gender sensitive climate change communication …...contents background iii acknowledgment v gender...

Gender Sensitive Climate Change Communication Strategy

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GENDER SENSITIVE CLIMATE CHANGE COMMUNICATION STRATEGY

BackgroundAbout the ProjectClimate 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 dra-matic 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 poli-cies 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 vul-nerable 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 cli-mate 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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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)

Acknowledgment

REPUBLIC OF GHANAMINISTRY 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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ContentsBackground iiiAcknowledgment vGender Sensitive Climate Change Communication Strategy 11.0 Introduction 3 1.1 Background 5 1.2 Data Collection 5 1.2 Brief Description of the Three Research Areas 62.0 Findings 7 2.1 Knowledge, Attitudes to and Perceptions of Climate Change and Health 8 2.2 Human Activities that Lead to Climate Change 83.0 Impact of climate change 11 3.1 Impact of Climate Change 12 3.2 In the words of another interviewee: 164.0 climate change and Gender 23conclusion and recommendations 35Gender Sensitive climate change communication Strategy 37country Focus: Ghana 37executive Summary 39Introduction 41

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01By Dr Margaret I. Amoakohene, Professor K. Ansu-Kyeremeh & Ms Esi E. Thompson

Gender Sensitive Climate Change Communication Strategy

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1.0 Introduction

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The School of Communication Studies was contracted to carry out research in the three districts to gather data to be used to develop a communication strategy to support the pilot project. The study was conducted using two research methods: survey and individual in-depth interviews. A survey of 600 participants was conducted, 200 drawn from each of the three districts of the study – Bongo district (Upper East Region), Keta municipality (Volta Region) and Gomoa West district (Central Region). Sampling for the survey was mainly cluster with individuals chosen from the groupings. Clusters included decision leaders such as chiefs and queen mothers and opin-ion leaders, among whom were managers of civil society organisations. Women’s groups constituted another cluster as were occupa-tional groups such as artisans and teachers. In the case of the individual in-depth interviews, sampling was purposively done to select key regional and district level professionals, deci-sion makers and opinion leaders in each of the three districts and municipality to record any commonalities and/or differences in views expressed to aid in developing the com-munication strategy.

1.2 Data CollectionQuestionnaires for the survey were adminis-tered face-to-face. Twenty interviewers were trained to administer ten questionnaires each over a period of four days at each location. The demographics of the respondents included almost equal numbers of females (48.5%) and males (51.5%). Almost two-thirds (66.0%) were married while just above one in five (22.6%) had never married. The rest were divorced (5.6%), widowed (3.7%) or separated (2.0%). The big-gest cohort was traders (22.0%), followed by farmers and fishermen (14.7%) and teachers (13.5%). In terms of schooling, middle/junior secondary school leavers (24.5%) were almost as many as those who had experienced ter-tiary education (22.7%). Data for the individual in-depth interviews were personally collected by the consultants/researchers face-to-face with each of the six selected regional and dis-trict level professionals, decision makers and opinion leaders in the three locations.

1.1 BackgroundClimate 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 poli-cies 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.

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1.2 Brief Description of the Three Research Areas

bongo District Ghana, as at March 2012, had a total of 170 districts. Bongo is one of nine (9) districts (including two municipalities) in the Upper East region of Ghana. It is a poor farming community which is predominantly rural and characterized by large household sizes, a high population density, and a high fertility rate. The 2000 population and housing census put the population of Bongo at 77,885. The Bongo district is estimated to have a growth rate of 2.8% thus putting its population in 2006 at 91, 949. Currently, therefore, we estimate the total population of Bongo at 100,013. The six respondents interviewed from Bongo were the deputy regional director of health, the district director of health, a public health of-ficer, a catholic priest, a queen mother and a women’s group leader.

Gomoa West DistrictGomoa West is one of 17 districts of the Central region of Ghana. It is a fishing community with a total population of 194,792 which constitutes 12.23% of the Central regional population thereby making it the district with the highest population in that region. The sea provides the main source of economic activity for inhabit-ants of the region. Respondents interviewed from Gomoa were the District Director of Health Services, a public health nurse, a dis-trict nutrition officer, a catholic priest, a queen mother and a women’s group leader.

Keta MunicipalityKeta is located in the Volta region of Ghana with a current estimated population of about 177, 583. It is one of the region’s three (3) mu-nicipalities and 15 districts (totalling 18). The population of the Keta municipality is said to have been growing at a relatively low rate of 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 offi-cer, 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 were asked questions relating to their knowl-edge of climate change and its linkage to or impact on health and gender. They were also asked questions on attitudes and percep-tions of climate change as well as sources and channels of information including preferred and trusted channels for information on climate change. Findings of the study, com-bining the survey and individual interviews, are presented under the following headings: knowledge, attitudes and perceptions about climate change and health; impact of climate change; solutions to addressing health ef-fects of climate change; support required and sources of information about climate change and health.

2.1 Knowledge, Attitudes to and Perceptions of Climate Change and Health

All interviewees in all three locations of the study had some knowledge about climate change although many did not think the weather, climatic and environmental changes they were witnessing were the result of “cli-mate change” per se. Over four in five (84.1%) of the survey respondents knew about cli-mate change. Suffice it to say, though, that the knowledge was in the form of experiencing the way some aspects of climate or weather pat-terns were not as they had previously been. In other words, interviewees expressed their knowledge of climate change in terms of expe-rienced changes in weather, climate, and envi-ronmental conditions in their districts. About a quarter of survey interviewees (23.6%) had learnt about climate change within the last five years before the interview while about 15.3% had learnt about it just about two years before. Others ranged from four years (0.8%), 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.

Some interviewees described climate change as the changes that are experienced during certain seasons like the rise in temperatures. In Keta, the largest group of respondents (29.6%) had noticed climate change two years

before the study; in Bongo, it was the same two years for 25.4% of respondents and in Gomoa West also the same two years for 22.2% respondents. In Bongo, responses con-centrated (36.3%) on hearing about climate change five years before the survey. Gomoa West had the same five years by one in five (21.5%) of the respondents. In Keta, “two years ago” and “never” (both 19.8%) were the two largest concentrations followed closely by five years (18.2%). Fewer respondents in Keta (28.7%) knew about climate change than in both Bongo (34.5%) and Gomoa West (36.9%). Close to three in five in Keta (58.9%) didn’t know about climate change.

Respondents attributed climate change to both natural and manmade causes some of which they enumerated. They often demon-strated their knowledge and perceptions of climate change in terms of changes in rainfall patterns especially in the frequency, sporadic nature and quantity of rains, the intensity of heat from the sun and extremely high tem-peratures, long periods of drought, poor agricultural yields and the disappearance of trees and forest cover. Nine in ten (91.7%) of all survey respondents had noticed changes in rainfall patterns. The distribution among the research sites were as follows: Bongo (93.9%), Gomoa West (91.3%) and Keta (89.9%). An almost equal proportion (91.0%) of all respon-dents had noticed changes in temperature or heat patterns, Bongo (95.9%), Gomoa West (90.8%) and Keta (86.4%). Notice of changes in the general weather patterns was similarly high (84.3%) among all survey respondents. In Bongo, 87.8% had noticed such changes, and in Gomoa West (84.1%) and Keta (81.0%) had noticed changes too. These changes defined and described their attitudes towards climate change which also highlighted and explained the impact of the phenomenon on their health and living conditions.

2.2 Human Activities that Lead to Climate Change

Respondents believed some activities of some of their community members contributed to climate change. These activities included indiscriminate cutting of wood for wood fuel

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and charcoal, bush burning, sand winning, poor sanitation especially through the dump-ing of both human and solid waste, littering of plastic bags, faecal contamination of water bodies, and “galamsey”. With the exception of sand winning which was reported in Gomoa and Keta alone, respondents in all three re-search locations complained of all the other unhealthy human practices as giving rise to diseases, preventing the normal growth of vegetation and contributing to erratic rainfall patterns, extreme heat and climate change.

The felling of trees for fuel was seen as an ac-tivity that rapidly cleared the forest of its cover and led to climate change. Some respondents in Bongo referred to this as the disappearance of trees and indicated that the trees were be-ing cut indiscriminately for use as fuel wood (firewood and charcoal) without replacement. This had led to a former forest area in Bongo becoming bare, with no wind and storm breaks to protect people’s roofs and the soil from heavy storms and winds. For respon-dents in Keta and Gomoa, the problem was the over harvesting of and cutting of coconut trees at the beach for use in constructing bridges. This was said to have left the beaches so bare that the sea was now taking over the land and causing floods at the least rains.

Another human activity which was of concern to some respondents from fishing communi-ties, especially Gomoa, and seen as affecting livelihoods was overfishing. Some interview-ees indicated that overfishing had caused the lagoon to lose all its fish leading to very low yields. A cultural practice in Gomoa, for instance, whereby the lagoon was “closed” to fishing to allow fingerlings to grow for the fish to replenish itself was no longer in effect or being implemented as fishing was being done all year round. A respondent captured this more clearly:

“The lagoon in the town, for example, is virtu-ally dead because it has been overfished. Previously, there were to be ‘closed periods’ during which nobody was allowed to fish. But now, the enforcement isn’t there so, ... I don’t think there’s even ... we don’t hear of “closed periods” any more ... So, the lagoon has been overfished ... The fingerlings which would have

matured are being harvested in their young age” (women’s leader, Gomoa).

With regard to the loss of vegetation cover, some interviewees in Bongo and Gomoa were concerned about bushfires which were usu-ally caused by inhabitants who went in search of grass-cutters and other game as a cause of climate change. One interviewee from Bongo explained that:

“Some community members in their bid to catch game, set fire to grassy areas which lead to mass bush fires. Some say they do that to catch game. Others also set fire to the thatch used for roofing after they gather what they need so that new grass will grow” (public health nurse, Bongo).

Another cause of bushfire, according to the respondent, was related to theft as some members of the community stole thatch pre-pared by others for roofing and subsequently set fire to the area to deceive the owners that their thatch actually caught fire. Such activi-ties caused the vegetation cover to disappear resulting in large portions of the forest also disappearing. Vegetation cover, according to some respondents in Keta, also suffers as fisherman cut branches of trees to set traps in the lagoon for fish and women cut trees for wood fuel to smoke fish.

In all three locations, the effect of poor sanita-tion was a major issue of concern to all inter-viewees as one of the man made causes of cli-mate change. They all alluded to indiscriminate disposal of faecal matter by inhabitants since many homes did not have toilets or places of convenience.

“The absence of places of convenience in most homes has led to a situation where people defecate anywhere there is space. The excreta get washed into people’s homes and into wa-ter bodies when the heavy rains occur leading to health hazards,” according to a respondent in Bongo.

For respondents in Gomoa and Keta where dumping of faecal matter was largely done at the beach, this situation was attributed to the high water table which had rendered many homes incapable of constructing places of

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convenience. For Bongo, it was more the result of poverty and ignorance of the ramifications of indiscriminate disposal of human waste on health. Inhabitants therefore resorted to us-ing open spaces as places of convenience and when the rains set in, all the faecal material got washed into people’s homes and water bod-ies thereby contaminating sources of drinking water especially when flooding occurred.

In addition, interviewees in Keta, Gomoa and Bongo indicated that inhabitants were not careful with the disposal of refuse, especially plastic bags, thus worsening the sanitation problem in all three districts of the study. In Bongo, the indiscriminate dumping of refuse, especially plastics, was blamed as one of the causes of the silting of dams and rivers result-ing in the scarcity of drinking water. For some interviewees, the indiscriminate disposal of human and plastic waste was another cause of the devastating effects of climate change. According to a respondent from Bongo, “the disposal of plastic waste has become an eyesore in the Bongo district with large tracts of land littered with plastic bags. These dis-carded plastic bags end up in water bodies and people’s homes when the rains fall”.

Illegal mining of minerals, popularly referred to as “galamsey”, near water bodies was also mentioned as one of the human activities causing environmental degradation and increasing the effects of climate change. In the words of the district director of health for Bongo, “the problem is the mining, the galam-sey which is going on there”. Some respon-dents from Bongo believed that “galamsey” resulted in the silting of rivers thereby making those rivers unsuitable for animal life or for drinking by human beings. In both Gomoa and Bongo, illegal mining (galamsey) activities were a source of concern to respondents who also believed that these activities provided breeding grounds for mosquitoes leading to malaria. Whereas this position was corrobo-rated in Bongo, other interviewees in Gomoa did not support the views of the respondent who raised this concern.

Respondents in all three research locations mentioned the problem of sand winning as a man-made phenomenon which also contrib-uted to effects of climate change. For respon-dents along the beach, in Keta and Gomoa, sand winning occurred largely at the beach 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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3.0Impact of Climate Change

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(30.3%), and hunting (9.0%) were the climate change-impacted activities most often cited. Farming was one activity seen by respon-dents from all three research sites as the most affected by climate change. In Bongo, 30.3% of respondents; in Keta, 29.2%; and in Gomoa West, 27.6% of all respondents rated farming as the most affected. Farming was followed in Bongo by alcohol/pito brewing (19.7%); Keta by charcoal burning (22.4%); and Gomoa also by charcoal burning (22.4%). The third activity seen by respondents to have been most af-fected by climate change was charcoal burn-ing in Bongo (18.1%), trading (14.7%) in Gomoa West, and hunting (14.7%) in Keta.

All the above listed human activities, affected by climate change, resulted in the loss of eco-nomic activity and incomes which produced attendant problems of alcoholism and family separation especially in Bongo. In the case of Bongo, since respondents represented a typical savannah area farming community, the loss of vegetation cover through drought and excessive erratic rainfall meant a destruction of people’s livelihoods and sources of income. This situation, in turn, resulted in further degradation of the environment through tree-felling for fire wood and charcoal as well as “galamsey” as alternative sources of liveli-hood with its resultant destruction of water bodies and negative health implications for the people.

rainfall and heat PatternsAll interviewees in all three research sites indi-cated that rainfall patterns in their areas had changed dramatically. The rains came much later than expected and in huge quantities. Respondents were experiencing shorter rainy seasons and longer periods of drought or dry season with accompanying intense heat from the sun. These changes were seen as another manifestation of climate change. The queen mother of Bongo captured it this way:

“Also see the sun hitting so hard. The least rain when it comes is very serious and it takes time for it to come again. The drought is pro-longed. The trees are not there to protect the land.........”

3.1 Impact of Climate ChangeRespondents were asked about climatic events such as natural disasters that might have been experienced within their communities over a period of ten years preceding the interview. Respondents in the survey named rainfall (65.9%), intense heat from the sun (65.1%), floods (61.2%), prolonged drought (37.3%), sporadic rainfall (29.0%), prolonged harmattan (27.8%), bush fires (21.1%) and strong winds (0.2%) as climatic changes they had experi-enced. The impact of climate change was ex-plained in terms of changes in rainfall and heat patterns with shorter rainfall periods and pro-longed harmattan seasons destroying the en-vironment and introducing hitherto unknown insect species and diseases. By way of promi-nence, intense heat from the sun (30.3%) was cited as the most frequent unusual weather condition. This was followed by floods (18.7%); heavy rainfall (17.4%) and prolonged drought (14.0%). Other climatic changes were sporadic rains (7.5%), prolonged harmattan (6.3%), and bush fires (5.6%) with strong winds marginally mentioned (0.2%).

The two coastal areas studied - Gomoa West and Keta - had had similar experiences with climatic events or natural disasters ten years before the study. Both of them had had experiences with heavy rainfall (24.3% and 24.6%, respectively) and intense heat from the sun (Gomoa West 22.4% and Keta 22.1%). Hinterland and savannah area, Bongo, had differently experienced intense heat from the sun (19.4%), prolonged drought (17.5%) and heavy rainfall (16.4%) in that order. Most fre-quent of the climatic events or natural disas-ters was prolonged drought (30.3%) in Bongo, and intense heat from the sun in Gomoa West (38.8%) and Keta (31.6%).

Since the impact of climate change also mani-fested in the disappearance of trees resulting in loss of economic activity and incomes, re-spondents were probed for human activities which in their view were affected by climate change events including natural disasters. Top of activities listed as negatively impacted by climate change was farming, which was mentioned by close to four in five (78.1%) re-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 Gomoa, indicated that there had been drastic changes in rainfall patterns in the municipal-ity and that although the rains used to come during particular periods, this pattern had stopped. Instead, the rains had become spo-radic, unpredictable and come with stormy winds. Specifically for Keta, there used to be three rainy seasons but the pattern could no longer be identified as rains now fell even during the harmattan in November, which should be part of the dry season. They indi-cated an increase in the amount of rainfall and although they said they experienced some flooding annually, the situation had worsened in recent times. A particular sub district of Keta, Afiedenyigba, for instance, now experi-ences annual flooding not only because it is below sea level, but also because the lagoon now overflows its banks during the rainy sea-son and the sea takes over the land. Places that used to be foot-paths in the dry season for commuting across communities had also been taken over by the lagoon. There is also delayed rainfall and intense heat experienced especially during the night which used not to be the case.

Interviewees from Gomoa, just as those from both Bongo and Keta, also indicated an in-crease in the amount of rainfall and that, like Keta, although the land was a low lying area which used to be flooded annually during rainfalls, flooding had become disastrous in recent times thereby worsening the situation. Also, like Bongo and Keta, the duration of the rainy season had shortened and the dry season had become prolonged leading to ex-treme heat and dry conditions in those areas. Respondents reported cases of destruction of some mud houses, roofs of other houses ripped off, and communities completely cut off during heavy rains. Some of these happen-ings in Gomoa and Keta were attributed to the overflow of the lagoon and the blockage of water ways which prevented excess rain water from entering into the sea.

In addition to general discomfort as a result of extreme heat and inconveniences as well as some disasters from excessive erratic rains, the effects of the changes described above could be felt in many aspects of the lives of the communities studied including the following:

Agricultural Delayed and sporadic rains in all three research sites produced negative effects on farming and livelihoods of people in those areas. The erratic rainfall patterns and soil erosion have rendered some farm lands infertile and un-able to support plant life. Also, stormy rains being experienced have tended to wash away the top layer of the soil that contains soil nutri-ents leaving behind land that cannot support plant growth. The intensity of the rains often cause huge gullies to be formed especially in Bongo thereby rendering the land unsuitable for farming as reported by some respondents.

“But now if you walk this way you will see gullies like rivers, gullies because of erosion. And the rain … it comes torrentially and then washes off the top soil” (public health nurse, Bongo).

Food production has thus been affected as the above conditions have led to very low farm yields. The result of this is insufficient food for households and families with children being the worst affected. Women were also reported to be the most negatively affected by food shortages at home as they not only had to look for food for the family but also had to deny themselves food for the sake of their children and sometimes, their husbands. The public health nurse in Bongo put it this way:

“Because of the poor harvest the woman would have to go and get something to sup-plement. And if she doesn’t do it then she will suffer the consequences and hunger because the little she has, she has to give it to the chil-dren and the husband”.

Furthermore, the fact that the rains have become erratic and difficult to predict has led to situations in which in Bongo, for in-stance, farmers either plant their crops too early or too late as the rains do not fall at the required intervals. In Keta, agricultural pro-duce was said to have reduced as a result of the erratic and heavy rainfall patterns. Farmers have had to harvest their produce earlier than normal to avoid having them destroyed by floods. In Gomoa, just as Keta, agricultural produce and food production were also said to have decreased as a result of the erratic and heavy rains as well as

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activities of some people including overfish-ing. Overfishing in the lagoon in Gomoa had led to a situation where fish yields were get-ting lower and lower thereby affecting both food production and incomes of fishermen and fishmongers. A respondent captured these thoughts in the following words:

“As I said, by this time, we get a lot of fish and many people become happy because money will be in the system. But these days, because the land is not good for fishing and it is not also good for farming there is no money.... Formally, you’ll have a lot of fresh maize by this time; but these days, there is no maize as before” (women’s leader, Gomoa).

Some interviewees from Keta reported that low fish yields were being recorded by fish-ermen from both the lagoon and the sea. The queen mother interviewed in Keta spe-cifically explained that “Keta school boys” (a type of fish) which in the past used to be harvested and used as manure on farms had also become scarce. She said, due to low fish yields nowadays, even that type of fish was no longer available in large quanti-ties as catch for human consumption. It had also become very expensive.

Silting of dams and other water bodies was reported to have adverse effects on agricul-ture and on inhabitants. The silting of dams and some rivers, especially in Bongo, was said to have led to situations in which water had become a scarce resource and had also led to low fish catch, low food production as well as low incomes for families. Agriculture, food pro-duction and family incomes have also been af-fected in other ways. One of these is the har-vesting of fingerlings in fishing communities in all three research sites. In some cases also, especially in Gomoa, erratic rainfall patterns had forced some farmers to harvest their produce before they were mature and ready for consumption. These farmers, in order to make such farm produce ready for use, apply chemicals such as carbide to force the pro-duce to ripen quickly for the market thereby endangering life. Food production and family incomes were also adversely affected by the absence of storage facilities in some places as this led to some of the produce getting rotten and being thrown away.

Socio-economic LifeThe climate change implications on the socio-economic lives of the people of Bongo, Keta and Gomoa were diverse and various ranging from joblessness, homelessness and poverty through hunger, family difficulties and sepa-ration to health problems. The livelihoods of farmers and fishermen in Bongo, for instance, have been seriously affected by drought and the silting of dams and other river bodies. Low fish, crop and other farm yields have been a problem in all districts but in the case of Keta and Bongo, these have rendered some young men jobless and led to increased levels of pov-erty. Although the Bongo district, for instance, is poverty endemic, the effects of climate change in the area have led to a deterioration of the poverty situation with its attendant problem of migration for greener pastures. Floods which have become rampant in the Bongo district due to the stormy rains, have introduced another dimension to the misery of the community. Because a lot of the houses in the area are built of clay and thatch, they are easily destroyed when heavy rains fall and people’s properties are swept away. A case in point is that of the Katanga community in Bongo whose members have had to con-stantly rebuild their houses each time there is a storm as the houses are almost always pulled down by rain. Floods, which in some cases destroy land and other property, have also rendered some people homeless in all locations of the study and have further wors-ened cases of poverty in the three districts.

The effect on family togetherness and cohe-sion has been phenomenal. Prices of food items (farm produce), especially in the Keta mu-nicipality but also in Bongo and Gomoa, have shot up to levels which make some families incapable of feeding themselves. Some of the men in Bongo, according to some interview-ees, had, as a result, taken to excessive drink-ing of alcohol with serious consequences for family life. Some community members in Keta were also reported to have taken to excessive drinking and smoking. The low farm yields which led to low incomes forced some people, especially women in Bongo, to engage in other income generating ventures such as trading and head pottering in other places away from home to supplement family incomes and to

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take care of their families. Indeed, in all cases, it was explained that the burden of poverty was more on women (than men) who usu-ally had to take care of themselves and their families, especially children. Unfortunately, many of these women were not economically empowered and depended mainly on their husbands. Therefore, with inadequate income coming in from husbands, women had to find ways of taking care of themselves and their families.

Children who are the primary responsibility of their mothers are, therefore, left to others for long periods and thereby forced to endure long periods of parental absence with disas-trous effects on parenting and family cohe-sion. Such parental challenges introduced some indirect implications of climate change, as reported in Keta, including increased cases of teenage pregnancy and unsafe abortions. Furthermore, there were some reported health implications of climate change and some of the conditions which engendered it such as diseases that accompany floods. Some respondents reported that diseases led to loss of man days at work and lower incomes.

“It (the flood) produces mosquitoes which go on biting people and then the people suffer from malaria and it affects their work and ...... I mean performance in society.....” (Religious leader in Gomoa).

environmental Climate change effects on the environment, as reported by respondents, were not only the result of natural causes but also man-made ones. Respondents mentioned the destruction of water bodies and arable lands through illegal mining operations (galamsey), floods and drought; destruction of forests and forest cover through extreme weather conditions, sand winning and tree-felling for wood fuel and charcoal; and problems with sanitation through indiscriminate disposal of human and domestic waste. Water resources were being destroyed by the activities of illegal miners (galamsey operators) who washed the minerals they mined in water bodies used for watering animals and sometimes for drinking. Once the water got polluted or silted it could no longer be used for such purposes. Also the

digging of the ground for “galamsey”, particu-larly in Bongo, rendered the soil ineffective to support plant life thereby limiting land avail-able for agriculture and also destroying the environment. The trenches left by the illegal miners also tended to collect water when it rained and became breeding grounds for mosquitoes.

The cutting of trees for fuel wood without re-placing them through replanting also affected the environment and caused the land to be bare as the forest cover and forest reserves got depleted and destroyed the balance of the ecosystem. In Gomoa and Keta, the wood was cut mainly for wood fuel to dry and smoke fish usually for commercial purposes while in Bongo, it was for domestic purposes either as wood fuel or as charcoal for cooking. In all cases, there were no conscious attempts to replace felled trees. Respondents in Gomoa were of the opinion that the disappearance of vegetation cover in Gomoa was one of the very obvious effects of manmade activities on climate change. A respondent mentioned a case where there was the cutting of coconut trees around the beaches for construction which had left the beaches bare. Another interviewee laid the problem of depletion of forests at the doorstep of women:

“It’s not the doing of men but women ... In fact, when you stay here for sometime ... around the district, you will see women cutting trees ..... They are doing this just for....to sell to the fish mongers to dry or smoke their fish.... You see that’s the one thing that women here are doing and it affects all of us especially so that we do not get rains and good food to eat, you see?”

3.2 In the words of another interviewee:

“Taking Gomoa as an example, there are some towns which have as their suffix ‘kwaa’... So we have Adam kwaaa, this kwaaa, that kwaa and kwaaa in the Gomoa language means forest... But they’ve all turned into, into grassland. This is because we’ve cut down all the trees. And that is what is causing the trouble” (women’s group leader in Gomoa).

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Sand winning was said to be a major environ-mental problem. Although this problem was reported largely at the beaches of Gomoa and Keta, it was not exclusive to them as Bongo also raised concerns about the phenomenon. Some of the interviewees in Keta reported that more than a third of Keta town had been taken over by the sea. According to them, the situation had only slowed down because of the sea defence wall that had been built but sand winning by some community members was reversing whatever gains had been made. Sand winning at the beaches had created a situation where the sea was gradually eroding the land.

“Sand winning is what is causing the problem. They are winning sand from the beaches for construction and this is allowing the sea to come to destroy the human habitat. The co-conut trees which were planted to check this have all been harvested. They use the trunks of the coconut for construction especially bridges and the rest. So now with the coconut trees removed, the sea waves come straight to the land” (Women’s leader in Gomoa).

Sanitation was also mentioned as a huge environmental problem in all three districts of the study. The main concerns raised in Bongo were of indiscriminate dumping of faecal mat-ter and plastic wastes. In Keta and Gomoa, re-spondents reported that the absence of both private and public places of convenience had led to people defecating anywhere especially along the beaches. In addition, the activities of fishermen from other towns such as Shama and Accra who sometimes docked at Apam and offloaded their catch of fish and filth onto the beaches were cited as another issue which impacted negatively on the environment. In the words of the religious leader interviewed in Gomoa:

“Sometimes there’s this movement of people from other parts, maybe from Accra, Elmina, Shama landing here with their catch. So when they land, whatever they carry from the sea, they deposit around here especially the filthy things. … They dump it around here. So around the coast there is filth all around.......and this also serves as an environmental disaster to us”.

Links between health and climate change, Insects and Diseases To the simple survey question: “Do you believe that certain illnesses have to do with climate change?” responses were an overwhelming “yes” (89.7%) with “no” recording only 10.3%. “Yes” response was highest in Bongo (93.4%) followed by Keta (88.5%) and lowest in Gomoa West (87.2%). This was a prelude to ques-tions that sought views on possible linkages between climate change (such as in rainfall and temperature patterns) and diseases or illnesses. Respiratory or breathing prob-lems (21.5%), sunburn (20.2%), injuries from extreme weather events (19.0%), infectious diseases (17.1%), and cancer (10.6%) were all seen as related to climate change. Other dis-eases mentioned were hypertension (5.0%), stroke (4.4%) and diabetes (2.1%). Sunburn (22.0%) was most mentioned in Bongo; re-spiratory and breathing problems (23.2%) in Gomoa West; and sunburn tying with respira-tory and breathing problems (20.4%) by Keta respondents.

A question sought views on what respon-dents saw as links between changes in rainfall patterns and health. Malaria (31.1%) headed the list of diseases or illnesses as-sociated with changes in rainfall patterns. Next was cholera (19.8%). Three others, skin rashes (5.4%), respiratory problems (5.2%) and rheumatism (5.0%), all around the one in twenty five range, were named. Apart from cancer (4.0%), all the other dis-eases cited as having some connection with changes in rainfall ranged from depression and hypertension (both at 0.2%) to CSM (2.9%). Links between changes in tempera-ture and diseases were less concentrated. At the top end were skin rashes (14.1%), skin burn (11.5%), malaria (11.2%) and respiratory problems (11.2%). The lower end stretched from waist pains (0.2%), through elephantia-sis (0.3%) to fever (6.7%) and cholera (7.1%).

A questionnaire item specifically sought to know from respondents if they knew any diseases that affected women because of cli-mate change. More than half (54.4%) of them said they did while the others (43.8%) did not. Women were, however, seen as able (54.4%) to contribute to climate stability than they were

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unable to (45.6%). In Bongo, they were seen as such by 74.9% of respondents. Majority, that is, more than half the respondents in Keta (58.3%) and Gomoa West (54.7%), however, did not believe that women could contribute to climate stability.

Along with changes in weather and envi-ronmental conditions, interviewees also mentioned the increase in some insects and diseases which were hitherto seasonal or even unknown to them. While the insects were predominantly mosquitoes, the diseases ranged from malaria and fever to food and water borne diseases such as diarrhoea, chol-era and malnutrition, upper respiratory tract infections such as pneumonia, colds, asthma and even skin diseases. All interviewees in all three research sites reported an increase in mosquitoes throughout the year. In all these areas, malaria (Bongo 30.2%, Gomoa West 23.2%, and Keta 38.6%) was the number one climate change related disease. It was followed in all three districts by cholera (Bongo 27.2%, Keta 15.8% and Gomoa West 15.2%). Third in Bongo was CSM (8.3%), skin rashes (9.9%) in Keta and respiratory problems (14.5%) in Gomoa West. According to some respondents in Bongo, about 10 to 20 years ago, mosqui-toes were seen only during the rainy season but these days, people have mosquito bites even in the dry season resulting in an increase in cases of malaria and fever. In the words of a women’s group leader:

“I have observed that these years, plenty mos-quitoes, we don’t know where they come from, even dry season … mosquitoes, so people get malaria”.

In Keta, the flood situation was said to have led to an increase in mosquitoes all year round. There also, respondents indicated that, hith-erto, mosquitoes were only present in the rainy season but their presence was now be-ing felt even during the dry season leading to an increase in malaria cases in the municipal-ity. Respondents attributed this to stagnant pools of water created after heavy downpours and floods which become breeding grounds for mosquitoes causing malaria. In Bongo, there was the added problem of gullies which formed from erosion and produced stagnant

waters and mosquitoes. Most interviewees in Gomoa mentioned the prevalence and, in some cases, an increase in the presence of some disease conditions as an effect of climate change. The most prevalent disease mentioned was malaria. However, one inter-viewee from Gomoa did not see malaria as an effect of climate change but rather as a human development:

“Malaria...yeah that one is our own doing. It is not the climate. Because we throw things around after eating them and then this holds water and it generates malaria and we leave our bushes and then the mosquitoes hide and hatch in there … that one is not climate change” (religious leader, Gomoa).

A deputy director of health in the Upper East region mentioned the presence of new spe-cies of malaria causing mosquitoes (P Ovalie and P Malarie) and new strains of CSM (W1/35) which were previously not found in the region. Another observed phenomenon was the in-crease in infections such as tuberculosis and CSM in the dry season. Since TB is air borne, the prolonged dry season accentuates the trans-fer of bacteria by TB patients to other people. Although the northern regions of Ghana are CSM endemic, interviewees in Bongo believed there has been an increase in reported cases of the disease. One respondent explained that poverty, as a result of low incomes, has led to many large families having to share small liv-ing spaces with small windows which produce very little ventilation. These conditions pre-cipitate and engender the spread of CSM and the prolonged dry season also aggravates the situation. Again due to poverty, many people are unable to access health services promptly when they notice problems with their health and this sometimes leads to fatalities.

Upper respiratory tract infections such as pneumonia, colds, asthma and food and water borne diseases such as diarrhoea and cholera, malnutrition and skin diseases in some cases were also mentioned as some of the prevalent health conditions although none of these had, so far, reached epidemic levels. Diarrhoea cases, in Keta, were said to be on the increase especially during the rainy season and this was said to be caused by poor waste disposals. The Keta municipal director

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them, they don’t wash them, and then they get cholera”.

Another observed health challenge related to climate change was malnutrition as a result of low agricultural yields. Low agricultural yields were said to relate to malnutrition with the explanation that because farm yields were low, and poverty high, families were unable to have healthy nutritious diets.

“There is insufficient food so people look mal-nourished, especially the children. You know those days you could just fetch groundnuts and prepare soup without thinking of whether it is there or not. But now, even you can’t get a bowl of groundnuts in a compound” (women’s group leader, Bongo).

Malnutrition was said to be most prevalent among children and pregnant women in all areas of the study. However, the Keta munici-pal director of health indicated that in 2011, a lot more men reported cases of diarrhoeal diseases than women. Malnutrition in Gomoa was also linked to the low produce and loss of livelihoods with women said to be the ones who bore the brunt of the problem. “During the lean season, there are a lot of nutritional problems like malnutrition” (public health nurse, Gomoa) which affect the people.

“Therefore we know when the....you know the.....economic status of the people goes down as well, the....nutrition and other things are also compromised and therefore there’s the tendency that it will also indirectly or di-rectly affect their health ...” (district director of health, Gomoa).

Interventions by various nongovernmental or-ganisations somewhat helped to address the issue of malnutrition, especially in Bongo but, according to the deputy director of health, “stunting is still there”.

Upper respiratory tract infections were also reported as some of the effects of climate change. The public health nurse interviewed in Keta mentioned respiratory tract infections as a set of infections that climate change was exacerbating in the municipality. According to the Gomoa district director of health, respira-tory issues were related to the prevalence of

of health reported an outbreak of cholera in some communities. In all research locations, floods and insanitary conditions were blamed for the increase in diarrhoea diseases. In fact, the Gomoa district was said to be an epicen-tre of cholera in Ghana. According to respon-dents, water sources get contaminated by sewage during floods and once people drink from those sources, they get infected with the bacteria. Although the Gomoa district was said to have a high water belt, the under-ground water is salty and unfit for drinking so boreholes and wells are not dug in the area. People therefore have to rely on tap water for consumption. In the dry season, normal tap flow is disrupted and people resort to drinking from rivers and streams which also increase the incidence of diarrhoea. According to a respondent:

“What we realise is that we have a water prob-lem....our source of drinking water, sometimes the tap water, will not flow for many months. And then the people will be drinking from streams, rivers and.....that brings about diarrhoea.... So during the lean season, it means that water will also dry up... and then when they try to use those waters they get diarrhoea”.

Diarrhoea among children in Gomoa was also linked to the onset of the mango sea-son. Mangoes tend to draw in flies and when people do not carefully wash their hands and the fruits before consuming them, they get diarrhoea. In the words of the public health nurse from Gomoa:

“During the mango season, you know when mango comes everybody wants to enjoy the mango and as much as mango is in, flies too are on the increase, so people tend to get diarrhoea..... Sometimes, they may not wash it well even the water to wash it well ....there is a question mark so....they tend to get diarrhoea...”

The public health nurse’s views were supported by the women’s leader in Gomoa who also said:

“During this time (rainy season) fruits like man-goes are in season but they are not coming from here....they bring them from outside... A lot of children like mangoes so as they eat

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bushfires whose smoke made work some-times impossible.

“But one particular thing that I’ve observed here is, we know bush fires are there but it is so predominant here. And it happens.... you may be in a residential area and you can literally be smoked out of your room. This is something which I haven’t seen at that rate happening and of course there’ll be smoke all over and.....these are not very good you know, they may exacerbate respiratory problems” (district director of health, Gomoa).

Tuberculosis was mentioned as a disease that had seen an increase in cases presented in Gomoa while Keta also reported a high inci-dence of anaemia among pregnant women. Another health situation mentioned was the prevalence of skin diseases due to the intense heat. The women’s leader in Gomoa who also runs a school mentioned skin rashes especial-ly among children during the dry season. This she attributed to the desire of people to be relieved of the heat by taking off their clothes, a habit which also led to respiratory diseases such as pneumonia.

“The prolonged drought season.....is.....dry sea-son is affecting the health of these children, especially. Most of them have skin rashes.....they get heat rashes all over and they remove their shirts.....and some remove their clothes....even....adults …they remove their clothes and it’s giving a lot of them pneumonia” (women’s leader, Gomoa).

Other diseases which had been disappear-ing, especially in Bongo, were said to be re-emerging. These were yellow fever and measles but interviewees were unable to tell whether these were as a result of changes in the climate or not. Among children in Keta, worm infestation was said to be very prevalent especially as potable water was scarce and floods were rampant. One interviewee from Bongo complained of early wrinkling of the skin as an effect of the high temperatures and intense heat from the sun. She admitted that although there has always been the problem of skin wrinkles in the past, its onset has be-come earlier and the incidence more rampant these days.

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4.0

Climate Change and Gender

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This section of the study addresses two main issues: the gender which contributed more to climate change activities and the gender which suffered more as a result of climate change and its effects. Against unequal representa-tion of females (48.5) and males (51.5) in the sample for the survey, greater proportions felt men (69.0%) were contributing more to climate change than women (31.0%). Bongo recorded more men (70.1%) as climate change culprits than women (29.9%); Keta also recorded more men (70.4%) than women (29.6%) and Gomoa West reported more men (66.5%) than wom-en (33.5%). However, a number of activities of women were seen by respondents as helping cause changes in rainfall patterns (and by extension climate change). Among them were cutting of trees for fuel wood (31.1%), charcoal burning (24.1%), farming (13.9%), pito/alcohol brewing (12.7%), fish smoking (9.5%), and bush fires (8.5%). One respondent (0.2) even believed women’s contribution to landfills was helping cause changes in rainfall patterns.

Changes in temperature were also seen as the consequence of the same actions by women. In this respect, charcoal burning (31.0%), cut-ting of trees for firewood (27.6%), brewing of pito (13.1%), fish smoking (10.2%), farming (8.6%), bush fire (8.5%), and land fill (0.9%) were all activities engaged in by women reckoned to affect changes in temperature. District by dis-trict, charcoal burning was first in both Bongo (30.8%) and Keta (33.5%) as what women do that may contribute to cause changes in tem-perature. Charcoal burning (26.9%), coupled with cutting of trees for firewood (26.9%) were rated as the two top women’s activities that could affect the temperature.

As regards consequences, most interviewees believed that although the effects of climate change, including health, were felt among both genders, women tended to suffer more. This was largely due to the socio-cultural roles of women but sometimes also attributed to their physiological make up:

“It affects women more. Because naturally, we are not physically as strong as men so that if there is something that will affect the body then we will suffer it more than the men” (Pognaaba (Queen mother) of Bongo).

During conditions of disease and ill-health, there appeared to be a lot of social expecta-tions imposed on women. Another respon-dent in Bongo had this to say:

“But then there are situations that affect wom-en more. When I talk about the under 5 sick-nesses, the woman will suffer with the child throughout and sometimes the man says I have nothing so it’s the woman who should know how and where she can get the money to send the child to the hospital or to be able to insure herself and the child so that when the child is sick she will be able to take care of the child” (Women’s group leader, Bongo).

A male religious leader interviewed in Bongo also had this to say:

“Most often when we have things like malaria, cholera, women tend to be affected, at times, not directly but indirectly because they are the ones who take care of the children and of course when something affects the child, certainly, the one who takes care of the child is suffering a lot”.

Many respondents in both Gomoa and Keta tended to agree with these positions. In all those situations, according to them, the bur-den was on women who had to take care of their husbands and children. Therefore, di-rectly and sometimes indirectly, women bore the brunt of the effects of climate change.

“In our Ghanaian system, women labour more than men. Let me take for example… the men go fishing. They bring the fish and …the women will have to dry the fish, smoke it and then go and market it. After marketing it, they have to manage the money in such a way that it can.....once they (men) bring the fish throughout the lean period, you (woman) have to look after them including their ‘akpeteshie’ (local gin) consumption and their smoking and everything. You have to provide it. So they (women) if there’s something which affects the life cycle, it affects them most. So now that the fish catch is low, women are suffering.

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They have to … look after the home (Women’s leader, Gomoa).

The other interviewees in Gomoa, unlike the women’s group leader and those in Bongo and Keta, were of the opinion that the impact of climate change was felt equally by men and women.

respondents’ Assessment of the climate change SituationFor all the effects of climate change discussed above, interviewees were of the opinion that the impact would worsen in the near future if the necessary actions were not taken to miti-gate particularly the human induced causes and effects of climate change. All interviewees in both Keta and Gomoa, except one, were of the opinion that things would get worse in the future if measures were not put in place to curb the situation. The only person who saw a bright future was the queen mother who, according to her, had started some initiatives in her community to deal with sanitation:

“Because of that, I am preparing to buy some dust bins and put them in the town so that if somebody drinks …pure water or chews sug-ar cane, they can put it in it. They’ve started changing small, small. So in 20 years or even in 10 years time, I think they will change and ev-erything will be ok” (Queen mother of Gomoa).

There was some understanding of climate change issues – their causes and effects - and how they relate to health in all districts of the study. Interviewees portrayed some un-derstanding of the human causes of climate change and the need to reduce those activi-ties which brought about the phenomenon in order to save the environment and mitigate the effects of climate change. However, some respondents in the study admitted they were quite limited in their knowledge about the phenomenon. In fact, information obtained from the study showed that knowledge about climate change that some interviewees had was not only limited but also sometimes in-adequate, misleading or even incorrect. One interviewee in Gomoa, for instance, did not really see a link between climate change and health. In his own words:

“For me, in fact as I said, I haven’t seen any.....the climate change.....I haven’t seen any effect on our bodies except those that we create ourselves, you see. But the climate itself does not....the sea breeze, the air we breathe, the rainfall don’t have any effect on us but where we create it.....that’s our problem” (Religious leader, Gomoa).

Solutions to Addressing climate change All interviewees in all three research locations were unanimous in their quest for informa-tion and education on climate change. They believed that information and education were the main solution to understanding issues of climate change and health in their districts as well as nationally. They, therefore, requested for more information on climate change, its causes (natural and especially man-made), its effects and how it relates to human existence and the health of individuals. A lot of solutions were suggested for dealing with the impact of climate change. Prominent among these were education, discipline and enforcement of bye-laws.

Education was key to all respondents in all research locations. All interviewees in Keta, for example, suggested that education would be the best solution to help community members know about and understand climate change, its impact, and what can be done to reduce its negative effects on the lives of people. In line with this, resources for education would need to be provided in the municipality. Similarly, the most predominant of suggested solutions to addressing the issue of climate change from both Gomoa and Bongo was the need for educating people about the phenomenon, its impact on the lives of people and how to miti-gate particularly its health effects. Education on climate change was also meant to help ad-dress some perceptions that were detrimental to the health of inhabitants:

“So we can educate them on the importance of knowing that though the streams are there, when the leaves are in them and make the water coloured, it doesn’t mean it is medicinal. That doesn’t mean it is medicinal. Rather, we should let them know that so much dirt and bacteria can be harboured in the water and

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therefore they need not drink it raw”(public health nurse, Gomoa).

It was also suggested that climate change issues be incorporated into the curriculum of pupils at the basic level so that they can grow up to be climate-change conscious. Respondents from Gomoa also suggested that religious bodies should take steps to educate their members on climate change citing the example of the Methodist Church in Gomoa which uses its weekly Bible lesson booklets to teach topics on climate change and issues concerning environmental conservation.

On the ecosystem and agriculture, various suggestions were made ranging from outlaw-ing bush burning, encouraging tree planting and crop rotation to revisiting some discarded cultural and traditional practices which positively impacted the environment and improved crop and fish yield. A respondent from Bongo, for instance, suggested that tree planting be adopted as part of the culture of the area and bush burning be made a taboo in order to change the rainfall pattern.

“Maybe the rainfall season pattern may change because my little knowledge tells me that trees support rain so if there are trees the rains will come and limit the heat” (Pognaaba, Bongo).

Some respondents from Gomoa advocated the planting of trees as a system that should be institutionalised and observed as used to be the case in colonial times:

“During the colonial days, we had this day meant for tree planting ...‘Abor day’.... You see this neem tree is called ‘Abor day’. It is because that was the tree that was planted on that day. Abor is a Portuguese word for trees so tree day so we should re-introduce the Abor days so that each community would be encour-aged to create a wood lot. Fishing communi-ties should be encouraged to create wood lots from which they can harvest to sustain their means of livelihoods” (women’s leader, Gomoa).

Crop rotation, the use of improved seeds as well as the use of composite manure were also advocated for. These were to be supported by

the Ministry of Agriculture. Another sugges-tion made was the development of climate resistant varieties of crops to support the agricultural sector. Some respondents from Gomoa, Bongo and Keta called for the re-introduction of certain traditional practices which tended to improve agricultural yield. According to one of those from Gomoa:

“Some cultural practices which have been dis-carded will have to be re-introduced like these closed periods for fishing in the lagoons”.

In order to reduce overgrazing, the women’s group leader of Bongo who herself is a retired agriculturalist, suggested that particular foli-age should be grown for animals. She said she had done those experiments before as an ag-ricultural officer and the trial was successful. Other solutions suggested were the growing of vetriva grass to check soil erosion and the reclamation of mined lands as a way of man-aging land degradation due to illegal mining.

The issue of implementation of laws and bye-laws came up forcefully as an area of concern and which would help ensure discipline in the system. Respondents reported that there were both cultural and national bye-laws which could protect the environment but these were not being implemented. “If these bye-laws were implemented with their ac-companying sanctions”, they believed, “people would be more careful with the way they treat the environment”. In Gomoa, it was suggested that both national and traditional bye-laws be reinstituted and enforced including laws on water bodies, sanitation, and forest cover preservation:

“We may need once again to apply bye-laws which protect the environment. We can find those laws in the statute books of the lo-cal government” (district director of health, Gomoa).

Respondents also suggested alternative sources of livelihoods as solutions to the deg-radation of forests and the environment gen-erally. In the particular case of wood fuel, one interviewee suggested that alternative fuel sources as well as low wood fuel consump-tion mechanisms could help to minimise the depletion of wood resources. Furthermore,

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alternative means of livelihood would need to be provided for women (especially) to aug-ment their sources of income.

“Women should be introduced to other forms of smoking fish. That is why this Chorkor smoker was introduced. The chorkor smokers consume less firewood but they still consume firewood. Now that we are going into the gas age, if this can be introduced to use gas as fuel for smoking fish in place of firewood, it will improve the health of the women. Secondly, if they are introduced to other means of liveli-hoods like this tie dye, soap making and the rest... so that during the lean season they can fall on that as a means of maintaining the home” (women’s leader, Gomoa).

Other solutions presented in Gomoa included the promotion of fish farming.

Planning to Deal with health Effects of Climate Change Whereas the Bongo district said it had put in place an emergency/epidemic preparedness committee with representatives from various sectors at the regional coordinating council that meets on a quarterly basis to discuss and address epidemic and emergency situations, neither Keta nor Gomoa reported any such committees. Emergency preparedness plans had been drawn up in Bongo and were being implemented in the district. Also, stakeholder meetings were reported to be held on de-partmental basis with representatives from various sectors making inputs into depart-mental plans. It must be indicated, however, that even in Bongo, these preparations were not for climate change per se but responses to epidemics and disasters which have been rampant in the district.

At the Keta municipal level, it was indicated that no planning had been done with respect to the impact of climate change. This was at-tributed to low knowledge levels about the situation. It was mentioned that conscious-ness about climate change was now rising out of some sensitisation activities that some district health staff had been privileged to attend. Similarly at the Gomoa district level, it was indicated that no concerted efforts had been put into planning for climate change and

health apart from the normal planning done for health. It was also indicated that conscious-ness of climate change, like Keta, was now rising out of some sensitisation activities that some district health staff had been privileged to attend. All interviewees in both Gomoa and Keta, however, indicated that climate change issues needed to be considered in health planning with inputs made by all stakeholders, particularly, beneficiaries of the programme.

In spite of the lack of coordinated attempts to plan for climate change, there were individual and group efforts reported in Bongo and Gomoa aimed at mitigating the effects of the problem. The Catholic Church in Bongo, for instance, had its own way of protecting the environment which was done through the celebration of abor week during which trees were planted and members were encouraged to plant more trees. The women’s group lead-er, also in Bongo, indicated that she had been leading groups of women to plant commercial trees as a way of saving the environment and, at the same time, generating income for those women. Similarly, the women’s leader in Gomoa reported that she had started a tree planting exercise but had faced many challenges as people were not interested in the venture. On her part, the queen mother of Gomoa who is also a nurse was focusing on enhancing sanitation in her community by providing dustbins at vantage points and using festive occasions to educate her citizens on the need to maintain good sanitary condi-tions. She had put in place sanctions for those who flouted the sanitation laws.

Although all these efforts were good, there was clearly no concerted effort directed at dealing with climate change consequences on the lives of people in the areas studied, especially Keta and Gomoa. It appeared that although planning was being done in all districts, it was not specific to managing or mitigating the effects of climate change per se. The emergency preparedness committee of the Upper East region, for instance, works on all other emergency situations and may not give particular and full attention to climate change and health issues. All interviewees expressed the need for climate change issues to be incorporated in health planning for all districts. It would be important to establish

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a committee that specifically and proactively plans for climate change and health issues at the district level with a coordinator who fo-cuses solely on those issues in the committee if issues of climate change and health are to receive urgent attention. The communication strategy would need to address this situation in order to make climate change a priority is-sue in planning at various levels.

Support requiredThe kind of support requested by various interviewees reflected their specific needs in their various areas of operation. The one major support that interviewees from various back-grounds in Bongo mentioned was financial. Others were training, logistics such as trans-portation (vehicles, bikes and fuel), farm imple-ments and medicines for immunising animals. The deputy regional director of health for the Upper East region specifically mentioned the implementation of policies on incentives for members of staff who consented to work in the northern parts of Ghana in spite of the harsh climatic and other environmental condi-tions. The district health director for Bongo, on her part, also requested for infrastructure in those communities to enhance the work of health workers involved in the Community based Health Planning Service (CHPS) as they provided the much needed community health support for various communities.

While no specifically directed planning was being done for climate change and health issues in Keta, interviewees indicated some resources that they would need to plan effec-tively to deal with climate change and health issues. These included:

� Educational materials (posters, films on climate change, etc)

� Logistics such as fuel, vehicles, bicycles, etc.

� Personnel � Training � Supply of medicines; and � Money or funding.

Similarly, while there was no direct planning being done for climate change and health in Gomoa, interviewees indicated that in order to plan effectively to deal with climate change and health issues, they would need, among others:

� Educational materials such as posters and films on climate change, etc.

� Training � Logistics such as fuel and vehicles; and � Funding.

Sources of Information Interviewees in all three research locations indicated that they did not receive much information on climate change and health. From Keta, Bongo and Gomoa, interviewees said there was no information or database on climate change and health available to them in their districts or municipality. There was, there-fore, no information that interviewees could access locally to improve their knowledge of the phenomenon apart from the mass media. In the cases of Keta and Gomoa, their sources of information on climate change were mainly the mass media, principally television and newspapers. For some respondents (the nutrition officer and public health nurse of Gomoa), this was mainly through the weather forecasts. Bongo respondents reported that the information they had was what they had themselves sought for from online sources and journals, or had been exposed to through the traditional media such as television, radio, newspapers and billboards.

Respondents in the survey, contrary to those interviewed in-depth, had been receiving information on climate change and health principally from (multiple choice) radio (62.2%), television (33.1%), co-tenants (17.1%), public and community engagements (15.1%), chiefs or opinion leaders (10.3%), family and friends (11.8%), co-workers (9.2%), newsletters (8.8%), drama (6.8%), and newspaper (5.3%). Asked to indicate one specific medium, survey re-spondents generally sourced their climate change knowledge mainly from radio (50.1%). Over a quarter (27.3%) sourced that informa-tion from television. More of them sourced climate change knowledge from family (8.9%),

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friend (3.9%), co-worker (1.7%) or co-tenant (0.8%) altogether (15.3%) than from the news-paper (5.0%). In all three research locations, the three top information and knowledge sources in each district or municipality were: Bongo - radio (36.9%), television (27.5%) and family (13.1%); Gomoa West - radio (40.2%), television (22.5%) and some other sources (18.1%); then, Keta - radio (53.4%), television (19.1%) and other sources (19.1%). More of the respondents (59.5%) had been receiving in-formation on climate change and health than those who had not been receiving that kind of information (40.5%). More respondents in both Gomoa West (66.8%) and Bongo (62.2%) had been receiving information on climate change and health than those who had not. Keta was split between those who had been receiving information (49.2%) and those who had not (50.8%).

When asked if they were aware of platforms for discussion or information sharing about environmental problems, over half of survey respondents (52.0%) were and the other proportion (48.0%) were unaware of any such platforms. While in Bongo 68.4% knew such a platform, in Keta 40.8% and in Gomoa West 45.8% did not. Respondents in all locations of the study indicated their interest in receiv-ing more information on climate change and “how it relates to health” (its linkage to health). Virtually all (91.9%) survey respondents as well as those interviewed overwhelmingly would like to receive information about cli-mate change and health: Bongo (95.9%), Keta (91.0%) and Gomoa West (88.7%). Subjects on which respondents wanted information were: updates on climate change (22.5%), health im-plications of climate change (22.3%) and health effects of climate change (21.0%). Others were ways of mitigating climate change (17.7%) and treatment for climate change induced infec-tions (16.5%).

types and Formats of Information requiredThe municipal director of health for Keta, for instance, would like to receive information on health conditions that are caused by climate change and how to prepare to deal with such

situations. The public health nurse in Keta, on her part, was interested in knowing the signs of climate change, its effects on human beings as well as precautions that could be taken to mitigate those effects. Health professionals interviewed in Bongo believed that it would be important for information from meteorologi-cal services on climatic conditions, for exam-ple, to be shared with the district and regional health directorates in order for them to plan effectively. Such information, they believed, would enable health workers to relate trends they observe in the health situation of their lo-calities to possible climatic changes in order to be sufficiently informed to incorporate climate change and health education in their public education activities.

Furthermore, Bongo respondents were of the opinion that there might be the need for other sectors such as the Environmental Protection Agency (EPA) and the Ministry of Food and Agriculture (MOFA) to share information they have on the districts with the health director-ates to improve planning for the health of their communities. This view was supported by respondents from Gomoa who also said that information provision must be done in an inter-sectoral manner with sectors such as environment, agriculture and forestry playing key roles in the information dissemination and education process. One interviewee request-ed, for example, that institutions such as the National Disaster Management Organization (NADMO), Ministries of Education and Agriculture be provided the platform to com-municate how climate change impacts their various sectors. The goal of such inter-sectoral collaboration should be to help beneficiaries of information disseminated and properly relate climate change issues to various sectors and to development in general.

Other respondents who were not health work-ers were also interested in receiving some more information on climate change. The types of information they require include the impact of climate change on health, social and economic life of people, agriculture and food production as well as on other livelihoods. The women’s group leader of Gomoa, for instance, said that she would be particularly interested

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in information on climate change, health and tree planting. Of much relevance would be to provide information on the causes and effects of climate change as well as how the effects can be mitigated both proactively and reactively. All such information could be put together in a database on specific districts for reference purposes.

From the survey, districts differed in terms of what kind of information they required. Bongo respondents were equally split on how to avoid adverse health effects of cli-mate change (21.7%), health implications of climate change (21.2%), and ways of mitigating climate change (21.2%). Gomoa West wanted an update on climate change (26.3%), health implications of climate change (23.0%), and how to avoid adverse health effects of climate change (20.1%). In the case of Keta, concerns were with health implications of climate change (22.8%), up-date on climate change (22.6%) and how to avoid adverse health effects of climate change (21.3%).

Preferred channels for receiving and Sharing InformationIn terms of channels or modes of communica-tion survey respondents would like to receive information on climate change from, radio (48.7%) topped the list of media followed by television (28.2%). Public/community engage-ment (23.9%), internet (22.7%), chiefs and opinion leaders (16.0%), drama (13.8%), news-paper (4.8), brochure (4.0%), family and friends (7.4%), co-tenants (5.7%), newsletter (3.2%) and co-workers (3.0%) were also mentioned as possible channels. As regards channels for receiving information on climate change and its effects on health and gender, respondents in the interview distinguished between how they wanted to receive information for them-selves and how such information should be passed on to members of their communities. For themselves, respondents largely pre-ferred to receive information in a format that could be understood and, more importantly, used as a reference material. Therefore, the most preferred channel used should be one

which preserved information in hard copy or printed format such as journals, magazines and newspapers to enable them read and also have material for reference when passing on such information to others.

Other interviewees mentioned mass media channels such as radio and television as their preferred channels but these would have to be carried on evening programmes. Some other interviewees (in Gomoa) mentioned workshops as their preferred channels in or-der to have the opportunity to dialogue and have answers to their questions. Channels such as churches and religious group ac-tivities were also mentioned as appropriate for passing on climate change information. Formats respondents would want that type of information presented in were: video (25.6%), drama (17.7%), discussion (17.5%), picture (13.2%), songs (11.0%), demonstration (10.0%), role play (4.0%), and puppetry (1.1%). Gomoa West was largely split between video (23.5%) and discussion (24.4%) as the most preferred formats. Keta, though, was more convinced by video (32.4%) than drama (17.4%). Bongo respondents were also almost split between video (22.5%) and drama (20.1%).

The study showed that interviewees in all loca-tions did not consciously pass on knowledge they had about climate change and health to others. In order to pass on information to people in their communities, however, re-spondents preferred a combination of some more traditional, modern and community-based approaches. Interviewees in all three locations provided a list of channels – many of which were the same or similar - which they believed, would be ideal for their communi-ties. Some interviewees in Keta mentioned mass media channels such as radio and televi-sion as their preferred channels but said that information through these media should be carried on evening programmes for them to be able to listen or watch. Other channels and sources of information and communication suggested by Keta interviewees as effective for communicating with community members included:

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� Community durbars � Radio � Drama and theatre � Use of Community based

surveillance volunteers � Use of chiefs and queen

mothers as spokespersons � Use of religious and social group

meetings (e.g. drumming groups, borborbo groups, etc.)

� Use of public address systems � Interpersonal communication channels

such as face-to-face encounters.

Similarly, interviewees in Gomoa mentioned the following channels and sources of in-formation and communication as effective media for communicating with community members:

� Community durbars � Radio � Use of community health workers

on their house-to-house visits and child welfare clinics (CWC)

� Use of chiefs and queen mothers as spokespersons

� Use of religious group meetings � Communication through health facilities � Communication through

schools and teachers � Dissemination through organised

groups such as hair dressers and dressmakers associations

� Use of information vans � Organisation of talk shows � Education during festive

occasions and concerts.

Some channels and sources of information and communication suggested by interview-ees in Bongo as effective for communicating with community members included:

� Community durbars � Radio � Use of agricultural extension officers � Use of community health workers

on their house-to-house visits and CHPS facilities as resource centres for information

� Use of chiefs and queen mothers as spokespersons

� Video shows and jingles.

communicating climate change, Gender and healthThe study also examined how and what to communicate about climate change. For ex-ample, were men and women to be segregat-ed or the youth and the elderly put together? Whereas respondents from Keta indicated that the same information should be given to both men and women, the district nutrition officer of Gomoa was of the view that men should be segregated from women when information was to be passed on because of experiences she has had when both men and women were put together. However, other interviewees were of the opinion that since cli-mate change affected both males and females, there should be no segregation. Similarly, respondents from Bongo did not think it was necessary to segment men and women or any other group unless a particular situation 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 respon-dents 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 mu-nicipal 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 atmosphere or environment and people’s livelihoods for them to understand. Such information, they said, should be in the local languages and be practical enough for people to appreciate. It should contain such simple actions or activities as to enable community members to prevent climate change effects. The communication strategy would, therefore, have to consider providing respondents with training and skills to communicate knowledge 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 op-portunity which need to be leveraged in the communication strategy. Nonetheless, there is the need to help interviewees understand other factors which could engender and facili-tate climate change and were detrimental to

their health but of which they may not have been aware. There is a clear need for the com-munication strategy to consider ways in which knowledge levels of interviewees could be enhanced to equip them to pass on accurate information to community members bearing in mind that they are reference points for dif-ferent issues in their communities. Any inac-curacies in their knowledge may be passed on to their community members, a situation which may not be beneficial to their lives.

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5.0Conclusion and Recommen-dations

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The study found that information that inter-viewees had on climate change and health, which in itself was not comprehensive, was rarely communicated to others. It would be important to pass on information in hard copy or printed format to interviewees and others in their positions to enable them read and also refer to such material as and when the need arose. Other respondents also mentioned ra-dio and television as channels they would pre-fer to receive information from but added that programmes should be in the evenings when they would likely be at home. These would be considered in the communication strategy.

The need to equip stakeholders with skills to take advantage of speaking opportunities to put out well-structured simple messages on climate change and health would need to be considered. Such information would need to be related to the livelihoods of audiences being targeted and ride on their aspirations for good health and wellbeing. There would be the need to provide key players with infor-mation on climate change and its impact on various aspects of life in order to improve their knowledge levels and to enable them pass on such knowledge. This would help beneficiaries to properly relate climate change issues to various challenges they have to deal with.

Spokespersons such as chiefs, queen moth-ers, community health workers, and agri-cultural extension officers would need to be educated and provided with appropriate information and knowledge on climate change and its impact on various areas of life such as agriculture, health, and socio-cultural life. This will enable them understand the issues involved and to accurately communicate such information to community members. They also need to be provided with speaking points and questions and answers (Q & As) which are relevant to the communities they visit or

represent. Feedback mechanisms also need to be established to gather information from community members on information they receive, how they react to the information as well as the kind of information they require in order to meet their specific needs.

It was found out in Bongo that some radio programmes were organised where resource persons in the district were invited to provide expert opinion on health issues. This channel should be more systematically explored to propagate information on climate change and health. Communication materials, produced in simple, precise language that is catchy and easy to understand, will need to be prepared and used for public education activities. Religious leaders agreed that their platforms in churches and mosques could be used for education. Religious platforms have the advantage of enjoying a large following and some level of credibility in Ghana and would serve a useful purpose for the pilot project if used effectively.

It was also suggested that since climate change impacted both men and women, messages should be targeted at both generally but, depending on the goal of the communication effort, there might be the need to segment the community into various groups including gender. It was observed, for instance, that the northern regions of Ghana have strong cul-tural and gender ties that sometimes dictate how communication should flow. In order to create an environment where women and the youth would feel comfortable to share their views in open forums, for example, it would be important to segment them and target them with specific information on climate change and health. Such information should, of ne-cessity, relate to how participants contribute to the situation and how they could mitigate the effects.

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Gender Sensitive Climate Change Communication StrategyCountry Focus: Ghana01

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Executive SummaryClimate 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 health risks associated with climate change, there has been limited identification and implementation of policies and strategies and measures to protect the health of the most vulnerable populations in Ghana. This is compounded by a dearth of information and documentation of the phenomenon unlike elsewhere including the United States. This as-signment, as part of Ministry of Health/United Nations Development Programme (UNDP)/Global Environmental Facility pilot project on climate change adaptation for health in Ghana, was to develop a gender-sensitive climate change communication strategy to fill the documentation void in the Ministry as well as help reduce the paucity of information on climate change and health in Ghana.

Surveys and in-depth interviews were con-ducted in three pilot districts (Bongo- Upper East Region, Keta - Volta Region and Gomoa West - Central Region) to gather baseline data for the development of the communica-tion strategy. Bongo is a poor farming and predominantly rural community, Keta and Gomoa are predominantly fishing communi-ties with the sea as the main source of liveli-hood. The research focused on knowledge, attitudes, perceptions and experiences of climate change, types and sources of informa-tion, channels of information and communica-tion as well as preferred and required types of information and information channels.

The baseline study found that respondents could relate changes in their environment to changes in climatic conditions although some of them did not know about climate change as a concept. Respondents trusted certain sources to provide credible information within both the traditional and new media. There was also a clear desire on the part of key stakeholders including policy makers and spokespersons to be channels for disseminat-ing information about climate change to con-stituents if they were properly equipped for such purpose. Although participants indicated that women clearly suffered more from the ef-fects of climate change due to their physiology and cultural roles, they wanted information to focus on and shared equally among both men and women except when it was gender-specific. Information to be provided should also relate to the livelihoods of audiences and ride on their aspirations for good health and wellbeing. From the data gathered, a SWOT analysis was undertaken on each pilot district to develop a communication strategy.

The overall goal for the gender sensitive cli-mate change communication strategy was outlined as:

To create awareness and knowledge about cli-mate change and gender in the promotion of health and the facilitation of positive attitudes and behaviours [that effectively respond to climate variability]

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The thrust of the developed communication strategy is awareness creation and knowledge acquisition to make the public aware of the existence of climate change issues and the health and gender implications of their impact. The strategy seeks to build on the knowledge community members had on climate change so as to stimulate a desire to apply such knowl-edge to enhance their livelihoods and reduce the effects of climate variability on their lives.

Thus, the strategy makes use of such familiar communication forms/channels as drama, festivals, radio programming, community durbars, community health volunteers, spokespersons and neighbours to provide information. In addition to these other chan-nels (such as the traditional modes of com-munication), have also been outlined in the strategy to explore their effectiveness during the implementation process. It is anticipated that other community specific channels may be discovered during the roll-out of the pilot project at the implementation stage. The strategy further addresses the need for re-cord keeping of the implementation process as a first step toward documenting climate change adaptability processes in Ghana.

The different stakeholders and audiences have been identified and appropriately segmented and mapped out for targeting with appropriate communication tactics. The choice of communication channels and media for the strategy and plan was based on the analysis of these stakeholders, their preferred and trusted communication chan-nels, their communication and information needs as well as the nature of messages to be communicated to them. Furthermore, on the basis of the programme goal and the com-munication needs identified through the situ-ation analysis, information needs analysis has also helped develop a relevant theme which guides key and sub messages that respond to the information needs of the audience.

Finally, since effective monitoring and evalu-ation is critical for the success of any inter-vention including this strategy, the commu-nication strategy contains a comprehensive monitoring and evaluation (M&E) component with agreed indicators of success to facilitate monitoring of its implementation. The strat-egy, therefore, provides measures for moni-toring and evaluating its implementation and also makes provision for feedback.

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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 dif-ferent 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 spend-ing 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 sci-entific 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 most of the causes of climate change are hu-man induced (Boston and Lempp, 2010). Its effects are felt in various aspects of human life including health and economy with women being more vulnerable. The effects on health include intensity of transmission of vector ( tick and rodent) borne diseases and food and waterborne diseases as well as changes in prevalence of diseases associated with air pollutants and aeroallergens. In Ghana, anecdotal evidence shows that climatic vari-ability adversely affects the country’s natural resources such as land, water, forests and vegetation, as well as human capital, health, energy, food security and physical infrastruc-ture. Furthermore, diseases such as ma-laria, diarrhoea, cerebro-spinal meningitis and other infections are climate-sensitive diseases that could cause grave challenges as a result of significant changes in climatic conditions. There is, therefore, the need to consider ways of adapting health policies and strategies to climate change issues to check the negative impact on human life and people’s livelihoods.

In view of this, the Ministry of Health in part-nership with the United Nations Development Programme (UNDP) is implementing a Global Environment Facility (GEF) funded project to pilot climate change adaption for health in Ghana with a using malaria, cerebro-spinal meningitis and diarrhoeal diseases as tracer diseases, in three districts - Bongo (Upper East Region), Keta (Volta Region) and Gomoa West (Central Region). A critical part of the project is the development of a gender-sensitive climate change communication strategy to fill the documentary void in the Ministry of Health as well as to reduce the paucity of information on climate change and health.

Information sources on climate change are varied and various at all levels. However, where robust epistemic communities are formed around such important phenomena as climate change, human rights, or any other issue of such magnitude, information sources transcend national borders. In such cases, ac-cording to Aday and Livingston (2008), vibrant alternative sources of information and news frames formed include transnational advo-cacy networks and the global media. Gripsrud (2007), indeed, asserts that the media can con-tribute to and influence new legislation on cli-mate change. The media, therefore, constitute

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an important public in the communication strategy both as sources and disseminators of information although other alternative local group and interpersonal sources have equally been deemed to be of importance.

task of consultant(s)The consultants were expected to undertake the following specific tasks to achieve the ob-jectives of the assignment:

� Report on the gap analysis of the communication needs and capacities of target groups and communication needs of activities to be undertaken

� Present goals and SMART targets of the proposed communication strategy

� Submit a detailed analysis identifying the settings, channels, message and media for reaching the critical publics with the communication strategy

� A detailed dissemination strategy with recommended outlets and media for reaching the publics and audiences identified

� Proposals, in outline, of the types of educational and informational materials suggested for use as part of the communication strategy

� An implementation plan, including a detailed resource list and estimated budget

� A Gantt chart timetabling the roll-out of the strategy and

� A draft evaluation instrument for measuring the achievement of the goals and targets of the strategy

� Work with technical personnel from the Ministry of Health and Ghana Health Service in carrying out the assignment with the objective to enhance and sustain capacity of health workers.

Desired DeliverablesThe consultants were to provide the following:

� An inception report describing the methodology and approach

� Submit a draft report providing a clear description of what exists and an analysis of the strengths, weaknesses, opportunities and potentials

� An in-person presentation to the project management committee and identified stakeholder groups

� Final technical report (5 hard copies and a soft copy on CD) packaged into a publication ready format

� A Policy Brief based on the technical report

� Organize workshop with stakeholders, including a high-level policy briefing for decision makers.

objectives The stated objectives for the assignment were as follows:

� Assess information and communication needs of key target groups (health workers at the national, regional, district and sub-district levels) including also for implementation work in pilot sites, national coverage, local level policy makers, high level decision makers, business community and the public

� Explore existing gender sensitive climate change communication strategies

� Design an appropriate gender-sensitive communication and awareness strategy to be carried on electronic, print and off electronic media and applicable to the wider community.

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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 lead-ers 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 communica-tion 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 on climate change based on experienced changes in weather, rainfall patterns and environmental climatic conditions such as prolonged dry season.

- Knowledge and awareness of the linkages between climate change, health and gender

- Awareness and concern that these changes can be caused by both nature and man.

- Awareness of the human causes of climate change and some ways to minimise such human activities.

- Existence of local communication systems as channels for providing additional information

- Willingness of respondents to receive more information on climate change and its effects on health and gender

- Willingness of respondents to play communication leadership roles to tackle climate change

- Absence of toilets or places of convenience

- Inadequate knowledge about climate friendly modern farming practices.

- Lack of expert information about the linkage between climate change and health and gender issues in the districts.

- Lack of data on climate change impact on health and gender in the districts.

- Misconceptions about the causes and effects of some diseases and their relationship to climate change and gender.

- No direct relationship or coordination between related agencies such as meteorological services, EPA and health.

- Insufficient knowledge of links between climate change, gender and everyday happenings in society.

- Lack of access to expert information about climate change health and gender.

- Difficulty in translating climate change concepts into local languages.

- Difficulty in reducing climate change concepts into simple everyday English language.

- Difficulty in designing health and gender-specific messages on climate change.

- Opportunity to build on knowledge and awareness that respondents already had about climate change and health.

- Interviewees suggested solutions for dealing with climate change including enforcement of traditional and local authority bye-laws.

- Incorporating issues of climate change in school curricular at the basic and secondary levels.

- Providing climate change education during local events such as festivals, etc.

- Agreement by all interviewees that climate change needs to be considered and factored into health planning.

- Existence of Community Based Health Planning and Services (CHPS) facilities in all districts.

- The existence of mass communication channels (radio and local public address systems) in the districts used for information dissemination to be converted into information sharing.

- Willingness of all interviewees to receive climate change information and education and to pass it on if provided with the skills 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.

- Pervasiveness of climate change contributing activities such as bush burning, tree-cutting for firewood and charcoal, sand winning and Illegal gold mining(“galamsey”), etc.

- Limited of arable lands and water sources for farming and fishing leading to over cropping and over fishing.

- Poverty, inadequate financial support and lack of alternative sources of incomes and livelihoods.

- Poor agricultural yields leading to unsustainable livelihoods.

- Low yields leading to less nutritious meals and increases in cases of anaemia and malnutrition

- Increases in cases of diarrhoea and malaria during rainy season.

- Use of chemicals to force farm produce to ripen which can affect the health of consumers.

- Women suffering more in terms of health implications of climate change due to culture and their physiology.

- High levels of illiteracy and their effects on making the right choices about life and health.

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Bongo - Awareness and reasonable appreciation of the gravity of the situation by community and opinion leaders.

- Existence of emergency preparedness committee made up of representatives of various Ministries Departments and Agencies with a plan in place for fighting effects of climate change.

- Commitment on the part of community leaders and health workers to champion the cause to safeguard the environment

- The size of huts and poor ventilation leading to easy spread of diseases such as CSM.

- The existence of mud huts (which are easily washed away during heavy rains).

- Many women are not economically empowered and are therefore very dependent on their husbands.

- Poor agricultural yields leading to mothers having to move to “greener pastures” for employment and leaving their children unattended.

- Some initiatives by some community members (such as queen mother and women’s group leaders) can be leveraged for the programme.

- Initiatives instituted to save the environment (eg tree planting, commercial tree production, etc )

- The system of holding periodic stakeholder meetings.

- Activities by the Catholic church such as Abor Week aimed at preserving the environment.

- Disappearance of trees and forest cover through firewood and charcoal burning as well as bush fires.

- Prolonged drought and dry weather conditions and their effects on health economic wellbeing of all.

- The prolonged dry season leading to increases in cases of CSM and other such diseases.

- Re-emergence of hitherto controlled diseases (measles, yellow fever)

- Illegal mining -“galamsey” and its destruction of the environment.

- Increased migration due to increased poverty

Gomoa West - Awareness and appreciation that there is a problem which requires attention by community and opinion leaders.

- Commitment on the part of community leaders and health workers to champion the cause to safeguard the environment

- Inability to determine specific gendered effects of climate change.

- High levels of poverty and lack of alternative sources of livelihood

- Construction of a sea defence wall to mitigate the effects of sea erosion

- Existence of initiatives aimed at saving the environment such as tree planting by women’s group leaders and provision of dust bins by queen mother.

- Uncontrolled human activities such as sand winning bush fires, over harvesting of coconut trees for construction, and over fishing in lagoons.

- Dumping of faecal material at the beaches.

- Increases in cases of diarrhoea during the rainy season with the onset of the mango season.

Keta - Awareness and appreciation that there is a problem which requires attention by community and opinion leaders.

- Commitment on the part of community leaders and health workers to champion the crusade to safeguard the environment

- Low knowledge levels about climate change and its impact.

- The mosquito net campaign led to many homes owning and using mosquito nets.

- Construction of sea defence wall.

- Uncontrolled human activities such as sand winning, over harvesting of coconut trees and over fishing in the lagoons.

- Dumping of faecal material at the beaches.

- Increases in social vices such as teenage pregnancy and illegal abortions

- Increases in cases of worm infestation among children.

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

Figure One: Conceptual FrameworkLimited Awareness

Full Awareness

Motivation/Decision Action Sustaining

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 strat-egy 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 com-munity members to evolve for themselves new ways of positively enhancing climate variability that could be replicated in other places.

the StrategyThe main aim of the strategy is to provide a framework for the communication compo-nent of the pilot project while documenting the process in the various districts. The strat-egy emphasises a participatory communica-tion approach which involves the beneficiary community and also provides avenues for feedback to enhance the process. It is recog-nized that such an approach will improve the quality of the decisions to protect the environ-ment and climate as well as the health of com-munity members and its gender implications because it stimulates the participation of all stakeholders in the implementation of the programme and leads to sustainability.

The communication strategy and methods used shall facilitate dialogue about climate change and health among a large number of different stakeholders, such as opinion lead-ers, traditional authorities, local government authorities, the business community, the media, private organisations (including NGOs, women’s organizations, community organisa-tions, trade unions, etc), religious organisa-tions as well as the general public.

Communication in the strategy emphasises the need to recognise differences of stake-holders by acknowledging their different backgrounds in society. Some stakeholders will need assistance and motivation to join the dialogue, especially the poor, disadvantaged and women. For example, available radio re-ceiving sets would enhance communication through that medium. This strategy would place some emphasis on the effects of climate change on gender, especially women as they are known to be more vulnerable. It gives sug-gestions on the use of various communica-tion tools and information channels, and how messages can be conveyed to the general public and specific target audiences.

It is important to explain the role of human ac-tivities in climate change and how this affects health in order to stress the need for manag-ing the natural resources that are becoming more scarce and poorer in quality as popu-lation increases. Since traditional leaders, local authorities, and opinion leaders (health workers, priests, women’s group leaders, etc.) have influence over what their communities do, they would be targeted for education and information sharing both as beneficiaries and

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as channels. In this way, their credibility would become a facilitating factor for their messages to be received and acted upon.

The strategy will consider, analyse and exploit windows of opportunities to create interest in the media for climate change, gender and health issues in the selected districts and sug-gest ways to maintain a clear concept of the need to balance costs and benefits. Although the immediate outcome of communication and information dissemination is awareness creation and education, in general, it is the intention that the strategy eventually should foster behavioural change among the public, particularly in the selected districts, in relation to the environment and health.

It is expected that the communication strat-egy will help to:

� Amplify information on the mitigation of the effects of climate change on the health of constituents

� Support the health sector to proactively communicate information on the gender factor in climate change and its impact on health of the populace.

� Communicate best practices in effective climate change to constituents and document the effects of these best practices on the health status of constituents

� Ensure access to accurate and efficient information in the districts and to all stakeholders

� Communicate Ghana’s knowledge, experiences and policies with regard to climate change and health nationally and internationally.

Strategy DevelopmentThe process of communication involves a number of elements that need to be recog-nised and incorporated into any action plan with the capacity to stimulate and realise ef-fective sharing of knowledge and information. These elements include a defined message, an appropriate medium or channel and an audience whose attributes or characteristics must be properly recognised. In addition, the message must be measurable (in terms of its impact on the targeted audience such as observable change in behaviour, attitude or

adoption of an innovation). Feedback, at all levels and times, is also expected as a tool for measuring message effect. A communication plan of action must usually contain elements that are sustainable. In putting in place a plan of action that would ensure that the target audience understand climate change and its implications for gender and their health and to actually facilitate positive behaviour devel-opment, the message, appropriate medium, feedback and audience need careful and fun-damental consideration.

Message DevelopmentThe development of messages, the reception and understanding of which would establish the desired link between the communica-tor and the audience, requires attention to a number of issues. For instance, messages must be clear, simple and easy to understand. There must be some means for testing their effectiveness before their implementation. It is always preferable to share (dialogical) rather than disseminate (unidirectional) messages. The advantage of sharing which dissemination does not have, unless it is intentionally sought, is feedback (instantaneous or delayed). Sharing also encourages listening on the part of the communicator who then is able to clari-fy, explain or even reformulate the message to improve comprehension and acceptance.

Selection of MediumVarious media and communication formats have certain advantages and disadvantages especially when viewed against the message to be communicated and the audience target-ed. It is not enough to assume that the MEDIA are available to carry messages to audiences; suitability of the chosen medium or format for communicating a message is crucial (Reynolds and Anderson 1992; Sugrue and Clark 2000). For example, a message sent through radio, television or radio cassette recorder requires a reception device such as a radio cassette player available to the audience if the message is to be accessed.

It is thus important to undertake an inventory of all forms of communication available (or that can be made available with cost consequenc-es) to the audience and noting the attributes

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of each form of communication. This will assist in matching a form with the communicative characteristics of a message and its audience. The possibilities of multi-media approaches to sharing messages are also enhanced by such an inventory in compiling which various communication types, namely, intrapersonal, interpersonal, small group and mass will emerge.

Audience CharacteristicsThe more the socio-economic, cultural, politi-cal and other characteristics of the audience are known and understood by the com-municator, the more adequate the design of the message and the more appropriate the selected medium or media for sharing the message. The baseline studies preceding this report collected such relevant information.

FocusCommunication is a process that achieves various levels of results over certain periods of time. For effectiveness in terms of preparation, presentation and evaluation, however, like the implementation of all planned activities, it is useful to set specific objectives and deadlines for achieving those objectives. This allows some degree of measuring whether the mes-sage is having the desirable impact. Activities may have some semblance of terminal points; that is, one may consider enough messages to have been packaged to be sent out or results of audience studies (especially for feedback purposes) would need to be utilised for their usefulness to be established. However, com-munication activities can hardly be regarded as exclusive or compartmentalised because they are activities which usually complement each other. So, while certain programmes may seem to be taking place as stand-alone ac-tivities, one can expect that, most of the time, virtually all activities outlined may be occurring simultaneously.

the coMMuNIcAtIoN GoALThe goal of the communication strategy is to create awareness and knowledge about climate change and its impact on health as well as its gender ramifications and promote or facilitate positive attitudes and behaviours towards climate variability.

coMMuNIcAtIoN objectIVeSThe objectives of the communication strategy are to:

� Increase stakeholder and general public awareness about climate change and its implications for health

� Educate stakeholders about human activities that could lead to climate change and how these can be managed

� Promote positive attitudes and behaviours towards climate change and its implications for health

� Develop and employ appropriate avenues for knowledge sharing on climate change and health among community members

� Ensure effective monitoring and evaluation of the implementation of the communication strategy.

� Mobilise community members to work with, own and sustain the project by developing monitoring mechanisms that promote positive climate change and health improvement.

KeY PLAYerS � Ministry of Health � Ghana Health service � Regional Health Directorates � District Health directorates � District assemblies � Ministry of Environment, Science

and Technology/ EPA � Ministry of Local Government

and Rural Development � 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 � Community members � Traditional authorities � Religious authorities � Women’s group leaders � Teachers � Farmers � Health workers including

Community Health Workers � Programme implementation team � Youth groups � Social groups

MeSSAGeS theme: Climate change affects everybody’s health. Climate change is also a women’s issue.

KeY MeSSAGeOur environment is our health. Let us come together to fight climate change for better health. Together we fight climate change for healthier life.

Strategy highlights � Prepare human and material resources � Advocacy with leaders and

gatekeepers (influencers) of stakeholders and general public

� Raise public awareness about Climate change and educate the public about its effects on livelihoods as well as ways of mitigating the effects

� Social mobilization for programme support

� Facilitate adoption of positive behaviours towards climate enhancing activities and initiatives among various stakeholders and the general public

Channels and Materials

chANNeL AND ActIVItY chArActerIStIcS

� Culturally sensitive � For facilitation and promotion of change � Facilitation of education � In support of advocacy � Participatory nature � Facilitation of easy feedback

MAterIALS

Advocacy Materials � PowerPoint presentation

� Text � Pictures

� Facts sheets � Brochures � Newsletters � Speaking points � Websites � Questions and Answers � Frequently Asked Questions � Features

Behaviour Change Materials � Drama kits � Video � Games and activities � Facilitation manuals � Poster flipcharts � Pocket guide � Songs � Leaflets � Materials dissemination plan � Radio discussion programmes � Indigenous communication (e.g.

songs, stories, narrations, orations, proverbs, and analogies)

Social Mobilization Materials � Radio programmes � 12 month drama series � Magazine programme � Poster flipcharts � Pocket guide � Speaking points � Questions and Answers � Songs � Newsletter � Leaflets � Materials dissemination plan � Radio documentary � Indigenous communication

General � Mailing list

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ILLuStrAtIoN oF coMMuNIcAtIoN MAterIALS AND ActIVItIeS Group Discussions: Non-literate cultures are steeped in oral traditions with a strong reli-ance on dialogue-oriented and participatory approaches to communication (Oniekwere 1994). Group Discussions provide good opportunities for using these elements of traditional communication. It will be useful to develop group discussion guides on the subject of climate change and health and train local facilitators to use them. Such participa-tory approaches promote social dialogue and facilitate social acceptance.

radio Programmes: The widespread use of radio by the rural communities as well as the increasing use of local languages on many FM stations makes more of the population want to listen to radio and partake in radio discus-sions. It will therefore be more effective and appropriate to use the medium of radio due to its extensive reach and widespread use and the ability of the communities to carry them around. This will be done by studio panel discussions and interviews. It will also bring stakeholders to one meeting, to reflect differ-ent opinions, encourage and build consensus which is usually an approach for resolving issues among non – literate and semi – liter-ate communities. It can also be used to draw out misconceptions and fears about climate change and health and relay solutions from the experts. Radio discussions are participa-tory and non-intimidating and will promote appreciation of the issues about climate change.

Local Public address systems or Information centres: These are increasing and becoming the case that communities have set up community public address sys-tems with megaphones situated at vantage points through which information is sent out to the entire community. These systems seem to be replacing the role of the gong-gong beater in many communities. These systems will also be considered for commu-nity mobilisation activities.

Documentary: Documentaries are good for awareness creation and also for advocacy purposes. A documentary will be produced on the achievements of the programme to be used for advocacy purposes as well as educat-ing the general public on climate change and health issues. The documentary will be in the local languages and shown at community education forums.

Drama: Dramatic Skits on climate change impact will be developed and produced to show around the various communities. The Skits will be interactive and help to easily iden-tify issues as well as communicate messages. For the purpose of this project, perceptions, attitudes, etc that need to be managed will be identified and skits developed in a way that will help the management. Generic skits will be developed with guidelines and facilitation kits for their adaptation. It would be more effec-tive if community members are recruited into the drama skits.

cartoon Strips: Comic Strips are effective in helping people follow the flow of actions and impact of these actions. These will thus be developed and produced for education on climate change and especially for school chil-dren, they would be considered. Once these school children are educated about these is-sues they will in turn pass on the information to their parents and other members of their communities.

training Modules and Facilitation Kits: These will be developed for the training of all those who will be involved in the facilitation of decision-making in relation to the progamme. This would include Community health nurses, teachers, health workers, religious leaders, etc.

Presentations: Presentations in the mar-kets, churches, mosques and antenatal clin-ics can directly reach women who are more vulnerable. Presentations will also be made to opinion leaders, Community gate keepers and traditional and religious authorities. As they function predominantly in oral and visual societies, the presentations will be made up of mostly pictures.

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one-on-one Discussions: These will be organised with carefully worded speaking points as guides. The objective will be to teach through one-on-one sessions as well as insti-gate and sustain supportive behaviour.

Fact Sheets: Fact Sheets will be developed and produced and sent out periodically es-pecially to the policy makers, health workers at the regional and district levels as well as media and selected CSOs and NGOs. The me-dia and NGOs will share the information with communities, thereby increasing awareness, education and information flow.

community communication Approaches: A wide variety of traditional community ap-proaches such as games, theatre, and folk media can be used (Oniekwere 1994). A number of skit ideas can thus be developed in the multimedia package for different uses in different contexts. These skits will basically seek to draw out and address climate change and health related issues and questions on people’s minds. Thus a set of pre-prepared FAQ’s could form the basis of the skit ideas.

Posters: Various posters will be developed and produced on the issue of climate change and health and circulated and posted in stra-tegic places to create awareness.

Implementation Plan

IMPLeMeNtAtIoN PLAN - SuMMArY

Quarter 1 � Development of themes,

messages and materials � Pretesting of messages and materials � Advocacy visits to key players to share

the project and seek their support � Training of spokespersons

and facilitators � Training of health personnel and relevant

representatives from key stakeholders � Establishing feedback mechanisms � Quarter 2 � Social mobilization activities � Awareness and Education � Showcasing � What is the situation? � Why that situation? � What are the implications

of the situation for ¡ The individual? ¡ Loved ones? ¡ The community? ¡ The nation?

� What can be done to turn the situation around?

� 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

neededAudience Means of

verification Indicator of success

Quarter 1

¡ Development of themes, messages and materials

¡ Pretest of messages, material and theme

Prepare human and material resources

¡ Research reports

¡ Communication strategy document

¡ Sample materials

¡ Project staff

¡ Selected community members

¡ Speaking points developed

¡ Q&As developed

¡ Themes and sub theme developed

Content analysis

Production of Communication Materials/Content

with the relevant messages

¡ Prepare human and material resources

¡ Link up with Meteorological Services; MoFA (e.g. fertilizer use); EPA, etc

Sample communication materials

Project staff ¡ Systematic penetration and use of communication materials

¡ Consistency in message

¡ Effective communication

¡ Increased awareness

¡ Positive behaviours towards the project

Content analysis

Identification of Opinion & Decision Leaders - National, Regional, District, Community


Communication materials. Training modules, Q&As

Identified opinion leaders ¡ Increased knowledge about climate change and health

¡ Positive behaviours toward project and issues

¡ Training report

¡

¡ Assessment reports

Compilation of an inventory of Forms of Communication

Indigenous, Small Group, Mass, Internet


¡ Literature/Press review; also sociometry

¡ Project staff

¡ Communication experts

¡ Itemised mode characteristics

¡ Reports

Development of training manuals

Training in communication skills


Training modules

Speaking Points

Q&As

¡ Project staff

¡ Spokespersons

¡ Representation of key player agencies

Increased knowledge about climate change and health

Positive behaviours toward project and issues

¡ Training reports


Development of training manuals

Training in presentation / facilitation skills


¡ Speaking Points

¡ Q&As

¡ Training manuals

¡ Sample presentations

¡ Communication experts ¡ Increased decision maker support climate change and health

¡ Training reports

¡


Training in advocacy for relevant staff Prepare human and material resources

¡ Training manuals/modules

¡ Presentations

¡ Case studies

¡ Communication experts ¡ Increased decision maker support climate change and health

¡ Training reports

¡


Advocacy visits to identified opinion leaders, policy makers, traditional authorities to share the project and seek their support and commitment

Project staff

Communication experts

Research reports, fact sheets, Q&As

Identified opinion leaders in each district

Increased decision maker support climate change and health

Activity reports

Training of

¡ Local communicators

¡ NGOs

¡ CSOs



¡ Presentations

Case studies

Local communicators

NGOs

CSOs

¡ Increased knowledge about climate change and health

¡ Positive behaviours toward project and issues

¡ Training reports

¡


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Identification and training of champions for various institutions and civil society groups

Project staff


¡ Speaking points

¡ Q&As

¡ Research reports

¡ Poster Flip charts


Presentation

champions for various institution

Civil society groups

Increased decision maker support on climate change and health

Training reports

Assessment reports

Development of material distribution plan


Sample communication support materials

Project staff ¡ Systematic penetration and use of communication materials

¡ Consistency in message

¡ Effective communication



Content Analyses

Establishment of climate change and health committee in districts


Research reports

Policy documents

Representative from relevant MDAs and CSOs

Issues proactively managed Committee plans and report

Development of radio programmes Prepare humanand material resources

Radio scripts

Resource persons

General public Increased knowledge about programme Positive behaviours toward issues

Content analysis

Listerner ship surveys

Advocacy with policy makers and gatekeepers (national and regional level)

¡ Factsheet

¡ Progress reports

¡ Q&As

¡ Information kits

Policy makers and gate keepers at regional and national levels



¡ Increased decision maker support on climate change and health

Activity reports

Orientation for media personnel on climate change and health


Factsheets

Information pack

Q&As

Selected media in districts ¡ Increased awareness

¡ Increased publicity about project

¡ Accurate reporting

Media reports

Content analysis

Development of data base on climate change issues in each district. This would become a knowledge platform on climate change

Prepare human and resources

¡ Research reports

¡ Fact sheets

¡ Posters

¡ Comic strips

¡ Newsletters

¡ Picture posters

¡ Updates on environment and weather

¡ All data and information produced as part of the project

¡ Community members

¡ Project staff

¡ General public

¡ Increased knowledge

¡ Improved access to information

¡ Increased penetration and use of communication materials


Surveys

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Quarter 2 and 3: Awareness Creation and Education ¡ - Distribution of comic strips and pocket guides

¡ - Open air talks at markets, OPDs, churches mosques,

¡ Public discussions on climate change and health

¡ - Use of community health nurses to educate women on climate change and health

¡ - community drama and community discussion on climate change and health

¡ - discussions at women’s group meetings

¡ Presentation and discussion at antenatal and post natal clinics

¡ Periodic presentation to schools in the districts

¡ - Local drama on the cases and effects of climate change on health

¡ - use of agric extension officers to educate farmers on climate change especially during at the beginning of planting season.

¡ - Education during festive occasions

¡ Raise public awareness about Climate change and educate the public about its effects on livelihoods as well as ways of mitigating the effects

¡

¡ Social mobilization for programme support

¡

¡ Facilitate adoption of positive behaviours towards climate enhancing activities and initiatives among various stakeholders and the general public

¡ Skits

¡ Picture Posters

¡ Puppetry

¡ Pocket Guides

¡ Poster Flip Charts

¡ Discussion guides

¡ Facilitation guides

¡ Powerpoint presentations

¡ Posters

¡ Radio documentary

¡ Games and activities

¡ Community members

¡ School pupils

¡ Members of religious organizations

¡ Women’s groups

¡ Farmers groups

¡ Fishermen groups.

¡ Dress makers associations, hair dressers associations etc

¡ Increased knowledge

¡ - Increased penetration and use of communication materials

¡ -Positive behaviours towards the project

¡ Surveys

¡ FGDs

¡

¡ Impact assessment

¡

¡ Observations

¡ Education during festivals

¡

¡

¡

¡

¡

¡

¡ Training programmes for farmers/fishermen on more innovative ways of farming/fishing and addressing anxieties they may have

¡

¡ -institution of local by-laws that protect the environment

¡

¡

¡

¡ - tie campaign to already running health programmes eg malaria(IPT and ACTs), etc

¡ - information made available at CHPs facilities

¡ - Presentations during child welfare clinics

¡ Raise public awareness about Climate change and educate the public about its effects on livelihoods as well as ways of mitigating the effects

¡

¡

¡ - Facilitate adoption of positive behaviours towards climate enhancing activities and initiatives among various stakeholders and the general public

¡ Cinema Vans

¡ Picture Posters

¡ Skits

¡ Puppetry

¡ Pocket Guides

Facilitation guide

Q&As, pocket guides, teaching aids etc

Local by –laws

Facilitation guide

Q&As, pocket guides, teaching aids speaking points, counseling cards etc

¡ General public

¡ Farmer associations

¡ Fishermen association

¡ Traditional leaders

¡ District assembly members

¡ General public

¡ Nursing mothers

Increased penetration and use of communication materials


¡ Increased penetration and use of communication materials


¡ Positive attitudes

Increased penetration and use of communication materials


Positive attitudes

Surveys

Impact assessment

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Provision of periodic information to selected opinion leaders (at the health directorate, religious leaders, women’s group leaders, and traditional leaders)

- Raise public awareness about Climate change and educate the public about its effects on livelihoods as well as ways of mitigating the effects

Speaking points, fact sheets, newsletter

Opinion leaders (at the health directorate, religious leaders, women’s group leaders, and traditional leaders)

Increase knowledge about climate change and health

Reports

Provision of periodic updates from GMA to districts (health directorates) to facilitate planning and implementation (information on climate change impacts on health, how to mitigate climate change effects on health and other socio-economic areas such as economy, agriculture, environment etc)


Factsheets

Updates on climate change issues

Newsletter

Climate change and health committee, relevant staff in health directorate at the district and regional levels


Reports

Evening radio programme on climate change effects on health (to be placed just before or after news)

- Facilitate adoption of positive behaviours towards climate enhancing activities and initiatives among various stakeholders and the general public

¡ Speaking points

¡ Programme running order

¡ Synopsis

General public Increase knowledge about climate change and health

positive behaviours

Content analysis

Surveys

Community based surveillance volunteers to periodically share information and leaflets on climate change and health.


¡ Speaking points

¡ Counseling cards

¡ Facilitation guides

¡ Q&As

Clients of surveillance volunteers

Increase knowledge about climate change

Positive behaviours

Surveys

Meeting of social groups (drumming, boborbo, hair dressers, dress makers etc) to discuss climate change and health and how this can affect their group


Speaking points, fact sheets, newsletter, Q&As, video documentary

social groups (drumming, boborbo, hair dressers, dress makers etc)


positive behaviours

Focus group discussion

Quarter 4 Periodic messages through the community Public health system (asking community members if they have undertaken any climate enhancing activities)


Selected messages General community members

Create awareness

Increase knowledge

Positive behaviours

Surveys

Small group discussions (eg with drought players, on climate change)

- Facilitate adoption of positive behaviours towards climate enhancing activities and initiatives among various stakeholders and the general public

Speaking points

Flyers

Q&As

Identified group- drought players, union, cooperatives etc

Create awareness

Increase knowledge

Positive behaviours

Surveys

FGDs

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Monitoring and EvaluationGeneral Monitoring and evaluation activities Activity When

Periodic impact evaluation

¡ 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

Every quarter

Input Evaluation

¡ Content Analyses to review existing communication materials

¡ Pretesting of Communication materials

¡ Technical Expert Reviews

Before the implementation of an major activity

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 devel-opment 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.

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REPUBLIC OF GHANAMINISTRY OF HEALTH

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

www.climatehealthghana.org

gender sensitive climate change communication …...contents background iii acknowledgment v gender...

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