University of Ghana

University of Ghana http://ugspace.ug.edu.gh AN ETHNOGRAPHIC STUDY OF SANITATION AND DEFECATORY PRACTICES IN PERI-URBAN COMMUNITIES: THE CASE OF PRAMPRAM IN THE GREATER ACCRA REGION OF GHANA BY LETICIA AGYEIWAA ACKUN (10392128) THIS THESIS IS SUBMITTED TO THE UNIVERSITY OF GHANA, LEGON IN PARTIAL FULFILMENT OF THE REQUIREMENT FOR THE AWARD OF PhD SOCIOLOGY JULY, 2015 University of Ghana http://ugspace.ug.edu.gh DECLARATION Candidate’s Declaration I hereby declare that this thesis is a result of my own research work carried out in the Ningo- Prampram District under the supervision of Prof. K.A. Senah and Prof. P. B. Adongo of the University of Ghana and Prof. Helle Samuelsen of the University of Copenhagen. Neither this thesis nor a part has been presented for another degree in this university or elsewhere. References cited in this work have been duly acknowledged. …….……………………………….. …………….………... LETICIA AGYEIWAA ACKUN DATE (CANDIDATE) Supervisors’ Declaration We hereby declare that the preparation and presentation of the thesis were supervised in accordance with the guidelines on supervision of a thesis laid down by the University of Ghana, Legon. …...……………………. …….…………………. PROF. K. A SENAH DATE (PRINCIPAL SUPERVISOR) ………………………… ………………………….. PROF. HELLE SAMUELSEN DATE (SUPERVISOR) ……………………………… …………………..…... PROF. P. B. ADONGO DATE (SUPERVISOR) i University of Ghana http://ugspace.ug.edu.gh ABSTRACT This study sought to interrogate factors leading to the low patronage of improved sanitation facilities in peri-urban settings. The study’s main emphasis was on the Prampram community located in the Ningo-Prampram District of the Greater Accra Region in Ghana. A recent study by the Joint Monitoring Programme for water and sanitation (JMP) shows that, in Ghana, only 14% of the people have access to improved sanitation or decent toilet facilities. Ghana was graded 48th among 51 African countries in terms of meeting the Millennium Development Goal (MGD) target 7, which aimed at increasing (by half) the number of people who have access to improved sanitation by 2015. The study, therefore, interrogated issues in relation to socio-cultural practices, socio-economic lives of the various groups as well as their hygiene and sanitation practices that inform the people’s preferences for household toilets and how this translates into their uptake of sanitation. The study adopted an ethnographic approach and drew on data collected over a period of eight months to understand perceptions and preferences for various sanitation options in the Prampram community. The field work involved participant observation, informal conversation, in- depth interviews and focus group discussions. The study concluded that dirt, sanitation or hygiene can only be operationalized within a social context. It was observed that the study community’s perception of dirt as “matter out of place” as defined by Mary Douglas; their perceptions of smell and contagion; their concept of public and private spaces; and the socialization process that children go through contribute to their hygiene behaviours and sanitation practices. ii University of Ghana http://ugspace.ug.edu.gh DEDICATION This work is dedicated to all who are in the fight against open defecation worldwide and especially in Ghana. May we never give up despite the challenges. Aluta Continua!!! iii University of Ghana http://ugspace.ug.edu.gh ACKNOWLEDGEMENT This thesis could not have been possible but for the diverse support I received financially, intellectually and emotionally. My first thanks go to the Almighty God who has brought me this far in my academic pursuit. I am very grateful to God for granting me good health and the wisdom and strength to accomplish this task. I also wish to express my most profound thanks to my supervisors, Prof. Kodjo Senah and Prof. Phillip B. Adongo, both of the University of Ghana, and Prof. Helle Samuelsen from the University of Copenhagen who guided me throughout the period of my PhD study. I am very grateful to them for their direction, their meticulous critiquing of the work to keep it focused and the time spent reading through the thesis to bring it to an acceptable level. I am also heavily indebted to my family, especially my husband for all the support he gave me, and my children for the sacrifices they made to enable me to complete my study. This work would not have been possible but for the financial support received from DANIDA through their Ministry of Foreign Affairs in Ghana. I thank them for the opportunity to undertake some courses in the University of Copenhagen, Denmark on two occasions to gain cross cultural experiences and to access facilities and literature, which would have otherwise been difficult to obtain in Ghana. Special thanks goes to Prof. Flemming Konradsen, the Principal Investigator for the Sustainable Sanitation (SUSA) Ghana Project, for his insight and direction at the initial stages of the development of the proposal and at the conceptual phase of the study. The Dodowa Health Research Center (DHRC) was instrumental in getting me convenient accommodation and supporting me in my field work. They also coordinated my ‘Work Package’ for which I am very grateful. Special thanks go to Dr. Margaret Gyapong, the Director of the Center, Ms. Adriana Oppong, the Coordinator of the project and the entire staff of DHRC, not forgetting Michael iv University of Ghana http://ugspace.ug.edu.gh Nartey, my field assistant who helped me with the translation and interviewing of study participants in the local language. I am very grateful for the immense help he gave me throughout the eight month period of ethnographic study on the field, waking up at dawn to accompany me to observe activities undertaken both at the household as well as the community level. Dr. Thilde Rheinlander, our Post Doctorate supervisor was also supportive in reading through my drafts and providing some insights and direction. I am very grateful for all your support. This thesis would not have been possible but for the cooperation and support of the Chief, elders and the people of Prampram who always welcomed me into their homes to observe their domestic chores and to share their personal experiences during in-depth interviews, which gave me a lot of insight into the issues being interrogated by the study. This work is, to a large extent, a product of their input during interviews, focus group discussions (FGDs) and informal conversations. My special thanks also go to the assembly members of Prampram, especially, Honorable(s) Napoleon and Sampson who were always willing to offer assistance whenever it was needed. I owe the entire community members a debt of gratitude and believe that, as far as possible, this write up reflects their opinions and sentiments. Finally to the Head, lecturers, and especially colleagues in the Sociology Department who together journeyed with me in our pursuit of academic excellence, I say ‘ayekoo’ to all of us. You were a source of inspiration and comfort when things got very difficult. Mention should also be made of Peter Obeng, Fred Nimo, James Paul Kretchy and Sarah Van Ess, my SUSA colleagues for the joy we shared during our field work at Prampram and also for their support and encouragement during the cold and lonely periods in Denmark. Things v University of Ghana http://ugspace.ug.edu.gh could have been worse but for your support. I owe you all many thanks. Special thanks also go to all those who willingly went through some of my script and provided input. Despite the contributions of all the people mentioned towards the completion of this thesis, I take sole responsibility for any shortcomings or errors that may occur in the representation or interpretation of field data. L A. A. vi University of Ghana http://ugspace.ug.edu.gh LIST OF ACRONYMS CAP - Country Action Plan CAQDAS - Computer Assisted Qualitative Data Analysis Software CBO - Community Based Organisation CHPs - Community-Based Health Planning and Services CLTS - Community Led Total Sanitation CWSA - Community Water and Sanitation Agency CWSP - Community Water and Sanitation Project CSIR - Council for Scientific and Industrial Research DANIDA - Danish International Development Agency DEHSU - District Environmental Health and Sanitation Unit DHMT - District Health Management Team DHRC - Dodowa Health Research Centre DWSP - District Water and Sanitation Plan DWST - District Water and Sanitation Team EHA - Environmental Health Assistant EHO - Environmental Health Officer EHP - Environmental Health Programme EHSU - Environmental Health and Sanitation Unit EHSD - Environmental Health and Sanitation Division EPA - Environmental Protection Agency ERC - Ethical Review Committee ESICOME - Expanded Sanitary Inspection and Compliance Enforcement FGD - Focus Group Discussion GES - Ghana Education Service GHS - Ghana Health Service GNA - Ghana News Agency GSG - ‘Go Sanitation Go!’ GWCL - Ghana Water Company Limited ICT - Indigenous Contagious Theory IDWSSD - International Drinking Water Supply and Sanitation Decade IRB - Institutional Review Board IRC - International Research Centre vii University of Ghana http://ugspace.ug.edu.gh JHS - Junior High School JMP - Joint Monitoring Programme KVIP - Kumasi Ventilated Improved Pit MAF - MDG Accelerated Framework MDG - Millennium Development Goals MLGRD - Ministry of Local Government and Rural Development MMDAs - Metropolitan, Municipal and District Assemblies MoE - Ministry of Education MoH - Ministry of Health MWRWH - Ministry of Water Resources Works and Housing

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