health care, whether the country in question is Ghana or Canada.
Isaac Luginaah
"It is impossible to provide proper services to our rural communities, let alone universal care," said Luginaah. "If you are rural, you are already challenged, and that inequality exists in Canada, Ghana and every other country in the world. These are isolated communities, so offering proper reproductive health care to rural women is a global issue and what's happening in Ghana is a perfect example."
The research, co-authored by Baada, Luginaah, Western's Canada Research Chair in Global Women's Issues Bipasha Baruah and sociology professor Yujiro Sano, was published by the Journal of Health Care for the Poor and Underserved.
Among the researchers' recommendations are a call for educational and sensitization campaigns for migrant men to promote women's reproductive health, and support for community-based social programs providing health information and resources for migrants and non-migrants in settler communities.
But things also have to change at the structural level, says Baada.
Improving women's earning potential and economic outlook would break down barriers to better reproductive health care, she said. One way of doing this would be to train women in trades such as craft making, dressmaking or food processing to ensure they have sustainable livelihoods outside of farming.
Physical health-care facilities need to be improved, as well, said Baada, a Ghanaian from Nandom-Bekyiellu in the country's upper west region.
"When women do try to seek health care they often find the infrastructure and equipment they need is not available, so many prefer to treat themselves at home, said Baada. "Ghana still has a lot of underdeveloped health-care services. We just don't have adequate health-care personnel and facilities."
