Dr. Charity Binka Urges Daring Motion on Sexual and Reproductive Health and Rights in Ghana

For Immediate Conceptualization: In a powerful statement marking Sexual and Reproductive Health Awareness Day, Dr. Charity Binka, Executive Director of Women, Media and Change (WOMEC), has called for a decisive shift from symbolic observance to concrete, sustained national action to protect the sexual and reproductive health and rights (SRHR) of women and young people in Ghana. Her appeal highlights critical gaps in information, service access, and policy implementation that threaten health, dignity, and development.

Introduction: Beyond Awareness to Action

Sexual and reproductive health and rights (SRHR) are fundamental human rights, enshrined in international covenants and national constitutions, including Ghana’s 1992 Constitution. Yet, as Dr. Charity Binka asserts, these rights remain theoretical for many Ghanaians, particularly women, adolescents, and marginalized groups. Her statement serves as a crucial diagnostic of the state of SRHR in Ghana, moving beyond annual awareness campaigns to demand systemic change. This article expands on her call, providing context, analysis, and a practical framework for the “daring motion” she envisions—a coordinated, multi-stakeholder effort to translate policy into lived reality for every citizen.

Key Points: The Core of Dr. Binka’s Appeal

Dr. Binka’s press release, issued in Accra, distills the complex challenge of SRHR into actionable imperatives. The central themes are:

• Rights-Based Imperative: SRHR are non-negotiable human rights, not privileges subject to cultural or political compromise.
• Implementation Gap: The persistent disconnect between national/international commitments and on-the-ground service delivery and protection.
• Triple Threat: The lethal combination of misinformation, stigma, and unequal access to quality healthcare.
• Media as Accountability Partner: The press must move beyond episodic reporting to sustained, evidence-based scrutiny of SRHR policies and outcomes.
• Accelerated, Measurable Progress: Incremental change is insufficient; bold, budgeted, and results-oriented strategies are required.

Background: The SRHR Landscape in Ghana

Understanding the urgency of Dr. Binka’s call requires contextualizing Ghana’s SRHR landscape within regional and global frameworks.

Ghana’s Policy Framework and Commitments

Ghana is a signatory to key international agreements, including the International Conference on Population and Development (ICPD) Programme of Action, the Sustainable Development Goals (SDGs)—particularly SDG 3 (Good Health and Well-being) and SDG 5 (Gender Equality)—and the Maputo Protocol on the rights of women in Africa. Domestically, the National Reproductive Health Policy and the Adolescent Health Service Policy provide a blueprint. However, implementation has been inconsistent, underfunded, and often hampered by socio-cultural barriers and fragmented health systems.

Persistent Challenges and Data

Despite progress, key indicators reveal deep-seated challenges:

• Maternal Health: Ghana’s maternal mortality ratio remains high, with significant regional disparities. Preventable complications from unsafe abortion, postpartum hemorrhage, and eclampsia persist.
• Adolescent SRHR: Adolescent pregnancy rates are a concern, particularly in rural and underserved communities. Access to comprehensive sexuality education (CSE) and youth-friendly services is patchy.
• Contraceptive Access: Unmet need for family planning among married and unmarried women indicates gaps in service availability, affordability, and method choice.
• Cervical Cancer: As Dr. Binka notes, it remains a leading cause of cancer death among women, with screening and treatment services limited outside major urban centers.
• Sexually Transmitted Infections (STIs): Including HIV, syphilis, and gonorrhea, remain prevalent, with stigma hindering testing and treatment.

These issues are exacerbated by misinformation (often spread via social media), deep-rooted stigma surrounding sexuality, abortion, and infertility, and systemic inequalities in access based on geography, income, and age.

Analysis: Deconstructing the Barriers

Dr. Binka’s statement implicitly points to a multi-layered failure. A structural analysis reveals the interplay of factors blocking SRHR advancement in Ghana.

1. The Policy-to-Practice Chasm

Ghana often excels in policy formulation but falters in execution. The gap stems from:

• Inadequate and Unpredictable Financing: SRHR programs compete with other health priorities. Domestic budget allocations are often insufficient and unreliable, creating dependency on volatile donor funding.
• Health System Weaknesses: Stock-outs of essential medicines and supplies (e.g., contraceptives, antibiotics for STIs), insufficient trained healthcare providers (especially in rural areas), and poor infrastructure.
• Weak Coordination: Fragmentation between the Ghana Health Service, the Ministry of Education (for CSE), the Ministry of Gender, and local government structures leads to duplicated efforts and gaps.

2. The Stigma and Misinformation Ecosystem

Social and cultural norms are powerful determinants of SRHR outcomes.

• Cultural and Religious Norms: Taboos around discussing sexuality, especially with adolescents, and opposition to comprehensive sexuality education and safe abortion services (where legally permitted) create an environment of silence and fear.
• Gender Inequality: Power imbalances limit women’s and girls’ autonomy in making decisions about their bodies, seeking care, or negotiating safe sex.
• Digital Misinformation: Myths about contraception, menstrual health, and abortion proliferate online, often unchecked, directly contradicting medical evidence and deterring care-seeking.

3. The Media’s Dual Role: Amplifier and Accountability Mechanism

Dr. Binka correctly identifies the media as a critical, yet under-leveraged, actor. The media can:

• Perpetuate Harm: Through sensationalist, inaccurate, or value-laden reporting that reinforces stigma and misinformation.
• Drive Change: By consistently highlighting SRHR as a development issue, investigating service delivery failures, platforming expert voices (doctors, researchers), and holding policymakers accountable for budget releases and program results.

The current state is often one of episodic coverage around specific days (e.g., World AIDS Day) rather than the sustained, investigative journalism needed for systemic accountability.

4. The Adolescent and Youth Blind Spot

Services are frequently designed for adults, ignoring the specific needs of adolescents. Barriers include:

• Lack of confidential, non-judgmental services.
• Provider bias and refusal to serve unmarried youth.
• Legal and policy ambiguities around the age of consent for health services.
• Inadequate integration of CSE into the formal school curriculum.

Practical Advice: Pathways to Daring Motion

Translating Dr. Binka’s call into action requires a coordinated strategy with clear roles for each stakeholder. This is the blueprint for “daring motion.”

For the Government and Policymakers

• Increase and Ring-Fence Domestic Funding: Pass a parliamentary resolution guaranteeing a minimum percentage of the health budget for SRHR, with specific allocations for commodities, training, and adolescent services.
• Strengthen Health Systems: Invest in supply chain management to eliminate stock-outs. Scale up training and deployment of midwives, nurses, and community health workers skilled in SRHR, including safe abortion care where legal.
• Accelerate Implementation of Existing Policies: Conduct a gap analysis of the National Reproductive Health Policy and Adolescent Health Policy. Create public dashboards tracking key indicators (e.g., contraceptive prevalence rate, adolescent pregnancy rate, facility readiness).
• Legal and Regulatory Reform: Clarify and disseminate guidelines on the legal provisions for abortion (under the 1985 PNDC Law 111, as amended) to reduce provider fear and improve access. Enact and enforce laws protecting the right to confidential healthcare for minors.
• Integrate CSE: Fully integrate age-appropriate, evidence-based Comprehensive Sexuality Education into the national school curriculum, training teachers and engaging parents.

For the Media

• Adopt SRHR as a Beats: Assign dedicated health reporters to cover SRHR as a continuous development beat, not just on awareness days.
• Commit to Evidence-Based Reporting: Consult gynecologists, public health experts, and demographers. Fact-check claims about health effects. Use respectful, non-stigmatizing language.
• Investigative Journalism: Investigate the use of SRHR budgets, the quality of services in specific districts, and the root causes of maternal deaths.
• Platform Diverse Voices: Feature stories of women, youth, health workers, and policymakers. Use multimedia (documentaries, podcasts, data visualizations) to explain complex issues like endometriosis or cervical cancer screening.
• Hold Forums: Organize town halls and televised debates bringing together health officials, traditional leaders, religious leaders, and youth to discuss SRHR challenges.

For Civil Society Organizations (CSOs) like WOMEC

• Community Mobilization & Education: Conduct grassroots dialogues using trusted community entry points (churches, mosques, women’s groups, youth clubs) to combat misinformation and stigma.
• Advocacy & Watchdog Role: Develop scorecards to rate government performance on SRHR commitments. Use media partnerships to amplify findings.
• Empower Youth-Led Initiatives: Fund and train youth peer educators and advocates. Support youth-led demand-generation for services.
• Legal Literacy: Educate communities, especially women and youth, about their legal rights to health services and protection from discrimination.

For Healthcare Providers and the Ghana Health Service

• Zero Tolerance for Stigma: Implement and enforce a code of conduct guaranteeing non-discriminatory, confidential, and respectful care for all, including adolescents, LGBTQ+ individuals, and people living with HIV.
• Task-Shifting/Task-Sharing: Empower community health nurses and midwives to provide a wider range of services, including contraceptive implants and basic STI treatment, to improve geographic access.
• Establish Robust Referral Networks: Ensure clear pathways from community to primary to secondary/tertiary care, especially for complications and cancer screening.
• Client Feedback Mechanisms: Implement simple, anonymous feedback systems (e.g., SMS, suggestion boxes) to identify and address service delivery problems in real-time.

FAQ: Addressing Common Queries on SRHR in Ghana

Q1: Is advocating for sexual and reproductive health and rights the same as promoting sexual activity?

A: No. SRHR advocacy is about ensuring that all individuals, regardless of their sexual activity status, have the right to:

• Access accurate information about their bodies and health.
• Make free and informed decisions about sexuality and reproduction.
• Access quality healthcare services (including prevention, treatment, and palliation) without discrimination, coercion, or violence.
• Be protected from harmful practices like