Gender Sensitive Climate Change Communication Strategy GENDER SENSITIVE CLIMATE CHANGE COMMUNICATION STRATEGY

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Background

About the Project Climate change, including climate variability, has multiple influences on human health. Both direct and indirect impacts are expected. These include altera- tions in the geographic range and intensity of transmission of vector-, tick-, and rodent-borne diseases and food- and waterborne diseases, and changes in the prevalence of diseases associated with air pollutants and aeroallergens. Climate change could alter or disrupt natural systems, making it possible for diseases to spread or emerge in areas where they had been limited or had not existed, or for diseases to disappear by making areas less hospitable to the vector or the pathogen. The World Health Organization (WHO) estimates that climate change may already be causing over 150,000 deaths globally per year. While direct and immediate impacts such as deaths in heat waves and floods can often be dramatic and provoke immediate policy-responses, the most important long-term influences will likely act through changes in natural ecosystems and their impacts on disease vectors, waterborne pathogens, and contaminants.

Despite the increasing understanding of health risks associated with climate change, there has been limited identification and implementation of strategies, policies, and measures to protect the health of the most vulnerable populations. Reasons for this include the relatively recent appreciation of the links between climate change and health, which means that existing public health related policies and practices globally do not reflect needs with respect to managing likely climate change-related health impacts.

Recognizing the fact that Ghana experiences an extremely high burden of climate-sensitive diseases such as malaria, diarrhoeal, cerebrospinal meningitis and other infectious diseases and given the fact that Ghana is significantly vulnerable to climatic changes, The Ministry of Health (MOH), Ghana in partnership of United Nations Development Programme (UNDP) is implementing a Global Environment Facility (GEF) funded project to pilot climate change adaptation for health in Ghana.

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Malaria, Cerebrospinal Meningitis and Diarrhoeal Diseases, were identified as climate sensitive diseases of interest for the pilot project. The pilot will cover three districts – Bongo in the Upper East Region, Keta in the Volta region and Gomoa West in the Central region.

The proposed project will develop systems and response mechanisms to strength- en the integration of climate change risks into the health sector. Critical barriers will be overcome to shift the current response capacity of the health sector from being reactive towards being more anticipatory, deliberate and systematic. Project actions will identify, implement, monitor, and evaluate adaptations to reduce likely future burdens of malaria, diarrhoeal diseases, and cerebrospinal meningitis (CSM), priority climate change-related health issues identified by national stakeholders.

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Acknowledgment

The production of this report was facilitated by the Climate Change and Health Project Implementation Unit, Ministry of Health, led by Benjamin Yaw Manu, the Project Manger, with the support of Abena Nakawa, the Project Associate, and in consultation with Mr. Isaac Adams, Director, Research, Statistics, Information Management, Ghana.

The content of this report was developed, discussed and validated through extensive consultations led by the Ministry of Health with stakeholders from government agencies including Ghana Health Service, Ghana Meteorological Service, National Malaria Control Programme, National Development Planning Commission, National Disaster Management Organization, Ministry of Local Government and Rural Development, Environmental Protection Agency, Ministry of Environment Science and Technology, National Disease Control Programme, Health Promotion Unit, Ministry of Health, Ministry of Finance and Economic Planning (External Relations Unit)

REPUBLIC OF GHANA MINISTRY OF HEALTH

INTEGRATING CLIMATE CHANGE INTO THE MANAGEMENT OF PRIORITY HEALTH RISKS IN GHANA

www.climatehealthghana.org

‘Photos used in this report were taken by the project and as such are the property of the project’

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Contents

Background iii Acknowledgment v Gender Sensitive Climate Change Communication Strategy 1 1.0 Introduction 3 1.1 Background 5 1.2 Data Collection 5 1.2 Brief Description of the Three Research Areas 6 2.0 Findings 7 2.1 Knowledge, Attitudes to and Perceptions of Climate Change and Health 8 2.2 Human Activities that Lead to Climate Change 8 3.0 Impact of Climate Change 11 3.1 Impact of Climate Change 12 3.2 In the words of another interviewee: 16 4.0 Climate Change and Gender 23 Conclusion and Recommendations 35 Gender Sensitive Climate Change Communication Strategy 37 Country Focus: Ghana 37 Executive Summary 39 Introduction 41

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Gender Sensitive Climate Change 01 Communication Strategy

By Dr Margaret I. Amoakohene, Professor K. Ansu-Kyeremeh & Ms Esi E. Thompson

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1.0 Introduction

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1.1 Background Climate change has in recent years become an issue of prominence in both global and national discourse. Evidence abounds that climatic variability continues to adversely affect Ghana’s natural resources such as land, water, forest and vegetation, as well as the nation’s human capital. Despite the increasing understanding of health risks associated with climate change, there has been limited identification and implementation of strategies, polices and measures to protect the health of the most vulnerable populations. There is, therefore, the need to consider ways of adapting health policies and strategies to issues of climate change. In view of this, the Ministry of Health, in partnership with the United Nations Development Programme (UNDP), is implementing a project funded by the Global Environment Facility (GEF) to pilot climate change adaption for health in Ghana using malaria, cerebrospinal meningitis and diarrhoeal diseases as tracer diseases, in three districts, namely, Bongo in the Upper East Region, Gomoa in the Central Region and Keta in the Volta Region.

The School of Communication Studies was 1.2 Data Collection contracted to carry out research in the three districts to gather data to be used to develop Questionnaires for the survey were adminis- a communication strategy to support the pilot tered face-to-face. Twenty interviewers were project. The study was conducted using two trained to administer ten questionnaires each research methods: survey and individual in- over a period of four days at each location. The depth interviews. A survey of 600 participants demographics of the respondents included was conducted, 200 drawn from each of the almost equal numbers of females (48.5%) and three districts of the study – Bongo district males (51.5%). Almost two-thirds (66.0%) were (Upper East Region), Keta municipality (Volta married while just above one in five (22.6%) had Region) and Gomoa West district (Central never married. The rest were divorced (5.6%), Region). Sampling for the survey was mainly widowed (3.7%) or separated (2.0%). The big- cluster with individuals chosen from the gest cohort was traders (22.0%), followed by groupings. Clusters included decision leaders farmers and fishermen (14.7%) and teachers such as chiefs and queen mothers and opin- (13.5%). In terms of schooling, middle/junior ion leaders, among whom were managers of secondary school leavers (24.5%) were almost civil society organisations. Women’s groups as many as those who had experienced ter- constituted another cluster as were occupa- tiary education (22.7%). Data for the individual tional groups such as artisans and teachers. In in-depth interviews were personally collected the case of the individual in-depth interviews, by the consultants/researchers face-to-face sampling was purposively done to select key with each of the six selected regional and dis- regional and district level professionals, deci- trict level professionals, decision makers and sion makers and opinion leaders in each of opinion leaders in the three locations. the three districts and municipality to record any commonalities and/or differences in views expressed to aid in developing the communication strategy.

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1.2 Brief Description of the Gomoa West District Three Research Areas Gomoa West is one of 17 districts of the Central region of Ghana. It is a fishing community with Bongo District a total population of 194,792 which constitutes Ghana, as at March 2012, had a total of 170 12.23% of the Central regional population districts. Bongo is one of nine (9) districts thereby making it the district with the highest (including two municipalities) in the Upper population in that region. The sea provides the East region of Ghana. It is a poor farming main source of economic activity for inhabit- community which is predominantly rural and ants of the region. Respondents interviewed characterized by large household sizes, a high from Gomoa were the District Director of population density, and a high fertility rate. Health Services, a public health nurse, a dis- The 2000 population and housing census put trict nutrition officer, a catholic priest, a queen the population of Bongo at 77,885. The Bongo mother and a women’s group leader. district is estimated to have a growth rate of 2.8% thus putting its population in 2006 at Keta Municipality 91, 949. Currently, therefore, we estimate the Keta is located in the Volta region of Ghana total population of Bongo at 100,013. The six with a current estimated population of about respondents interviewed from Bongo were 177, 583. It is one of the region’s three (3) mu- the deputy regional director of health, the nicipalities and 15 districts (totalling 18). The district director of health, a public health of- population of the Keta municipality is said to ficer, a catholic priest, a queen mother and a have been growing at a relatively low rate of women’s group leader. 0.5% since 1970. From a total population of 104,100 in 1970, it reached about 111,700 in 1984. The 2000 population census puts the total population at 133,661 which constitutes 8.2% of the regional total population. Keta is a predominantly fishing community with the sea as the main source of livelihood of the people. Like Gomoa, interviewees from Keta were made up of the district director of health, a public health nurse, a district nutrition officer, a catholic priest, a queen mother and a women’s group leader.

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2.0 Findings

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Respondents in all three research locations before the study; in Bongo, it was the same were asked questions relating to their knowl- two years for 25.4% of respondents and in edge of climate change and its linkage to or Gomoa West also the same two years for impact on health and gender. They were also 22.2% respondents. In Bongo, responses con- asked questions on attitudes and percep- centrated (36.3%) on hearing about climate tions of climate change as well as sources and change five years before the survey. Gomoa channels of information including preferred West had the same five years by one in five and trusted channels for information on (21.5%) of the respondents. In Keta, “two years climate change. Findings of the study, com- ago” and “never” (both 19.8%) were the two bining the survey and individual interviews, largest concentrations followed closely by are presented under the following headings: five years (18.2%). Fewer respondents in Keta knowledge, attitudes and perceptions about (28.7%) knew about climate change than in climate change and health; impact of climate both Bongo (34.5%) and Gomoa West (36.9%). change; solutions to addressing health ef- Close to three in five in Keta (58.9%) didn’t fects of climate change; support required and know about climate change. sources of information about climate change and health. Respondents attributed climate change to both natural and manmade causes some of which they enumerated. They often demon- strated their knowledge and perceptions of 2.1 Knowledge, Attitudes to climate change in terms of changes in rainfall and Perceptions of Climate patterns especially in the frequency, sporadic Change and Health nature and quantity of rains, the intensity of heat from the sun and extremely high tem- All interviewees in all three locations of the peratures, long periods of drought, poor study had some knowledge about climate agricultural yields and the disappearance of change although many did not think the trees and forest cover. Nine in ten (91.7%) of weather, climatic and environmental changes all survey respondents had noticed changes in they were witnessing were the result of “cli- rainfall patterns. The distribution among the mate change” per se. Over four in five (84.1%) research sites were as follows: Bongo (93.9%), of the survey respondents knew about cli- Gomoa West (91.3%) and Keta (89.9%). An mate change. Suffice it to say, though, that the almost equal proportion (91.0%) of all respon- knowledge was in the form of experiencing the dents had noticed changes in temperature or way some aspects of climate or weather pat- heat patterns, Bongo (95.9%), Gomoa West terns were not as they had previously been. (90.8%) and Keta (86.4%). Notice of changes In other words, interviewees expressed their in the general weather patterns was similarly knowledge of climate change in terms of expe- high (84.3%) among all survey respondents. In rienced changes in weather, climate, and envi- Bongo, 87.8% had noticed such changes, and ronmental conditions in their districts. About in Gomoa West (84.1%) and Keta (81.0%) had a quarter of survey interviewees (23.6%) had noticed changes too. These changes defined learnt about climate change within the last and described their attitudes towards climate five years before the interview while about change which also highlighted and explained 15.3% had learnt about it just about two years the impact of the phenomenon on their health before. Others ranged from four years (0.8%), and living conditions. through one year (8.8%) to something beyond 20 years (10.2%). Importantly, almost one in ten (9.0%) had never heard about climate change. 2.2 Human Activities that Lead to Climate Change Some interviewees described climate change as the changes that are experienced during Respondents believed some activities of some certain seasons like the rise in temperatures. of their community members contributed In Keta, the largest group of respondents to climate change. These activities included (29.6%) had noticed climate change two years indiscriminate cutting of wood for wood fuel

8 || GENDER SENSITIVE CLIMATE CHANGE COMMUNICATION STRATEGY and charcoal, bush burning, sand winning, matured are being harvested in their young poor sanitation especially through the dump- age” (women’s leader, Gomoa). ing of both human and solid waste, littering of plastic bags, faecal contamination of water With regard to the loss of vegetation cover, bodies, and “galamsey”. With the exception of some interviewees in Bongo and Gomoa were sand winning which was reported in Gomoa concerned about bushfires which were usu- and Keta alone, respondents in all three really caused by inhabitants who went in search search locations complained of all the other of grass-cutters and other game as a cause of unhealthy human practices as giving rise to climate change. One interviewee from Bongo diseases, preventing the normal growth of explained that: vegetation and contributing to erratic rainfall patterns, extreme heat and climate change. “Some community members in their bid to catch game, set fire to grassy areas which lead The felling of trees for fuel was seen as an ac- to mass bush fires. Some say they do that to tivity that rapidly cleared the forest of its cover catch game. Others also set fire to the thatch and led to climate change. Some respondents used for roofing after they gather what they in Bongo referred to this as the disappearance need so that new grass will grow” (public of trees and indicated that the trees were be- health nurse, Bongo). ing cut indiscriminately for use as fuel wood (firewood and charcoal) without replacement. Another cause of bushfire, according to the This had led to a former forest area in Bongo respondent, was related to theft as some becoming bare, with no wind and storm members of the community stole thatch pre- breaks to protect people’s roofs and the soil pared by others for roofing and subsequently from heavy storms and winds. For respon- set fire to the area to deceive the owners that dents in Keta and Gomoa, the problem was their thatch actually caught fire. Such activi- the over harvesting of and cutting of coconut ties caused the vegetation cover to disappear trees at the beach for use in constructing resulting in large portions of the forest also bridges. This was said to have left the beaches disappearing. Vegetation cover, according to so bare that the sea was now taking over the some respondents in Keta, also suffers as land and causing floods at the least rains. fisherman cut branches of trees to set traps in the lagoon for fish and women cut trees for Another human activity which was of concern wood fuel to smoke fish. to some respondents from fishing communities, especially Gomoa, and seen as affecting In all three locations, the effect of poor sanita- livelihoods was overfishing. Some interview- tion was a major issue of concern to all inter- ees indicated that overfishing had caused viewees as one of the man made causes of cli- the lagoon to lose all its fish leading to very mate change. They all alluded to indiscriminate low yields. A cultural practice in Gomoa, for disposal of faecal matter by inhabitants since instance, whereby the lagoon was “closed” to many homes did not have toilets or places of fishing to allow fingerlings to grow for the fish convenience. to replenish itself was no longer in effect or “The absence of places of convenience in most being implemented as fishing was being done homes has led to a situation where people all year round. A respondent captured this defecate anywhere there is space. The excreta more clearly: get washed into people’s homes and into wa- “The lagoon in the town, for example, is virtu- ter bodies when the heavy rains occur leading ally dead because it has been overfished. to health hazards,” according to a respondent Previously, there were to be ‘closed periods’ in Bongo. during which nobody was allowed to fish. But For respondents in Gomoa and Keta where now, the enforcement isn’t there so, ... I don’t dumping of faecal matter was largely done at think there’s even ... we don’t hear of “closed the beach, this situation was attributed to the periods” any more ... So, the lagoon has been high water table which had rendered many overfished ... The fingerlings which would have homes incapable of constructing places of

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convenience. For Bongo, it was more the result Illegal mining of minerals, popularly referred of poverty and ignorance of the ramifications to as “galamsey”, near water bodies was also of indiscriminate disposal of human waste on mentioned as one of the human activities health. Inhabitants therefore resorted to us- causing environmental degradation and ing open spaces as places of convenience and increasing the effects of climate change. In when the rains set in, all the faecal material got the words of the district director of health for washed into people’s homes and water bod- Bongo, “the problem is the mining, the galam- ies thereby contaminating sources of drinking sey which is going on there”. Some respon- water especially when flooding occurred. dents from Bongo believed that “galamsey” resulted in the silting of rivers thereby making In addition, interviewees in Keta, Gomoa and those rivers unsuitable for animal life or for Bongo indicated that inhabitants were not drinking by human beings. In both Gomoa careful with the disposal of refuse, especially and Bongo, illegal mining (galamsey) activities plastic bags, thus worsening the sanitation were a source of concern to respondents who problem in all three districts of the study. In also believed that these activities provided Bongo, the indiscriminate dumping of refuse, breeding grounds for mosquitoes leading to especially plastics, was blamed as one of the malaria. Whereas this position was corrobo- causes of the silting of dams and rivers result- rated in Bongo, other interviewees in Gomoa ing in the scarcity of drinking water. For some did not support the views of the respondent interviewees, the indiscriminate disposal of who raised this concern. human and plastic waste was another cause of the devastating effects of climate change. Respondents in all three research locations According to a respondent from Bongo, “the mentioned the problem of sand winning as a disposal of plastic waste has become an man-made phenomenon which also contrib- eyesore in the Bongo district with large tracts uted to effects of climate change. For respon- of land littered with plastic bags. These dis- dents along the beach, in Keta and Gomoa, carded plastic bags end up in water bodies sand winning occurred largely at the beach and people’s homes when the rains fall”. and caused the sea to take over the land. Sand winning in Bongo, where there is no sea shore because it is in the hinterland, takes place anywhere there is sand and affects both arable land and animal grazing land.

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Impact of 3.0 Climate Change

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3.1 Impact of Climate Change (30.3%), and hunting (9.0%) were the climate change-impacted activities most often cited. Respondents were asked about climatic events Farming was one activity seen by respon- such as natural disasters that might have been dents from all three research sites as the most experienced within their communities over a affected by climate change. In Bongo, 30.3% period of ten years preceding the interview. of respondents; in Keta, 29.2%; and in Gomoa Respondents in the survey named rainfall West, 27.6% of all respondents rated farming (65.9%), intense heat from the sun (65.1%), as the most affected. Farming was followed in floods (61.2%), prolonged drought (37.3%), Bongo by alcohol/pito brewing (19.7%); Keta sporadic rainfall (29.0%), prolonged harmattan by charcoal burning (22.4%); and Gomoa also (27.8%), bush fires (21.1%) and strong winds by charcoal burning (22.4%). The third activity (0.2%) as climatic changes they had experi- seen by respondents to have been most af- enced. The impact of climate change was ex- fected by climate change was charcoal burn- plained in terms of changes in rainfall and heat ing in Bongo (18.1%), trading (14.7%) in Gomoa patterns with shorter rainfall periods and pro- West, and hunting (14.7%) in Keta. longed harmattan seasons destroying the environment and introducing hitherto unknown All the above listed human activities, affected insect species and diseases. By way of promi- by climate change, resulted in the loss of eco- nence, intense heat from the sun (30.3%) was nomic activity and incomes which produced cited as the most frequent unusual weather attendant problems of alcoholism and family condition. This was followed by floods (18.7%); separation especially in Bongo. In the case of heavy rainfall (17.4%) and prolonged drought Bongo, since respondents represented a (14.0%). Other climatic changes were sporadic typical savannah area farming community, the rains (7.5%), prolonged harmattan (6.3%), and loss of vegetation cover through drought and bush fires (5.6%) with strong winds marginally excessive erratic rainfall meant a destruction mentioned (0.2%). of people’s livelihoods and sources of income. This situation, in turn, resulted in further The two coastal areas studied - Gomoa West degradation of the environment through and Keta - had had similar experiences with tree-felling for fire wood and charcoal as well climatic events or natural disasters ten years as “galamsey” as alternative sources of liveli- before the study. Both of them had had hood with its resultant destruction of water experiences with heavy rainfall (24.3% and bodies and negative health implications for 24.6%, respectively) and intense heat from the people. the sun (Gomoa West 22.4% and Keta 22.1%). Hinterland and savannah area, Bongo, had differently experienced intense heat from the Rainfall and Heat Patterns sun (19.4%), prolonged drought (17.5%) and All interviewees in all three research sites indi- heavy rainfall (16.4%) in that order. Most fre- cated that rainfall patterns in their areas had quent of the climatic events or natural disas- changed dramatically. The rains came much ters was prolonged drought (30.3%) in Bongo, later than expected and in huge quantities. and intense heat from the sun in Gomoa West Respondents were experiencing shorter rainy (38.8%) and Keta (31.6%). seasons and longer periods of drought or dry season with accompanying intense heat from Since the impact of climate change also mani- the sun. These changes were seen as another fested in the disappearance of trees resulting manifestation of climate change. The queen in loss of economic activity and incomes, re- mother of Bongo captured it this way: spondents were probed for human activities which in their view were affected by climate “Also see the sun hitting so hard. The least change events including natural disasters. rain when it comes is very serious and it takes Top of activities listed as negatively impacted time for it to come again. The drought is pro- by climate change was farming, which was longed. The trees are not there to protect the mentioned by close to four in five (78.1%) re- land...... ” spondents. Charcoal burning (48.2%), fishing (39.4%), alcohol/pito brewing (31.2%), trading

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Interviewees in Keta, like those in Bongo and Agricultural Gomoa, indicated that there had been drastic Delayed and sporadic rains in all three research changes in rainfall patterns in the municipal- sites produced negative effects on farming ity and that although the rains used to come and livelihoods of people in those areas. The during particular periods, this pattern had erratic rainfall patterns and soil erosion have stopped. Instead, the rains had become spo- rendered some farm lands infertile and un- radic, unpredictable and come with stormy able to support plant life. Also, stormy rains winds. Specifically for Keta, there used to be being experienced have tended to wash away three rainy seasons but the pattern could the top layer of the soil that contains soil nutri- no longer be identified as rains now fell even ents leaving behind land that cannot support during the harmattan in November, which plant growth. The intensity of the rains often should be part of the dry season. They indi- cause huge gullies to be formed especially in cated an increase in the amount of rainfall and Bongo thereby rendering the land unsuitable although they said they experienced some for farming as reported by some respondents. flooding annually, the situation had worsened in recent times. A particular sub district of “But now if you walk this way you will see gullies Keta, Afiedenyigba, for instance, now experi- like rivers, gullies because of erosion. And the ences annual flooding not only because it is rain … it comes torrentially and then washes below sea level, but also because the lagoon off the top soil” (public health nurse, Bongo). now overflows its banks during the rainy season and the sea takes over the land. Places Food production has thus been affected as that used to be foot-paths in the dry season the above conditions have led to very low for commuting across communities had also farm yields. The result of this is insufficient been taken over by the lagoon. There is also food for households and families with children delayed rainfall and intense heat experienced being the worst affected. Women were also especially during the night which used not to reported to be the most negatively affected be the case. by food shortages at home as they not only had to look for food for the family but also had Interviewees from Gomoa, just as those from to deny themselves food for the sake of their both Bongo and Keta, also indicated an in- children and sometimes, their husbands. The crease in the amount of rainfall and that, like public health nurse in Bongo put it this way: Keta, although the land was a low lying area which used to be flooded annually during “Because of the poor harvest the woman rainfalls, flooding had become disastrous in would have to go and get something to sup- recent times thereby worsening the situation. plement. And if she doesn’t do it then she will Also, like Bongo and Keta, the duration of suffer the consequences and hunger because the rainy season had shortened and the dry the little she has, she has to give it to the chil- season had become prolonged leading to ex- dren and the husband”. treme heat and dry conditions in those areas. Respondents reported cases of destruction Furthermore, the fact that the rains have of some mud houses, roofs of other houses become erratic and difficult to predict has ripped off, and communities completely cut led to situations in which in Bongo, for in- off during heavy rains. Some of these happen- stance, farmers either plant their crops too ings in Gomoa and Keta were attributed to the early or too late as the rains do not fall at the overflow of the lagoon and the blockage of required intervals. In Keta, agricultural pro- water ways which prevented excess rain water duce was said to have reduced as a result from entering into the sea. of the erratic and heavy rainfall patterns. Farmers have had to harvest their produce In addition to general discomfort as a result of earlier than normal to avoid having them extreme heat and inconveniences as well as destroyed by floods. In Gomoa, just as Keta, some disasters from excessive erratic rains, agricultural produce and food production the effects of the changes described above were also said to have decreased as a result could be felt in many aspects of the lives of the of the erratic and heavy rains as well as communities studied including the following:

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1 4 || GENDER SENSITIVE CLIMATE CHANGE COMMUNICATION STRATEGY activities of some people including overfish- Socio-Economic Life ing. Overfishing in the lagoon in Gomoa had The climate change implications on the socio- led to a situation where fish yields were get- economic lives of the people of Bongo, Keta ting lower and lower thereby affecting both and Gomoa were diverse and various ranging food production and incomes of fishermen from joblessness, homelessness and poverty and fishmongers. A respondent captured through hunger, family difficulties and sepa- these thoughts in the following words: ration to health problems. The livelihoods of “As I said, by this time, we get a lot of fish and farmers and fishermen in Bongo, for instance, many people become happy because money have been seriously affected by drought and will be in the system. But these days, because the silting of dams and other river bodies. Low the land is not good for fishing and it is not fish, crop and other farm yields have been a also good for farming there is no money.... problem in all districts but in the case of Keta Formally, you’ll have a lot of fresh maize by and Bongo, these have rendered some young this time; but these days, there is no maize as men jobless and led to increased levels of pov- before” (women’s leader, Gomoa). erty. Although the Bongo district, for instance, is poverty endemic, the effects of climate Some interviewees from Keta reported that change in the area have led to a deterioration low fish yields were being recorded by fish- of the poverty situation with its attendant ermen from both the lagoon and the sea. problem of migration for greener pastures. The queen mother interviewed in Keta spe- Floods which have become rampant in the cifically explained that “Keta school boys” Bongo district due to the stormy rains, have (a type of fish) which in the past used to be introduced another dimension to the misery harvested and used as manure on farms of the community. Because a lot of the houses had also become scarce. She said, due to in the area are built of clay and thatch, they low fish yields nowadays, even that type of are easily destroyed when heavy rains fall and fish was no longer available in large quanti- people’s properties are swept away. A case ties as catch for human consumption. It had in point is that of the Katanga community in also become very expensive. Bongo whose members have had to con- stantly rebuild their houses each time there Silting of dams and other water bodies was is a storm as the houses are almost always reported to have adverse effects on agricul- pulled down by rain. Floods, which in some ture and on inhabitants. The silting of dams cases destroy land and other property, have and some rivers, especially in Bongo, was said also rendered some people homeless in all to have led to situations in which water had locations of the study and have further wors- become a scarce resource and had also led to ened cases of poverty in the three districts. low fish catch, low food production as well as low incomes for families. Agriculture, food pro- The effect on family togetherness and cohe- duction and family incomes have also been af- sion has been phenomenal. Prices of food fected in other ways. One of these is the har- items (farm produce), especially in the Keta mu- vesting of fingerlings in fishing communities nicipality but also in Bongo and Gomoa, have in all three research sites. In some cases also, shot up to levels which make some families especially in Gomoa, erratic rainfall patterns incapable of feeding themselves. Some of the had forced some farmers to harvest their men in Bongo, according to some interview- produce before they were mature and ready ees, had, as a result, taken to excessive drink- for consumption. These farmers, in order to ing of alcohol with serious consequences for make such farm produce ready for use, apply family life. Some community members in Keta chemicals such as carbide to force the pro- were also reported to have taken to excessive duce to ripen quickly for the market thereby drinking and smoking. The low farm yields endangering life. Food production and family which led to low incomes forced some people, incomes were also adversely affected by the especially women in Bongo, to engage in other absence of storage facilities in some places as income generating ventures such as trading this led to some of the produce getting rotten and head pottering in other places away from and being thrown away. home to supplement family incomes and to

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take care of their families. Indeed, in all cases, digging of the ground for “galamsey”, particu- it was explained that the burden of poverty larly in Bongo, rendered the soil ineffective to was more on women (than men) who usu- support plant life thereby limiting land avail- ally had to take care of themselves and their able for agriculture and also destroying the families, especially children. Unfortunately, environment. The trenches left by the illegal many of these women were not economically miners also tended to collect water when it empowered and depended mainly on their rained and became breeding grounds for husbands. Therefore, with inadequate income mosquitoes. coming in from husbands, women had to find ways of taking care of themselves and their The cutting of trees for fuel wood without re- families. placing them through replanting also affected the environment and caused the land to be Children who are the primary responsibility bare as the forest cover and forest reserves of their mothers are, therefore, left to others got depleted and destroyed the balance of for long periods and thereby forced to endure the ecosystem. In Gomoa and Keta, the wood long periods of parental absence with disas- was cut mainly for wood fuel to dry and smoke trous effects on parenting and family cohe- fish usually for commercial purposes while in sion. Such parental challenges introduced Bongo, it was for domestic purposes either some indirect implications of climate change, as wood fuel or as charcoal for cooking. In all as reported in Keta, including increased cases cases, there were no conscious attempts to of teenage pregnancy and unsafe abortions. replace felled trees. Respondents in Gomoa Furthermore, there were some reported were of the opinion that the disappearance health implications of climate change and of vegetation cover in Gomoa was one of the some of the conditions which engendered very obvious effects of manmade activities on it such as diseases that accompany floods. climate change. A respondent mentioned a Some respondents reported that diseases led case where there was the cutting of coconut to loss of man days at work and lower incomes. trees around the beaches for construction which had left the beaches bare. Another “It (the flood) produces mosquitoes which go interviewee laid the problem of depletion of on biting people and then the people suffer forests at the doorstep of women: from malaria and it affects their work and ...... I mean performance in society.....” (Religious “It’s not the doing of men but women ... In fact, leader in Gomoa). when you stay here for sometime ... around the district, you will see women cutting trees ..... Environmental They are doing this just for....to sell to the fish mongers to dry or smoke their fish.... You see Climate change effects on the environment, that’s the one thing that women here are doing as reported by respondents, were not only and it affects all of us especially so that we do the result of natural causes but also man- not get rains and good food to eat, you see?” made ones. Respondents mentioned the destruction of water bodies and arable lands through illegal mining operations (galamsey), floods and drought; destruction of forests 3.2 In the words of another and forest cover through extreme weather interviewee: conditions, sand winning and tree-felling for “Taking Gomoa as an example, there are some wood fuel and charcoal; and problems with towns which have as their suffix ‘kwaa’... So we sanitation through indiscriminate disposal of have Adam kwaaa, this kwaaa, that kwaa and human and domestic waste. Water resources kwaaa in the Gomoa language means forest... were being destroyed by the activities of illegal But they’ve all turned into, into grassland. This miners (galamsey operators) who washed the is because we’ve cut down all the trees. And minerals they mined in water bodies used for that is what is causing the trouble” (women’s watering animals and sometimes for drinking. group leader in Gomoa). Once the water got polluted or silted it could no longer be used for such purposes. Also the

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Sand winning was said to be a major environ- Links between Health and Climate mental problem. Although this problem was Change, Insects and Diseases reported largely at the beaches of Gomoa and To the simple survey question: “Do you believe Keta, it was not exclusive to them as Bongo that certain illnesses have to do with climate also raised concerns about the phenomenon. change?” responses were an overwhelming Some of the interviewees in Keta reported “yes” (89.7%) with “no” recording only 10.3%. that more than a third of Keta town had been “Yes” response was highest in Bongo (93.4%) taken over by the sea. According to them, the followed by Keta (88.5%) and lowest in Gomoa situation had only slowed down because of West (87.2%). This was a prelude to ques- the sea defence wall that had been built but tions that sought views on possible linkages sand winning by some community members between climate change (such as in rainfall was reversing whatever gains had been made. and temperature patterns) and diseases Sand winning at the beaches had created a or illnesses. Respiratory or breathing prob- situation where the sea was gradually eroding lems (21.5%), sunburn (20.2%), injuries from the land. extreme weather events (19.0%), infectious “Sand winning is what is causing the problem. diseases (17.1%), and cancer (10.6%) were all They are winning sand from the beaches for seen as related to climate change. Other dis- construction and this is allowing the sea to eases mentioned were hypertension (5.0%), come to destroy the human habitat. The co- stroke (4.4%) and diabetes (2.1%). Sunburn conut trees which were planted to check this (22.0%) was most mentioned in Bongo; re- have all been harvested. They use the trunks spiratory and breathing problems (23.2%) in of the coconut for construction especially Gomoa West; and sunburn tying with respira- bridges and the rest. So now with the coconut tory and breathing problems (20.4%) by Keta trees removed, the sea waves come straight respondents. to the land” (Women’s leader in Gomoa). A question sought views on what respon- Sanitation was also mentioned as a huge dents saw as links between changes in environmental problem in all three districts of rainfall patterns and health. Malaria (31.1%) the study. The main concerns raised in Bongo headed the list of diseases or illnesses as- were of indiscriminate dumping of faecal mat- sociated with changes in rainfall patterns. ter and plastic wastes. In Keta and Gomoa, re- Next was cholera (19.8%). Three others, spondents reported that the absence of both skin rashes (5.4%), respiratory problems private and public places of convenience had (5.2%) and rheumatism (5.0%), all around led to people defecating anywhere especially the one in twenty five range, were named. along the beaches. In addition, the activities of Apart from cancer (4.0%), all the other dis- fishermen from other towns such as Shama eases cited as having some connection with and Accra who sometimes docked at Apam changes in rainfall ranged from depression and offloaded their catch of fish and filth onto and hypertension (both at 0.2%) to CSM the beaches were cited as another issue which (2.9%). Links between changes in tempera- impacted negatively on the environment. In ture and diseases were less concentrated. the words of the religious leader interviewed At the top end were skin rashes (14.1%), skin in Gomoa: burn (11.5%), malaria (11.2%) and respiratory problems (11.2%). The lower end stretched “Sometimes there’s this movement of from waist pains (0.2%), through elephantia- people from other parts, maybe from Accra, sis (0.3%) to fever (6.7%) and cholera (7.1%). Elmina, Shama landing here with their catch. So when they land, whatever they carry A questionnaire item specifically sought to from the sea, they deposit around here know from respondents if they knew any especially the filthy things. … They dump it diseases that affected women because of cli- around here. So around the coast there is mate change. More than half (54.4%) of them filth all around...... and this also serves as an said they did while the others (43.8%) did not. environmental disaster to us”. Women were, however, seen as able (54.4%) to contribute to climate stability than they were

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1 8 || GENDER SENSITIVE CLIMATE CHANGE COMMUNICATION STRATEGY unable to (45.6%). In Bongo, they were seen as waters and mosquitoes. Most interviewees such by 74.9% of respondents. Majority, that in Gomoa mentioned the prevalence and, is, more than half the respondents in Keta in some cases, an increase in the presence (58.3%) and Gomoa West (54.7%), however, of some disease conditions as an effect of did not believe that women could contribute climate change. The most prevalent disease to climate stability. mentioned was malaria. However, one interviewee from Gomoa did not see malaria as Along with changes in weather and envi- an effect of climate change but rather as a ronmental conditions, interviewees also human development: mentioned the increase in some insects and diseases which were hitherto seasonal or “Malaria...yeah that one is our own doing. It even unknown to them. While the insects is not the climate. Because we throw things were predominantly mosquitoes, the diseases around after eating them and then this holds ranged from malaria and fever to food and water and it generates malaria and we leave water borne diseases such as diarrhoea, chol- our bushes and then the mosquitoes hide era and malnutrition, upper respiratory tract and hatch in there … that one is not climate infections such as pneumonia, colds, asthma change” (religious leader, Gomoa). and even skin diseases. All interviewees in all three research sites reported an increase in A deputy director of health in the Upper East mosquitoes throughout the year. In all these region mentioned the presence of new spe- areas, malaria (Bongo 30.2%, Gomoa West cies of malaria causing mosquitoes (P Ovalie 23.2%, and Keta 38.6%) was the number one and P Malarie) and new strains of CSM (W1/35) climate change related disease. It was followed which were previously not found in the region. in all three districts by cholera (Bongo 27.2%, Another observed phenomenon was the in- Keta 15.8% and Gomoa West 15.2%). Third crease in infections such as tuberculosis and in Bongo was CSM (8.3%), skin rashes (9.9%) CSM in the dry season. Since TB is air borne, the in Keta and respiratory problems (14.5%) in prolonged dry season accentuates the trans- Gomoa West. According to some respondents fer of bacteria by TB patients to other people. in Bongo, about 10 to 20 years ago, mosqui- Although the northern regions of Ghana are toes were seen only during the rainy season CSM endemic, interviewees in Bongo believed but these days, people have mosquito bites there has been an increase in reported cases even in the dry season resulting in an increase of the disease. One respondent explained that in cases of malaria and fever. In the words of a poverty, as a result of low incomes, has led to women’s group leader: many large families having to share small living spaces with small windows which produce “I have observed that these years, plenty mos- very little ventilation. These conditions pre- quitoes, we don’t know where they come from, cipitate and engender the spread of CSM and even dry season … mosquitoes, so people get the prolonged dry season also aggravates the malaria”. situation. Again due to poverty, many people are unable to access health services promptly In Keta, the flood situation was said to have led when they notice problems with their health to an increase in mosquitoes all year round. and this sometimes leads to fatalities. There also, respondents indicated that, hitherto, mosquitoes were only present in the Upper respiratory tract infections such as rainy season but their presence was now be- pneumonia, colds, asthma and food and ing felt even during the dry season leading to water borne diseases such as diarrhoea and an increase in malaria cases in the municipal- cholera, malnutrition and skin diseases in ity. Respondents attributed this to stagnant some cases were also mentioned as some pools of water created after heavy downpours of the prevalent health conditions although and floods which become breeding grounds none of these had, so far, reached epidemic for mosquitoes causing malaria. In Bongo, levels. Diarrhoea cases, in Keta, were said to there was the added problem of gullies which be on the increase especially during the rainy formed from erosion and produced stagnant season and this was said to be caused by poor waste disposals. The Keta municipal director

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of health reported an outbreak of cholera in them, they don’t wash them, and then they some communities. In all research locations, get cholera”. floods and insanitary conditions were blamed for the increase in diarrhoea diseases. In fact, Another observed health challenge related to the Gomoa district was said to be an epicen- climate change was malnutrition as a result of tre of cholera in Ghana. According to respon- low agricultural yields. Low agricultural yields dents, water sources get contaminated by were said to relate to malnutrition with the sewage during floods and once people drink explanation that because farm yields were from those sources, they get infected with low, and poverty high, families were unable to the bacteria. Although the Gomoa district have healthy nutritious diets. was said to have a high water belt, the under- ground water is salty and unfit for drinking so “There is insufficient food so people look mal- boreholes and wells are not dug in the area. nourished, especially the children. You know People therefore have to rely on tap water for those days you could just fetch groundnuts consumption. In the dry season, normal tap and prepare soup without thinking of whether flow is disrupted and people resort to drinking it is there or not. But now, even you can’t get a from rivers and streams which also increase bowl of groundnuts in a compound” (women’s the incidence of diarrhoea. According to a group leader, Bongo). respondent: Malnutrition was said to be most prevalent “What we realise is that we have a water prob- among children and pregnant women in all lem....our source of drinking water, sometimes areas of the study. However, the Keta munici- the tap water, will not flow for many months. And pal director of health indicated that in 2011, then the people will be drinking from streams, a lot more men reported cases of diarrhoeal rivers and.....that brings about diarrhoea.... So diseases than women. Malnutrition in Gomoa during the lean season, it means that water was also linked to the low produce and loss will also dry up... and then when they try to use of livelihoods with women said to be the ones those waters they get diarrhoea”. who bore the brunt of the problem. “During the lean season, there are a lot of nutritional Diarrhoea among children in Gomoa was problems like malnutrition” (public health also linked to the onset of the mango sea- nurse, Gomoa) which affect the people. son. Mangoes tend to draw in flies and when people do not carefully wash their hands and “Therefore we know when the....you know the fruits before consuming them, they get the.....economic status of the people goes diarrhoea. In the words of the public health down as well, the....nutrition and other things nurse from Gomoa: are also compromised and therefore there’s the tendency that it will also indirectly or di- “During the mango season, you know when rectly affect their health ...” (district director of mango comes everybody wants to enjoy health, Gomoa). the mango and as much as mango is in, flies too are on the increase, so people tend to Interventions by various nongovernmental or- get diarrhoea..... Sometimes, they may not ganisations somewhat helped to address the wash it well even the water to wash it well issue of malnutrition, especially in Bongo but, ....there is a question mark so....they tend to according to the deputy director of health, get diarrhoea...” “stunting is still there”.

The public health nurse’s views were supported Upper respiratory tract infections were also by the women’s leader in Gomoa who also said: reported as some of the effects of climate change. The public health nurse interviewed “During this time (rainy season) fruits like man- in Keta mentioned respiratory tract infections goes are in season but they are not coming as a set of infections that climate change was from here....they bring them from outside... exacerbating in the municipality. According to A lot of children like mangoes so as they eat the Gomoa district director of health, respiratory issues were related to the prevalence of

2 0 || GENDER SENSITIVE CLIMATE CHANGE COMMUNICATION STRATEGY bushfires whose smoke made work some- “The prolonged drought season.....is.....dry sea- times impossible. son is affecting the health of these children, especially. Most of them have skin rashes..... “But one particular thing that I’ve observed they get heat rashes all over and they remove here is, we know bush fires are there but it their shirts.....and some remove their clothes.... is so predominant here. And it happens.... even....adults …they remove their clothes and you may be in a residential area and you can it’s giving a lot of them pneumonia” (women’s literally be smoked out of your room. This is leader, Gomoa). something which I haven’t seen at that rate happening and of course there’ll be smoke all Other diseases which had been disappear- over and.....these are not very good you know, ing, especially in Bongo, were said to be they may exacerbate respiratory problems” re-emerging. These were yellow fever and (district director of health, Gomoa). measles but interviewees were unable to tell whether these were as a result of changes in Tuberculosis was mentioned as a disease that the climate or not. Among children in Keta, had seen an increase in cases presented in worm infestation was said to be very prevalent Gomoa while Keta also reported a high inci- especially as potable water was scarce and dence of anaemia among pregnant women. floods were rampant. One interviewee from Another health situation mentioned was the Bongo complained of early wrinkling of the prevalence of skin diseases due to the intense skin as an effect of the high temperatures and heat. The women’s leader in Gomoa who also intense heat from the sun. She admitted that runs a school mentioned skin rashes especial- although there has always been the problem ly among children during the dry season. This of skin wrinkles in the past, its onset has be- she attributed to the desire of people to be come earlier and the incidence more rampant relieved of the heat by taking off their clothes, these days. a habit which also led to respiratory diseases such as pneumonia.

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Climate Change and 4.0 Gender

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This section of the study addresses two main During conditions of disease and ill-health, issues: the gender which contributed more to there appeared to be a lot of social expecta- climate change activities and the gender which tions imposed on women. Another respon- suffered more as a result of climate change dent in Bongo had this to say: and its effects. Against unequal representation of females (48.5) and males (51.5) in the “But then there are situations that affect wom- sample for the survey, greater proportions felt en more. When I talk about the under 5 sick- men (69.0%) were contributing more to climate nesses, the woman will suffer with the child change than women (31.0%). Bongo recorded throughout and sometimes the man says I more men (70.1%) as climate change culprits have nothing so it’s the woman who should than women (29.9%); Keta also recorded more know how and where she can get the money men (70.4%) than women (29.6%) and Gomoa to send the child to the hospital or to be able West reported more men (66.5%) than wom- to insure herself and the child so that when en (33.5%). However, a number of activities of the child is sick she will be able to take care of women were seen by respondents as helping the child” (Women’s group leader, Bongo). cause changes in rainfall patterns (and by extension climate change). Among them were A male religious leader interviewed in Bongo cutting of trees for fuel wood (31.1%), charcoal also had this to say: burning (24.1%), farming (13.9%), pito/alcohol brewing (12.7%), fish smoking (9.5%), and “Most often when we have things like bush fires (8.5%). One respondent (0.2) even malaria, cholera, women tend to be believed women’s contribution to landfills was affected, at times, not directly but helping cause changes in rainfall patterns. indirectly because they are the ones who take care of the children and of Changes in temperature were also seen as the consequence of the same actions by women. course when something affects the In this respect, charcoal burning (31.0%), cut- child, certainly, the one who takes ting of trees for firewood (27.6%), brewing of care of the child is suffering a lot”. pito (13.1%), fish smoking (10.2%), farming (8.6%), bush fire (8.5%), and land fill (0.9%) were Many respondents in both Gomoa and Keta all activities engaged in by women reckoned to tended to agree with these positions. In all affect changes in temperature. District by dis- those situations, according to them, the bur- trict, charcoal burning was first in both Bongo den was on women who had to take care of (30.8%) and Keta (33.5%) as what women do their husbands and children. Therefore, di- that may contribute to cause changes in tem- rectly and sometimes indirectly, women bore perature. Charcoal burning (26.9%), coupled the brunt of the effects of climate change. with cutting of trees for firewood (26.9%) were rated as the two top women’s activities that “In our Ghanaian system, women labour could affect the temperature. more than men. Let me take for example… the men go fishing. They bring the fish and As regards consequences, most interviewees …the women will have to dry the fish, smoke believed that although the effects of climate it and then go and market it. After marketing change, including health, were felt among it, they have to manage the money in such a both genders, women tended to suffer more. way that it can.....once they (men) bring the fish This was largely due to the socio-cultural roles throughout the lean period, you (woman) have of women but sometimes also attributed to to look after them including their ‘akpeteshie’ their physiological make up: (local gin) consumption and their smoking and everything. You have to provide it. So they “It affects women more. Because naturally, (women) if there’s something which affects we are not physically as strong as men so the life cycle, it affects them most. So now that if there is something that will affect the that the fish catch is low, women are suffering. body then we will suffer it more than the men” (Pognaaba (Queen mother) of Bongo).

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They have to … look after the home (Women’s “For me, in fact as I said, I haven’t seen any..... leader, Gomoa). the climate change.....I haven’t seen any effect on our bodies except those that we create The other interviewees in Gomoa, unlike the ourselves, you see. But the climate itself does women’s group leader and those in Bongo not....the sea breeze, the air we breathe, the and Keta, were of the opinion that the impact rainfall don’t have any effect on us but where of climate change was felt equally by men and we create it.....that’s our problem” (Religious women. leader, Gomoa).

Respondents’ Assessment of Solutions to Addressing the Climate Change Situation Climate Change For all the effects of climate change discussed All interviewees in all three research locations above, interviewees were of the opinion that were unanimous in their quest for informa- the impact would worsen in the near future if tion and education on climate change. They the necessary actions were not taken to miti- believed that information and education were gate particularly the human induced causes the main solution to understanding issues of and effects of climate change. All interviewees climate change and health in their districts as in both Keta and Gomoa, except one, were of well as nationally. They, therefore, requested the opinion that things would get worse in the for more information on climate change, its future if measures were not put in place to causes (natural and especially man-made), its curb the situation. The only person who saw effects and how it relates to human existence a bright future was the queen mother who, and the health of individuals. A lot of solutions according to her, had started some initiatives were suggested for dealing with the impact in her community to deal with sanitation: of climate change. Prominent among these were education, discipline and enforcement “Because of that, I am preparing to buy some of bye-laws. dust bins and put them in the town so that if somebody drinks …pure water or chews sug- Education was key to all respondents in all ar cane, they can put it in it. They’ve started research locations. All interviewees in Keta, for changing small, small. So in 20 years or even in example, suggested that education would be 10 years time, I think they will change and ev- the best solution to help community members erything will be ok” (Queen mother of Gomoa). know about and understand climate change, its impact, and what can be done to reduce its There was some understanding of climate negative effects on the lives of people. In line change issues – their causes and effects - and with this, resources for education would need how they relate to health in all districts of to be provided in the municipality. Similarly, the study. Interviewees portrayed some un- the most predominant of suggested solutions derstanding of the human causes of climate to addressing the issue of climate change from change and the need to reduce those activi- both Gomoa and Bongo was the need for ties which brought about the phenomenon in educating people about the phenomenon, its order to save the environment and mitigate impact on the lives of people and how to miti- the effects of climate change. However, some gate particularly its health effects. Education respondents in the study admitted they were on climate change was also meant to help ad- quite limited in their knowledge about the dress some perceptions that were detrimental phenomenon. In fact, information obtained to the health of inhabitants: from the study showed that knowledge about climate change that some interviewees had “So we can educate them on the importance was not only limited but also sometimes in- of knowing that though the streams are there, adequate, misleading or even incorrect. One when the leaves are in them and make the interviewee in Gomoa, for instance, did not water coloured, it doesn’t mean it is medicinal. really see a link between climate change and That doesn’t mean it is medicinal. Rather, we health. In his own words: should let them know that so much dirt and bacteria can be harboured in the water and

2 6 || GENDER SENSITIVE CLIMATE CHANGE COMMUNICATION STRATEGY therefore they need not drink it raw”(public the Ministry of Agriculture. Another sugges- health nurse, Gomoa). tion made was the development of climate resistant varieties of crops to support the It was also suggested that climate change agricultural sector. Some respondents from issues be incorporated into the curriculum Gomoa, Bongo and Keta called for the re- of pupils at the basic level so that they can introduction of certain traditional practices grow up to be climate-change conscious. which tended to improve agricultural yield. Respondents from Gomoa also suggested that According to one of those from Gomoa: religious bodies should take steps to educate their members on climate change citing the “Some cultural practices which have been dis- example of the Methodist Church in Gomoa carded will have to be re-introduced like these which uses its weekly Bible lesson booklets closed periods for fishing in the lagoons”. to teach topics on climate change and issues concerning environmental conservation. In order to reduce overgrazing, the women’s group leader of Bongo who herself is a retired On the ecosystem and agriculture, various agriculturalist, suggested that particular foli- suggestions were made ranging from outlaw- age should be grown for animals. She said she ing bush burning, encouraging tree planting had done those experiments before as an ag- and crop rotation to revisiting some discarded ricultural officer and the trial was successful. cultural and traditional practices which Other solutions suggested were the growing positively impacted the environment and of vetriva grass to check soil erosion and the improved crop and fish yield. A respondent reclamation of mined lands as a way of man- from Bongo, for instance, suggested that tree aging land degradation due to illegal mining. planting be adopted as part of the culture of the area and bush burning be made a taboo The issue of implementation of laws and bye- in order to change the rainfall pattern. laws came up forcefully as an area of concern and which would help ensure discipline in the “Maybe the rainfall season pattern may system. Respondents reported that there change because my little knowledge tells me were both cultural and national bye-laws that trees support rain so if there are trees the which could protect the environment but rains will come and limit the heat” (Pognaaba, these were not being implemented. “If these Bongo). bye-laws were implemented with their accompanying sanctions”, they believed, “people Some respondents from Gomoa advocated would be more careful with the way they treat the planting of trees as a system that should the environment”. In Gomoa, it was suggested be institutionalised and observed as used to that both national and traditional bye-laws be the case in colonial times: be reinstituted and enforced including laws on water bodies, sanitation, and forest cover “During the colonial days, we had this day preservation: meant for tree planting ...‘Abor day’.... You see this neem tree is called ‘Abor day’. It is because “We may need once again to apply bye-laws that was the tree that was planted on that day. which protect the environment. We can find Abor is a Portuguese word for trees so tree those laws in the statute books of the lo- day so we should re-introduce the Abor days cal government” (district director of health, so that each community would be encour- Gomoa). aged to create a wood lot. Fishing communities should be encouraged to create wood Respondents also suggested alternative lots from which they can harvest to sustain sources of livelihoods as solutions to the deg- their means of livelihoods” (women’s leader, radation of forests and the environment gen- Gomoa). erally. In the particular case of wood fuel, one interviewee suggested that alternative fuel Crop rotation, the use of improved seeds as sources as well as low wood fuel consump- well as the use of composite manure were also tion mechanisms could help to minimise the advocated for. These were to be supported by depletion of wood resources. Furthermore,

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alternative means of livelihood would need health apart from the normal planning done to be provided for women (especially) to aug- for health. It was also indicated that conscious- ment their sources of income. ness of climate change, like Keta, was now rising out of some sensitisation activities that “Women should be introduced to other forms some district health staff had been privileged of smoking fish. That is why this Chorkor to attend. All interviewees in both Gomoa and smoker was introduced. The chorkor smokers Keta, however, indicated that climate change consume less firewood but they still consume issues needed to be considered in health firewood. Now that we are going into the gas planning with inputs made by all stakeholders, age, if this can be introduced to use gas as particularly, beneficiaries of the programme. fuel for smoking fish in place of firewood, it will improve the health of the women. Secondly, In spite of the lack of coordinated attempts to if they are introduced to other means of liveli- plan for climate change, there were individual hoods like this tie dye, soap making and the and group efforts reported in Bongo and rest... so that during the lean season they Gomoa aimed at mitigating the effects of the can fall on that as a means of maintaining the problem. The Catholic Church in Bongo, for home” (women’s leader, Gomoa). instance, had its own way of protecting the environment which was done through the Other solutions presented in Gomoa included celebration of abor week during which trees the promotion of fish farming. were planted and members were encouraged to plant more trees. The women’s group lead- Planning to Deal with Health er, also in Bongo, indicated that she had been Effects of Climate Change leading groups of women to plant commercial trees as a way of saving the environment Whereas the Bongo district said it had put in and, at the same time, generating income for place an emergency/epidemic preparedness those women. Similarly, the women’s leader committee with representatives from various in Gomoa reported that she had started a sectors at the regional coordinating council tree planting exercise but had faced many that meets on a quarterly basis to discuss and challenges as people were not interested in address epidemic and emergency situations, the venture. On her part, the queen mother neither Keta nor Gomoa reported any such of Gomoa who is also a nurse was focusing committees. Emergency preparedness plans on enhancing sanitation in her community had been drawn up in Bongo and were being by providing dustbins at vantage points and implemented in the district. Also, stakeholder using festive occasions to educate her citizens meetings were reported to be held on de- on the need to maintain good sanitary condi- partmental basis with representatives from tions. She had put in place sanctions for those various sectors making inputs into depart- who flouted the sanitation laws. mental plans. It must be indicated, however, that even in Bongo, these preparations were Although all these efforts were good, there not for climate change per se but responses was clearly no concerted effort directed at to epidemics and disasters which have been dealing with climate change consequences rampant in the district. on the lives of people in the areas studied, especially Keta and Gomoa. It appeared At the Keta municipal level, it was indicated that although planning was being done in all that no planning had been done with respect districts, it was not specific to managing or to the impact of climate change. This was at- mitigating the effects of climate change per tributed to low knowledge levels about the se. The emergency preparedness committee situation. It was mentioned that conscious- of the Upper East region, for instance, works ness about climate change was now rising on all other emergency situations and may out of some sensitisation activities that some not give particular and full attention to climate district health staff had been privileged to change and health issues. All interviewees attend. Similarly at the Gomoa district level, it expressed the need for climate change issues was indicated that no concerted efforts had to be incorporated in health planning for all been put into planning for climate change and districts. It would be important to establish

2 8 || GENDER SENSITIVE CLIMATE CHANGE COMMUNICATION STRATEGY a committee that specifically and proactively Similarly, while there was no direct planning plans for climate change and health issues at being done for climate change and health the district level with a coordinator who fo- in Gomoa, interviewees indicated that in cuses solely on those issues in the committee order to plan effectively to deal with climate if issues of climate change and health are to change and health issues, they would need, receive urgent attention. The communication among others: strategy would need to address this situation Educational materials such as posters in order to make climate change a priority is- and films on climate change, etc. sue in planning at various levels. Training Logistics such as fuel and vehicles; and Support Required Funding. The kind of support requested by various Sources of Information interviewees reflected their specific needs in their various areas of operation. The one major Interviewees in all three research locations support that interviewees from various back- indicated that they did not receive much grounds in Bongo mentioned was financial. information on climate change and health. Others were training, logistics such as trans- From Keta, Bongo and Gomoa, interviewees portation (vehicles, bikes and fuel), farm imple- said there was no information or database on ments and medicines for immunising animals. climate change and health available to them in The deputy regional director of health for the their districts or municipality. There was, there- Upper East region specifically mentioned the fore, no information that interviewees could implementation of policies on incentives for access locally to improve their knowledge of members of staff who consented to work in the phenomenon apart from the mass media. the northern parts of Ghana in spite of the In the cases of Keta and Gomoa, their sources harsh climatic and other environmental condi- of information on climate change were mainly tions. The district health director for Bongo, the mass media, principally television and on her part, also requested for infrastructure newspapers. For some respondents (the in those communities to enhance the work nutrition officer and public health nurse of of health workers involved in the Community Gomoa), this was mainly through the weather based Health Planning Service (CHPS) as they forecasts. Bongo respondents reported that provided the much needed community health the information they had was what they had support for various communities. themselves sought for from online sources and journals, or had been exposed to through While no specifically directed planning was the traditional media such as television, radio, being done for climate change and health newspapers and billboards. issues in Keta, interviewees indicated some resources that they would need to plan effec- Respondents in the survey, contrary to those tively to deal with climate change and health interviewed in-depth, had been receiving issues. These included: information on climate change and health principally from (multiple choice) radio (62.2%), Educational materials (posters, television (33.1%), co-tenants (17.1%), public films on climate change, etc) and community engagements (15.1%), chiefs Logistics such as fuel, or opinion leaders (10.3%), family and friends vehicles, bicycles, etc. (11.8%), co-workers (9.2%), newsletters (8.8%), Personnel drama (6.8%), and newspaper (5.3%). Asked Training to indicate one specific medium, survey re- Supply of medicines; and spondents generally sourced their climate Money or funding. change knowledge mainly from radio (50.1%). Over a quarter (27.3%) sourced that information from television. More of them sourced climate change knowledge from family (8.9%),

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3 0 || GENDER SENSITIVE CLIMATE CHANGE COMMUNICATION STRATEGY friend (3.9%), co-worker (1.7%) or co-tenant situations. The public health nurse in Keta, on (0.8%) altogether (15.3%) than from the news- her part, was interested in knowing the signs paper (5.0%). In all three research locations, of climate change, its effects on human beings the three top information and knowledge as well as precautions that could be taken to sources in each district or municipality were: mitigate those effects. Health professionals Bongo - radio (36.9%), television (27.5%) and interviewed in Bongo believed that it would be family (13.1%); Gomoa West - radio (40.2%), important for information from meteorologi- television (22.5%) and some other sources cal services on climatic conditions, for exam- (18.1%); then, Keta - radio (53.4%), television ple, to be shared with the district and regional (19.1%) and other sources (19.1%). More of the health directorates in order for them to plan respondents (59.5%) had been receiving in- effectively. Such information, they believed, formation on climate change and health than would enable health workers to relate trends those who had not been receiving that kind they observe in the health situation of their lo- of information (40.5%). More respondents in calities to possible climatic changes in order to both Gomoa West (66.8%) and Bongo (62.2%) be sufficiently informed to incorporate climate had been receiving information on climate change and health education in their public change and health than those who had not. education activities. Keta was split between those who had been receiving information (49.2%) and those who Furthermore, Bongo respondents were of the had not (50.8%). opinion that there might be the need for other sectors such as the Environmental Protection When asked if they were aware of platforms Agency (EPA) and the Ministry of Food and for discussion or information sharing about Agriculture (MOFA) to share information they environmental problems, over half of survey have on the districts with the health director- respondents (52.0%) were and the other ates to improve planning for the health of proportion (48.0%) were unaware of any such their communities. This view was supported platforms. While in Bongo 68.4% knew such a by respondents from Gomoa who also said platform, in Keta 40.8% and in Gomoa West that information provision must be done in 45.8% did not. Respondents in all locations an inter-sectoral manner with sectors such as of the study indicated their interest in receiv- environment, agriculture and forestry playing ing more information on climate change and key roles in the information dissemination and “how it relates to health” (its linkage to health). education process. One interviewee request- Virtually all (91.9%) survey respondents as ed, for example, that institutions such as the well as those interviewed overwhelmingly National Disaster Management Organization would like to receive information about cli- (NADMO), Ministries of Education and mate change and health: Bongo (95.9%), Keta Agriculture be provided the platform to com- (91.0%) and Gomoa West (88.7%). Subjects on municate how climate change impacts their which respondents wanted information were: various sectors. The goal of such inter-sectoral updates on climate change (22.5%), health im- collaboration should be to help beneficiaries plications of climate change (22.3%) and health of information disseminated and properly effects of climate change (21.0%). Others were relate climate change issues to various sectors ways of mitigating climate change (17.7%) and and to development in general. treatment for climate change induced infections (16.5%). Other respondents who were not health workers were also interested in receiving some Types and Formats of more information on climate change. The types of information they require include the Information Required impact of climate change on health, social and The municipal director of health for Keta, for economic life of people, agriculture and food instance, would like to receive information on production as well as on other livelihoods. The health conditions that are caused by climate women’s group leader of Gomoa, for instance, change and how to prepare to deal with such said that she would be particularly interested

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in information on climate change, health and which preserved information in hard copy or tree planting. Of much relevance would be printed format such as journals, magazines to provide information on the causes and and newspapers to enable them read and effects of climate change as well as how the also have material for reference when passing effects can be mitigated both proactively and on such information to others. reactively. All such information could be put together in a database on specific districts for Other interviewees mentioned mass media reference purposes. channels such as radio and television as their preferred channels but these would have to From the survey, districts differed in terms be carried on evening programmes. Some of what kind of information they required. other interviewees (in Gomoa) mentioned Bongo respondents were equally split on workshops as their preferred channels in or- how to avoid adverse health effects of cli- der to have the opportunity to dialogue and mate change (21.7%), health implications have answers to their questions. Channels of climate change (21.2%), and ways of such as churches and religious group ac- mitigating climate change (21.2%). Gomoa tivities were also mentioned as appropriate West wanted an update on climate change for passing on climate change information. (26.3%), health implications of climate Formats respondents would want that type of change (23.0%), and how to avoid adverse information presented in were: video (25.6%), health effects of climate change (20.1%). In drama (17.7%), discussion (17.5%), picture the case of Keta, concerns were with health (13.2%), songs (11.0%), demonstration (10.0%), implications of climate change (22.8%), up- role play (4.0%), and puppetry (1.1%). Gomoa date on climate change (22.6%) and how West was largely split between video (23.5%) to avoid adverse health effects of climate and discussion (24.4%) as the most preferred change (21.3%). formats. Keta, though, was more convinced by video (32.4%) than drama (17.4%). Bongo Preferred Channels for Receiving respondents were also almost split between and Sharing Information video (22.5%) and drama (20.1%). In terms of channels or modes of communica- The study showed that interviewees in all location survey respondents would like to receive tions did not consciously pass on knowledge information on climate change from, radio they had about climate change and health (48.7%) topped the list of media followed by to others. In order to pass on information television (28.2%). Public/community engage- to people in their communities, however, re- ment (23.9%), internet (22.7%), chiefs and spondents preferred a combination of some opinion leaders (16.0%), drama (13.8%), news- more traditional, modern and community- paper (4.8), brochure (4.0%), family and friends based approaches. Interviewees in all three (7.4%), co-tenants (5.7%), newsletter (3.2%) locations provided a list of channels – many of and co-workers (3.0%) were also mentioned which were the same or similar - which they as possible channels. As regards channels for believed, would be ideal for their communi- receiving information on climate change and ties. Some interviewees in Keta mentioned its effects on health and gender, respondents mass media channels such as radio and televi- in the interview distinguished between how sion as their preferred channels but said that they wanted to receive information for them- information through these media should be selves and how such information should be carried on evening programmes for them to passed on to members of their communities. be able to listen or watch. Other channels and For themselves, respondents largely pre- sources of information and communication ferred to receive information in a format that suggested by Keta interviewees as effective could be understood and, more importantly, for communicating with community members used as a reference material. Therefore, the included: most preferred channel used should be one

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Community durbars Some channels and sources of information Radio and communication suggested by interview- Drama and theatre ees in Bongo as effective for communicating Use of Community based with community members included: surveillance volunteers Community durbars Use of chiefs and queen Radio mothers as spokespersons Use of agricultural extension officers Use of religious and social group Use of community health workers meetings (e.g. drumming groups, on their house-to-house visits borborbo groups, etc.) and CHPS facilities as resource Use of public address systems centres for information Interpersonal communication channels Use of chiefs and queen such as face-to-face encounters. mothers as spokespersons Similarly, interviewees in Gomoa mentioned Video shows and jingles. the following channels and sources of information and communication as effective Communicating Climate media for communicating with community Change, Gender and Health members: The study also examined how and what to Community durbars communicate about climate change. For ex- Radio ample, were men and women to be segregat- Use of community health workers ed or the youth and the elderly put together? on their house-to-house visits Whereas respondents from Keta indicated and child welfare clinics (CWC) that the same information should be given to Use of chiefs and queen both men and women, the district nutrition mothers as spokespersons officer of Gomoa was of the view that men Use of religious group meetings should be segregated from women when Communication through health facilities information was to be passed on because of Communication through experiences she has had when both men and schools and teachers women were put together. However, other Dissemination through organised interviewees were of the opinion that since cli- groups such as hair dressers and mate change affected both males and females, dressmakers associations there should be no segregation. Similarly, Use of information vans respondents from Bongo did not think it was Organisation of talk shows necessary to segment men and women or Education during festive any other group unless a particular situation occasions and concerts. warranted it because climate change and its impact were felt by all. The district director of health for Gomoa even talked about the need to mainstream climate change into planning at all levels of governance in order to ensure that it received the needed attention. All respondents believed that such information should relate climate change to the weather pattern and health of communities as well as what they could do to prevent its effects.

As regards what to communicate, the municipal director of health for Keta specifically requested for training in communication skills to help them effectively pass on information and knowledge they acquire to support the project. Interviewees in Gomoa and Bongo also indicated the need for training to relate

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climate change to observable changes in the their health but of which they may not have atmosphere or environment and people’s been aware. There is a clear need for the com- livelihoods for them to understand. Such munication strategy to consider ways in which information, they said, should be in the local knowledge levels of interviewees could be languages and be practical enough for people enhanced to equip them to pass on accurate to appreciate. It should contain such simple information to community members bearing actions or activities as to enable community in mind that they are reference points for dif- members to prevent climate change effects. ferent issues in their communities. Any inac- The communication strategy would, therefore, curacies in their knowledge may be passed have to consider providing respondents with on to their community members, a situation training and skills to communicate knowledge which may not be beneficial to their lives. and information to others in ways that would make such information usable and relevant to them. Messages would also need to be properly packaged for them to communicate effectively with their community members.

The observation that respondents had some knowledge of climate change and some of its causes and effects is a strength and an opportunity which need to be leveraged in the communication strategy. Nonetheless, there is the need to help interviewees understand other factors which could engender and facilitate climate change and were detrimental to

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Conclusion and Recommen- 5.0 dations

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The study found that information that inter- represent. Feedback mechanisms also need viewees had on climate change and health, to be established to gather information from which in itself was not comprehensive, was community members on information they rarely communicated to others. It would be receive, how they react to the information as important to pass on information in hard copy well as the kind of information they require in or printed format to interviewees and others order to meet their specific needs. in their positions to enable them read and also refer to such material as and when the need It was found out in Bongo that some radio arose. Other respondents also mentioned ra- programmes were organised where resource dio and television as channels they would pre- persons in the district were invited to provide fer to receive information from but added that expert opinion on health issues. This channel programmes should be in the evenings when should be more systematically explored to they would likely be at home. These would be propagate information on climate change and considered in the communication strategy. health. Communication materials, produced in simple, precise language that is catchy and The need to equip stakeholders with skills to easy to understand, will need to be prepared take advantage of speaking opportunities to and used for public education activities. put out well-structured simple messages on Religious leaders agreed that their platforms climate change and health would need to be in churches and mosques could be used considered. Such information would need for education. Religious platforms have the to be related to the livelihoods of audiences advantage of enjoying a large following and being targeted and ride on their aspirations some level of credibility in Ghana and would for good health and wellbeing. There would serve a useful purpose for the pilot project if be the need to provide key players with infor- used effectively. mation on climate change and its impact on various aspects of life in order to improve their It was also suggested that since climate change knowledge levels and to enable them pass on impacted both men and women, messages such knowledge. This would help beneficiaries should be targeted at both generally but, to properly relate climate change issues to depending on the goal of the communication various challenges they have to deal with. effort, there might be the need to segment the community into various groups including Spokespersons such as chiefs, queen moth- gender. It was observed, for instance, that the ers, community health workers, and agri- northern regions of Ghana have strong cul- cultural extension officers would need to be tural and gender ties that sometimes dictate educated and provided with appropriate how communication should flow. In order to information and knowledge on climate change create an environment where women and the and its impact on various areas of life such youth would feel comfortable to share their as agriculture, health, and socio-cultural life. views in open forums, for example, it would be This will enable them understand the issues important to segment them and target them involved and to accurately communicate such with specific information on climate change information to community members. They and health. Such information should, of ne- also need to be provided with speaking points cessity, relate to how participants contribute and questions and answers (Q & As) which to the situation and how they could mitigate are relevant to the communities they visit or the effects.

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Gender Sensitive Climate Change Communication Strategy 01 Country Focus: Ghana

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3 8 || GENDER SENSITIVE CLIMATE CHANGE COMMUNICATION STRATEGY Executive Summary Climate variability appears to have gender implications as they relate to health of women, especially in Ghana’s developing context. The effects of climate change are believed to be more acute in developing countries than in advanced countries although the climate changes brought about by American dependence on fossil fuels, for instance, are said to have helped to produce hurricane Katrina whose devastation in New Orleans was phenomenal (Bradley, 2007). In Ghana, anecdotal evidence shows that climatic variability is adversely affecting the country’s natural resources such as land, water, forests and vegetation, as well as human capital, health, energy, food security and physical infrastructure, with women being more vulnerable.

Despite the increasing understanding of The baseline study found that respondents health risks associated with climate change, could relate changes in their environment to there has been limited identification and changes in climatic conditions although some implementation of policies and strategies of them did not know about climate change and measures to protect the health of the as a concept. Respondents trusted certain most vulnerable populations in Ghana. This is sources to provide credible information compounded by a dearth of information and within both the traditional and new media. documentation of the phenomenon unlike There was also a clear desire on the part of elsewhere including the United States. This as- key stakeholders including policy makers and signment, as part of Ministry of Health/United spokespersons to be channels for disseminat- Nations Development Programme (UNDP)/ ing information about climate change to con- Global Environmental Facility pilot project stituents if they were properly equipped for on climate change adaptation for health in such purpose. Although participants indicated Ghana, was to develop a gender-sensitive that women clearly suffered more from the ef- climate change communication strategy to fill fects of climate change due to their physiology the documentation void in the Ministry as well and cultural roles, they wanted information as help reduce the paucity of information on to focus on and shared equally among both climate change and health in Ghana. men and women except when it was gender- specific. Information to be provided should Surveys and in-depth interviews were con- also relate to the livelihoods of audiences and ducted in three pilot districts (Bongo- Upper ride on their aspirations for good health and East Region, Keta - Volta Region and Gomoa wellbeing. From the data gathered, a SWOT West - Central Region) to gather baseline analysis was undertaken on each pilot district data for the development of the communica- to develop a communication strategy. tion strategy. Bongo is a poor farming and predominantly rural community, Keta and The overall goal for the gender sensitive cli- Gomoa are predominantly fishing communi- mate change communication strategy was ties with the sea as the main source of liveli- outlined as: hood. The research focused on knowledge, attitudes, perceptions and experiences of To create awareness and knowledge about cli- climate change, types and sources of informa- mate change and gender in the promotion of tion, channels of information and communica- health and the facilitation of positive attitudes tion as well as preferred and required types of and behaviours [that effectively respond to information and information channels. climate variability]

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The thrust of the developed communication The different stakeholders and audiences strategy is awareness creation and knowledge have been identified and appropriately acquisition to make the public aware of the segmented and mapped out for targeting existence of climate change issues and the with appropriate communication tactics. health and gender implications of their impact. The choice of communication channels and The strategy seeks to build on the knowledge media for the strategy and plan was based community members had on climate change on the analysis of these stakeholders, their so as to stimulate a desire to apply such knowl- preferred and trusted communication chan- edge to enhance their livelihoods and reduce nels, their communication and information the effects of climate variability on their lives. needs as well as the nature of messages to be communicated to them. Furthermore, on Thus, the strategy makes use of such familiar the basis of the programme goal and the com- communication forms/channels as drama, munication needs identified through the situ- festivals, radio programming, community ation analysis, information needs analysis has durbars, community health volunteers, also helped develop a relevant theme which spokespersons and neighbours to provide guides key and sub messages that respond to information. In addition to these other chan- the information needs of the audience. nels (such as the traditional modes of communication), have also been outlined in the Finally, since effective monitoring and evalu- strategy to explore their effectiveness during ation is critical for the success of any inter- the implementation process. It is anticipated vention including this strategy, the commu- that other community specific channels may nication strategy contains a comprehensive be discovered during the roll-out of the pilot monitoring and evaluation (M&E) component project at the implementation stage. The with agreed indicators of success to facilitate strategy further addresses the need for re- monitoring of its implementation. The strat- cord keeping of the implementation process egy, therefore, provides measures for moni- as a first step toward documenting climate toring and evaluating its implementation and change adaptability processes in Ghana. also makes provision for feedback.

4 0 || GENDER SENSITIVE CLIMATE CHANGE COMMUNICATION STRATEGY Introduction Climate change, especially its health and gender implications, has in recent years become an issue of prominence in both global and national discourse. Although it was initially seen as an environmental issue, it is now understood to affect different aspects of human life both locally and globally. Around the world, scientific communities, universities, Non-Governmental Organizations (NGOs), advocacy groups and individual countries generate important information about climate change and other such issues of universal importance including human rights and nuclear non-proliferation (Aday & Livingston, 2008). Climate change has been noted to link everyday consumer behaviour in one country with a global level of concern (Lauristin, 2007). It is, therefore, no longer just a local development issue but a global development issue often cited as one of pressing public spending needs (Lewis, 2008) especially of advanced economies. Some five years ago, Mitcham (2007) reported that the United States had since the 1980s invested some $25 billion in global climate change research with a view to increasing scientific understanding of the dynamics of climate change in order to better inform public decision making and enhance environmental sustainability.

It is becoming more and more apparent that In view of this, the Ministry of Health in part- most of the causes of climate change are hu- nership with the United Nations Development man induced (Boston and Lempp, 2010). Its Programme (UNDP) is implementing a Global effects are felt in various aspects of human life Environment Facility (GEF) funded project to including health and economy with women pilot climate change adaption for health in being more vulnerable. The effects on health Ghana with a using malaria, cerebro-spinal include intensity of transmission of vector meningitis and diarrhoeal diseases as tracer ( tick and rodent) borne diseases and food diseases, in three districts - Bongo (Upper East and waterborne diseases as well as changes Region), Keta (Volta Region) and Gomoa West in prevalence of diseases associated with (Central Region). A critical part of the project is air pollutants and aeroallergens. In Ghana, the development of a gender-sensitive climate anecdotal evidence shows that climatic vari- change communication strategy to fill the ability adversely affects the country’s natural documentary void in the Ministry of Health as resources such as land, water, forests and well as to reduce the paucity of information on vegetation, as well as human capital, health, climate change and health. energy, food security and physical infrastructure. Furthermore, diseases such as ma- Information sources on climate change are laria, diarrhoea, cerebro-spinal meningitis and varied and various at all levels. However, other infections are climate-sensitive diseases where robust epistemic communities are that could cause grave challenges as a result formed around such important phenomena of significant changes in climatic conditions. as climate change, human rights, or any other There is, therefore, the need to consider ways issue of such magnitude, information sources of adapting health policies and strategies to transcend national borders. In such cases, ac- climate change issues to check the negative cording to Aday and Livingston (2008), vibrant impact on human life and people’s livelihoods. alternative sources of information and news frames formed include transnational advocacy networks and the global media. Gripsrud (2007), indeed, asserts that the media can contribute to and influence new legislation on climate change. The media, therefore, constitute

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an important public in the communication Desired Deliverables strategy both as sources and disseminators The consultants were to provide the following: of information although other alternative local group and interpersonal sources have equally An inception report describing the been deemed to be of importance. methodology and approach Submit a draft report providing a clear Task of Consultant(s) description of what exists and an analysis of the strengths, weaknesses, The consultants were expected to undertake opportunities and potentials the following specific tasks to achieve the ob- An in-person presentation to the jectives of the assignment: project management committee Report on the gap analysis of the and identified stakeholder groups communication needs and capacities Final technical report (5 hard copies of target groups and communication and a soft copy on CD) packaged needs of activities to be undertaken into a publication ready format Present goals and SMART targets of the A Policy Brief based on proposed communication strategy the technical report Submit a detailed analysis identifying Organize workshop with stakeholders, the settings, channels, message and including a high-level policy media for reaching the critical publics briefing for decision makers. with the communication strategy A detailed dissemination strategy Objectives with recommended outlets and The stated objectives for the assignment were media for reaching the publics as follows: and audiences identified Assess information and communication Proposals, in outline, of the types needs of key target groups (health of educational and informational workers at the national, regional, district materials suggested for use as part and sub-district levels) including also of the communication strategy for implementation work in pilot sites, An implementation plan, national coverage, local level policy including a detailed resource makers, high level decision makers, list and estimated budget business community and the public A Gantt chart timetabling the Explore existing gender sensitive climate roll-out of the strategy and change communication strategies A draft evaluation instrument for Design an appropriate gender-sensitive measuring the achievement of the communication and awareness goals and targets of the strategy strategy to be carried on electronic, Work with technical personnel from the print and off electronic media and Ministry of Health and Ghana Health applicable to the wider community. Service in carrying out the assignment with the objective to enhance and sustain capacity of health workers.

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Methodology for Developing the Strategy To provide baseline data and serve as the basis for the development of the communication strategy, studies were conducted in the three districts on climate change, health and gender. Apart from a survey of identifiable trade and occupational groups, key players and opinion leaders were also interviewed as part of data gathering. The study report is attached as Appendix 1. Subsequently, A SWOT (strengths, weaknesses, opportunities and threats) analysis of all the three research locations was undertaken based on information from both survey and in-depth interviewees provided in the research. This was to give a clearer picture of what the situation was and what possible opportunities needed to be leveraged, while mitigating weaknesses and threats that could impede the pilot project. Through analysis of the baseline study and the SWOT analysis, a conceptual framework was developed to guide the development of the communication strategy. Table 1 presents a SWOT analysis of the target districts.

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Table 1: SWOT Analysis

DISTRICT STRENGTHS WEAKNESSES OPPORTUNITIES THREATS All districts - Existence of knowledge - Absence of toilets or places - Opportunity to build on - Pervasiveness of climate on climate change based of convenience knowledge and awareness change contributing on experienced changes in - Inadequate knowledge that respondents already had activities such as bush weather, rainfall patterns about climate friendly modern about climate change and burning, tree-cutting for and environmental climatic farming practices. health. firewood and charcoal, sand conditions such as prolonged - Interviewees suggested winning and Illegal gold dry season. - Lack of expert information mining(“galamsey”), etc. about the linkage between solutions for dealing with - Knowledge and awareness climate change and health climate change including - Limited of arable lands and of the linkages between and gender issues in the enforcement of traditional and water sources for farming climate change, health and districts. local authority bye-laws. and fishing leading to over gender cropping and over fishing. - Lack of data on climate - Incorporating issues of - Awareness and concern that change impact on health and climate change in school - Poverty, inadequate financial these changes can be caused gender in the districts. curricular at the basic and support and lack of alternative by both nature and man. secondary levels. sources of incomes and - Misconceptions about the livelihoods. - Awareness of the human causes and effects of some - Providing climate change causes of climate change and diseases and their relationship education during local events - Poor agricultural yields some ways to minimise such to climate change and gender. such as festivals, etc. leading to unsustainable human activities. livelihoods. - No direct relationship - Agreement by all - Existence of local or coordination between interviewees that climate - Low yields leading to less communication systems related agencies such as change needs to be nutritious meals and increases as channels for providing meteorological services, EPA considered and factored into in cases of anaemia and additional information and health. health planning. malnutrition - Willingness of respondents - Insufficient knowledge - Existence of Community - Increases in cases of to receive more information of links between climate Based Health Planning and diarrhoea and malaria during on climate change and its change, gender and everyday Services (CHPS) facilities in all rainy season. effects on health and gender happenings in society. districts. - Use of chemicals to force - Willingness of respondents - Lack of access to expert - The existence of mass farm produce to ripen which to play communication information about climate communication channels can affect the health of leadership roles to tackle change health and gender. (radio and local public address consumers. climate change systems) in the districts used - Difficulty in translating - Women suffering more in for information dissemination terms of health implications of climate change concepts into to be converted into local languages. climate change due to culture information sharing. and their physiology. - Difficulty in reducing climate - Willingness of all - High levels of illiteracy and change concepts into simple interviewees to receive everyday English language. their effects on making the climate change information right choices about life and - Difficulty in designing health and education and to pass it health. and gender-specific messages on if provided with the skills on climate change. needed to do so. - Willingness of opinion leaders, who interface with community members, to collaborate with and provide platforms for education on climate change and health.

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Bongo - Awareness and reasonable - The size of huts and poor - Some initiatives by some - Disappearance of trees and appreciation of the gravity of ventilation leading to easy community members (such as forest cover through firewood the situation by community spread of diseases such as queen mother and women’s and charcoal burning as well and opinion leaders. CSM. group leaders) can be as bush fires. leveraged for the programme.

- Existence of emergency - The existence of mud huts - Initiatives instituted to save - Prolonged drought and dry preparedness committee (which are easily washed the environment (eg tree weather conditions and their made up of representatives away during heavy rains). planting, commercial tree effects on health economic of various Ministries production, etc ) wellbeing of all. Departments and Agencies with a plan in place for - Many women are not economically empowered and - The system of holding - The prolonged dry season fighting effects of climate periodic stakeholder change. are therefore very dependent leading to increases in cases of on their husbands. meetings. CSM and other such diseases.

- Commitment on the part - Activities by the Catholic of community leaders and - Poor agricultural yields church such as Abor Week - Re-emergence of hitherto health workers to champion leading to mothers having to aimed at preserving the controlled diseases (measles, the cause to safeguard the move to “greener pastures” environment. yellow fever) environment for employment and leaving their children unattended. - Illegal mining -“galamsey” and its destruction of the environment.

- Increased migration due to increased poverty Gomoa West - Awareness and appreciation - Inability to determine - Construction of a sea - Uncontrolled human that there is a problem specific gendered effects of defence wall to mitigate the activities such as sand which requires attention climate change. effects of sea erosion winning bush fires, over by community and opinion harvesting of coconut trees for leaders. construction, and over fishing - High levels of poverty and - Existence of initiatives aimed in lagoons. lack of alternative sources of at saving the environment - Commitment on the part livelihood such as tree planting by of community leaders and women’s group leaders and - Dumping of faecal material health workers to champion provision of dust bins by at the beaches. the cause to safeguard the queen mother. environment - Increases in cases of diarrhoea during the rainy season with the onset of the mango season. Keta - Awareness and appreciation - Low knowledge levels about - The mosquito net campaign - Uncontrolled human that there is a problem climate change and its impact. led to many homes owning activities such as sand which requires attention and using mosquito nets. winning, over harvesting of by community and opinion coconut trees and over fishing leaders. in the lagoons. - Construction of sea defence wall. - Commitment on the part - Dumping of faecal material of community leaders and at the beaches. health workers to champion the crusade to safeguard the environment - Increases in social vices such as teenage pregnancy and illegal abortions - Increases in cases of worm infestation among children.

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Conceptual Framework Based on this SWOT analysis and the baseline study, our conceptual framework is set out in Figure One:

Figure One: Conceptual Framework Limited Full Motivation/ Sustaining Action Awareness Awareness Decision Action

In spite of some knowledge already held by respondents, it is clear from the research that knowledge about climate change and their implications for health and gender is limited and inadequate. In some cases there are misconceptions about some health conditions and their causes in relation to climate change.

Facilitating and promoting behaviour change requires a carefully planned communication strategy that leverages their knowledge about environmental changes and its linkages to present climate change and health. This helps them to understand the ripple effect of climate change on various aspects of live and livelihood (awareness and knowledge) and work with them to manage issues they may have with a view to enabling them decide to change or modify activities that have negative effects on the climate and their health. All this would build enabling capacity to help them decide to take action that would mitigate the effects of climate change particularly on their health (Decision and Action). It would also be the focus of this strategy to work with community members to evolve for themselves new ways of positively enhancing climate variability that could be replicated in other places.

The Strategy Communication in the strategy emphasises the need to recognise differences of stake- The main aim of the strategy is to provide a holders by acknowledging their different framework for the communication compo- backgrounds in society. Some stakeholders nent of the pilot project while documenting will need assistance and motivation to join the the process in the various districts. The strat- dialogue, especially the poor, disadvantaged egy emphasises a participatory communica- and women. For example, available radio re- tion approach which involves the beneficiary ceiving sets would enhance communication community and also provides avenues for through that medium. This strategy would feedback to enhance the process. It is recog- place some emphasis on the effects of climate nized that such an approach will improve the change on gender, especially women as they quality of the decisions to protect the environ- are known to be more vulnerable. It gives sug- ment and climate as well as the health of com- gestions on the use of various communica- munity members and its gender implications tion tools and information channels, and how because it stimulates the participation of all messages can be conveyed to the general stakeholders in the implementation of the public and specific target audiences. programme and leads to sustainability. It is important to explain the role of human ac- The communication strategy and methods tivities in climate change and how this affects used shall facilitate dialogue about climate health in order to stress the need for manag- change and health among a large number of ing the natural resources that are becoming different stakeholders, such as opinion lead- more scarce and poorer in quality as popu- ers, traditional authorities, local government lation increases. Since traditional leaders, authorities, the business community, the local authorities, and opinion leaders (health media, private organisations (including NGOs, workers, priests, women’s group leaders, etc.) women’s organizations, community organisa- have influence over what their communities tions, trade unions, etc), religious organisa- do, they would be targeted for education and tions as well as the general public. information sharing both as beneficiaries and

4 6 || GENDER SENSITIVE CLIMATE CHANGE COMMUNICATION STRATEGY as channels. In this way, their credibility would adoption of an innovation). Feedback, at all become a facilitating factor for their messages levels and times, is also expected as a tool for to be received and acted upon. measuring message effect. A communication plan of action must usually contain elements The strategy will consider, analyse and exploit that are sustainable. In putting in place a plan windows of opportunities to create interest of action that would ensure that the target in the media for climate change, gender and audience understand climate change and its health issues in the selected districts and sug- implications for gender and their health and gest ways to maintain a clear concept of the to actually facilitate positive behaviour devel- need to balance costs and benefits. Although opment, the message, appropriate medium, the immediate outcome of communication feedback and audience need careful and fun- and information dissemination is awareness damental consideration. creation and education, in general, it is the intention that the strategy eventually should Message Development foster behavioural change among the public, particularly in the selected districts, in relation The development of messages, the reception to the environment and health. and understanding of which would establish the desired link between the communica- It is expected that the communication strat- tor and the audience, requires attention to egy will help to: a number of issues. For instance, messages must be clear, simple and easy to understand. Amplify information on the mitigation There must be some means for testing their of the effects of climate change effectiveness before their implementation. It on the health of constituents is always preferable to share (dialogical) rather Support the health sector to proactively than disseminate (unidirectional) messages. communicate information on the The advantage of sharing which dissemination gender factor in climate change and does not have, unless it is intentionally sought, its impact on health of the populace. is feedback (instantaneous or delayed). Communicate best practices Sharing also encourages listening on the part in effective climate change to of the communicator who then is able to clari- constituents and document the fy, explain or even reformulate the message to effects of these best practices on improve comprehension and acceptance. the health status of constituents Ensure access to accurate and efficient information in the districts Selection of Medium and to all stakeholders Various media and communication formats Communicate Ghana’s knowledge, have certain advantages and disadvantages experiences and policies with especially when viewed against the message regard to climate change and health to be communicated and the audience target- nationally and internationally. ed. It is not enough to assume that the MEDIA are available to carry messages to audiences; Strategy Development suitability of the chosen medium or format for The process of communication involves a communicating a message is crucial (Reynolds number of elements that need to be recog- and Anderson 1992; Sugrue and Clark 2000). nised and incorporated into any action plan For example, a message sent through radio, with the capacity to stimulate and realise ef- television or radio cassette recorder requires fective sharing of knowledge and information. a reception device such as a radio cassette These elements include a defined message, player available to the audience if the message an appropriate medium or channel and an is to be accessed. audience whose attributes or characteristics must be properly recognised. In addition, the It is thus important to undertake an inventory message must be measurable (in terms of of all forms of communication available (or that its impact on the targeted audience such as can be made available with cost consequenc- observable change in behaviour, attitude or es) to the audience and noting the attributes

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4 8 || GENDER SENSITIVE CLIMATE CHANGE COMMUNICATION STRATEGY of each form of communication. This will assist THE COMMUNICATION GOAL in matching a form with the communicative The goal of the communication strategy is characteristics of a message and its audience. to create awareness and knowledge about The possibilities of multi-media approaches climate change and its impact on health as to sharing messages are also enhanced by well as its gender ramifications and promote such an inventory in compiling which various or facilitate positive attitudes and behaviours communication types, namely, intrapersonal, towards climate variability. interpersonal, small group and mass will emerge. COMMUNICATION OBJECTIVES Audience Characteristics The objectives of the communication strategy are to: The more the socio-economic, cultural, politi- cal and other characteristics of the audience Increase stakeholder and general are known and understood by the com- public awareness about climate change municator, the more adequate the design of and its implications for health the message and the more appropriate the Educate stakeholders about human selected medium or media for sharing the activities that could lead to climate message. The baseline studies preceding this change and how these can be managed report collected such relevant information. Promote positive attitudes and behaviours towards climate change Focus and its implications for health Develop and employ appropriate Communication is a process that achieves avenues for knowledge sharing various levels of results over certain periods of on climate change and health time. For effectiveness in terms of preparation, among community members presentation and evaluation, however, like the Ensure effective monitoring and implementation of all planned activities, it is evaluation of the implementation useful to set specific objectives and deadlines of the communication strategy. for achieving those objectives. This allows Mobilise community members to work some degree of measuring whether the mes- with, own and sustain the project by sage is having the desirable impact. Activities developing monitoring mechanisms may have some semblance of terminal points; that promote positive climate that is, one may consider enough messages to change and health improvement. have been packaged to be sent out or results of audience studies (especially for feedback KEY PLAYERS purposes) would need to be utilised for their Ministry of Health usefulness to be established. However, com- Ghana Health service munication activities can hardly be regarded Regional Health Directorates as exclusive or compartmentalised because District Health directorates they are activities which usually complement District assemblies each other. So, while certain programmes may Ministry of Environment, Science seem to be taking place as stand-alone ac- and Technology/ EPA tivities, one can expect that, most of the time, Ministry of Local Government virtually all activities outlined may be occurring and Rural Development simultaneously. Meteorological Services National Disaster Management Organisation Civil Society Organisations Recognized groups Media Ministry of Food and Agriculture (Agriculture Extension Division)

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TARGET GROUPS MATERIALS Community members Traditional authorities Advocacy Materials Religious authorities PowerPoint presentation Women’s group leaders Text Teachers Pictures Farmers Facts sheets Health workers including Brochures Community Health Workers Newsletters Programme implementation team Speaking points Youth groups Websites Social groups Questions and Answers Frequently Asked Questions MESSAGES Features

Theme: Climate change affects everybody’s Behaviour Change Materials health. Climate change is also a women’s issue. Drama kits Video KEY MESSAGE Games and activities Our environment is our health. Let us come Facilitation manuals together to fight climate change for better Poster flipcharts health. Together we fight climate change for Pocket guide healthier life. Songs Leaflets Materials dissemination plan Strategy Highlights Radio discussion programmes Prepare human and material resources Indigenous communication (e.g. Advocacy with leaders and songs, stories, narrations, orations, gatekeepers (influencers) of proverbs, and analogies) stakeholders and general public Raise public awareness about Climate Social Mobilization Materials change and educate the public about Radio programmes its effects on livelihoods as well as 12 month drama series ways of mitigating the effects Magazine programme Social mobilization for Poster flipcharts programme support Pocket guide Facilitate adoption of positive Speaking points behaviours towards climate enhancing Questions and Answers activities and initiatives among various Songs stakeholders and the general public Newsletter Leaflets Channels and Materials Materials dissemination plan CHANNEL AND ACTIVITY Radio documentary CHARACTERISTICS Indigenous communication Culturally sensitive General For facilitation and promotion of change Mailing list Facilitation of education In support of advocacy Participatory nature Facilitation of easy feedback

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ILLUSTRATION OF Documentary: Documentaries are good for COMMUNICATION MATERIALS awareness creation and also for advocacy AND ACTIVITIES purposes. A documentary will be produced on the achievements of the programme to be Group Discussions: Non-literate cultures are used for advocacy purposes as well as educat- steeped in oral traditions with a strong reli- ing the general public on climate change and ance on dialogue-oriented and participatory health issues. The documentary will be in approaches to communication (Oniekwere the local languages and shown at community 1994). Group Discussions provide good education forums. opportunities for using these elements of traditional communication. It will be useful Drama: Dramatic Skits on climate change to develop group discussion guides on the impact will be developed and produced to subject of climate change and health and train show around the various communities. The local facilitators to use them. Such participa- Skits will be interactive and help to easily iden- tory approaches promote social dialogue and tify issues as well as communicate messages. facilitate social acceptance. For the purpose of this project, perceptions, attitudes, etc that need to be managed will be Radio Programmes: The widespread use of identified and skits developed in a way that will radio by the rural communities as well as the help the management. Generic skits will be increasing use of local languages on many FM developed with guidelines and facilitation kits stations makes more of the population want for their adaptation. It would be more effec- to listen to radio and partake in radio discus- tive if community members are recruited into sions. It will therefore be more effective and the drama skits. appropriate to use the medium of radio due to its extensive reach and widespread use and Cartoon Strips: Comic Strips are effective in the ability of the communities to carry them helping people follow the flow of actions and around. This will be done by studio panel impact of these actions. These will thus be discussions and interviews. It will also bring developed and produced for education on stakeholders to one meeting, to reflect differ- climate change and especially for school chil- ent opinions, encourage and build consensus dren, they would be considered. Once these which is usually an approach for resolving school children are educated about these is- issues among non – literate and semi – liter- sues they will in turn pass on the information ate communities. It can also be used to draw to their parents and other members of their out misconceptions and fears about climate communities. change and health and relay solutions from the experts. Radio discussions are participa- Training Modules and Facilitation Kits: tory and non-intimidating and will promote These will be developed for the training of all appreciation of the issues about climate those who will be involved in the facilitation of change. decision-making in relation to the progamme. This would include Community health nurses, Local Public address systems or teachers, health workers, religious leaders, Information Centres: These are increasing etc. and becoming the case that communities have set up community public address sys- Presentations: Presentations in the mar- tems with megaphones situated at vantage kets, churches, mosques and antenatal clin- points through which information is sent ics can directly reach women who are more out to the entire community. These systems vulnerable. Presentations will also be made seem to be replacing the role of the gong- to opinion leaders, Community gate keepers gong beater in many communities. These and traditional and religious authorities. As systems will also be considered for commu- they function predominantly in oral and visual nity mobilisation activities. societies, the presentations will be made up of mostly pictures.

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One-on-One Discussions: These will be Implementation Plan organised with carefully worded speaking points as guides. The objective will be to teach IMPLEMENTATION through one-on-one sessions as well as insti- PLAN - SUMMARY gate and sustain supportive behaviour. Quarter 1 Fact Sheets: Fact Sheets will be developed Development of themes, and produced and sent out periodically es- messages and materials pecially to the policy makers, health workers Pretesting of messages and materials at the regional and district levels as well as Advocacy visits to key players to share media and selected CSOs and NGOs. The me- the project and seek their support dia and NGOs will share the information with Training of spokespersons communities, thereby increasing awareness, and facilitators education and information flow. Training of health personnel and relevant representatives from key stakeholders Community Communication Approaches: Establishing feedback mechanisms A wide variety of traditional community ap- Quarter 2 proaches such as games, theatre, and folk Social mobilization activities media can be used (Oniekwere 1994). A Awareness and Education number of skit ideas can thus be developed Showcasing in the multimedia package for different uses What is the situation? in different contexts. These skits will basically Why that situation? seek to draw out and address climate change What are the implications and health related issues and questions on of the situation for people’s minds. Thus a set of pre-prepared ¡¡ The individual? FAQ’s could form the basis of the skit ideas. ¡¡ Loved ones? ¡¡ The community? Posters: Various posters will be developed ¡¡ The nation? and produced on the issue of climate change What can be done to turn and health and circulated and posted in stra- the situation around? tegic places to create awareness. When should this be done? How should it be done? Who should do it? What is my role? Where to get needed information?

Quarter 3 Social mobilization Behaviour development/change Showcasing Monitoring

Quarter 4 Behaviour development Social mobilization Monitoring and evaluation

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Table 2: Implementation Roll-out Plan Activity Strategy Materials Audience Means of Indicator of needed verification success Quarter 1

¡¡ Development of themes, Prepare human and ¡¡ Research reports ¡¡ Project staff ¡¡ Speaking points Content analysis messages and materials material resources ¡¡ Communication strategy ¡¡ Selected community developed ¡¡ Pretest of messages, material document members ¡¡ Q&As developed and theme ¡¡ Sample materials ¡¡ Themes and sub theme developed Production of ¡¡ Prepare human and Sample communication Project staff ¡¡ Systematic Content analysis Communication material resources materials penetration and use of Materials/Content ¡¡ Link up with communication materials with the relevant messages Meteorological ¡¡ Consistency in message Services; MoFA ¡¡ Effective communication (e.g. fertilizer use); EPA, etc ¡¡ Increased awareness ¡¡ Positive behaviours towards the project Identification of Opinion & Decision ¡¡ Prepare human and Communication materials. Identified opinion leaders ¡¡ Increased knowledge ¡¡ Training report Leaders - National, Regional, District, material resources Training modules, Q&As about climate change ¡¡ Community and health ¡¡ Assessment reports ¡¡ Positive behaviours toward project and issues Compilation of an inventory of Forms ¡¡ Prepare human and ¡¡ Literature/Press review; ¡¡ Project staff ¡¡ Itemised mode ¡¡ Reports of Communication material resources also sociometry ¡¡ Communication experts characteristics Indigenous, Small Group, Mass, Internet Development of training manuals Prepare human and Training modules ¡¡ Project staff Increased knowledge about ¡¡ Training reports material resources Speaking Points ¡¡ Spokespersons climate change and health ¡¡ Assessment reports Training in communication skills Q&As ¡¡ Representation of key Positive behaviours toward player agencies project and issues

Development of training manuals Prepare human and ¡¡ Speaking Points ¡¡ Communication experts ¡¡ Increased decision maker ¡¡ Training reports material resources ¡¡ Q&As support climate change ¡¡ and health Training in presentation / facilitation ¡¡ Training manuals ¡¡ Assessment reports skills ¡¡ Sample presentations Training in advocacy for relevant staff Prepare human and ¡¡ Training manuals/ ¡¡ Communication experts ¡¡ Increased decision maker ¡¡ Training reports material resources modules support climate change ¡¡ ¡ and health ¡ Presentations ¡¡ Assessment reports ¡¡ Case studies Advocacy visits to identified opinion Project staff Research reports, fact Identified opinion leaders in Increased decision maker Activity reports leaders, policy makers, traditional Communication sheets, Q&As each district support climate change and authorities to share the project and experts health seek their support and commitment Training of Communication ¡¡ Training manuals/ Local communicators ¡¡ Increased knowledge ¡¡ Training reports ¡¡ Local communicators experts modules NGOs about climate change ¡¡ ¡ and health ¡¡ NGOs ¡ Presentations CSOs ¡¡ Assessment reports ¡ Case studies ¡ Positive behaviours ¡¡ CSOs toward project and issues

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Identification and training of Project staff ¡¡ Speaking points champions for various Increased decision maker Training reports champions for various institutions Communication ¡¡ Q&As institution support on climate change and civil society groups and health experts ¡¡ Research reports Civil society groups Assessment reports ¡¡ Poster Flip charts ¡¡ Training manuals/ modules Presentation Development of material distribution Prepare human and Sample communication Project staff ¡¡ Systematic Content Analyses plan material resources support materials penetration and use of communication materials ¡¡ Consistency in message ¡¡ Effective communication ¡¡ Increased awareness ¡¡ Positive behaviours towards the project Establishment of climate change and Prepare human and Research reports Representative from relevant Issues proactively managed Committee plans and health committee in districts material resources Policy documents MDAs and CSOs report Development of radio programmes Prepare humanand Radio scripts General public Increased knowledge Content analysis material resources Resource persons about programme Positive Listerner ship surveys behaviours toward issues Advocacy with policy makers and ¡¡ Factsheet Policy makers and gate ¡¡ Increased awareness Activity reports gatekeepers (national and regional ¡¡ Progress reports keepers at regional and ¡¡ Positive behaviours level) national levels ¡¡ Q&As towards the project ¡ ¡¡ Information kits ¡ Increased decision maker support on climate change and health Orientation for media personnel on Prepare human and Factsheets Selected media in districts ¡¡ Increased awareness Media reports climate change and health material resources Information pack ¡¡ Increased publicity about Content analysis Q&As project ¡¡ Accurate reporting Development of data base on Prepare human and ¡¡ Research reports ¡¡ Community members ¡¡ Increased knowledge Surveys climate change issues in each district. resources ¡¡ Fact sheets ¡¡ Project staff ¡¡ Improved access to This would become a knowledge information platform on climate change ¡¡ Posters ¡¡ General public ¡ ¡¡ Comic strips ¡ Increased penetration and use of ¡¡ Newsletters communication materials ¡¡ Picture posters ¡¡ Positive behaviours ¡¡ Updates on environment towards the project and weather ¡¡ All data and information produced as part of the project

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Quarter 2 and 3: Awareness Creation and Education ¡¡ - Distribution of comic strips and ¡¡ Raise public ¡¡ Skits ¡¡ Community members ¡¡ Increased knowledge ¡¡ Surveys pocket guides awareness about ¡¡ Picture Posters ¡¡ School pupils ¡¡ - Increased ¡¡ FGDs ¡ Climate change and ¡ - Open air talks at markets, OPDs, ¡¡ Puppetry ¡¡ Members of religious penetration and use of ¡¡ churches mosques, educate the public communication materials about its effects ¡¡ Pocket Guides organizations ¡¡ Impact assessment ¡ ¡ ¡ Public discussions on climate on livelihoods as ¡¡ Women’s groups ¡ -Positive behaviours change and health well as ways of ¡¡ Poster Flip Charts towards the project ¡¡ ¡¡ Farmers groups ¡¡ - Use of community health nurses mitigating the ¡¡ Discussion guides ¡¡ Observations effects ¡ to educate women on climate ¡¡ Facilitation guides ¡ Fishermen groups. change and health ¡¡ ¡ ¡¡ Powerpoint presentations ¡ Dress makers ¡¡ - community drama and ¡¡ Social mobilization associations, hair dressers ¡¡ Posters community discussion on climate for programme associations etc change and health support ¡¡ Radio documentary ¡¡ - discussions at women’s group ¡¡ ¡¡ Games and activities meetings ¡¡ Facilitate adoption ¡¡ Presentation and discussion at of positive antenatal and post natal clinics behaviours towards ¡¡ Periodic presentation to schools in climate enhancing the districts activities and initiatives among ¡¡ - Local drama on the cases and various stakeholders effects of climate change on and the general health public ¡¡ - use of agric extension officers to educate farmers on climate change especially during at the beginning of planting season. ¡¡ - Education during festive occasions ¡¡ Education during festivals ¡¡ Raise public ¡¡ Cinema Vans ¡¡ General public Increased penetration and Surveys ¡¡ awareness about ¡¡ Picture Posters use of communication Climate change and materials ¡¡ ¡¡ Skits educate the public ¡¡ -Positive behaviours ¡¡ about its effects ¡¡ Puppetry towards the project Impact assessment on livelihoods as ¡¡ well as ways of ¡¡ Pocket Guides ¡¡ Increased penetration ¡¡ mitigating the and use of effects communication materials ¡¡ ¡¡ ¡¡ -Positive behaviours ¡¡ Training programmes for farmers/ towards the project fishermen on more innovative ¡¡ Facilitation guide ¡¡ Farmer associations ¡¡ Positive attitudes ways of farming/fishing and ¡¡ - Facilitate Q&As, pocket guides, ¡¡ Fishermen association addressing anxieties they may adoption of positive teaching aids etc have behaviours towards ¡¡ climate enhancing ¡¡ Traditional leaders activities and ¡¡ -institution of local by-laws that Local by –laws initiatives among ¡¡ District assembly protect the environment Increased penetration and various stakeholders members use of communication ¡¡ and the general materials public ¡¡ ¡¡ -Positive behaviours towards the project ¡¡ ¡¡ General public Positive attitudes ¡¡ - tie campaign to already ¡¡ Nursing mothers running health programmes eg malaria(IPT and ACTs), etc Facilitation guide ¡¡ - information made available at Q&As, pocket guides, CHPs facilities teaching aids speaking points, counseling cards etc ¡¡ - Presentations during child welfare clinics

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Provision of periodic information - Raise public Speaking points, fact sheets, Opinion leaders (at the Increase knowledge about Reports to selected opinion leaders (at awareness about newsletter health directorate, religious climate change and health the health directorate, religious Climate change and leaders, women’s group leaders, women’s group leaders, and educate the public leaders, and traditional traditional leaders) about its effects on leaders) livelihoods as well as ways of mitigating the effects

Provision of periodic updates - Raise public Factsheets Climate change and health Increase knowledge about Reports from GMA to districts (health awareness about Updates on climate change committee, relevant staff climate change and health directorates) to facilitate planning Climate change and issues in health directorate at the and implementation (information on educate the public district and regional levels climate change impacts on health, about its effects on Newsletter how to mitigate climate change livelihoods as well as effects on health and other socio- ways of mitigating the economic areas such as economy, effects agriculture, environment etc)

Evening radio programme on climate - Facilitate adoption ¡¡ Speaking points General public Increase knowledge about Content analysis change effects on health (to be of positive behaviours ¡¡ Programme running climate change and health Surveys placed just before or after news) towards climate order positive behaviours enhancing activities and initiatives among ¡¡ Synopsis various stakeholders and the general public Community based surveillance - Raise public ¡¡ Speaking points Clients of surveillance Increase knowledge about Surveys volunteers to periodically share awareness about ¡¡ Counseling cards volunteers climate change information and leaflets on climate Climate change and Positive behaviours change and health. educate the public ¡¡ Facilitation guides about its effects on ¡¡ Q&As livelihoods as well as ways of mitigating the effects Meeting of social groups (drumming, - Raise public Speaking points, fact sheets, social groups (drumming, Increase knowledge about Focus group discussion boborbo, hair dressers, dress makers awareness about newsletter, Q&As, video boborbo, hair dressers, dress climate change and health etc) to discuss climate change and Climate change and documentary makers etc) positive behaviours health and how this can affect their educate the public group about its effects on livelihoods as well as ways of mitigating the effects Quarter 4

Periodic messages through the - Raise public Selected messages General community Create awareness Surveys community Public health system awareness about members Increase knowledge (asking community members if Climate change and they have undertaken any climate educate the public Positive behaviours enhancing activities) about its effects on livelihoods as well as ways of mitigating the effects Small group discussions (eg with - Facilitate adoption Speaking points Identified group- drought Create awareness Surveys drought players, on climate change) of positive behaviours Flyers players, union, cooperatives Increase knowledge towards climate etc enhancing activities Q&As Positive behaviours FGDs and initiatives among various stakeholders and the general public

|| 5 7 GENDER SENSITIVE CLIMATE CHANGE COMMUNICATION STRATEGY

Monitoring and Evaluation General Monitoring and evaluation activities Activity When Periodic impact evaluation Every quarter ¡¡ Establish issues logs ¡¡ Surveys ¡¡ Testimonies ¡¡ Focus Group Discussions ¡¡ Reader Surveys ¡¡ Viewer and listener Surveys ¡¡ Lessons learnt Sessions ¡¡ Media Content Analyses ¡¡ Weekly/Monthly/Quarterly Activity Reports Input Evaluation Before the implementation of an major activity ¡¡ Content Analyses to review existing communication materials ¡¡ Pretesting of Communication materials ¡¡ Technical Expert Reviews Output evaluation ¡¡ Periodic checks for all communication support materials ¡¡ Impact Surveys and Focus Group Discussions

Sources: Aday, Sean and Livingston, Steven (2008). Taking the state out of state–media relations theory: how transnational advocacy networks are changing the press–state dynamic. Media, War & Conflict Vol. 1(1): 99–107. Bradley, Richard (2007). Meditations on Manufactured Consent and Historical Agency. Cultural Studies - Critical Methodologies, Volume 7 Number 2, 2007 110-117. Gittings, John (2007). After Trident: Proliferation or Peace? International Relations Vol. 21(4): 387–410. Gripsrud, Jostein (2007). Television and the European Public Sphere. European Journal of Communication Vol. 22(4): 479–492. Lauristin, Marju (2007). The European Public Sphere and the Social Imaginary of the ‘New Europe’. European Journal of Communication. Vol. 22(4): 397–412. Lewis, Justin (2008). The role of the media in boosting military spending. Media, War & Conflict Vol. 1(1): 108–117. Mitcham, Carl (2007). Qualitative Science Policy. Qualitative Health Research Volume 17 Number 10 December 2007. Oniekwere, Evelyne (1994) Rapport de consultation: Communication participative pour le development et ong du Ghana, du Nigeria et du Cameroun. Reunion d’Elaboration d’UN progamme de Recherche en Communication Participative pour le Developpement en Afrique Centrale et de l’Ouest. Mimeo. Reynolds, A. & Anderson, R.H. (1992). Selecting and Developing Media for Instruction. New York: Van Nostrand. Sugrue, B. & Clark, R. E. (2000), Media Selection for Training. In S. Tobias & D. Fletcher (Eds.), Training & Retraining: A Handbook for Business, Industry, Government and the Military. New York: Macmillan.

5 8 || GENDER SENSITIVE CLIMATE CHANGE COMMUNICATION STRATEGY

|| 5 9 REPUBLIC OF GHANA MINISTRY OF HEALTH

INTEGRATING CLIMATE CHANGE INTO THE MANAGEMENT OF PRIORITY HEALTH RISKS IN GHANA