83 * PSPDiscussion Paper Series Public Disclosure Authorized 19705 November 1995 Poverty Assessment in Ghana Using Qualitative and Participatory Research Public Disclosure Authorized Methods Andy Norton Ellen Bortei-Doku Aryeetey Public Disclosure Authorized David Korboe D.K. Tony Dogbe November 1995 Public Disclosure Authorized Poverty and Social Policy Department Human Capital Development and Operations Policy The World Bank Abstracts This Booklet of Abstracts contains short summaries of recent PSP Discussion Papers; copies of specific papers may be requested from Patricia G. Sanchez via All-in-One. The views expressed in the papers are those of the authors and do not necessarily represent the official policy of the Bank. Rather, the papers reflect work in progress. They are intended to make lessons emerging from the current work program available to operational staff quickly and easily, as well as to stimulate discussion and comment. They also serve as the building blocks for subsequent policy and best practice papers. Preface This paper is one of a series undertakenas part of the ExtendedPoverty Study in Ghana. A synthesis of this work is available in Ghana: Poverty Past, Present and Future (Report No. 140504-GH.Population and HumanResources Division, West CentralAfrica Department, World Bank, WashingtonD.C., June 29, 1995). Four of the backgroundpapers are appearing in the Povertyand Social PolicyDiscussion Paper Series: Harold Coulombeand Andrew McKay, 'An Assessmentof Trends in Poverty in Ghana, 1988-92.' Poverty and Social Policy DiscussionPaper No. 81, World Bank, WashingtonD.C. (November1995) Lionel Demery, Shiyan Chao, Rene Bernierand Kalpana Mehra, 'The Incidenceof Social Spendingin Ghana.' Povertyand Social PolicyDiscussion Paper No. 82, World Bank,Washington D.C. (November1995) Andy Norton, David Korboe, Ellen Bortei-Dorkuand D.K. Tony Dogbe, 'Poverty Assessmentin Ghana using Qualitativeand ParticipatoryResearch Methods.' Poverty and Social Policy DiscussionPaper No. 83, World Bank, Washington D.C. (November1995) Christine Jones and Ye Xiao, 'Accountingfor the Reductionin Rural Poverty in Ghana, 1988-1992.'Poverty and Social PolicyDiscussion Paper No. 84, World Bank, WashingtonD.C. (November1995) The papers draw upon the work of many. The contributionsof the Ghana Statistical Service, Ministryof Health, and Ministryof Educationin the Governmentof Ghana, and of UNICEFand the CanadianIntemational Development Agency (CIDA), are gratefullyacknowledged. The views expressedare those of the authors. They should not be attributedto the World Bank, its Board of Directors,its managementor any of its membercountries. Acknowledgments This overview report has been compiledby Andrew Norton, drawing heavily on inputs from the other authors. Fieldwork for this study has been carried out over three phases, with inputs of support from ODA (field costs phase I & 2) GTZ (support to costs of training, phase 1) and UNICEF (support to phase 3). Acknowledgments are due to: the field teams (members listed below) for their enthusiasmand commitment;the two Task Managers who have been involved in the Extended Poverty Study for the World Bank, Lionel Demery and Tom Stephens, for their firm support; the administrativeand logistical staff of CEDEP (the NGO who coordinatedthe study) for their efficiency and hard work; and above all the membersof poor rural and urban communitieswho gave their time to share their analysesof poverty with us. Team members: Phase 1. ResearchSupervisor - Dr. AndrewNorton Lead Researcher-Dr. Ellen Bortei-DokuAryeetey TeamLeaders - Dr. Felix Fiadjoe - Mr.Dan Inkoom - M. Wim Alberts Members - Mrs.MargaretDoku - Ms. MargaretAssan - Ms. JudithThompson - Mr.Samuel Dodoo - Mr.Martin Dery - Mr.Dominic B. Kanyoke - Mr. ThomasKuby - Mr. D.K. (Tony)Dogbe - Mr. Ben Arthur AdministrativeOfficer Mrs. SalomeAhenkora ResearchManager - Mr. D.K. (Tony)Dogbe Phase 2 Research Supervisor - Dr. Andrew Norton Lead Researcher - Dr. Ellen Bortei-Doku Aryeetey Team Leaders - Mr. Wim Alberts - Mr. D.K. (Tony) Dogbe Members - Dr. Felix Fiadjoe - Rev. Fr. Anyomi - Mr. Robert Kuwornu - Mr. Robert Agarku - Mrs. Salome Ahenkora - Mr. Charles Owusu - Mr. Dan Amuah - Mr. Martin Dery - Mr. Samuel Dodoo - Mr. Dominic B. Kanyoke - Mr. Paa Kwesi Afari Administrative Officer Ms. Celia Marshall Research Manager - Mr. D.K. (Tony) Dogbe Travelling Secretariat - - Mr. Kwaku Ahenkora - Mr. Kwame Apiagyei Phase 3 Research Supervisors - Mr D.K. Tony Dogbe - Dr Andrew Norton Lead Researcher - Dr David Korboe Team Leaders - Mr. Kweku Ahenkora - Mr. D.K. Tony Dogbe - Dr. David Korboe Members - Mr. Dela Afenyadu - Ms. Vida Affum - Mrs.Doris Amoyaw - Ms. Mercy Anim - Ms. Theresa Baffoe - Mr. Robert de Graft Agyarko - Mr. Samuel Duodu - Mr. Dominic Kanyoke - Mr. Kwaine Manhyia - Mr. Kojo Mbir - Mr. Kojo Mensah-Abrampa - Mr. Kwame Opoku - Ms. Dora Owusu - Ms. Petrina Owusu Yeboah Administrative Officer - Mrs Salome Ahenkora * Abstract The Ghana Participatory Poverty Assessment was conducted over three phases in fifteen communities by mixed teams of academic researchers, government staff and personnel of NGOs. Key findings on the local experience of poverty included the following: the main elements in defining the poorest members of communities were disability, age combined with the lack of adult children, widowhood and childlessness; the incidence and depth of poverty is greatest in the rural north; assets at the community level (such as access to water for domestic and productive use, access to services and natural resources) are seen as more important to rural communities than urban; gender dimensions are critical to understanding poverty - this emerged primarily through the finding that there are substantial elements of separation to men's and women's livelihood in much of urban and rural Ghana. The concept of vulnerability captures many dimension of the experience of deprivation in rural Ghana. Seasonal vulnerability is particularly strong in the rural north (especially the Upper Regions), manifested in chronic food insecurity often affecting whole communities. Views of long-term trends in rural communities focused on environmental issues such as declining access and quality of water, declining soil fertility and declining common property resources for the vulnerable to fall back on in times of crisis. Key long-term trends identified by the urban poor related to the evolution of policy frameworks in the era of adjustment. While a considerable improvement is seen as having occurred in the early phase of economic reform (1983 to 1988) there is a general perception that opportunities for the urban poor have been becoming more constrained in the last six to seven years. The investigation of the conmunities' own assessment of their priority needs was a consistent theme in the research. The strongest elements emerging from the priority rankings in the rural north were food security, water (both for domestic and productive use), access to health care, and education. The picture that emerged from priority rankings in the rural south was more diverse. Again, access to curative healthcare emerged as a strong and consistent priority, while improvements in transport infrastructure (roads and bridges) was also a strong theme - reflecting problems in accessing both markets and services. Other common themes included access to credit, off-farm employment and water for domestic use. The most consistent concerns in priority rankings in urban communities were with inadequate employment opportunities and the supply of small-enterprise credit. The condition of the urban infrastructure was also a major issue - with supply of water again a strong theme. Investigation of the barriers the poor face in accessing healthcare services highlighted the following issues: cost barriers are a major issue in accessing formal healthcare, both in terms of overall cost and the lack of flexibility in rescheduling treatments. Furthermore, provisions for exempting the poor from user charges are not working. In education, the major concern of most community members and teachers canvassed was with issues of quality rather than of basic access. Major concerns included: poor quality of teaching and facilities; lack of supervision of teachers; lack of clear feedback to parents on childrens' performance; the policy of retrenchment of untrained teachers leading to shortages of teachers in isolated rural communities. CONTENTS Executive Summary and Key Policy Findings 1. Introduction 1.1 Background of the Study 1.2 Methodology 1.3 Field Sites 2. Main Findings 2.1 Local Conceptions of Poverty 2.2 Priorities of the Poor in Poverty Reduction 2.2.1 Strategies for Moving out of Poverty 2.3 Vulnerability: Dynamic Dimensions of Poverty 2.3.1 Seasonal Dimensions of Poverty 2.3.2 Long-Term Trends in Poverty 2.4 Survival Strategies and 'Safety Nets' 2.4.1 Survival and Coping Strategies 2.4.2 Formal and Informal Safety Nets 2.5 Perceptions of Service Quality and Access in the Health Sector 2.6 Perceptions of Service Quality and Access in the Education Sector 2.6.1 Access and Utilization 2.6.2 Local Views of Education Quality 2.6.3 Perceived Relevance of Education 2.7 Domestic Water and Sanitation ExecutiveSummary and Key Policy Messages The Ghana ParticipatoryPoverty Assessmentwas conducted over three phases, and a total of fifteen communitieswere involved, selected to give a representativepicture of the living conditionsof the poor in Ghana. In particular, care was taken to represent adequatelythe rural and urban