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All analysed data are freely available to the public from the Measure DHS website, thus www. The World Health Organisation WHO recommends that breastfeeding should be initiated within the first hour of delivery followed by exclusive breastfeeding up to 6 months. This study examined the determinants of early initiation of breastfeeding in Ghana using data from the Ghana Demographic and Health Survey. A sample size of was used for the study. Breastfeeding is essential for the growth and development of newborns by providing vital nutrients [ 1 ].
Demographics of Ghana
Although the population of Ghana is young and generally youthful, there is evidence of rapid increases in the size of the elderly cohort.
Although demographic projections estimate that the proportion of the population younger than 15 years will experience continuous decline overtime due in part to decline in fertility, the rise in the elderly population is expected to also continue due to declining mortality rates resulting in longevity. Unfortunately, the growth in the elderly proportion of the population is occurring at the same time traditional systems of protection and care for the aged are breaking down on account of urbanization, socioeconomic development, and globalization.
This has implications for public policy and the overall wellbeing of the elderly. This paper provides a snapshot overview of the demographic dynamics of Ghana focusing on the characteristics of aging, the challenges confronting the elderly, policy interventions, and gaps, as well as some pertinent issues including emerging research that are shaping deliberations about the elderly in the country.
In March , Ghana celebrated 60 years of independence from British colonial rule. That celebration also symbolized the transition of all persons in Ghana, born before or in the year of the liberation from colonial rule and are still living, to the category of the population described as the elderly. The population of Ghana is relatively youthful but changing demographic trends since the s show signs of gradual increase in the size of the elderly population defined as persons 60 years and older Ghana Statistical Service, b.
Drawing on data, from the Population and Housing Censuses and the periodic Ghana Living Standards Survey GSS reports produced by the Ghana Statistical Service GSS , as well as other secondary sources, this paper discusses the phenomenon of demographic transitions occurring in Ghana with particular attention to its gerontological dimensions and implications for the livelihood of the elderly, research, and public policy.
From a modest population size of 6. The population of Ghana is projected to reach The youthful nature of the population is influenced by factors such as high rates of fertility and declining mortality rate especially among infants Ghana Statistical Service, Population pyramid of Ghana, Changes have also been observed in those aged between 25 and 59 years.
Although the proportion of persons in this age bracket constituted Already, evidence shows that the proportion of persons aged 60 years and older is on the rise in Ghana. The first postcolonial census showed the share of the elderly population in was 4. This has increased to 5. Although the population 60 years and older decreased from 7. Again, the cohort of the population under 15 years is expected to decrease further to Similarly, it is projected that the proportion of persons 80 years and older will continue to increase and peak at 1.
From a median age of 21 in , Ghana is projected to enter into an intermediate population bracket with a median age of Social characteristics such as educational attainment, economic activity, living arrangements, and marital status are important variables that provide information about the overall living condition of the elderly in society.
Records show that Educational qualification is crucial because even in old age, high educational attainment can be used to leverage re-entry and participation in the labor market, and by extension obtain access to income and therefore afford quality health care and other services. For instance, Gender disparity in the educational attainment in favor of males among the elderly suggests that majority of older women are unable to enter the formal job market, thereby raising the possibility of elderly females falling into abject poverty more than their males counterparts.
In much the same way, there are relatively more elderly persons with no formal education living in the rural areas compared to the urban areas. Given the role of education in securing livelihood opportunities and preparation toward retirement, the urban elderly may be enjoying better conditions than their rural colleagues.
In terms of economic activity, the elderly mostly live in the same household with other family members, help with taking care of grandchildren and other relatives to enable the economically active population in the family focus on their work.
The working generation provides support for the elderly, in an arrangement that suggests that the cost associated with raising that working generation when they were young is an investment and insurance against the uncertainties of life in old age. Therefore, the elderly continue to contribute to the overall welfare of the family by helping to raise, educate, and transmit time-honored indigenous wisdom and traditional values to the younger generation in their care, while also supporting with the performance of minimal house keeping duties, where health conditions allow.
Table 1 earlier provides detail information on the employment status of the elderly in Ghana. Overall, due to the low levels of educational attainment among the elderly, only small fraction of 2. Although the elderly make up less than a tenth of the total national population, they constitute 8. Of the total labor force in Ghana, elderly male constitute 9.
Even though about More than half of the elderly in Ghana are in some form of marital union, which is either being married, or living together. In addition, among those who were previously married, about The proportion of urban elderly who have never married is slightly higher than those with similar experiences in the rural areas.
The gradual emergence of unmarried adults in Ghanaian society where child bearing has always been seen as investment and security against the uncertainties of old age, is one example of the modernization induced transformations shaping the society.
For these unmarried elderly and those without children, preparation for care and support in old age meant fostering other children if they are to avoid falling into the trap of elderly neglect. Early research on aging in Ghana has shown that the protection offered the elderly in Ghanaian society has come under some pressures from modernization, urbanization, and search for better livelihood Aboderin, ; Apt, , ; Mba, In some parts of Ghana, elderly persons are also subjected to cruel treatment resulting from sociocultural beliefs.
For instance, it is not uncommon for elderly women in parts of Northern Ghana to be accused of witchcraft and banished from their communities. This inhumane practice has the potential to impose on the elderly victims loneliness, separation, insomnia, and persistent anxiety.
One study in shows that the elderly population in Ghana is exposed to several health risks from smoking, alcoholism, obesity, hypertension, insufficient nutritional intake, and very low physical activity emanating largely from the breakdown of the familial care arrangement as well as absence of protection by the state.
The enormity of the challenges confronting the elderly population in Ghana is illustrated by the coping strategies ranging from self-medication, living off the streets by begging, cohabiting with others as a strategy for paying lower rents, working for others as laborers or house helps, selling productive and valuable assets, borrowing money from people, eating rotten foods, to deliberating skipping, delaying, or eating fewer meals.
Overall, the level of poverty among the elderly is high and so is the level of disability among them United Nations Population Fund, Atobrah observed that the challenges imposed by abject poverty on the elderly has often compelled them to sell personal belongings in order to enable them meet other social obligations. Notwithstanding the rapid pace of aging, the country is yet to develop specific policies targeted primarily at addressing the various vulnerabilities associated with aging.
Aspects of existing public policies such as the a the Pensions Program, b the National Health Insurance Scheme NHIS , and the c Livelihood Empowerment Against Poverty LEAP designed to address the challenges of income insecurity, health care needs, and other constraints imposed by abject poverty among the elderly have, as discussed below, proven palpably inadequate. For instance, the first pension programs which were established in the colonial administration were targeted not at providing retirement income security of the elderly but were designed to serve as reward for loyalty awarded to Africans who served the Crown diligently and without blemish Kpessa, After independence, a new pension program known as the Provident Fund was introduced but was designed as a contributory program based on formal sector earnings.
Later, these provident funds were changed to a social insurance program known as the Social Security and National Insurance Trust SSNIT that pays both one lump sum amount and subsequently regular monthly benefits to contributors when they retire. Recently, the scheme has been transformed into a three-tier pension system that allows for diversification of retirement income through private sector participation in the provision of old age income security Kpessa, Notwithstanding reforms over the years, the pension program in Ghana continues to be limited scope.
Because the state is unable to reach workers in the informal sector through payroll tax deductions, the large majority of the elderly population who spent their entire productive life in the informal economy working as fishermen, farmers, transport conductors, traders, hawkers, street vendors, artisans, domestic helps, and could not contribute the payroll-based pension scheme are left without any pension benefits or any other form of reliable old age income support.
This point is further illustrated by reports from the SSNIT showing that as at the end of , the total number of the elderly persons in Ghana receiving statutory old age income support from SSNIT was far less than one percent of that cohort of the population Social Security and National insurance Trust, Because the formal sector of the economy is so small, out of This situation points to an imminent gerontological crisis if proactive policy interventions are not introduced to avert it.
In , policy makers also introduced a mandatory NHIS financed through subscription premiums and funds allocated by the central government. In addition, there exist on optional basis, community mutual health insurance schemes as well as the private commercial health insurance scheme on the market. By design, the NHIS has specific health challenges and list of drugs that are approved for coverage under the scheme.
In other words, the NHIS does not cover all illnesses, diseases, and health challenges. The elderly 70 years and older exempted from paying any premium but can access the services of the scheme for free. Unfortunately, the arrangement does not adequately address the health needs of the elderly for a number of reasons. First, the age at which the elderly qualifies to obtain free health care benefits from the scheme meant that the proportion of the elderly younger than 70 years is left uncovered by the scheme.
Second, the bureaucratic delays associated with processing retirement income benefits for pensioners and the fact that most of the elderly are not covered under the retirement income security system meant that the proportion of the elderly between 60 and 69 years group have difficulty subscribing to the NHIS.
Third, it is not enough for the NHIS to exempt the elderly 70 years and older especially when their major health challenges such as arthritis, stroke, hypertension, heart diseases, diabetes, malignant neoplasm, trachoma, blindness, and cancers are not covered under the NHIS-approved list of services financed by the Scheme. In effect, the coverage provided for the elderly under the NHIS does not address the health challenges of aging and thus leave the elderly quite vulnerable in the fight against man-made and natural aging-related degenerative diseases.
Another program known as the LEAP was introduced in to periodically transfer cash from the central government to poor households in Ghana with the dual intension of mitigating poverty and empowering the extreme poor to save and invest.
Those who are eligible to receive LEAP cash transfer include households that have orphaned or vulnerable children, the elderly poor 65 years and older , and any person with extreme disability who is unable to work. By the end of , a total of , households were receiving LEAP cash transfer.
Although part of LEAP that targets the elderly is a form of social pension, the implementation of the program has so far suffered several setbacks. For instance, targeting to ensure that all the elderly poor are reached is a challenge largely because of unreliable household data, which results in errors of inclusion and exclusion.
In addition, the scope of LEAP so far is limited covering only few of the elderly who serve as caregivers for orphans and vulnerable children.
Thus, the large majority of the elderly poor without caregiving responsibility are excluded. Additionally, the amount of money received by the beneficiaries is woefully inadequate. In its present form, LEAP is heavily dependent on donor funding hence there are questions about its sustainability given that funding from the donors could be stopped at anytime.
A number of emerging aging-related issues in Ghana can be identified. Ghana eventually adopted a national policy framework in to serve as a springboard mainstreaming issues affecting the elderly in the public policy processes Government of Ghana, This policy document identifies a number of pertinent issues relating to aging for which further research would be instrumental in order to ensure decisions are made on the basis of scientific knowledge and the principles of best practice.
In a recent review of existing literature on aging in Ghana, it was observed that the study of aging in the country has so far focused on a demographic profiles and patterns of aging, b health status of the elderly, c elderly care and support systems, d roles and responsibility of the aged, e social representation of the elderly, and f issues relating to their socioeconomic status de-Graft Aikins et al.
The authors provide a brief but insightful multidisciplinary collection of reference points for further analysis of aging in Ghana. Subsequently, a multidisciplinary Centre for Ageing Studies CAS has been established in at the University of Ghana, with a mandate not only to conduct aging-related research and share findings to guide policy making but also to offer training in gerontology. Finally, the country is gradually witnessing the emergence of private professionalized social care for the elderly, arguably as replacements for the deterioration in intergenerational reciprocities.
One study in this area suggests that families are resorting to the use of nonfamily care givers, to supplement efforts of the family as a result of constrains on time due to work, formal education, and migration related unavailability Coe, In its present form, families that can afford the services of caregivers rely on recruitment agencies or recommendations from others in their social network to recruit trained or untrained caregivers, who often live in the same household with the rest of the family.
Under this arrangement, social care for the elderly is outsourced to nonfamily caregivers; however, the services are provided within the regular family settings in the full glare and often with assistance from other family members in the household.
The proportion of the elderly population in Ghana is one of the highest in sub-Saharan Africa and it is increasing rapidly World Health Organization, Aging of the population has social and economic implications for public policy and development. However, the growing research interest in the subject by scholars and practitioners of diverse disciplinary backgrounds is an excellent starting point to generate needed evidence for policy design and implementation.
The opportunities for research, innovation, and creativity offered by population aging is not only limitless, it also traverses disciplinary boundaries and therefore provides avenues for multidisciplinary collaboration among researchers and policy makers in Ghana and beyond. The author wishes to acknowledge the support this article received from the Book and Research Allowance provided by the Government of Ghana to academic faculty.
Aboderin , I. Intergenerational Support and Old Age in Africa. London UK : Transactional Publishers. Google Scholar.
The Demography of Ghana describes the condition and overview of Ghana's population. This article is about the demographic features of the population of Ghana, including population density , ethnicity, education level, health of the populace, religious affiliations and other aspects of the population. Ghana is a multilingual country in which about eighty languages are spoken. Ghana has more than seventy ethnic groups, each with its own distinct language. Ghana has more than seventy ethnic groups. Konkomba people at 3.
Ghana Statistical Service (GSS), Ghana Health Service (GHS), and ICF Macro. Ghana. Demographic and Health Survey Accra, Ghana: GSS, GHS,.
Although the population of Ghana is young and generally youthful, there is evidence of rapid increases in the size of the elderly cohort. Although demographic projections estimate that the proportion of the population younger than 15 years will experience continuous decline overtime due in part to decline in fertility, the rise in the elderly population is expected to also continue due to declining mortality rates resulting in longevity. Unfortunately, the growth in the elderly proportion of the population is occurring at the same time traditional systems of protection and care for the aged are breaking down on account of urbanization, socioeconomic development, and globalization. This has implications for public policy and the overall wellbeing of the elderly.
Despite the high antenatal care attendance rate in Ghana, skilled birth attendance is relatively low. There is limited evidence on whether antenatal care attendance translates into skilled birth attendance in the Ghanaian research discourse. This study investigates whether antenatal care attendance translates into skilled birth.
In Ghana, home delivery among women in urban areas is relatively low compared to rural areas. However, the few women who deliver at home in urban areas still face enormous risk of infections and death, just like those in rural areas. The present study investigated the factors associated with home delivery among women who live in urban areas in Ghana. Data for this study was obtained from the Ghana Demographic and Health Survey.
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Demographic and Health Survey 2014
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