Samuel Asiedu Owusu

Mobility, education and livelihood trajectories for young people in rural Ghana: a gender perspective

This paper examines the gendered implications of Africas transport gap (the lack of cheap, regular and reliable transport) for young people in rural Ghana, with particular reference to the linkages between restricted mobility, household work demands, access to education and livelihood potential. Our aim is to show how mobility constraints, especially as these interact with household labour demands, restrict young peoples access to education and livelihood opportunities. Firstly, the paper considers the implications of the direct constraints on young peoples mobility potential as they travel to school. Then it examines young peoples (mostly unpaid) labour contributions, which are commonly crucial to family household production and reproduction, including those associated with the transport gap. This has especially important implications for girls, on whom the principal onus lies to help adult women carry the heavy burden of water, firewood, and agricultural products required for household use. Such work can impact significantly on their educational attendance and performance in school and thus has potential knock-on impacts for livelihoods. Distance from school, when coupled with a heavy workload at home will affect attendance, punctuality and performance at school: it may ultimately represent the tipping point resulting in a decision to withdraw from formal education. Moreover, the heavy burden of work and restricted mobility contributes to young peoples negative attitudes to agriculture and rural life and encourages urban migration. Drawing on research from rural case study sites in two regions of Ghana, we discuss ethnographic material from recent interviews with children and young people, their parents, teachers and other key informants, supported by information from an associated survey with children ca. 9–18 years.

Out of the reach of children? Young people’s health-seeking practices and agency in Africa’s newly-emerging therapeutic landscapes

Despite a dominant view within Western biomedicine that children and medicines should be kept apart, a growing literature suggests that children and adolescents often take active roles in health-seeking. Here, we consider young peoples health-seeking practices in Ghana: a country with a rapidly-changing therapeutic landscape, characterised by the recent introduction of a National Health Insurance Scheme, mass advertising of medicines, and increased use of mobile phones. Qualitative and quantitative data are presented from eight field-sites in urban and rural Ghana, including 131 individual interviews, focus groups, plus a questionnaire survey of 1005 8-to-18-year-olds. The data show that many young people in Ghana play a major role in seeking healthcare for themselves and others. Young peoples ability to secure effective healthcare is often constrained by their limited access to social, economic and cultural resources and information; however, many interviewees actively generated, developed and consolidated such resources in their quest for healthcare. Health insurance and the growth of telecommunications and advertising present new opportunities and challenges for young peoples health-seeking practices. We argue that policy should take young peoples medical realities as a starting point for interventions to facilitate safe and effective health-seeking.

Grandfathers, Google, and Dreams: Medical Pluralism, Globalization, and New Healing Encounters in Ghana

Across contemporary Africa, pluralistic medical fields are becoming increasingly complex, giving rise to newly emerging constellations of healing practices and a vast array of therapeutic possibilities. We present portraits of four ‘traditional’ healers in southern Ghana who selectively adapt, adopt, and modify elements of biomedical, ‘local,’ and ‘exotic’ healing practices in eclectic and creative ways, positioning themselves strategically in a highly pluralistic, contested, and globalized medical arena. Their practices are informed by ‘traditional’ knowledge, passed down through families and acquired through spiritually directed dreams, but also from medical textbooks, Google searches, ‘scientific’ experimentation, and interactions with the biomedical sector. The healers make use of modern information and communication technologies to increase their geographical reach, and respond to the opportunities and risks of an increasingly global but strongly differentiated therapeutic market. However, while apparently transgressing therapeutic boundaries, they are simultaneously drawing on a discourse of stabilizing and straddling those boundaries to legitimize their practices.

Taking the long view : temporal considerations in the ethics of children's research activity and knowledge production.

Children are increasingly engaged in the research process as generators of knowledge, but little is known about the impacts on childrens lives, especially in the longer term. As part of a study on childrens mobility in Ghana, Malawi and South Africa, 70 child researchers received training to conduct peer research in their own communities. Evaluations at the time of the project suggested largely positive impacts on the child researchers: increased confidence, acquisition of useful skills and expanded social networks; however, in some cases, these were tempered with concerns about the effect on schoolwork. In the follow-up interviews 2 years later, several young Ghanaian researchers reported tangible benefits from the research activity for academic work and seeking employment, while negative impacts were largely forgotten. This study highlights the unforeseeable consequences of research participation on childrens lives as they unfold in unpredictable ways and underscores the temporal nature of childrens engagement in research.

Who bears the cost of ‘informal mhealth’? Health-workers’ mobile phone practices and associated political-moral economies of care in Ghana and Malawi

Africa’s recent communications ‘revolution’ has generated optimism that using mobile phones for health (mhealth) can help bridge healthcare gaps, particularly for rural, hard-to-reach populations. However, while scale-up of mhealth pilots remains limited, health-workers across the continent possess mobile phones. This article draws on interviews from Ghana and Malawi to ask whether/how health-workers are using their phones informally and with what consequences. Health-workers were found to use personal mobile phones for a wide range of purposes: obtaining help in emergencies; communicating with patients/colleagues; facilitating community-based care, patient monitoring and medication adherence; obtaining clinical advice/information and managing logistics. However, the costs were being borne by the health-workers themselves, particularly by those at the lower echelons, in rural communities, often on minimal stipends/salaries, who are required to ‘care’ even at substantial personal cost. Although there is significant potential for ‘informal mhealth’ to improve (rural) healthcare, there is a risk that the associated moral and political economies of care will reinforce existing socioeconomic and geographic inequalities.