## _cr04207 — Executive Summary and APR 2003 Highlights ## Source details **Canonical URL:** [_cr04207 — Executive Summary and APR 2003 Highlights](https://www.imf.org/-/media/websites/imf/imported-full-text-pdf/external/pubs/ft/scr/2004/_cr04207.pdf) ## Other formats - [Markdown version](/-/media/websites/imf/imported-full-text-pdf/external/pubs/ft/scr/2004/_cr04207.pdf.md) - [Structured JSON version](/-/media/websites/imf/imported-full-text-pdf/external/pubs/ft/scr/2004/_cr04207.pdf.json) --- ### Introduction and M&E framework - GPRS is the operational development policy framework; implementation began in 2002 and informs national and district policy and budgets. - APR provides systematic review of GPRS programmes and uses Medium Term Priorities (MTPs) and 52 core indicators (expanded) from the GPRS M&E Plan. - Primary data sources: sector MDAs, GSS surveys including: - Core Welfare Indicators Questionnaire (CWIQ2) Monitoring Survey — sample 49,000 households (67% rural, 37% urban; 51.3% female, 48.7% male). - Ghana Demographic and Health Survey (GDHS) 2003 — nationally representative sample of more than 6,6oo households; all women age 15-49 and men age 15-59 interviewed; included HIV and haemoglobin testing. - M&E challenges: - Data inconsistency and availability across sources. - Infrequent national outcome/impact surveys due to inadequate resources. - Need to harmonise data collection and motivate MDA/district staff for routine reporting. - Institutional arrangements: - National Intra-Agency Poverty Monitoring Groups (NIPMG) organised by thematic area (Macro-Economic Stability; Production & Gainful Employment; Human Resources Development & Basic Services; Governance; Vulnerable & Excluded). - Regional Poverty Monitoring Groups and expansion of RPCUs to support district M&E. - Civil Society Organizations to be integrated more fully starting Q2 2004. *Key commissioned PSIA studies (summarised in appendices):* - Energy Sector Reform in Ghana: Electricity Tariffs; - Tackling Vulnerability and Exclusion in Ghana; - Distributional Impact of Ghana’s Petroleum Pricing Policy; - Economic Transformation of the Agricultural Sector; - Enhancing Capacity for Pro-Poor Decentralisation. --- ### Macro‑Economic Stability — outcomes, indicators and policy actions - Growth and sectoral performance: - Real GDP growth 2003 = 5.2 percent (budget projection 4.7 percent; GPRS MTP target 4.9%). - Agriculture growth 2003 = 6.1 percent; cocoa sub‑sector 2003 = 16.4 percent; food crop growth 2003 = 5.3 percent. - Real GDP per capita growth 2003 = 2.6 percent (population growth assumption 2.6 percent). - Prices, external and monetary: - CPI (Annual Avg) 2003 = 26.7 percent; CPI (end‑period) 2003 = 23.6 percent. - Food price inflation end‑2003 = 21.5 percent (2002 = 15%). - Petroleum price shock: 90.4% increase in Feb 2003; budget target revised from 9.0% to 22% (end‑2003). - Cedi depreciation by December 2003: against US dollar = 4.7 percent; against euro = 22.5 percent; against pound sterling = 13.0 percent. - Gross international reserves (end‑2003) = 1,095 (Millions of USD) = covers 3.9 months of imports. - Public finances and debt: - Overall budget deficit 2003 = 4.5 percent of GDP (target 4.3%; 2002 = 6.8%). - Total revenue 2003 = 21.4 percent of GDP; grants 2003 = 4.8 percent of GDP; total expenditure 2003 = 29.3 percent of GDP. - Domestic debt/GDP ratio decreased from 29.1% in 2002 to 22.6% in 2003. - Net domestic financing 2003 = -0.1 percent of GDP (net repayment). - External debt service 2003 = 5.9 percent of GDP; external debt service/export ratio 2003 = 16.8 percent; NPV of external debt/export ratio 2003 = 143.5. - Divestiture receipts 2003 = 0.7 percent of GDP. - Financial conditions: - 91‑day Treasury bill rate fell from 35.3 percent (June 2003) to 18 percent (end‑2003). - Credit to private sector growth 2003 = 37.5 percent (from -11% in 2001). - Growth of domestic revenue 2003 = 56.2% (Indicator Level 2002 = 28.8%). - Policy actions implemented in 2003: - Use of HIPC savings: ¢144 billion used for domestic debt payment; total HIPC disbursements ¢850.79 billion by end‑2003. - Continued issuance of GoG Index Linked Bond and Cocoa bills. - Public expenditure management reforms: Financial Administration Bill passed Dec 2003; Expenditure Initiation Forms introduced; monthly reporting with no more than 8 weeks lag; BPEMS and Budget & Public Expenditure Management System implementation in MFEP and CAGD. - Tax administration measures: TIN implementation; Large Taxpayers Unit (LTU) to be launched in 2 phases; improved accounting for Non Tax Revenues. - Monetary policy: Monetary Policy Committee established; Bank of Ghana law reinforced independence. - Recommended policy initiatives: - Maintain macro‑stability while pursuing higher growth above “hovering around 5%”. - Increase revenue collection efficiency; use TOR Debt Recovery Fund expected to yield 1.2 trillion cedis to partly fund petroleum subsidy shortfalls. - Curtail discretionary expenditures while protecting poverty reduction expenditures; reduce net domestic debt repayments from 2.2% of GDP to about 1.5%. - Expand Budget and Public Expenditure Management System to six other MDAs by November 2004; operationalise Financial Administration Act, Internal Audit Agency Act and Public Procurement Act. - Strengthen labour market information frequency and financial sector institutional efficiency. --- ### Production and Gainful Employment — focus areas, outputs and indicators - Thematic focus: (i) modernising agriculture; (ii) environmental protection/re‑afforestation; (iii) infrastructural development (ICT, energy, roads); (iv) enabling private sector development. - Agriculture and mechanisation: - Percent arable land under irrigation target 0.12%(33,000ha); Indicator Level 2002 = 0.04%(11,000ha); Status 2003 = additional 1,200ha irrigated; total estimated = 0.08. - Farmer‑tractor ratio improved from 1:180,000 (2002) to 1:150,000 (2003). - AESD rehabilitated 100 universal tractors; import process for 200 tractors initiated; contracts for local manufacture of silos, mills and processors funded by ¢48.2 billion HIPC. - Farm gate cocoa price raised to 69% of FOB in 2003/2004; cocoa output 2002/2003 = 496,793 metric tonnes; cocoa export volume growth 2003 = 11.4 percent. - Post‑harvest: 218 out of 253 sub‑projects completed since 2002. - Extension officer–farmer ratio remained 1:4500 (no progress) in one table and 1:2200 in other agriculture tables — source tables preserve these exact figures. - Fisheries and aquaculture: - Area under fish farm target 450ha; Indicator Level 2002 = 350-400ha; Status 2003 = 450ha (target achieved). - Quantity per unit area unchanged at 2.5 tonnes/ha/yr (Indicator Level 2002 and 2003). - Environment and land: - Rate of deforestation decreased from 65,000 ha/yr to 50,000 ha/yr. - Ha of degraded forest reserve planted 2003 = 25,691 ha (Target 60,000ha). - Land title certificates issued in 2003 = 1,131. - Customary land administration units established in 2003 = 2. - Infrastructure — ICT, energy, roads: - Fixed phone lines increased from 200,000 (2002) to 283,000 (Nov 2003). - 257 schools provided with ICT in 2003 (versus 0 in 2002). - Energy sector: implemented automatic price adjustment mechanism (PURC quarterly adjustments); 18% increase in prices for end users implemented; lifeline pricing instituted. - Electricity statistics: Total power generated = 1,652 megawatts; Available capacity 1,484MW; Installed capacity 2,064MW; Peak demand recorded = 1,090MW; ratio demand/supply = 0.73. - Roads: Length of motorable feeder roads = 32,601.8 kilometres (36% good; 26% fair; 38% poor). - Feeder roads maintenance: routine maintenance achieved 15,200 km in 2003 (Target 17,100 km; % target = 89); periodic maintenance 4,278 km (Target 4,820 km; % target = 88.7); total maintenance 19,478 km (Target 21,920 km; % target = 88.8). - Private sector facilitation: - Time to start a business reduced from 129 to 85 days. - Customs clearance at Tema and Takoradi reduced from 2 days to one day. - GCNET installed at ports; turn around time at Tema Port between 24 to 48 hours; KIA = 4 hours. - Policy recommendations: - Encourage private commercial farming with mechanisation & irrigation; establish industrial estates/clusters for agricultural machinery. - Intensify feeder roads rehabilitation to provide market access. - Commence Phase II Natural Resource Management Programme for re‑afforestation. - Expand MOFA Annual Survey to include non‑food crops. - Channel microcredit through local Rural Commercial Banks with a DA Project Coordinator to manage relations (HIPC microcredit concerns). --- ### Human Resources Development and Basic Services — education, health, water & sanitation - Education — key outputs and indicators: - Gross Primary Enrolment Ratio (GPER): Indicator Level 2002 = 79.5; Status 2003 = 81.1; Target 2005 = 88.5. - GPER for girls: Indicator Level 2002 = 77; Status 2003 = 77.7. - Upper West Region GPER 2002/2003 = 69.6 (up from 63.1). - Percentage of trained teachers in primary schools: 2001/2002 = 69.9; 2002/2003 = 73.5. - Classroom construction in 2003: 685 3‑unit classroom blocks constructed; HIPC disbursement 39 billion cedis for additional 440 six‑unit blocks; GETFund contribution 14.9 billion cedis. - Distance education enrolment: increased from 750 (2001/2002) to 3,618 (2003/2004); additional 4,500 students admitted to distance programmes with GETFund allocation 839.3 million cedis. - Recommended: continue equity policies; increase focus on quality; regular impact assessment of teacher retention schemes. - Health — status, outputs and policy: - Infant mortality: Indicator Level 2002 = 57/1000; Status 2003 = 64/1000 (Target 2005 = 50/1000) — Not on track. - Under‑five mortality: Indicator Level 2002 = 108/1000; Status 2003 = 111/1000 (Target 2005 = 95/1000) — Not on track. - Child malnutrition (underweight): Indicator Level 2002 = 26.0; Status 2003 = 35.8 (Target 2005 = 20.0) — Not on track. - Immunization (DPT3) Status 2003 = 91.1 (Target 2005 = 90) — Exceeded. - Proportion of supervised deliveries Status 2003 = 47.1 (Target 2005 = 55) — On track. - Model health centres/hospitals completed 2003: 15 Health Centres and 2 District Hospitals; additional 15 health centres started under Saudi Phase II. - National Health Insurance Act passed; 45 districts piloting the scheme (different pilot stages across districts); HIPC funds release 41.6 billion cedis to 108 districts to facilitate 120 District Mutual Health Insurance Schemes. - Recurrent budget for exemptions increased from 12.8 billion cedis (2002) to 24 billion cedis (2003); additional 17.2 billion cedis provided for deprived Northern and Central regions. - Recommended: review health sector priorities given increases in infant/child mortality; accelerate full NHIS implementation; expand child nutrition programmes; target exemptions effectively. - Water and sanitation: - Percent rural population access to safe water: 2000 = 40.0%; Status 2003 = 46.6% (CWIQ/GSS figures vary including 46.38%/63.0% in other indicator tables — source preserved numeric values). - Water facility outputs 2003: new boreholes constructed = 1,290; boreholes rehabilitated = 115; new hand‑dug wells = 61; small community/town pipe systems completed = 65. - Guinea worm cases: 2002 = 5,545; 2003 = 8,000 (44.3% increase). - National average access to adequate sanitation ~ just over 55%; three northern deprived regions ~ 20% or lower. - Recommended: investigate water quality despite increased access; prioritise sanitation in next GPRS phase. --- ### Governance — security, rule of law, decentralisation and public sector reform - Security and rule of law: - Police logistics: 470 new vehicles and communication equipment procured in 2003; patrol fleet increased from 100 (2000) to close to 700 (end‑2003). - Police staffing (Dec 2003): staff strength = 15240; new recruits by end‑2003 = 854; potential recruits on standby = 1,254; police‑citizen ratio = 1:1121 (target by 2004 = 1:925; international standard cited = 1:500). - WAJU expansion: new regional office in Tema; district office in Swedru; WAJU desks in Dansoman and Odorkor. - Legal Aid Board: legal aid cases handled ~ 4,500 in 2003; legal aid clinics in all regions; 4,500 cases handled in court for the poor; Legal Aid Board preparing brochures in seven Ghanaian languages. - Anti‑corruption: Ghana Anti‑Corruption Coalition restructured; Accountability Office established in Office of the President; Central Internal Audit Bill passed; Audit Service established 67 district offices. - Recommended: intensify public dissemination of policies and public forums; revise governance indicators to represent broader governance actors. - Decentralisation and local government: - NDAP prepared; Local Government Service Bill passed (laid before Parliament and gazetted on 31/12/2003). - District composite budgets piloted in Dangme East, Dangme West and Akuapem North. - District Assemblies’ Common Fund (DACF) releases improved; DACF 2003 total = ¢449.3 billion; GoG salaries & wages to districts = ¢103.961394,494 (exact table figure preserved). - Internally Generated Funds (IGF) 2003 total = ¢178.7 billion (up from ¢155.1 billion in 2002); regional IGF figures preserved in tables. - Recommended: sustain support to DAs for citizen participation; RCCs to approve regional projects to shorten approval and improve monitoring. - Public sector reform: - Chief directors placed on performance contracts; monthly chief directors meetings institutionalised. - Census of public service staff undertaken; payroll cleaning removed fake names. - Recommended: adjust central government structures to be efficient, effective and private sector friendly; strengthen capacity to set development agenda. --- ### The vulnerable and the excluded — programmes, outputs and PSIA findings - Groups prioritised: women, children, PLWHAs, persons with disability (PWDs), chronically poor, and children orphaned by AIDS. - Women and microfinance: - Women’s Development Fund: disbursed ¢10 billion to 500,000 women (source table text); Ministry created 50,000 new jobs for women. - Office of the Senior Minister microcredit: micro credit to 43,156 farmers across 10 regions (HIPC funded entry). - Legal aid and social welfare: - Legal Aid Board: legal assistance 2002 = 4,225; 2003 = above 5,000; Legal Aid Board offices computerized and networked with USAID assistance. - Department of Social Welfare provided employable skills to PWDs: 2002 = 593; 2003 = 653; trained PWDs assisted to be self‑employed: 2002 = 80; 2003 = 108. - HIV/AIDS: - DHS 2003: general awareness of AIDS nearly universal; 96% women and 98% men aware of contraceptive methods for avoiding AIDS. - Prevention of mother‑to‑child transmission implemented at 19 sites. - ART provided at Korle Bu, Komfo Anokye, Atua Government Hospital and St. Martin De Porres Hospital. - Of estimated 62,000 persons needing ART, less than 1 percent (550) receive treatment. - Sentinel site sero‑prevalence increased from 3.4 to 3.6 percent in 2003. - Recommended: strengthen coordination of anti‑HIV/AIDS stakeholders; improve vetting, contracting and sanctions to prevent misapplication of resources. - PSIA common messages: - Poverty and vulnerability are multi‑faceted; smallholder farmers and rural women are among the most vulnerable. - Pro‑poor policy design, clearer definitions and better targeting and participation are essential. --- ### Performance of District Assemblies and HIPC fund utilization - District funding sources: GoG salaries & wages, DACF, HIPC relief, IGF, donor support. - District IGF 2003 = ¢178.7 billion (2002 = ¢155.1 billion). - HIPC cumulative allocations (2002–2003 cumulative total HIPC transfers = ¢1,110,901,232,859): - District Assemblies: 20.6% - Education: 17.0% - Water: 9.7% - Roads: 7.87% - Health: 6.47% - Domestic Debt payment: 20.3% - HIPC-funded outputs 2002–2003 (selected totals and counts): - Total HIPC‑funded projects nationwide = 1,516 projects. - Education projects = 609; Health projects = 194; Sanitation projects = 563; Water projects = 141. - HIPC transfers into account 2003 = US$108.96 million (expected US$113.33 million); expected lodged for 2004 = US$150.33 million (including 2003 balance). - Issues in HIPC management and recommended actions: - Project selection not always from DMTDPs; recommend strict project selection from District Medium Term Development Plans. - Communication lapses: funds lodged without directives; recommend a single national point of contact and improved audit/communication processes. - Microcredit management: DA capacity questioned; recommend channeling microcredit through local Rural Commercial Bank with management fee and DA Project Coordinator. - DPCU involvement: insufficient; recommend formal documentation and communication of DPCU role in HIPC M&E. --- ### Core indicators — expansion and selected exact values (selected entries preserved) - Core indicator list expanded from 52 to include 7 agriculture and 2 environment indicators. - Selected indicator values/status (exact figures preserved): - Real per capita GDP growth rate: Target 2.1%; Indicator Level 2002 = 1.8%; Status 2003 = 2.6%. - Food price inflation: Target 15%; Indicator Level 2002 = 22%; Status 2003 = 21.5; Progress: Target not achieved. - Growth of Domestic revenue: Indicator Level 2002 = 28.8%; Status 2003 = 56.2%. - Growth of credit to agriculture: Indicator Level 2002 = 9.04%; Status 2003 = 51.12%. - Proportion of total resources going to key GPRS sectors: Target 64.75; Indicator Level 2002 = 79.6; Status 2003 = 74.78; Progress: Achieved. - Rate of deforestation: Target 65,000ha per yr; Status 2003 = 50,000ha per yr. - Ha of degradable forest reserve planted: Target 60,000ha; Indicator Level 2002 = 25,691 ha; Progress: On track. - Real per capita agriculture growth rate: Target 1.9%; Indicator Level 2002 = 1.8%; Status 2003 = 3.5%. - Infant mortality rate: Target 50/1000; Indicator Level 2002 = 57/1000; Status 2003 = 64/1000; Progress: Not on track. - Child malnutrition (underweight): Target 20; Indicator Level 2002 = 26; Status 2003 = 35.8; Progress: Not on track. - Percent of rural households with access to safe water (GSS‑CWIQ): Target 54; Indicator Level 2002 = 49.5 (1997); Status 2003 = 63.0; Progress: Exceeded (source contains alternative 46.4/46.38 figures in other tables — exact values preserved above). - Reduction in reported cases of Guinea worm: Target 0; Indicator Level 2002 = 5,545; Status 2003 = 8,000 (44.3% increase since 2002); Progress: Not on track. - Length of motorable feeder roads: Indicator Level 2002 = 32,601 km (36% good; 26% fair; 38% poor) — Progress: Improving. --- ### Summary of key policy recommendations (selected and exact wording preserved where numeric) - MACRO: - Maintain macro‑economic stability while pursuing higher growth; continue to reduce debt burden by increasing revenue collection and efficiency. - Use TOR Debt Recovery Fund expected to yield 1.2 trillion cedis to partly fund petroleum subsidy shortfalls. - Curtail discretionary expenditures while protecting poverty reduction expenditures; reduce net domestic debt repayments from 2.2% of GDP to about 1.5%. - Expand Budget & Public Expenditure Management System; operationalise Financial Administration Act, Internal Audit Agency Act and Public Procurement Act. - PRODUCTION & EMPLOYMENT: - Encourage private commercial farming with mechanisation and irrigation; intensify feeder roads rehabilitation. - Commence Phase II Natural Resource Management Programme for re‑afforestation. - Expand MOFA Annual Survey coverage to include non‑food crops. - HUMAN RESOURCES & BASIC SERVICES: - Continue equity policies in education; increase emphasis on quality and teacher retention; conduct regular impact assessments. - Review health sector priorities given adverse trends in infant and child mortality; strengthen child nutrition programmes; accelerate NHIS implementation and improve targeting for exemptions. - Investigate water quality and prioritise sanitation given rising Guinea worm cases despite increased access. - GOOD GOVERNANCE: - Intensify public dissemination, public forums and citizen engagement; revise governance indicators for fuller representation. - Sustain decentralisation support to DAs; improve DACF and HIPC communication and project selection procedures. - VULNERABLE & EXCLUDED: - Review logistics and service conditions of Legal Aid Board and Department of Social Welfare; mainstream assistance and improve inter‑agency collaboration; strengthen GAC coordination and partner vetting. - DISTRICT HIPC FUND UTILISATION: - Ensure projects are selected from DMTDPs; establish RCC approval at regional level; improve communication and single point of contact for HIPC; channel microcredit via Rural Commercial Bank with DA Project Coordinator; involve DPCU in HIPC M&E formally. --- *Source: _cr04207 - EXECUTIVE SUMMARY and APR 2003 content (IMF staff summary of Ghana 2003 GPRS implementation).* ### EXECUTIVE SUMMARY ### EXECUTIVE SUMMARY ### Introduction - 1.1 Background - 1.2 GPRS Monitoring and Evaluation - 1.3 Data Collection Process and Challenges - 1.3.1 National Core Welfare Monitoring Survey - 1.3.2 Ghana Demographic and Health Survey 2003 - 1.4 GPRS M&E Institutional Arrangements - 1.4.1 National Intra-Agency Poverty Monitoring Group (NIPMG) - 1.4.2 Civil Society Organizations - 1.4.3 Regional Poverty Monitoring Groups - 1.5 GPRS Dissemination - 1.6 Poverty and Social Impact Analysis - 1.7 Strengthening the M&E Process - 1.8 GPRS Core Indicators - 1.9 Sections of the report ### The Links Between the GPRS and the 2003 Budget - 2.1 Introduction - 2.2 Discretionary Budget for 2003 and the Medium Term Priorities? - 2.3 Donor Resources and GPRS Priorities? - 2.4 Conclusions ### Macro-Economic Stability - 3.1 Introduction - 3.2 Trends In Macro stability Indicators - 3.3 Poverty Reduction Impact - 3.4 Macro-Stability Policy Developments - 3.5 Recommended Policy Initiatives ### Production and Gainful Employment - 4.1 Introduction - 4.2 Outcome/Impact Indicators - 4.3 Policy Developments/Measures/Triggers - 4.3.1 Rural Development Based On Modernised Agriculture - 4.3.2 Environmental Protection through Re-Aforestation - 4.3.3 Enhanced Infrastructural Development - 4.3.4 Strengthened Private Sector - 4.4 Recommended Policy Initiatives ### Human Resource Development and Basic Services - 5.1 Introduction - 5.2 Education Sector - 5.2.1 Achievements in the Education Sector - 5.2.2 Policy Measures - 5.2.3 Recommended Policy Initiatives - 5.3 Health Sector - 5.3.1 Progress and Achievements in the Health Sector - 5.3.2 Policy Measures - 5.4 Improve Access to Safe Water and Sanitation in Rural Areas - 5.5 Recommended Policy Initiatives ### Governance - 6.1 Introduction - 6.2 Policy Priorities, Measures And Activities - 6.3 Progress On Policy Implementation On Security And Rule Of Law - 6.4 Nature of Interventions - 6.4.1 Support to the Police Service - 6.4.2 Strengthening the Attorney General’s Office - 6.4.3 The Campaign Against Corruption - 6.4.4 Support to Parliament - 6.5 Recommended Policy Initiatives - 6.6 Decentralisation - 6.7 Nature of Interventions - 6.7.1 Strengthening the Administrative capacity of District Assemblies - 6.7.2 Deepening District Assembly association with civil society - 6.8 Recommended policy initiatives - 6.9 Public Sector Reforms - 6.9.1 Recommended policy initiatives - 6.10 Monitoring the GPRS - 6.11 Policy Recommendation ### The Vulnerable and the Excluded - 7.1 Introduction - 7.2 Progress On Priorities Of Social Justice, Equity, Hiv/Aids And Disability - 7.3 Nature of Interventions - 7.4 Recommended Policy Initiatives ### Performance of District Assemblies - 8.1 Introduction - 8.2 Financial Performance - 8.2.1 Sources of Funds to Districts - 8.3 An Assessment of Utilization of HIPC Relief Savings - 8.3.1 HIPC Savings - 8.3.2 Allocations HIPC Funds by MDAs - 8.3.3 Release of HIPC Funds to District Assemblies - 8.3.4 Details of type of projects - 8.3.5 Key Issues & Observations in the Mgt of HIPC Funds and Projects ### Progress on the Millennium Development Goals - Section 9: PROGRESS ON THE MILLENNIUM DEVELOPMENT GOALS ### Summary of Policy Recommendations - 10.1 Macro Economic Stability - 10.2 Production & Gainful Employment - 10.3 Human Resource Devt & Basic Services - 10.4 Good Governance - 10.5 Vulnerable & The Excluded - 10.6 District Assembly HIPC Fund Utilization Policy ### Technical Appendices - Appendix 1: Status report on HIPC Completion Point - Appendix 2: Status Report on PRSC2 Triggers - Appendix 3: Status Report On MDBS 2004 - Appendix 4: Summary Report Of The PSIA Studies - 4.1 PSIA on Tackling Vulnerability and Exclusion in Ghana - 4.2 PSIA on Energy Sector Reform In Ghana : Electricity Tariffs - 4.3 PSIA on Enhancing Capacity for Pro-Poor Decentralization - 4.4 PSIA on Economic Transformation of the Agricultural Sector - 4.5 Common Issues from the PSIA Studies ### Lists of Tables (selected) - LINKING 2003 BUDGET TO GPRS - Table 2.1: Distribution of Total Discretionary Expenditure: 2001-2003 - Table 2.2: Distribution of Total GOG Expenditure 2001-2003 - Table2 3: Expenditures in Priority Areas as % of Total Expenditure - Table 2.4: Poverty Reduction Expenditures by Sector and Source - Table 2.5: Distribution of Total Donor Expenditure: 2001-2003 - Table 2.6: Utilization of Discretionary Payments ¢Billion - MACROECONOMIC STABILITY - Table 3.1: Selected Macroeconomic Stability Indicators - Table 3.2: Welfare Indicators 2003 - Table 3.3: Unemployment Rates - Table 3.4: Policy Objectives of MTP, HIPC, PRSC-2, and MDBS - PRODUCTION AND GAINFUL EMPLOYMENT - Table 4.1: Production and Gainful Employment Indicators - Table 4.2: Difficulty with Food Needs - Table 4.3: Policy Developments Matrix for MTP, HIPC, PRSC, and MDBS - Table 4.4: CWIQ Result on Household Land Ownership - Table 4.5: Impact of Roads Conditions on Poverty - Table 4.6: Activities in the Road Sector - Table 4.7: Kilometres of Feeder Roads Improved - HUMAN RESOURCE AND PROVISION OF BASIC SERVICES - Table 5.1: Summary of Status of Priority Indicators in the Education Sector - Table 5.2: Trends in Gross Primary School Enrolment Ratio. - Table 5.3: Primary Gross Enrolment Ratio for Girls (PGER), 2001/02-2002/03 - Table 5.4: Trends in Quality Education Indicators - Table 5.5: Summary of Status of Access Indicators - Table 5.6: Summary of Status of Reducing Gender Disparities Indicators - Table 5.7: Summary of Status of Improving Skills Training Indicators - Table 5.8: Summary of Status of Efficiency and Equity of Financing Education Indicators - Table 5.9: Summary of Status of Priority Health Indicators in 2003 - Table 5.10: Basic Health Sector Indicators, 1988-2003 (%) - Table 5.11: Proportion of Supervised Deliveries by Health Professionals, 1998 and 2003 - Table 5.12: Summary of Status of Enhancing Delivery and Access to Health Indicators - Table 5.13: Summary of Status of Indicators for Ensuring Sustainable Health Care Financing that Protects the Poor - Table 5.14: Summary of Indicators on Access to Safe Water in Rural Areas - Table 5.15: Achievements in Water Facility Delivery, 2002 and 2003 - Table 5.16: Trends in the Reported Cases of Guinea Worm - GOVERNANCE VULNERABLE AND EXCLUDED - Table 6.1: Status of Governance Indicators Monitored (MTPs, PRSC2, MDBS, HIPC) - Table 7.1: Status of Vulnerable & Excluded Indicators Monitored (MTPs, PRSC2, MDBS, HIPC) - Table 7.2: Comparative Welfare Services Provided to the Vulnerable and Excluded by Year - Table 7.3: Statistics of Cases Reported to Women and Juvenile Unit (WAJU) Ghana Police Service from January 1999 to December 2003 - Table 7.4: Legal Aid Target Indicators ### Lists of Figures (selected) - HUMAN RESOURCE DEVELOPMENT AND BASIC SERVICES - Fig. 5.1 Percentage of Children Malnourished (underweight) by Region - Fig. 5.2 Access to Safe Water by Regions, 2003 - Fig. 5.3 Access to Adequate Sanitation by Region (2003) - GOVERNANCE VULNERABLE AND EXCLUDED - Fig. 6.1a Crime Statistics - Fig. 6.1b Crime Statistics - Fig. 7.1 Access to Water - Fig. 7.2 Access to Health Services by Region *Source: _cr04207 - EXECUTIVE SUMMARY* ### Introduction ### Introduction ### Overview of the GPRS and the APR - The Ghana Poverty Reduction Strategy (GPRS) is the key development policy framework for the country. Implementation began in 2002 and has been used to inform all key policy and budgetary decisions at national and district levels. - The Annual Progress Report (APR) provides a framework for the systematic review of GPRS programmes and projects implementation and their impacts on socio-economic development for the year. - APR uses the Medium Term Priorities (MTPs) and the relevant 52 indicators identified in the GPRS M&E Plan as its main frame of reference. - APR comments on the status of GPRS-based triggers and targets used in donor support programmes such as the Poverty Reduction Support Credit (PRSC), the Multi Donor Budget Support (MDBS), the Poverty Reduction and Growth Facility (PRGF), and for meeting the floating HIPC completion point. - APR provides an assessment of performance in achieving the Millennium Development Goals. ### Sources of information and M&E challenges - Primary sources: sector ministries, departments and agencies. - Additional data: earlier surveys of the Government Statistical Service (GSS) and two new GSS surveys conducted in the first quarter of 2003: - Core Welfare Indicators Questionnaire (CWIQ2) Monitoring Survey - Ghana Demographic and Health Survey (GDHS) - M&E challenges identified: - Need to facilitate harmonization of data and other information collected as part of the M&E exercise. - Data inconsistency and availability from different sources viewed as a major challenge. ### GPRS dissemination and stakeholder engagement - GPRS communication strategy developed and being implemented to improve public dissemination. - Establishment of National Intra-Agency Poverty Monitoring Groups based on GPRS thematic areas; these are inter-sectoral and include government and non-government representatives. - Poverty monitoring groups have: - Held a series of meetings deepening MDA involvement in GPRS M&E. - Commented on the APR and provided significant input to baselines, targets & indicator achievements. ### Evidence-based policy and commissioned studies - Growing enthusiasm among key stakeholders for poverty and social impact assessment studies. - Five commissioned studies (summaries of four completed studies are presented in technical appendices): a. Energy Sector Reform in Ghana: Electricity Tariffs; b. Tackling Vulnerability and Exclusion In Ghana; c. Assessment of the Distributional Impact and Effects of Ghana’s Petroleum Pricing Policy; d. Economic Transformation of the Agricultural Sector; e. Enhancing Capacity for Pro-Poor Decentralization. ### APR structure - APR provides evidence on government programmes and projects across five GPRS thematic areas: - Macroeconomic Stability; - Production & Gainful Employment; - Human Resources Development and the Provision of Basic Services; - Vulnerability and Exclusion; - Good Governance. - Progress assessment uses input, output or outcome indicators to measure implementation extent. ### Macro-Economic Stability — Key outcomes and indicators - Macroeconomic stability described as favourably on track, attributed to improved fiscal management, increased cocoa production and higher world prices for cocoa and gold. - GDP growth: - 5.2% growth rate of GDP in 2003 exceeded the target of 4.7% set at the beginning of the year and the GPRS target of 4.9%. - Growth largely attributed to agriculture, specifically cocoa. - Food crop sub-sector: - Growth in food crop sub-sector in 2003 of 5.3% was marginally above growth in 2002. - Real per capita food crop growth rate increased marginally. - Credit to agriculture: - Credit to the agricultural sector grew at 51% in 2003 after dipping to 9% in 2002 compared with the 21% growth rate in 2001. - Domestic revenue: - Growth of domestic revenue as a percentage of GDP increased constantly between 2000 and 2003 exhibiting a smooth steady rise. - Domestic debt ratio: - Domestic debt/GDP ratio decreased from 29.1% in 2002 to 22.6% in 2003. - Private sector credit: - Growth of credit to private sector from –11% in 2001 to 37.5% in 2003. - Overall budget deficit: - Overall budget deficit was 4.9% of GDP in 2003 against a target of 4.3%, a decline from 6.8% in 2002. - Inflation: - End-2002 inflation rate: 15.2%. - 2003 budget target to reduce inflation to 9.0% at end-2003 was revised to 22% following a 90.4% increase in petroleum prices in February 2003. - By end-2003 inflation rate was 23.6%. - Food price inflation increased from 15% in 2002 to 21.5% at end-2003. - Exchange rates (nominal cedi depreciation): - Depreciated by 4.7 per cent against the US dollar by December 2003. - Depreciated by 22.5 per cent against the euro. - Depreciated by 13.0 per cent against the pound sterling. ### Macro-Economic Stability — Policy actions implemented - Core macro measures included reducing and restructuring domestic debt, improving public expenditure management, improving fiscal resource mobilisation, and pursuing price and exchange rate stability. - Reducing and restructuring domestic debt: - Government used ¢144 billion of HIPC savings for domestic debt payment. - Continued implementation of GoG Index Linked Bond and Cocoa bills introduced since 2002. - Improving public expenditure management: - Strengthening budget control systems and training MDA Budget Committees and Budget Development unit members on GPRS-driven budgeting. - Introduction of Expenditure Initiation Forms as basis for fund release requests (all expenditures except wages). - Financial Administration Bill passed into law at the end of December 2003. - Strengthening budget execution and reporting by submitting monthly reports with no more than 8 weeks lag. - Publication of monthly reports on cash expenditures and commitments by MDAs classified by function in government gazette following a new reporting system. - Continued implementation of a Budget and Public Expenditure Management System in MFEP and CAGD in 2003. - Establishment of regulatory and oversight body to implement new procurement code. - Improving fiscal resource mobilization: - Strengthened revenue collection institutions & DAs for tax collection; implementation of the Tax Identification Number (TIN) and the Large Taxpayers Unit (LTU) to be launched in 2 phases. - Proper accounting for Non Tax Revenues collections to improve collection of non-tax revenues. - Pursuing price and exchange rate stability: - Establishment of a Monetary Policy Committee (MPC) using the prime rate to signal market expectations of inflation and hence interest rate. - Reinforcement of Bank of Ghana independence in the new Bank of Ghana Law. ### Macro-Economic Stability — Recommended policy initiatives - Government commitments and planned actions: - Continue maintaining macro-economic stability while pursuing more ambitious growth policies to raise growth beyond hovering around 5%. - Continue reducing the debt burden by increasing revenue collection through further efficiency improvements in revenue collecting agencies. - Use TOR Debt Recovery Fund, expected to yield 1.2 trillion cedis, to partly fund subsidies for delayed petroleum price adjustments. - Close the unplanned financing gap through fiscal adjustments consisting of curtailing discretionary expenditures but protecting poverty reduction expenditures. - Reduce net domestic debt repayments from 2.2% of GDP to about 1.5%. - Find more sources of revenue (non-tax revenue) through accelerated divestiture and increased dividends from state-owned companies. - Public expenditures: - Government expenditures generally reflected GPRS priorities, but published expenditures do not clearly show extent to which the poor benefited, especially in Northern, Upper east and Upper West and Central Regions. - A more detailed breakdown of expenditure will be provided to forge a closer link between budget allocations and beneficiary targets. - Public financial management reforms and capacity building: - Upgrade budget formulation, execution and reporting; strengthen link between budget and GPRS. - Expand the Budget and Public Expenditure Management System to six other MDAs by November 2004. - Operationalise the Financial Administration Act, the Internal Audit Agency Act and the Public Procurement Act; enhance External Audit Act activities. - Expect timely disbursement of pledges by Development Partners and encourage donors not party to MDBS to join. - Financial sector and labour market information: - Bank of Ghana will work to diffuse inefficient institutional structures in the financial sector to allow a well-functioning financial sector impacting growth and poverty reduction. - Government will work to ensure labour market information is made available more frequently; unemployment rate is identified as a critical macro indicator but not routinely reported on. ### Production and Gainful Employment — Focus areas - Thematic focus: policies to reduce poverty and stimulate growth via: - (i) development of the rural economy through modernising agriculture; - (ii) sustained environmental protection through re-afforestation; - (iii) enhancing infrastructural development; - (iv) creating an enabling environment for private sector activities and development. ### Modernised agriculture — Findings and indicators - Irrigation: - An additional 1200ha of land irrigated in 2003. - Total land area under irrigation estimated at 0.08%, indicating the percentage of land irrigated has doubled since 2002. - Farm and non-farm rural growth: - Farmer-tractor ratio improved from 1:180,000 to 1:150,000. - Increased access to mechanised tillage, harvesters and processing equipment. - Cocoa price policy: - Farm gate price of cocoa increased to 69% of FOB in the 2003/2004 cocoa-season. - Policy initiatives resulted in increased cocoa output of 496,793 metric tonnes during the 2002/2003-crop season. - Credit and mechanisation: - Agricultural Engineering Services Directorate (AESD) rehabilitated 100 universal tractors; initiated import process of 200 tractors from India; awarded contracts for local manufacture of silos, mill threshers, graters and pressers. - These programmes funded by a total of ¢48.2 billion from HIPC savings. - Irrigation project completion: - By 2003, 713 out of 1309 boreholes, dugouts, water storage, stream diversions, stream and tube well pumping facilities under construction had been completed. - Rehabilitation of Tono and Vea dams in the Upper East region completed at a cost of ¢950 million. - Aquaculture: - Despite increased area under fish farming, quantity of fish produced shows no progress from 2002 to 2003. - Inputs and services: - Projects undertaken in 2003 to improve access to inputs and services: credit for livestock and rice farming, animal vaccines, mass cocoa spraying, ostrich farming and improved seedlings. - High value crops: - Not much progress achieved in promoting high value crops despite projects such as introduction of new exportable fruit varieties (pineapple), screening planting materials and development of production guides. - Post-harvest loss reduction: - About 218 out of 253 sub-projects (drying floors, cooling plants, crop processors, storage facilities) completed since 2002. ### Environmental protection through re-afforestation and land reform - Deforestation and replanting: - Rate of deforestation per year decreased from 65,000 to 50,000 hectares. - Replanting achievements: 1300 hectares of urban area planted; 25,691 hectares of degraded forest reserves planted. - Land reform: - Progress in issuing Land Title certificates to individuals. - Establishment of 2 customary land administration units in 2003. ### Infrastructural development — ICT, energy, roads - Information and Communication Technology (ICT): - Fixed phone lines increased from 200,000 in 2002 to 283,000 in 2003. - 257 schools provided with ICT in 2003 compared with no schools in 2002. - Ghana Telecom initiated programme to roll out an additional 400,000 fixed-lines within 3 years to extend broadband connectivity to towns with Senior Secondary Schools and Training Colleges. - As of November 2003 cumulative fixed-lines were 283,000 (83,000 additional lines installed during the year). - Energy: - Energy sector reform measures included automatic price adjustments in electricity and full cost recovery in petroleum product pricing. - Implementation of automatic price adjustment mechanism implemented quarterly by PURC to reflect market prices. - An 18% increase in prices for end users was implemented (context: ongoing measures to ensure reliable supply, rural electrification, energy efficiency and renewable energy support). - Roads — motorable feeder roads: - Total length of motorable feeder roads: 32,601 kilometres. - Condition breakdown: 36% in good condition, 26% fair, and 38% in poor condition. - Improvements in routine and periodic maintenance: achieving 88.8% of targets in 2003 compared to 53.8% in 2002. ### Strengthening the private sector — administrative and procedural improvements - Trade and administrative barriers: - Clearance time at customs in Tema and Takoradi ports reduced from 2 days to one day. - Time spent on business registration procedures decreased by 34%. ### Production & employment — policy actions (summary) - Irrigation, mechanization, land acquisition for commercial farming, aquaculture, access to inputs and services, promotion of high value crops, post-harvest facilities, ICT rollout and energy pricing reforms were among the policy actions implemented in 2003. - Specific completed works and investments: - 713 out of 1309 water-related irrigation facilities completed by 2003. - Rehabilitation of Tono and Vea dams completed at ¢950 million. - ¢48.2 billion from HIPC savings funded mechanisation and processing equipment programmes. - 218 out of 253 post-harvest sub-projects completed since 2002. - 257 schools equipped with ICT; 283,000 cumulative fixed-lines as of November 2003. *Source: _cr04207 - Introduction* ### 2003. Cross subsidisation for LPG, kerosene, pre-mix marine gasoline for artisan fishermen ### 2003. Cross subsidisation for LPG, kerosene, pre-mix marine gasoline for artisan fishermen ### Roads - Major highways construction, maintenance and reconstruction started on Accra-Kumasi, Accra-Yamoransa and Accra-Aflao roads. - Feeder road activity in 2003 to reduce cost of bringing agricultural production to market: - About 15,200km of road maintained as routine in 2003. - About 4,278 km of feeder roads re-gravelled, rehabilitated or underwent spot improvement. ### Strengthening the Private Sector - Regulatory and administrative barriers reduced: time to start a business fell from 129 to 85 days. - Customs modernization: GCNET installed at the ports. ### Policy Initiatives: Production & Gainful Employment - Crop production is largely rain-fed; government will encourage private commercial farming with mechanisation and irrigation. - Ministry of Trade, Industry and PSI to encourage industrial estates and clusters emphasizing agricultural machinery development. - Intensification of infrastructural development, especially feeder roads rehabilitation, construction and maintenance to provide market access. - Phase II of the Natural Resource Management Programme to commence early for re-afforestation of degraded lands. - Ministry of Mines detached from Energy; current budget described as too small for poverty-alleviation activities. - Government will assess feasibility of using a percentage of the Mineral Development Fund as seed money outside GoG expenditures to finance poverty reduction projects. - Ministry of Tourism activities to be integrated in the GPRS update for 2006-2008. ### Data collection and monitoring - MDAs should be resourced to maintain units to provide quarterly information in a standard framework. - Ghana Statistical Service lacks capacity for data collection; needs strengthening and deeper involvement in government-sponsored data collection. - CWIQ could be conducted annually with a reduced sample size to continually monitor GPRS implementation. - Ministry of Food and Agriculture currently captures data for only food crops; Annual Survey coverage needs expansion to include non-food crops. - Emphasis shifted to the Rural Enterprise Development Programme: establishment of three enterprises each in all the 110 districts. ### Human Resource and Provision of Basic Services — Education Findings - Gross Primary Enrolment Ratio (GPER) increased from 79.5% in 2001/2002 to 81.1% in 2002/2003. - Upper West Region GPER increased by 6.5 percentage points from 63.1% in 2001/2003 academic year to 69.6% in 2002/2003, exceeding the GPRS target for 2005 projected at 63%. - National GPER for girls increased from 77% in 2001/2002 to 77.7% in 2002/2003. - Upper West Region girls’ GPER rose to 70.3% in 2002/2003 from 63% in 2001/2002. - Quality measures mixed: - CRT mastery: 9% of pupils in public schools achieved mastery in Maths and 12% mastery in English in 2001/2002. - Proportion of trained teachers in primary schools increased from 69.9% in 2001/2002 to 73.5% in 2002/2003. - Teacher attrition and study leave affect quality. Policy actions and outputs (2003) - 685 3-unit classroom blocks constructed in 2003. - HIPC fund disbursement: 39 billion cedis for construction of an additional 440 six-unit classroom blocks. - GETFund contribution: 14.9 billion cedis toward the same classroom construction. - 31 senior secondary schools in deprived districts selected for upgrading to model schools; 48 billion cedis disbursed to implement project; works progressing on first batch. Teacher retention schemes - Study leave with pay reduced: 5,000 teachers went on study leave in 2003/2004 versus 6,033 in 2001/2002. - Distance Education and Sandwich programmes: - Teachers enrolling increased from 750 in 2001/2002 to 3,618 in 2003/2004. - Additional 4,500 students (mainly teachers) admitted into Cape Coast University and Winneba distance education programmes; allocation of 839.3 million cedis from the GETFund. - Incentive packages for teachers in deprived areas included: - 5,000 radio cassette players - 5,000 sets of cooking utensils - 14, 400 bicycles - Teacher accommodation: 56 teacher accommodation units constructed in 2003, with 23% located in the three Northern regions. - District-sponsored teacher trainees bonding: - 2000/2001: 76% of teacher trainees admitted to the programme - 2002/2003: 91% of teacher trainees admitted to the programme - 2003/2004: All teacher trainees to be sponsored under the district programme Gender equity - ¢8.885 billion from the GET fund allocated to Ministry of Education, Youth and Sports for scholarships for pupils in basic schools in 2003/2004; fund not yet disbursed. Proposed 2004 disbursement formula favours girls. Recommended policy initiatives (education) - Continue policies to ensure more equity in access; shift greater attention to quality in the next GPRS round. - Regular impact assessment of teacher retention schemes to determine differential impacts. ### Human Resource and Provision of Basic Services — Health, Water and Sanitation Health findings - Infant mortality increased from 57 per 1000 live births in 1998 to 64 per 1000 births in 2003 (an increase of about 12.3%). - Childhood mortality increased from 108 per 1000 live births in 1998 to 118 per 1000 live births in 2003. - Child malnutrition (proportion underweight) increased by 10.5 percentage points in the last five years. - Regional prevalences above national average: Ashanti (46%), Greater Accra (40.4%), Western (36.9%). Water and sanitation findings - Rural population access to safe water increased from 40.0% in 2000 to 46.6% in 2003. - Reported guinea worm cases increased from 5,545 in 2002 to 8,000 in 2003. - National average access to safe sanitation remains just over 55 percent; access in three northern deprived regions around 20 percent or lower. Policy actions (health) - Government measures to enhance delivery and access in 2003: - Provision of at least one model health centre in each district. - Replacing the cash and carry system with an Insurance Scheme. - Increasing coverage of exemptions. - Carrying out rapid delivery programmes to reduce under-five and maternal mortality. - Improving access to safe water, especially in Guinea worm endemic areas. Model health centres and hospitals completed in 2003 - 15 Health Centres and 2 District Hospitals (Bimbilla and Begro) completed (support from OPEC Fund and Ghana Government). - Additional 15 health centres started under Saudi Phase II expected to be completed by January 2004. - Upgrading works initiated at Juabeso, New Edubiase and Nkwanta to be completed by June 2004. National Health Insurance Scheme (NHIS) implementation (pilots) - 45 districts piloting the scheme: - 10 managing benefits and claims - 15 at registration and collection of contributions - 7 coding streets and houses - 8 sensitising communities - 5 started stakeholder consultations - HIPC funds release: 41.6 billion cedis released to 108 districts, including 12 sub-metros, to facilitate implementation of 120 District Mutual Health Insurance Schemes. Exemptions and budgets - Recurrent budget spent on exemption increased from 12.8 billion cedis in 2002 to 24 billion cedis in 2003. - Government provided an additional 17.2 billion cedis to cover exemptions in the deprived Northern regions and the Central region. High Impact and Rapid Delivery Programmes - Ministry of Health and UNICEF implementing programmes to reduce under-five and maternal mortality in all districts of Northern and Upper East regions. Water and sanitation outputs (rural and peri-urban, emphasis on Guinea worm areas) - 1290 new boreholes constructed. - 115 boreholes rehabilitated. - 61 new hand-dug wells constructed. - 65 small community/town pipe systems completed. Recommended policy initiatives (health, water, sanitation) - Review health sector priorities in light of increases in infant and childhood mortality. - Strengthen and expand child nutritional programmes. - Accelerate full implementation of the National Health Insurance Scheme to ensure poor people have access to quality health services. - Give special attention to sanitation issues in the next phase of GPRS implementation. ### Governance — Security and Rule of Law Findings - Police service changes: recruitment of new personnel, increased logistics, creation of neighbourhood watch committees, and increased patrols reported reduction in crime rate. - Fleet expansion: provision of 470 new vehicles and communication equipment; patrol vehicle fleet increased from 100 in 2000 to close to 700 by end of 2003. - WAJU (Women and Juvenile) Unit extended presence: new offices in Tema (regional), a District office in Swedru, WAJU desks in Dansoman and Odorkor. - Civil society anti-corruption activity: Ghana Anti-Corruption Coalition restructured, acquired permanent office, installed ICT equipment, recruited an Executive Secretary and full staff complement; undertook a follow-up survey and published proceedings of its 5th Governance Workshop. Policy actions - Support to police: procurement of 470 new vehicles and communication equipment in 2003; fleet increase to about 700 by end-2003. - Strengthening AG’s office: - Legal Aid Clinics organized by the Legal Aid Board in all regions. - 4,500 cases handled in court for the poor. - Legal Aid Board prepared for publication and distribution of brochures in seven Ghanaian languages. - Training in Performance Management, Alternative Dispute Resolution, Court Automation, Case Management and Change Management for key Judicial Service staff. - Campaign against corruption: Ghana Anti-Corruption Coalition recruited staff, established office, installed ICT; accountability office in Office of the President established to advise on ethical compliance. - Support to Parliament: 35 Parliamentarians trained in computing and change management; NGP provided ICT equipment, user licenses, library software and technology for proposed parliamentary radio station. Recommended policy initiatives (security and rule of law) - Greater dissemination of information about policies, programmes and services to inform public of rights, obligations and services. - Intensify public forums (e.g., Peoples’ Assembly, regional and district replications) and use mass media and civil society to discuss governance, justice, accountability and security. - Revise governance indicators to present a more comprehensive representation of governance actors. ### Governance — Decentralisation Findings and actions - Capacity building within District Assemblies (DAs) improving service delivery and resource use efficiency. - Pilot composite budgets prepared in Dangme East, Dangme West and Akuapem North. - Civil society (e.g., ISODEC) engaged in budget advocacy with district assemblies. - Draft National Decentralization Action Plan (NDAP) prepared; consultations initiated. - Presidential Advisory Committee set up to provide policy guidance. - Passage of local government Service Bill raised morale of District staff. - Preparation of composite budgets in three districts. Recommended initiatives (decentralisation) - Sustain support to DAs to deepen citizen participation and ensure equity in resource allocation. - Regional Coordinating Council (RCC) to approve projects at regional level to shorten approval process and improve monitoring. ### Governance — Public Sector Reform Findings and actions - Civil Service leadership (chief directors) made more performance oriented via performance contracts with the Public Services Commission. - Monthly meetings of chief directors institutionalised. - Reorganisation of Civil Service structure: reassignment and hiring of chief directors to improve leadership capacity. - National Development Planning Commission improved monitoring and evaluation responsibilities; dissemination of 2002 APR improved public understanding and monitoring interest in GPRS. Recommended initiatives (public sector reform) - Adjust central government structures to make central machinery more efficient, effective and private-sector friendly. - Strengthen government capacity to set development agenda to enable private sector and social partners to contribute to national development. ### Programmes and Projects for the Vulnerable and the Excluded Women and children - Women’s Development Fund disbursed ¢10 billion to 500,000 women improving income earning opportunities. - Ministry created 50,000 new jobs for women. - Return of trafficked children from coastal communities around the Volta Lake; mothers assisted to withdraw and enrol children in schools; micro-finance support of over C825 million provided. Legal aid and justice for the poor - Legal Aid Board provided legal assistance to about 4,225 persons in 2002; increased to above 5,000 in 2003. - Legal Aid Board’s offices computerized and networked with USAID assistance. - Legal Aid Board handled many cases in court; many concluded through ADR. Disability - Disability Bill developed and under discussion. - Department of Social Welfare provided 653 PWD with employable skills in 2003 compared to 593 in 2002. - 108 trained PWD assisted to be self-employed in 2003 compared to 80 in 2002. HIV/AIDS Findings and services - Ghana AIDS Commission interventions in 2003: Information, Education and Communication; Advocacy; Peer Education; Voluntary Counselling and Testing; Capacity Building for CSO; Care and support for PLWHAs; Training and technical support for beneficiary groups. - DHS (2003) results: general awareness of AIDS nearly universal; 96 per cent of women and 98 per cent of men aware of a range of contraceptives for avoiding contracting AIDS. - VCT centres opened in many hospitals and clinics. - Prevention of mother-to-child transmission implemented at 19 sites. - ART provided at Korle Bu Teaching Hospital, Komfo Anokye Teaching Hospital, Atua Government Hospital and St. Martin De Porres Hospital, Agomenya. - Of the 62,000 persons that need treatment, less than 1 per cent (550) receive treatment. - Sero-prevalence rate increased in sentinel sites from 3.4 to 3.6 per cent in 2003. Policy actions and recommendations for vulnerable groups - Improve logistics and service conditions for Legal Aid Board and Department of Social Welfare to expand services to vulnerable and excluded. - Mainstream assistance to vulnerable and excluded groups; increase inter-agency collaboration across social and economic sectors; Poverty Monitoring Groups to play cross-fertilisation role. - Improve coordination among anti-HIV/AIDS stakeholders; strengthen vetting, organisation screening, contracting and sanctions to prevent misapplication of resources by partner groups. ### Performance of District Assemblies Findings - District Assemblies implement poverty-reducing programmes aligned to DMTDP and GPRS objectives. - District funding relies on GoG, development partners, DACF, HIPC relief, and IGF. - Timely release of DACF by MOF improved in 2003; arrears clearance arrangements put in place. - Internally generated funds (IGF) of districts totalled ¢178.7 billion for 2003, up from ¢155.1 billion in 2002; sources include fees & fines, rates, lands and licences. - Noted revenue declines in Volta, Northern and Upper East regions requiring investigation by MLGRD. HIPC cumulative allocations (since start of HIPC funds release) - District Assemblies: 20.6% - Education: 17.0% - Water: 9.7% - Roads: 7.87% - Health: 6.47% - Domestic Debt payment: 20.3% Recommended policy initiatives (districts) - Provide clear project selection approach to ensure projects chosen from District Medium Term Development Plan. - RCC to approve projects at regional level to reduce approval length and improve monitoring. - Improve communication and audit processes; establish a single point of contact to check and clarify funds transferred to Districts. - Microcredit support: channel funds through a local Rural Commercial Bank with management fee; identify a Project Coordinator from the DA to manage relationship. ### HIPC Completion Point, PRSC and MDBS - Government received support from bilateral and multilateral donors for GPRS implementation. - HIPC Initiative provided debt relief in support of poverty reduction. - World Bank PRSC programme supported GPRS implementation. - Nine bilateral donors agreed to provide development assistance through budget support, leading to the Multi-Donor Budget Support (MDBS) Initiative. - Releases from HIPC, PRSC and MDBS were made contingent upon agreed GPRS-based performance triggers and targets. - Most triggers and targets were met; Technical Appendices summarize performance and show government met or in some cases exceeded triggers required for HIPC completion point. *IMF staff summary of the Ghana 2003 GPRS implementation (content unit: _cr04207 - 2003. Cross subsidisation for LPG, kerosene, pre-mix marine gasoline for artisan fishermen).* ### 1.1 B ### 1.1 B ### Background - The Ghana Poverty Reduction Strategy (GPRS) is the operational development policy framework; implementation began in 2002 and is geared towards achieving the Medium Term Priorities of the government. - The Annual Progress Report (APR) provides a framework for systematic review of programme and project implementation and their socio-economic impacts for the year, and is used to monitor GPRS targets and outcomes through a set of indicators. - Once approved by Cabinet and endorsed by parliament, the APR will be disseminated widely as part of the ongoing GPRS dissemination process. - This APR will be used to inform: - The Medium Term Expenditure Framework (MTEF) process for the preparation of the next annual budget, to ensure that resources are refocused appropriately; - Any revisions to the 2004 annual budget; - The process of updating the GPRS, which is to begin in the fourth quarter of 2004; and - Future HIPC allocations to the District Assemblies. - The APR uses Medium Term Priorities (MTPs) and the relevant 52 indicators identified in the GPRS M&E Plan as its main frame of reference. - The APR also comments on status of GPRS-based triggers and targets for donor support programmes including the Poverty Reduction Support Credit (PRSC), the Multi Donor Budget Support (MDBS), the Poverty Reduction and Growth Facility (PRGF), and for meeting the floating HIPC completion point; it also assesses performance toward the Millennium Development Goals. ### APR 2003: Contents and Purpose - Builds on the 2002 APR and provides: - Data on baselines and targets including some that were not available for reporting in the 2002 APR; - An update on the GPRS core indicator achievements during the year; - The linkage between the 2003 Annual Budget and the GPRS; - An update on GPRS Medium Term Priority programmes and projects implemented in 2003; - The status of triggers and targets of the PRSC, the MDBS, the HIPC completion point, and the MDGs; - The status of the poverty and social impact analysis (PSIA); - The summary of progress and developments with respect to monitoring & evaluation; and - Recommended policy initiatives. ### GPRS Monitoring and Evaluation - M&E is critical to evaluate impact of government policies, maximize use of limited resources, and support evidence-based policy decision-making. - GPRS M&E plan was established in 2002; implementation began in 2003. - Ongoing work to strengthen data collection and analysis processes to provide effective and timely evaluation of GPRS implementation. - Growing stakeholder engagement in poverty and social impact studies and National Intra-Agency Poverty Monitoring Group meetings. ### Data Collection Process and Challenges - Primary sources for the report were sector ministries, departments and agencies. - Major challenges identified: - Data inconsistency and availability from different sources; - Problems related to accuracy and timeliness of data from primary and secondary sources; - Lack of motivation of staff in the MDA’s and Districts to institutionalise data collection and provision; - In-frequent national outcome/impact surveys by GSS due to inadequate resources; - The challenge of reporting on several indicator/trigger achievements across programs (GPRS MTPs, PRSC, MDBS, HIPC and MDGs). ### Surveys Used in the APR - Data also used from earlier GSS surveys and two new GSS surveys conducted in Q1 2003: - Core Welfare Indicators Questionnaire (CWIQ2) Monitoring Survey; - Ghana Demographic and Health Survey (GDHS) conducted later in the year. #### 1.3.1 National Core Welfare Monitoring Survey (CWIQ2) - Undertaken between February and April 2003 to provide information at the district level. - Sample: the CWIQ survey was administered to 49,000 households, of which 67% were rural and 37% urban, with 51.3% of total sample population being female and 48.7% male. - Qualitative survey covering income or consumption poverty, education, health, nutrition, access to safe water & sanitation, disability, vulnerability and social exclusion, access to basic infrastructure services and levels of unfulfilled basic needs. - Results provide a comprehensive baseline reflecting the situation at the beginning of full GPRS implementation. #### 1.3.2 Ghana Demographic and Health Survey 2003 (GDHS) - Carried out from late July to late October 2003 on a nationally representative sample of more than 6,6oo households. - All women age 15-49 and all men age 15-59 in these households were individually interviewed. - Individuals were tested for HIV; all women age 15-49 and children under age 5 were also tested for anaemia. - Collected data on fertility levels, marriage, sexual activity, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutritional status of women and young children, childhood mortality, maternal and child health, awareness regarding AIDS and other sexually transmitted diseases. - New features in 2003 GDHS: information on female and male circumcision, malaria and mosquito nets usage, haemoglobin and HIV testing. - GDHS data enhances information available on HIV/AIDS epidemic, infant mortality rate and child malnutrition in Ghana. ### GPRS M&E Institutional Arrangements - Arrangements are designed to facilitate active stakeholder participation to ensure policy recommendations are relevant and contribute to policy formulation and resource allocation aimed at poverty reduction and wealth creation. - Initiatives established to support NDPC’s GPRS M&E activities: - National Intra-Agency Poverty Monitoring Groups (NIPMG) chaired by representatives of MDAs; - GPRS Strategic Environment Assessment; - GPRS Dissemination Committee; - PSIA Technical and Advisory Committees. #### 1.4.1 National Intra-Agency Poverty Monitoring Group (NIPMG) - Poverty monitoring groups proposed at national, regional and district levels; five groups based on GPRS thematic areas established at national level (inter-sectoral, governmental and non-governmental representatives). - Composition examples (as listed): - Macro-Economic Stability — Chair: Min of Finance & Economic Planning; Secretary: GSS; members include Ministry of Finance & Economic Planning, Bank of Ghana, Ministry of Trade & PSI, Revenue Agency Governing Board, GSS, CIDA. - Production & Gainful Employment — Chair: Min of Food & Agriculture; Secretary: Tourism; members include Ministry of Food and Agriculture, Mines, Trade & PSI, Energy, Land and Forestry, Private Sector Development, Roads & Transport, Ports & Harbours, Environment and Science, Communications and Technology, Tourism, CIDA. - Human Resource Development & Basic Services — Chair: Min of Health; Secretary: Min of Education; members include Ministry of Education, Youth and Sports, Health, Works and Housing, Women and Children Affairs, Ghana Aids Commission, GSS, Community Water & Sanitation, World Bank. - Governance; Vulnerable & Excluded — Chair: Audit Service; Secretary: NCWD; members include Ministry of Justice, Audit Service, Parliamentary Affairs, Electoral Commission, CHRAJ, PURC, WAJU, Interior, Public Service Commission, Office Parliament, Local Government and Rural Development, Ministry of Women and Children Affairs, National Commission on Children, Ghana Prison Service, Social Welfare, Ministry of Manpower Development and Employment, DFID & DANIDA. - Main functions of poverty monitoring groups: - Highlighting importance of monitoring and evaluating the GPRS within relevant MDAs; - Providing data for updates of selected indicators and policy interventions; - Reviewing and validating data and policy recommendations. - NIPMG meetings since mid 2003 have deepened MDA involvement, provided input to baselines, targets & indicator achievements, and served as fora for data discussion and analysis validation. #### 1.4.2 Civil Society Organizations (CSOs) - Significant support has been received from CSOs at national level, but process needs strengthening by including CSOs more fully. - Inclusion of CSOs in the process is to be undertaken during the second quarter of 2004 through concluded interactions with key CSO representatives. - Forums will be held to establish effective representation mechanisms for diverse CSO interests. - Access to monitoring and evaluation results will enable CSOs to generate participatory review, increasing accountability and transparency in public resource allocation and utilization. #### 1.4.3 Regional Poverty Monitoring Groups - M&E institutional arrangements to be rolled out to regions by expanding Regional Planning Coordinating Units (RPCUs) to act as regional poverty monitoring groups. - Regional Poverty Monitoring Groups membership will include Regional Heads of GSS, regional representatives of relevant MDAs, representatives of NGOs and CSOs, NDPC regional representative, and a representative of the Regional House of Chiefs. - Roles of regional poverty monitoring groups: - Receive, collate and evaluate data from District level M&E for onward transmission to national level; - Evaluate, recommend and support M&E capacity building for District Assemblies; - Review data to ensure accuracy and consistency; - Facilitate dissemination of relevant feedback to all districts and stakeholders; - Ensure gender based analysis is undertaken in all districts; - Hold bi-annual workshops to involve all DAs within the region for cross District GPRS review and policy recommendations; - Provide bi-annual regional poverty status reports and make recommendations for policy review. ### GPRS Dissemination - A comprehensive communication strategy was developed at the end of Q3 2003 to inform and educate stakeholders about the GPRS; it was based on a communication needs assessment at national, district and community levels. - Objectives of the communication strategy: - To effectively create awareness about the goals, objectives, benefits and the monitoring and evaluation process of the GPRS; - To solicit stakeholder support and sense of ownership; - To regularly inform stakeholders about the progress of GPRS; and - To create forums to solicit feedback. - Implementation targeting National, Regional, District and Community levels has begun; a simplified version of the GPRS was prepared and translated into local languages to facilitate dissemination. ### Poverty and Social Impact Analysis (PSIA) - PSIA studies are being undertaken to determine impacts of socio-economic policies on the poor, analyzing distributional impacts and outcomes on welfare from policy reforms; findings will aid evidence-based policymaking and stimulate public debate. - NDPC, with support of Development Partners, commissioned five PSIA studies to assess ex-ante and post-facto impacts of policy reforms under the GPRS. - Commissioned PSIA studies and their aims: 1. Energy Sector Reform in Ghana: Electricity Tariffs - Effectiveness of current subsidy to protect the poor - Effects of tariff increases on residential consumers - Affordability of current tariffs 2. Tackling Vulnerability And Exclusion In Ghana - The nature and extent of vulnerability and social exclusion in Ghana - The conditions, events and underlying trends that present risks to individuals and households and exclude them from effective participation in mainstream economic, social and political activities - Deepen the understanding of coping mechanisms and strategies of individuals and households when risks materialise and how these could be strengthened and enhanced. 3. Assessment of the Distributional Impact and Effects of Ghana’s Petroleum Pricing Policy - To analyse the distributional impact of current petroleum pricing reforms on the welfare of different stakeholder groups, particularly the vulnerable and excluded - To assess the effectiveness of the targeting mechanism under the prevailing regime - To bolster the existing capacity for evidence-based policy making, national ownership and sustainable pro-poor policy formulation 4. Economic Transformation of the Agricultural Sector - The extent to which the Economic Transformation of the Agricultural Sector will compound or mitigate the constraints facing smallholder / subsistence farmers - Trade-offs between production-oriented and poverty-oriented agricultural policies - Allows for poor farmers to access and benefit from mechanisms to increase production - The Impact on food security and vulnerability - Whether guidelines for the allocation of HIPC funds sufficient to meet aims of growth and poverty reduction 5. Enhancing Capacity for Pro-Poor Decentralisation - Are decentralization measures designed to improve poverty reduction strategies at the local level - PSIA Technical Committees composed of representatives from stakeholder organizations are supporting researchers; a Steering Committee of Ministers and Heads of institutions has oversight and will spearhead implementation of recommendations. - Membership examples of Technical Committees (as listed): - Energy Sector Reform in Ghana: Electricity Tariffs — Ministry Of Energy, Energy Commission, PURC, MOFEP, Consumers Association, VRA, ECG, NED, NDPC & World Bank. - Tackling Vulnerability And Exclusion In Ghana — Ministry Of Manpower & Employment; Dept of social Welfare; Ministry of Women & Children; MOFEP; NADMO; Min. of Food & Agric; DFID & NDPC. - Assessment of the Distributional Impact and Effects of Ghana’s Petroleum Pricing Policy — Ministry of Energy; Energy Commission; Ministry Of Environment and Science; CSIR (STEPRI); Office Of The President; TOR; PURC; Consumers Association; UNDP, NDPC. - Economic Transformation of the Agricultural Sector — Ministry Of Food And Agriculture; GEPC; MOFEP; NADMO; CSIR; NDPC, DFID. - Enhancing Capacity for Pro-Poor Decentralisation — MLGRD; MOFEP; Management Services Division- Head of Civil Service; NALAG; Office Of The President, GTZ/KFW, NDPC. *Source: _cr04207 - 1.1 B* ### 1.7 S ### 1.7 S — STRENGTHENING THE M&E PROCESS ### Strengthening objectives and audience - Key objective: establish an effective feedback loop to ensure M&E results are disseminated widely and made relevant to various stakeholders. - Target audiences for feedback: - National decision makers: Cabinet, MDAs, Parliament. - Regional and district levels: Regional Poverty Monitoring Groups. - Policy makers, program managers, program beneficiaries, development partners, the media, CSOs, and research community. ### Planned activities to strengthen M&E - Review workshops: - Organized for a selected group of stakeholders to canvass ideas to improve the M&E process. - Emphasis on feedback to regional and district levels where most people feel left out. - Orientation sessions: - Held for policy decision makers in the MDAs to promote a culture of evidence-based policy making. - Establishment of Technical Committee: - The Technical Committee proposed in the M&E plan will be established. - Initial committee composition: senior representatives from NDPC, More, GSS, MLGRD, and Coop. - Dissemination of M&E results: - Results will be disseminated widely to policy makers, program managers, program beneficiaries, development partners, the media, CSOs and research community. - Timely feedback for budget formulation: - Key M&E results should be available at the time of budget formulation. - In addition to the 2003 APR, the third quarter GPRS M&E Quarterly Bulletin for 2004 will be completed in time to be used in the preparation of the 2005 Annual Budget. ### Role of M&E in policy use - Beyond broad dissemination, a well-established process to feed M&E results back to policy makers is crucial for usage in formulating policy. - Emphasis on integrating M&E outputs into budget preparation cycles. --- ### 1.8 GPRS CORE INDICATORS ### Scope and additions - The core indicator list extended from the original 52 core indicators to include an additional seven indicators for Agriculture and two indicators for the Environment. - Additional Agriculture indicators: - Percentage of post harvest losses - Tonnes of silo space established - Extension officer farmer ratio - Area under fish farm - Percent of arable land under irrigation - Number of dugouts constructed - Level of Mechanisation: tillage, harvesters & processing equipment - Additional Environment indicators: - Rate of deforestation - Hectares of degradable forest reserve planted ### Selection criteria for additional indicators - The availability of data - The extent to which they provided a balance between input, output and outcome indicators - The views of stakeholders - The links of the indicator to the Medium Term Priorities of the GPRS ### Summary of progress — key indicators and exact figures (selected entries) - Real per capita GDP growth rate - Target: 2.1% - Indicator Level 2002: 1.8% - Status 2003: 2.6% - Food price inflation - Target: 15% - Indicator Level 2002: 22% - Status 2003: 21.5 - Progress: Target not achieved - Growth of Domestic revenue - Indicator Level 2002: 28.8% - Status 2003: 56.2% - Growth of credit to agriculture - Indicator Level 2002: 9.04% - Status 2003: 51.12% - Proportion of total resources going to key GPRS sectors - Target: 64.75 - Indicator Level 2002: 79.6 - Status 2003: 74.78 - Progress: Achieved - Rate of deforestation - Target: 65,000ha per yr - Status 2003: 50,000ha per yr - Ha of degradable forest reserve planted - Target: 60,000ha - Indicator Level 2002: 25,691 ha - Progress toward target: On track - Real per capita agriculture growth rate - Target: 1.9% - Indicator Level 2002: 1.8% - Status 2003: 3.5% - Real per capita food crop growth rate - Target: 2.2% - Indicator Level 2002: 2.6% - Status 2003: 2.7% - Progress: Improving - Length of motorable feeder roads - Indicator Level 2002: 32,601 km (36% good, 26% fair, 38% poor) - Progress: Improving - Percentage of post harvest losses - Target: 15-20% - Indicator Level 2002: Cereals: 25-30% Perishables: 35%-40% - Status 2003: 20-25% 35-38% - Progress: Modest progress - Tonnes of silo space established - Target: 35mt - Indicator Level 2002: 35mt - Status 2003: 35mt - Progress: No progress - Extension officer farmer ratio - Target: 1:4000 - Indicator Level 2002: 1:4500 - Status 2003: The ratio remains 1 to 4500 because human resource management directorate did not receive the go ahead to recruit additional extension agents and agricultural officers - Progress: No progress - Area under fish farm - Target: 450ha - Indicator Level 2002: 350-400ha - Status 2003: 450ha - Progress: Target achieved - Percent of arable land under irrigation - Target: 0.12%(33,000ha) - Indicator Level 2002: 0.04%(11,000h) - Status 2003: An additional 1200ha of land irrigation in 2003, total land area under irrigation is currently estimated at 0.08 - Progress: Good progress - Number of dugouts constructed - Target: 262 - Indicator Level 2002: 237 - Status 2003: 713 out of 1309 (boreholes, dugouts, water storage, stream diversion, stream & tube well pumping) - Farmer access to mechanized tillage / Access to harvesters / Access to processing equipment - Targets: 15% / 5% / 30% - Indicator Level 2002: Less than 5% / Less than 2% / 20% - Status 2003: 8% in2003 2% in 2003 24% in 2003 made up of: 1. Cassava processing 2. Palm oil processing equipment 3.Rice Threshers and mills 4.Tomato processing equipment - Progress: Good progress - Child malnutrition (emphasis on poorest regions) - Target: 20 - Indicator Level 2002: 26 - Status 2003: 35.8 - Progress: Not on track - Infant mortality rate - Target: 50/1000 - Indicator Level 2002: 57/1000 - Status 2003: 64/1000 - Progress: Not on track - Gross enrolment ratio in pre-school and basic schools (primary / JSS) - Target: 88.5 - Indicator Level 2002: 79.5 - Status 2003: 81.1 - Progress: On track - Reduction in the reported cases of Guinea worm - Target: 0 - Indicator Level 2002: 5,545 - Status 2003: 8,000 (44.3% increase since 2002) - Progress: Not on track - Percent of rural household with access to safe water - GSS-CWIQ - Target: 54 - Indicator Level 2002: 49.5 (1997) - Status 2003: 63.0 - Progress: Exceeded - Percent of households with access to adequate toilet facilities (flush or KVIP) - Indicator Level 2002: 16.8 (1997) - Status 2003: 33.1% - Percent of deprived basic schools (primary/JSS) improved, with emphasis on the 3 Northern regions - Target: 30% -2004 - Indicator Level 2002: 20% - Status 2003: 685 classrooms block constructed in 2003. 420 of 685 (61.3%) of classrooms constructed were located in the 3 Northern regions - Progress: Exceeded - Immunization coverage (DPT3) - Target: 90 - Indicator Level 2002: 87.9 - Status 2003: 91.1 - Progress: Exceeded - Proportion of supervised deliveries - Target: 55 - Indicator Level 2002: 44.3 - Status 2003: 47.1 - Progress: On track - Percent of total government expenditure on health increased from 5.7% 2000 to 7% by 2004 - Target: 7 - Indicator Level 2002: 10.5 - Status 2003: 11.8 - Progress: Exceeded - At least 10% increase in the amount budgeted for exemption fees - Target: 12.8 Billion - Status 2003: Increased to 24 Billion. 17.2 billion was provided as additional money by the Government to increase coverage to the deprived Northern and central regions - Progress: On track - Reduction in the police/citizen ratio target - Target: 1:925 By 2004 - Indicator Level 2002: 1:1142 - Status 2003: 1:1,121 Police /citizen ratio - Progress: On track - Policy Feedback from M&E system - Target: 2002 Annual Progress Report, Communication Strategy, Quarterly Bulletin, 2002 APR was used to influence 2004 budget - Status 2003: 2003 APR prepared. - Progress: On track (Note: the table contains additional indicators and detailed entries not fully reproduced here; the above preserves the exact numeric values and status entries present in the source for selected key indicators.) --- *Source: _cr04207 - 1.7 S (IMF document content provided).* ### 2.2 D ### _cr04207 - 2.2 D ### Linkage between GPRS 2003 targets and 2003 budget outturns - Broad sector allocations in the 2003 budget show a clear linkage with GPRS sector targets, though the link between specific GPRS projects/programmes and the Budget is not easily discernible. - Sectoral changes (total discretionary expenditure): - Administration: 2001 34.86%; 2002 19.79%; 2003 14.84%; GPRS 2003 Target 14.2% - Economic: 2001 14.99%; 2002 18.02%; 2003 9.06%; GPRS 2003 Target 9.7% - o/w Ministry of Food & Agriculture: 2001 7.17%; 2002 4.69%; 2003 3.91% - Infrastructure: 2001 11.64%; 2002 17.20%; 2003 15.53%; GPRS 2003 Target 17.2% - Social: 2001 30.18%; 2002 34.71%; 2003 38.67%; GPRS 2003 Target 38.1% - o/w Ministry of Education: 2001 22.44%; 2002 24.14%; 2003 26.85% - o/w Ministry of Health: 2001 6.67%; 2002 9.38%; 2003 10.89% - Public Safety: 2001 7.94%; 2002 9.67%; 2003 11.52%; GPRS 2003 Target 11.1% - Utilities: 2003 2.69%; GPRS 2003 Target 2.7% - Contingency: 2001 0.39%; 2002 0.62%; 2003 4.62%; GPRS 2003 Target 6.9% - Grand Totals: 2001 100.00%; 2002 100.00%; 2003 100.00% - Observations: - Administration share declined and was close to GPRS target. - Social Services share increased consistently and slightly exceeded the GPRS target. - Infrastructure fell short of the GPRS projection for 2003. - Economic Services allocation declined sharply (almost 50% from 2002 to 2003); agricultural allocations have declined substantially since 2001. - Public Safety allocation rose above the GPRS target. ### Government of Ghana (GoG) expenditure distribution (GoG-only) - Selected GoG expenditure shares: - Administration: 2001 41.5%; 2002 25.8%; 2003 16.4% - o/w Ministry of Local Government Rural Development: 2001 2.4%; 2002 1.7%; 2003 1.8% - o/w Ministry of Finance: 2001 2.9%; 2002 4.0%; 2003 1.9% - o/w General govt Services: 2001 27.8%; 2002 8.3%; 2003 0 - Economic: 2001 5.3%; 2002 6.8%; 2003 5.4% - o/w Ministry of Food & Agriculture: 2001 1.4%; 2002 2.3%; 2003 1.7% - Infrastructure: 2001 4.4%; 2002 3.7%; 2003 3.8% - Social: 2001 37.2%; 2002 47.4%; 2003 45.8% - o/w Ministry of Education: 2001 28.4%; 2002 35.3%; 2003 33.4% - o/w Ministry of Health: 2001 0.0%; 2002 10.3%; 2003 11.2% - Public Safety: 2001 11.0%; 2002 15.3%; 2003 14.8% - Utilities: 2003 3.6% - Revenue Agencies: 2003 4.1% - Contingency: 2001 0.5%; 2002 1.0%; 2003 6.1% - Grand Totals: 2001 100.0%; 2002 100.0%; 2003 100.0% ### Expenditures in priority areas (as % of total expenditure) - Economic services: 2001 14.99; 2002 18.02; 2003 9.06 - Social Services: 2001 30.18; 2002 34.71; 2003 38.67 - Infrastructure: 2001 11.64; 2002 17.2; 2003 15.33 - Public Safety: 2001 7.94; 2002 9.67; 2003 11.53 - TOTAL (priority sectors): 2001 64.75; 2002 79.6; 2003 74.78 - Note: Apparent decline from 79.6% to 74.78% between 2002 and 2003 partly due to separate allocations in 2003 for utilities and Revenue Agencies and an increased Contingency cushion. ### Poverty-reduction expenditures (planned and actual 2003) - Planned 2003 poverty expenditures by sector (selected figures): - BASIC EDUCATION: 1569.87 (PE) ; 109.02 (HIPC) ; 78.88 (GETF) ; 58.8 (DACF) ; 94.7 (RDFUND) ; TOTAL 1911.27 - PRIMARY H. CARE: 523.29 (PE) ; 94.1 (HIPC) ; 132.6 (GETF) ; 76.22 (RDFUND) ; TOTAL 826.21 - POVERTY FOCUSED AGRIC: 87.95 (PE) ; 33.54 (HIPC) ; 20.4 (GETF) ; TOTAL 141.89 - RURAL WATER: 7.12 (PE) ; 4.51 (HIPC) ; 82.96 (GETF) ; 14.44 (RDFUND) ; TOTAL 109.03 - FEEDER ROADS: 4.45 (PE) ; 17.53 (HIPC) ; 40.8 (GETF) ; 20.2 (RDFUND) ; 144 (COCOAR) ; 15 (other) ; TOTAL 241.98 - RURAL ELECTRICITY: 1.21 (PE) ; 8.34 (HIPC) ; 40.8 (GETF) ; 41.57 (RDFUND) ; TOTAL 91.92 - OTHER POVERTY: 388.07 (PE) ; 144.39 (HIPC) ; 147.56 (GETF) ; 17.9 (RDFUND) ; TOTAL 697.92 - TOTAL POVERTY EXPENDITURES (Planned): 2581.96 (PE) ; 411.43 (HIPC) ; 544 (GETF) ; 58.8 (DACF) ; 265.03 (RDFUND) ; 144 (COCOAR) ; 15 (other) ; TOTAL 4020.22 - Actual 2003 poverty expenditures and related items (selected figures): - BASIC EDUCATION: PE 60.23; TOT2-4 2,086.45; HIPC 27.08; GETF 155.81; DACF 34.54; RDFUND 91.93; TOTAL 2395.81 - PRIMARY H. CARE: PE 77.91; TOT2-4 544.62; HIPC 19.18; GETF 205.77; DACF 0; RDFUND 65.63; TOTAL 835.2 - POVERTY FOCUSED AGRIC: PE 98.88; TOT2-4 83.06; HIPC 12.64; GETF 27.75; TOTAL 123.45 - RURAL WATER: PE 55.45; TOT2-4 4.64; HIPC 2.88; GETF 27.15; RDFUND 9.81; TOTAL 44.48 - FEEDER ROADS: PE 39.87; TOT2-4 5.63; HIPC 0.012; GETF 80.1; RDFUND 11.61; COCOAR 190.38; other 15; TOTAL 302.732 - RURAL ELECTRICITY: PE 92.51; TOT2-4 0; HIPC 4.1; GETF 25.78; RDFUND 24.48; TOTAL 54.36 - OTHER POVERTY: PE 4.64; TOT2-4 330.5; HIPC 79.79; GETF 185.29; RDFUND 112.55; TOTAL 708.13 - TOTAL POVERTY EXPENDITURES (Actual): 3054.9 (PE) ; 145.68 (TOT2-4) ; 707.65 (HIPC) ; 34.54 (GETF) ; 316.01 (DACF) ; 190.38 (RDFUND) ; 15 (COCOAR) ; TOTAL 4464.162 - Observations: - Poverty-related expenditures in 2003 constituted about 29% of total government expenditures and exceeded the planned 25.8% for the year. - Large shares of sectoral expenditures were poverty-focused (e.g., feeder roads 40% to 99% in some agriculture items). - 68% of recorded poverty-related expenditures were personnel emoluments (PE), implying a low non-salary component. ### Donor resources and sectoral priorities (2001-2003) - Distribution of donor expenditure by sector: - Administration: 2001 17.5%; 2002 10.4%; 2003 9.9% - o/w Ministry of Local Government Rural Development: 2001 5.7%; 2002 3.4%; 2003 5.5% - o/w Ministry of Finance: 2001 0.5%; 2002 1.8%; 2003 3.3% - o/w General govt Services: 2001 3.8%; 2002 0.0%; 2003 0.0% - Economic Services: 2001 40.2%; 2002 35.4%; 2003 20.3% - o/w Ministry of Food & Agriculture: 2001 22.3%; 2002 8.5%; 2003 10.7% - Infrastructure: 2001 30.5%; 2002 38.2%; 2003 51.5% - Social Services: 2001 11.8%; 2002 15.0%; 2003 16.7% - o/w Ministry of Education: 2001 6.9%; 2002 6.8%; 2003 6.7% - o/w Ministry of Health: 2001 4.9%; 2002 8.0%; 2003 9.9% - Public Safety: 2001 0.0%; 2002 1.0%; 2003 1.6% - Grand Totals: 2001 100.0%; 2002 100.0%; 2003 100% ### Distribution of total expenditures by type (utilization of discretionary payments) - Selected expenditure items (¢ billion): - Personal Emoluments: 2002 ¢4197.1; 2003 ¢5661.3; 2003 share 43.7% - Administration and Service: 2002 ¢1452.4; 2003 ¢1762.9; 2003 share 13.6% - o/w Service: 2002 ¢372.7; 2003 ¢662.7; 2003 share 5.1% - Investment: 2002 ¢1951.2; 2003 ¢3600.7; 2003 share 27.8% - o/w domestic financed: 2002 ¢299.6; 2003 ¢524.9; 2003 share 4.0% - o/w foreign financed: 2002 ¢1651.5; 2003 ¢3075.7; 2003 share 23.7% - Utility price subsidies: 2002 ¢449.9; 2003 ¢272.5; 2003 share 2.1% - HIPC financed Expenditure: 2002 ¢175.1; 2003 ¢866.3; 2003 share 6.7% - Others: 2002 ¢545.3; 2003 ¢797.3; 2003 share 6.1% - Total: 2002 ¢8771; 2003 ¢12961; 2003 share 100 - Observations: - Personnel emoluments dominated expenditures at 43.7% in 2003. - Investment share rose but domestic-financed investment was only 4.0% of total discretionary payments in 2003; foreign-financed investment accounted for 23.7%. - Budgeted investment in 2003 was only 64% of the estimated cost of funding the MTPs for 2003. - Reliance on donor financing for investment remains high, making development efforts susceptible to donor resource flow variability. ### Conclusions and policy implications - While sectoral allocations broadly reflect GPRS priorities, there was no direct identifiable link between specific GPRS projects/programmes and 2003 budget expenditures. - The 2003 budget linkage to the GPRS was an improvement on 2002, and the 2004 budget shows further improvements: - 2004 budget increased poverty-related expenditures by 27 percent. - 2004 budget established a one-to-one link between budget expenditures and the MTP programmes and projects. - Risks and recommendations: - Decline in allocations to Economic Services and Agriculture has negative implications for the poor; there is a need to augment resources to agriculture and economic sectors in subsequent years to enhance growth and sustain poverty reduction. - Maintain an appropriate balance between overheads (personnel emoluments and administrative expenses) and expenditures on services and investment. - Increase investments that generate employment to contribute substantially to poverty reduction. - Given donor dependence for investment, strengthen the MDBS and encourage more donors to join to reduce susceptibility to donor resource flow volatility. - In the short run, reliance on external financing for investment may continue, but a switch to grant funding or concessionary loans should be encouraged. *Source: _cr04207 - 2.2 D* ### 3. MACRO-ECONOMIC STABILITY ### 3. MACRO-ECONOMIC STABILITY ### 3.1 Introduction - Medium-term macro-stability objectives: achieve price stability, maintain interest rate levels conducive to savings and investments, ensure stable yet competitive exchange rates, and maintain a fiscally sustainable debt burden. - Policy frameworks and initiatives cited: Medium Term Priority (MTP) in the GPRS, Highly Indebted Poor Country’s (HIPC) Initiative, Multi Donor Budgetary Support (MDBS), Poverty Reduction and growth Facility (PRGF), Poverty Reduction Support Credit (PRSC). - Macro environment drivers in 2003: improved fiscal management, increased cocoa production, higher world prices for cocoa and gold. - GDP growth in 2003: 5.2 percent, attributed largely to agriculture (cocoa) and stable production conditions; expected to increase incomes and employment especially in cocoa areas and to benefit poor households through increased expenditures to poverty-reducing sectors. ### 3.2 Trends in Macro Stability Indicators Real GDP and Per Capita Growth - Real GDP growth: 2003 = 5.2 percent (exceeded budget projection of 4.7 percent and GPRS medium-term target of 4.9 percent). - Agriculture growth: increased from 4.4 percent (2002) to 6.1 percent (2003). - Industry growth: improved from 4.7 percent (2002) to 5.1 percent (2003); construction recorded 6.1 percent in 2003 versus 5.0 percent in 2002. - Services growth: 4.7 percent in 2003 (unchanged). - Population growth assumption: 2.6 percent; Real GDP per capita growth: 2.6 percent in 2003 (improved from below 2 percent since 2001). Selected price and external indicators (from Table 3.1 and text) - Consumer Price Index (Annual Avg): 2003 = 26.7 percent. - Consumer Price Index (End of period): 2003 = 23.6 percent. - GDP deflator (2003) = 28.6 percent. - Exports (fob) growth 2003 = 20.1 percent. - Imports (fob) growth 2003 = 20.1 percent. - Export volumes 2003 = -6.8 percent. - Import volumes 2003 = 6.9 percent. - Terms of Trade 2003 = 14.8 percent. - Gross international reserves (end-2003) = 1,095 (Millions of USD); covers 3.9 months of imports. - Cedi depreciation on inter-bank market by December 2003: against US dollar = 4.7 percent; against euro = 22.5 percent; against pound sterling = 13.0 percent. Inflation trends and shocks - 2003 budget initial inflation target: reduce from 15.2 percent (end-2002) to 9.0 percent (end-2003); target revised to 22 percent after a 90.4 percent increase in petroleum prices in February 2003. - End-2003 inflation rate: 23.6 percent (slightly above revised target). - Food price inflation: increased from 15 percent (2002) to 21.5 percent (end-2003). - Distributional assessment: a PSIA is underway to assess the distributional effect of the petroleum price increase. Government budget and public finances - Overall budget deficit: 2003 = 4.5 percent of GDP (target 4.3 percent); improved from 6.8 percent in 2002. - Net domestic financing: 2002 = 4.8 percent of GDP; 2003 = -0.1 percent (net repayment), exceeding 2003 target of zero financing. - Total revenue as % of GDP (2003) = 21.4 percent (Table 3.1 shows Total revenue 2003 = 21.4). - Grants as % of GDP (2003) = 4.8 percent. - Total expenditure as % of GDP (2003) = 29.3 percent. - Overall balance (including grants) 2003 = -4.3 percent of GDP. - Domestic primary balance 2003 = 1.8 percent of GDP. - Divestiture receipts 2003 = 0.7 percent of GDP. Domestic revenue and debt trends - Growth of domestic revenue: 2001 = exceeded 40 percent; 2002 = 27.5 percent; 2003 = 56.2 percent (rate of growth doubled in 2003). - Domestic revenue as % of GDP: 2003 = 21.28 percent (Table 3.2 references growth figures). - Total domestic debt (exclusive of revaluation stock): decreased by 298.2 billion cedis in 2003. - Domestic debt/GDP ratio: 2002 = 29.1 percent; 2003 = 22.6 percent. - Effect on monetary conditions: easing inflationary pressures led Monetary Policy Committee to reduce Treasury bill rates; 91-day Treasury bill rate fell from 35.3 percent in June 2003 to 18 percent at end-2003. - Credit to private sector: growth from -11 percent in 2001 to 37.5 percent in 2003. External debt and debt service - External debt service: declined from 7.8 percent of GDP in 2002 to 5.9 percent in 2003. - External debt service as percent of exports of goods and non-factor services: 2002 = 18.4 percent; 2003 = 16.8 percent. - NPV of external debt outstanding (in % of exports of goods & services): 2003 = 143.5 (Table 3.1 shows related multi-year figures: 2003 = 143.5; 2004 = 178.7; 2005 = 78.6; projections listed thereafter). Agricultural sector performance - Agriculture growth (2003) = 6.1 percent; agriculture growth in 2002 = 4.4 percent. - Cocoa sub-sector: moved from -0.5 percent (2002) to 16.4 percent (2003); attributed mainly to cumulative favourable impact of mass spraying initiated in 2001. - Food crop growth: 2003 = 5.3 percent; real per capita food crop growth increased marginally. - Real per capita agriculture growth (2003) = 3.5 percent (Table 3.2 indicates Real Per capita Agric growth rate 2003 = 3.5). - Dependence on weather for food crop performance highlighted; need for modernised agriculture with emphasis on irrigation. Credit to agriculture - Growth of credit to agriculture: 2001 = 20.83 percent; 2002 = 9.04 percent; 2003 = 51.12 percent. - Increased credit and increased access to financial services for private operators cited as contributors to agricultural output growth alongside mass spraying. Other notable indicators (selected from Table 3.1) - Real GDP Per Capita: 2003 = 2.6 percent. - Broad money (excluding foreign currency deposits) growth 2003 = 40.9 percent. - Reserve money (excluding foreign currency deposits) growth 2003 = 33.4 percent. - Gross investment (2003) = 23.2 percent of GDP; private investment (2003) = 14.0 percent of GDP; public investment (2003) = 9.2 percent of GDP. - Gross national saving (2003) = 24.9 percent of GDP. Policy-relevant observations and implications (drawn from text) - Macroeconomic stability in 2003 was broadly on track due to fiscal management and commodity-driven external strength. - Inflationary spike linked to petroleum price shock had distributional consequences under assessment. - Reduction in domestic debt/GDP and lower Treasury bill rates eased financial conditions but did not automatically translate into uniform private sector credit access because of structural and institutional bottlenecks. - Agricultural recovery, particularly cocoa, was central to growth; increased credit to agriculture and mass spraying seen as important policy levers. - Need to pursue modernised agriculture with emphasis on irrigation to reduce weather dependence in food crop performance. *Source: _cr04207 - 3. MACRO-ECONOMIC STABILITY* ### 3.3 P ### 3.3 P ### Poverty Reduction Impact - GPRS aims: improve real GDP growth to 5.0% and per capita income from 1.4% in 2001 to 2.4% in 2005. - Actual outcomes and drivers: - Growth of 5.2% exceeded the GPRS target. - Agricultural growth of 6.1% fuelled overall growth. - Increased cocoa production and higher cocoa producer prices (reaching 69% of f.o.b.) increased cocoa farmers’ incomes in 2003. - Distribution of increased GDP growth was skewed towards cocoa growing areas (Ashanti, Brong-Ahafo and Western regions); poverty endemic areas did not benefit much. - CWIQ 2003 microdata insights (limitations noted in footnote): - Across regions and urban/rural locations a greater proportion of households indicated they were worse off at the beginning of 2003 than in 2002, compared to those reporting improved conditions. - Degree of deterioration (difference between “worse now” and “better now”) was less serious for Ashanti, Brong-Ahafo, Northern and Upper East regions. - Explanations: cocoa sector performance in Ashanti and Brong-Ahafo; good food crop yields and infusion of government poverty reduction expenditures in Northern and Upper East. - Table 3.3: Household economic situation compared to one year ago (selected figures) - Total: worse now 51.5; better now 27 - Rural: worse now 51.6; better now 28.9 - Urban: worse now 51.4; better now 24.6 - Urban poor: worse now 53.1; better now 26.4 - By region (worse now / better now / Difference): - WR: 51.5 / 27 / 26.5 - CR: 48.6 / 27.5 / 21.1 - GR: 49.7 / 27.6 / 22.1 - VR: 58 / 16.3 / 41.7 - ER: 68.7 / 13.1 / 55.6 - AS: 57.9 / 27.5 / 30.4 - BA: 40.6 / 36.7 / 3.9 - NR: 47 / 35.7 / 11.3 - UE: 45.9 / 29.9 / 16 - UW: 45.9 / 26 / 19.9 - (Table source: Ghana Statistical Service, 2003 CWIQ data) ### Employment - Data limitations: - Annual tracking instruments are not available; reliance on CWIQ surveys that tend to understate unemployment. - 2003 survey conducted in the first quarter; results not generalisable for the whole year. Energy price shocks of February 2003 may have affected perceptions. Unemployment definition relies on individual self-assessment rather than ILO definition. - Unemployment trends: - Unemployment increased from 3.9% in 1997 to 5.4% in 2003 (CWIQ). - Unemployment worse for females than males overall. - Unemployment among the urban poor declined; male urban poor unemployment fell from 12.5% to 6.4%. - Among poverty endemic areas: Northern and Central regions experienced declines in unemployment rates; Upper West and Upper East experienced increases. - Table 3.4: Unemployment and underemployment (selected figures) - 2003 CWIQ totals: - Unemployed total 5.4; Rural 3.5; Rural poor 4.1; Urban 7.6; Urban poor 7 - Male unemployed 5.1; Female unemployed 5.6 - Underemployed total 13.6; Rural 14.9; Rural poor 8.9; Urban 12.1; Urban poor 10.7 - 1997 CWIQ totals: - Unemployed total 3.9; Rural 2.2; Rural poor 2.6; Urban 7; Urban poor 9 - Male unemployed 4.7; Female unemployed 3.2 - 2003 CWIQ by region (unemployed): - Total 5.4; WR 4.9; CR 3.1; GR 8.8; VR 4.4; ER 3.7; AS 6.5; BA 3; NR 2; UE 13.2; UW 4 - Male: Total 5.1; UE 14.4; UW 4.5 (selected regional figures) - Female: Total 5.6; UE 12.1; UW 3.6 (selected regional figures) - 2003 CWIQ underemployed by region (selected): - Total 14; ER 16.4; AS 17; BA 15; NR 6.7; UE 13.2; UW 8.4 - 1997 CWIQ by region (unemployed and underemployed) included much lower underemployment figures (e.g., underemployed total 1.1), reflecting definitional/reporting differences in surveys. - (Table source: Ghana Statistical Service, 1997 and 2003 CWIQ data) ### Macro-stability Policy Developments - Broad objectives pursued by government: - Reduce and restructure the domestic debt - Improve Public Expenditure Management - Improve fiscal resource mobilization - Pursue price and exchange rate stability #### Reduce and Restructure the Domestic Debt - HIPC and debt instruments: - Disbursements of HIPC funds amounted to ¢850.79 billion by end-2003; ¢144 billion (representing 17% of disbursements) was used for domestic debt payment. - As at the end of 2003, 225 billion cedis of domestic interest payments had been financed through HIPC savings. - GoG Index Linked Bond and Cocoa bills introduced since 2002 enabled a shift away from 90-day to medium and long-term credit regimes. - PRSC2 outcome: - Outstanding stock of Government securities fell from 17% of GDP in 2002 to 16.1% of GDP in 2003. #### Improving Public Expenditure Management - Key reforms and status (selected): - Financial information project (BPEMS operating system) is 65% completed due to lack of funds. - Financial Administration Bill passed into law at the end of December 2003. - Implementation of electronic expenditure reporting system installed in MFEP and CAGD; planned rollout to other MDAs (Ministry of Health in April, Roads and Transport and Education in May 2004; envisaged extension to several ministries by end-November 2004). - Expenditure Initiation Forms introduced as basis for requesting release of funds (except wages). - Monthly budget execution reports submitted with no more than 8 weeks lag; cash expenditures and commitments published monthly in government gazette. - Re-design of accounting and budgeting forms; customisation of Public Sector Budgeting Module for activity based budgeting; completion of an Interim Data Centre. - Regulatory and oversight body to implement new procurement code has been established. - Progress vs benchmarks: - Preliminary assessment: Ghana achieved 7 out of 16 Public Expenditure Management (PEM) benchmarks in 2003 compared with 1 out of 15 in 2001, and improved on 8 of these indicators. - Budget priorities and transparency: - Budgetary savings used in priority areas. - Budget Highlights produced for press, printed in the Daily Graphic, posted on the internet; regional peoples assembly conducted and a public exhibition at the Parliament House foyer. - A 27% increase in 2004 over 2003 budget in poverty reduction expenditures (noted under MTP, PRSC2, MDBS entries). #### Improve Fiscal Resource Mobilization - Measures taken: - Strengthened revenue collection institutions and tax collection units; Tax Identification Number (TIN) implementation in all revenue agencies is functional; Large Taxpayers Unit (LTU) being launched in 2 phases. - Improved collection and accounting for Non Tax Revenues (NTR); NTR accounts opened at Bank of Ghana for all MDAs; NTR lodgement into the consolidated fund in 2003 exceeded the 2002 lodgement by 44 percent. #### Pursue Price And Exchange Rate Stability - Monetary policy institutional changes and outcomes: - Monetary Policy Committee (MPC) established; meets every two months; uses the prime rate to signal market expectations of inflation. - Interest rate trajectory in 2003: from 27.0% through 24.0% to 21.5% by December 2003. - New Bank of Ghana Law reinforced central bank independence; law allows government to borrow not more than 10% of the previous years revenues. - Macro indicators reported for 2003 (Table 3.5 entry): - GDP growth rate of 5.2% - Agricultural growth rate 0f 6.1% - Budget deficit of 3.4% - Cedi depreciation rate of 4.7% against the dollar - Decreased domestic debt-GDP ratio of 22.6% - Growth of domestic revenue of 56.2% ### Recommended Policy Initiatives (for 2004) - Government commitments and intended measures: - Maintain macro-economic stability achieved in 2003 while pursuing more ambitious growth policies to lift growth above “hovering around 5%”. - Continue to reduce the debt burden by increasing revenue collection and improving efficiency of revenue agencies. - Use an optimum mix of appropriate fiscal and monetary policies to deliver on inflation and other macroeconomic targets. - Continue to strengthen public expenditure management. - Specific measures and targets: - Use the TOR Debt Recovery Fund expected to yield 1.2 trillion cedis to partly fund subsidies for delayed petroleum price adjustments. - Close unplanned financing gap through fiscal adjustments: curtail discretionary expenditures while protecting poverty reduction expenditures. - Reduce net domestic debt repayments from 2.2% of GDP to about 1.5%. - Find more sources of revenue (non-tax revenue) through accelerated divestiture and increased dividends from state-owned companies. - Governance and institutional actions: - Provide a more detailed breakdown of expenditure to show extent to which the poor (especially Northern, Upper East, Upper West and Central Regions) benefit. - Strengthen the link between the budget and GPRS; expand the Budget and Public Expenditure Management System to six other MDAs by November 2004. - Operationalise the Financial Administration Act, the Internal Audit Agency Act and the Public Procurement Act; enhance activities of the External Audit Act. - Encourage timely disbursement of pledges by Development Partners and invite donors not party to MDBS to join. - Bank of Ghana to address inefficient institutional structures in the financial sector to foster a well-functioning financial sector that supports growth and poverty reduction. - Improve labour market information frequency: government will work to ensure that labour market information be made available more frequently. *Source: _cr04207 - 3.3 P* ### 4. PRODUCTION AND GAINFUL EMPLOYMENT ### 4. PRODUCTION AND GAINFUL EMPLOYMENT ### Introduction - The thematic area focuses on policies to reduce poverty and stimulate growth by: (i) development of the rural economy through modernising agriculture, (ii) sustained environmental protection through re-afforestation, (iii) enhanced infrastructural development, and (iv) creating an enabling environment for private sector activities and development. - Indicators and targets for Agriculture, Energy, Lands and Forestry and Roads and Transport were revised following discussions with Ministries, Departments and Agencies (MDA’s). ### Outcome / Impact Indicators (summary of sectoral progress) - Food security - Target % of post harvest losses: 15-20% - Indicator Level 2002: Cereals: 25-30% ; Perishables: 35-40% - Indicator Level 2003: Cereals: 20-25% ; Perishables: 35-38% - Progress Towards Target: Modest progress - Tons of silo space established: Target 35mt; Indicator Level 2002: 35mt; Indicator Level 2003: 35mt; Progress: No progress - Extension officer–farmer ratio: Target 1:1200; Indicator Level 2002: 1:2200; Indicator Level 2003: The ratio remains 1 to 2200; Progress: No progress - 107 farmers, agricultural extension agents and students trained in animal traction technologies at Nyankpala, Nkwanta and the University of Ghana Agricultural Research Station, Legon. - 2003 CWIQ: Difficulty with food needs (Total 12.8%); regional extremes include UE, UW, VR; rural poor worse than urban (see Table 4.2 values as reported). - Fisheries - Quantity of fish produced per unit area of pond per cycle: Target 3 tonnes/ha/yr; Indicator Level 2002: 2.5tonnes/ha/yr; Indicator Level 2003: 2.5tonnes/ha/yr; On track - Area under fish farm: Target 450ha; Indicator Level 2002: 350-400ha; Indicator Level 2003: 450ha; Target achieved - No. of hatcheries constructed: Target 4; Indicator Level 2002: 3; Indicator Level 2003: 3; No progress - Quantity of fingerlings produced per unit area of fish cycle: 150,000 (Baseline in 2003) - Fishing sector growth: 2.8% in 2002 to 3.0% in 2003; aquaculture unlikely to have contributed much. - Provision of irrigation facilities - Percent of arable land under irrigation: Target 0.12%(33,000ha); Indicator Level 2002: 0.04%(11,000ha); Indicator Level 2003: currently estimated at 0.08%; Progress: Good (percent doubled since 2002; additional 1,200ha irrigated in 2003) - Mechanised Agriculture - Farmer access to mechanized tillage: Target 15%; Indicator Level 2002: Less than 5%; Indicator Level 2003: 8% ; Progress: Good progress - Access to harvesters: Target 5%; Indicator Level 2002: Less than 2%; Indicator Level 2003: 2% ; Progress: No progress - Access to processing equipment: Target 30%; Indicator Level 2002: 20%; Indicator Level 2003: 24% ; Progress: On track - Farmer tractor ratio: Target 1:90,000; Indicator Level 2002: 1:180,000; Indicator Level 2003: Currently the ratio stands at 1:150,000 - Agricultural area planted (MTP indicator) - Target 40,000ha/2008; Indicator Level 2002: 17,000ha; Indicator Level 2003: 30,326ha ; Progress: Good progress - Rural Sector farm and non-farm growth / Cocoa - Farm gate price of Cocoa: Target unspecified; Result: The farm gate price of cocoa was raised to 69% of FOB; Target met - Exports of cocoa increased by 11% ; Progress: Good progress - Lands and Forestry / Reforestation - Rate of deforestation: Target reduction from 65,000 per year to 50,000 per year ; Progress: Good progress - Number of CRMAS established (GPRS indicator): Target 1 ; Indicator Level 2002: 2 ; Indicator Level 2003: 1 ; Progress: No progress - Ha of urban areas planted: Target 20,000ha/2008 ; Indicator Level 2003: 1300ha ; Progress: Some progress - Ha of degraded forest reserve planted: Target 60,000/2008 ; Indicator Level 2003: 25,691ha ; Progress: On track - Amount of permanent employment generated: Target 100,000 jobs ; Indicator Level 2003: 95,000 jobs ; Progress: On track - Land Administration / Land Reform - No. of registered and titled urban lands to individuals: Target 1,300,000 parcels of land /2008 ; Indicator Level 2003: 1131 certificates issued in 2003 ; Comment: Target appears too ambitious - No. of titled and registered allodial titles to stools, skins and tendambas clans: Target 50 (2008) ; Indicator Level 2002: 15 ; Indicator Level 2003: No progress - Number of current land cases concluded: Target Reduced by 35,000(2008) ; Indicator Level 2003: 60000 currently in court ; Alternative Dispute Resolution commences in 2nd Quarter ; Not much progress - Number of customary land administration units established: Target 50 established(2008) ; Indicator Level 2002: 7 established ; Indicator Level 2003: 2 established (Gbawe., Wassa Amenfi) ; Progress: On track - Number of regional land courts established: Target 10(2008) ; Indicator Level 2002: 1 ; Indicator Level 2003: In proposal stage ; No progress reported on full establishment - Land Administration Project instituted in April 2003; 2 customary land administration units established in 2003. - Information & Communication Technology - No. of schools provided for ICT: Target 514/2005 ; Indicator Level 2002: 0 ; Indicator Level 2003: 257 ; Progress: Good progress - No. of fixed telephone lines installed: Target 400,000/2005 ; Indicator Level 2002: 200,000 ; Indicator Level 2003: 283,000 ; Progress: Some progress - Energy - Ratio of energy demand to energy supply: Indicator Level 2003: 0.73 (or 73 percent) - People with access to non-wood fuel energy: 43.4% (context: over 68% of total energy consumed in Ghana is from wood fuels) - Households with electricity: 50.6% (using 1997 and 2003 CWIQ, about 51% of households in 2003 had electricity compared with 37% in 1997) - Total electricity power generated (megawatts): 1,652 (reported in Table 4.1) - Available capacity (hydro and thermal): 1,484MW; Installed capacity: 2,064 Megawatts; Peak demand ever recorded: 1,090 MW; Ratio of energy demand to energy supply: 73 percent (or .73 to 1) indicating an excess supply of about 27 percent - Lifeline pricing for electricity sector developed and implemented: Done ; Target met - Phase out budget subsidies to petroleum sector: Process to remove subsidies in place (Price of Petroleum products increased by 90.4% in 2003) - Reduce system loss: 26%/2002 ; Indicator Level 2003: N/A - CWIQ findings: Overall increase in households using non-wood fuel for cooking, but declines among rural and urban poor; rural poor electricity access 7.2% in 2003 vs 6.2% in 1997; urban poor experienced a decrease. - Roads – Motorable Feeder Roads - Length of motorable feeder roads: 32,601.8 kms - Condition breakdown: Good 36% ; Fair 26% ; Poor 38% - Private Sector Development / Trade and Industry - Clearance time at customs reduced at Tema and Takoradi from 2 days to one day ; Progress: Good progress - Time decreased for business registration procedures by 34% - First year tranche of time‑bound implementation plan to remove key regulatory and administrative barriers: Business Registration and approval reform initiated; Land reform initiated in 2003; Taxation and Customs Administration reform initiated in 2003 - Improved export growth: 2003: US$2,31million (as reported) - Final draft of medium term private sector development strategy with action plan and monitoring and evaluation matrix: Final draft document submitted - Provision of processing equipment to micro and small–scale producers: No. of small-scale agro-processing firms established Target 50(2004) ; Status: In progress ### Modernized Agriculture — analytical observations - Fifteen indicators reported (Table 4.1) chosen for data availability and linkage with the MTP. - Food security indicators showed only marginal improvement in post-harvest losses and no new silo space in 2003; extension officer–farmer ratio remained 1:2,200. - Irrigation and mechanization showed good progress (percent irrigated doubled from 0.04% to 0.08%; farmer-tractor ratio improved from 1:180,000 to 1:150,000), but causal links between these improvements and crop production increases are not established; PSIA on Modernised Agriculture is in progress to examine causal linkages. ### Environmental Protection through Re-Afforestation - Progress in reducing deforestation from 65,000 to 50,000 hectares per year. - Replanting: 1300 hectares of urban area planted; 25,691 hectares of degraded forest reserve planted. - CRMAS: only one CRMAS established in 2003; limited progress. ### Land Reform (summary) - Land Administration Project started April 2003. - Issuance of land title certificates to individuals: 1131 certificates in 2003. - At current pace, target of 50 customary land administration units by 2008 unlikely to be met; regional land courts not advanced beyond proposal stage. ### Infrastructural Development (summary) - ICT: Fixed phone lines increased from 200,000 in 2002 to 283,000 in 2003; 257 schools provided with ICT in 2003 versus 0 in 2002. - Energy: Installed and available capacities, peak demand and excess supply computed as reported above; lifeline pricing implemented; ongoing PSIA on electricity tariffs and the poor. - Roads: 32,601.8 kms of motorable feeder roads; 36% good, 26% fair, 38% poor. ### Strengthening the Private Sector (summary) - Trade facilitation improvements: customs clearance time reduced from 2 days to one day at Tema and Takoradi. - Investment climate improvements: business registration time reduced by 34%; reforms initiated in business registration, land, taxation and customs administration in 2003. - Export performance: 2003 exports reported as US$2,31million; cocoa exports up 11%. *Source: GPRS, MDAs, PRSC, MDBS.* ### 4.3 P ### 4.3 P ### Policy developments, measures and triggers (overview) - Policy objectives: reduce incidence of poverty, improve standard of living in urban and rural areas under "Production and Gainful Employment". - Major program linkages: MTP, HIPC, PRSC, MDBS. - Agriculture, infrastructure, energy, roads, trade facilitation and private sector development are main policy areas with specified activities and status updates (see detailed sections below). ### AGRICULTURE — Modernized agriculture / Rural development - Lead ministry: Ministry of Food and Agriculture (MOFA). - Policy elements: - Increased access to irrigation services. - Improved agricultural mechanization. - Acquisition of land for commercial farming. - Aquaculture. - Increasing access to improved inputs (livestock and crop) and services. - Promotion of production of high yield varieties. - Encourage development of non-traditional exports. - Provision of storage facilities to reduce post-harvest losses. - Improvement of market access and extension services. - Progress summary: some progress in implementation, but "too early to assess their impacts." Findings and outputs (2002–2003): - Irrigation facilities: - By 2003, 713 out of 1309 boreholes, dugouts, water storage, stream diversion, stream and tube well pumping facilities under construction were completed. - Rehabilitation of Tono and Vea dams in the Upper East region completed at a cost of ¢950 million. - New models of micro irrigation developed on 80 hectares in 3 districts. - 80 Water Users Associations formed and trained in the Upper East region. - Mechanization: - AESD rehabilitated 100 universal tractors. - Initiated importing 200 tractors from India. - Contracts awarded for local manufacture of silos, mill threshers (rice, maize), graters and pressers (cassava, palm kernel). - Funded by ¢48.2 billion from the HIPC Fund. - Land acquisition for commercial farming: - Very little progress in 2002. - In 2003 MOFA and Ministry of Lands and Forestry initiated project to acquire land; inventory of agricultural land acquired by government undertaken. - Project expected to end in 2006. - Aquaculture (2003 projects): - Three dams in Upper East Region stocked with 32,000 fingerling of tilapia and catfish. - 20 fishponds at Tono project rehabilitated. - 13 ponds constructed in the Eastern Region. - 2,100 fingerling produced and used to restock community dams in Northern Region. - 1,030 fingerlings distributed to farmers in Volta Region. - Indicator: quantity of fish produced shows no progress from 2002 to 2003. - Access to improved inputs and services (2003): - Projects: credit for livestock and rice farming, animal vaccines, mass cocoa spraying, ostrich farming, improved seedlings. - SCIMP provided ¢7.6 billion to specialized companies/individuals for rice purchasing, processing, storage and marketing. - Food Crop Development Project (FCDP) disbursed ¢4.898 billion to 3,391 farmers for 3,134 hectares of cereals and legumes. - FCDP disbursed ¢1.252 billion as credit to 76 marketing groups (611 traders) in Nkwanta, Ejura, Wenchi and Damongo Districts. - SCIMP advanced funds to rural and community banks in 38 districts for on-lending. - Coconut Development Project: 168 hectares replanted out of annual target of 340 hectares for 162 farmers in 29 communities. - Animal feed quality standards established by Animal Production Directorate, Ghana Standards Board (GSB) and Animal Research Institute (ARI). - Funding facilitated through SCIMP for three incubators for ostrich hatching at Sogakope and Lashibi. - Dairy equipment procured and 425 dairy farmers/processors/vendors trained in hygienic milking and processing. - Cocoa protection and production: - ¢253.0 billion spent to protect cocoa farms against capsid and black pod; target area 1.6 million hectares (black pod control ~750,000 hectares; capsid control 850,000 hectares). - Two applications of capsid control and three applications of black pod control during the period. - Cocoa producer price increased to 69% of F.O.B. in 2003/2004 crop season in October, translating to producer price of ¢9.0 million per metric tonne. - Output: 496,793 metric tonnes in 2002/2003 crop season. - Export volume of cocoa beans in 2003 grew by 11.4 percent; cocoa products recorded 54.0 percent growth in value. - High value crops and non-traditional exports: - Production guides upgraded; farmers identified to multiply screened seeds (end of 2003). - RTIP supplied improved cassava planting materials to Ayensu Starch Company Limited for planting 464 hectares. - Pineapple observation trials for Maya Gold, MD2 and Cowboy varieties undertaken. - Five FARMAPINE cooperative groups trained in plastic mulch technique. - 12,860 exportable mango seedlings production and supply facilitated. - Post-harvest facilities: - About 218 out of 253 sub-projects (drying floors, cooling plants, crop processors, storage facilities) completed since 2002. - Market access and extension services (2003): - 47.7 kilometres of roads constructed in Upper West Region. - 516 Km of feeder roads and 124 village and district level markets constructed under VIP. - Kasoa Market improvements in Central Region at cost of 1 billion cedis. - Research-Extension Liaison Committees (RELCs) established in all 10 regions. - Farmer Based Organizations (FBO) and EDF committees active in 10 selected districts. Indicator: land ownership (2003 CWIQ) - Rural-Urban (Land owned compared to one year ago): - Less now: Total 2.6; R 3.8; RP 5.1; U 1.2; UP 2.5 - More now: Total 2.9; R 4.1; RP 7.1; U 1.4; UP 2.7 - Regional distribution (Land owned compared to one year ago): - Less now: Total 2.6 5.7 1.8 0.5 2.8 1.1 1.2 1.6 5.3 12.3 4.4 - More now: Total 2.9 5.3 2.5 1.1 2.1 1.3 3.1 10.7 24.5 - (Table formatting preserved as per source; regions abbreviations correspond to WR, CR, GR, VR, ER, AS, BA, NR, UE, UW.) ### Environmental protection — Reforestation and land reform - Lead MDAs: Ministry of Lands and Forestry, Ministry of Environment and Science, Ministry of Mines (secondary). - Objectives: re-afforestation of degraded forests, abandoned mining areas and major riverbanks; land reform via comprehensive national land use plan and improved land administration. - Forest Plantation Development Programme (2003): - Approved budget: 41 billion cedis. - HIPC Fund spending in 2003: 493.8 million cedis. - Replanting in forest reserves and urban areas contributing to decreased deforestation rate from 65,000 to 50,000 hectares a year. - Land Administration Program (LAP): - Initiated April 25, 2003. - Objective: develop sustainable, fair, efficient, cost effective and decentralized land administration system. - Estimated implementation time: at least fifteen (15) years. - Donor support: International Development Association, Nordic Development Fund, Canadian International Development Agency (CIDA), Department for International Development (DFID), German Technical Cooperation (GTZ), KfW. - Achievements (2003): - Land parcels identified for government land bank: Dawhenya to Dawa (Greater Accra), Winneba through Kwanyarko, Swedru up to Bundumburam (Central Region); negotiations with customary owners commenced March 2003. - Government inventory of public lands commenced May 2003 to determine retention and compensation. - Land Title Registry offices being opened in Sekondi-Takoradi and Koforidua (in addition to Accra and Kumasi). - Public education programme started August 2003 targeting traditional rulers and family heads to release land for investors; phase one targets the three northern regions. ### Enhanced infrastructural development — ICT, Energy, Roads ICT for development - Objectives: increase telephone access outside urban centres; provide ICT to schools. - Telecom rollout: - Ghana Telecom initiated programme to roll out additional 400,000 fixed lines within 3 years (from 2003 baseline). - As of 2002: total fixed telephone lines = 200,000. - Target by 2005: at least 400,000 fixed lines. - As of November 2003: cumulative fixed lines = 283,000 (83,000 lines installed during the year). - Kofi Annan ICT Centre completed in 2003 and commissioned in early 2004. - In 2003, 257 schools were equipped with ICT; target for 2005 is 514 schools. Energy sector - Main policy objectives: - Ensure reliable supply of high quality energy. - Energy provision to boost industrial development. - Expand supply of energy services economically, while protecting the poor. - Measures and status: - Implementation of cost recovery pricing for energy: Done / In progress across programs. - Rural electrification: - SHEP 3 Phase 3 implemented in 2003: 572 towns connected. - SHEP 4 Phase 1 survey work completed; high/low voltage and pole-mounted substations completed in 84 communities; Phase 1 expected to benefit 190 communities. - Automatic price adjustment formula for electricity developed and implemented; PURC implements automatic price adjustment on quarterly basis; price formulas for electricity and water administered by PURC. - Off-grid renewable energy: 4,500 solar PV installations benefiting off-grid communities. - Petroleum sector: - National Petroleum Tender Board established. - Automatic price adjustments in petroleum sector delayed; TOR has to be subsidised; Government will have to transfer TOR Debt Recovery Fund to make up for under recovery. - Cross-subsidisation from premium to LPG not implemented; diesel fuel is being subsidised. - National Petroleum Deregulation Committee formed to oversee deregulation. - Power sector reform: - Cabinet approved Power Sector Reform in 2003. - Power Reform Secretariat established. - Actions: development of public education and awareness strategy; formation of VRA holding company and legal review; restructuring of a large share of VRA and ECG debt obligations to government; preparation of a performance-based management contract with ECG. - Price impacts: - There was an 18% increase in prices for end users. - Projects and developments: - Bui Dam: cabinet committee set up; tendering process initiated. - Takoradi Thermal Plant: progress slow. - Rural Kerosene Distribution Improvement Programme: 700 out of planned 1,800 kerosene surface tanks distributed to rural areas in all 110 districts. - West Africa Gas Pipeline: negotiations at advanced stage. - Buipe–Bolga pipeline: Parliament has approved a $38.2 million loan agreement between government and Export–Import (EXIM) Bank of Korea for Buipe Bolgatanga Petroleum Products Pipeline Project; the loan is before Parliament, awaiting approval. Social impact indicator: - Electricity access (CWIQ data): households with electricity = 51% in 2003 compared with 37% in 1997. Roads sector - GPRS focus: provide access via better distribution of road network with emphasis on high poverty areas; maintenance of trunk and feeder roads; major highway construction for interregional connectivity. - Rationale: good infrastructure raises productivity and lowers costs; estimated that 1% growth in infrastructure development leads to 1% growth in GDP. - Impact of road condition on poverty (Table 4.5): - Upper East: Area 8,842; % below poverty line 88.2; Length in poor conditions 1620.70; % of poor roads 65.0 - Upper West: Area 18,376; % below poverty line 83.9; Length in poor conditions 1662.67; % of poor roads 59.4 - Northern: Area 70,384; % below poverty line 69.2; Length in poor conditions 4234.89; % of poor roads 64.1 - Brong Ahafo: Area 39,557; % below poverty line 35.8; Length in poor conditions 2941.62; % of poor roads 39.0 - Ashanti: Area 24,389; % below poverty line 27.7; Length in poor conditions 3350.33; % of poor roads 40.9 - Volta: Area 20,570; % below poverty line 37.7; Length in poor conditions 1487.70; % of poor roads 34.5 - Eastern: Area 19,323; % below poverty line 43.7; Length in poor conditions 2140.36; % of poor roads 47.3 - Greater Accra: Area 3,245; % below poverty line 5.2; Length in poor conditions 1005.14; % of poor roads 33.0 - Central: Area 9,826; % below poverty line 48.4; Length in poor conditions 1375.07; % of poor roads 35.8 - Western: Area 23,921; % below poverty line 27.3; Length in poor conditions 2644.77; % of poor roads 45.0 - Note: Roads lengths in poor condition do not include on-going works under Ghana Highway Authority & Department of Urban Roads. Source: Ministry of Roads and Transport, 2003 Review Report. - Road condition mix (2003 vs 2002): - Trunk road condition mix (2003): 29.4% good, 29.8% fair, 40.8% poor. (2002: 26% good, 27% fair, 47% poor.) - Feeder road condition mix (2003): 36% good, 26% fair, 38% poor. (2002: 33% good, 19% fair, 48% poor.) - Observation: majority of roads in poor condition are gravel network of trunk (secondary) roads with only 3% in good condition. - Major highways construction and status (2003): - Accra–Kumasi: - Bunso–Anyinam section completed in 2003. - Apedwa–Bunso: 62 percent completed. - Konongo–Anyinam: 28 percent completed. - Accra–Yamoransa: - Works started December 2003 on dual carriageway Mallam–Kasoa. - First phase of 41 km from Kasoa to Ankamu started in December 2003. - Accra–Aflao: - Work progressing on Tema–Sogakope section. - As at 31st December 2003, 36 percent of physical works completed at cost of ¢60.0 billion. - Feeder and farm roads: - Programme activities include improved farm roads to markets through regravelling, spot improvements and upgrading of feeder roads. - Implementation status: in progress / on course for various components. ### Trade facilitation and private sector strengthening - Trade facilitation measures: - Review targeted areas (cargo handling, stevedoring, etc.) and develop implementation plan. - Reduce length of customs procedures by extending GSMS/GCNet at Takoradi and Tema Ports. - Implement computerized risk management system under destination inspection. - Result: Customs procedures reduced to 1–2 days; GSMS/GCNet extension and risk management implementation in progress. - Private sector development (MTP / PRSC / MDBS linkages): - Objectives: improve access to credit at affordable prices; reduce bottlenecks; promote entrepreneurship; improve investment climate. - Status: - Improved access to credit programmes in progress. - Activities to reduce bottlenecks in progress. - Automation and computerization of Registrar General Department in progress. - Time bound plan to remove key regulatory and administrative barriers incorporated into Medium Term National Private Sector Development Strategy. - Cabinet approval of medium-term Private Sector Development Strategy: Done. - MOTI (agro-processing) status: - Providing processing equipment to micro and small-scale producers: Not on course. - Promote development of agri-business zones: Not on course. - Facilitating access to credit: No information. - Encouraging exports of MSEs: No information. - PRSC: Improve Trade Facilitation — activities in progress. *Source: _cr04207 - 4.3 P* ### 1. Kwame Nkrumah ### 1. Kwame Nkrumah ### Road projects: trunk and inter-city corridors — project list and implementation status - Road segments listed (with distances as provided): - Circle-Achimota (7km) - Achimota-Ofankor (5.7km) - Ofankor-Nsawam (17.6km) - Nsawam-Apedwa (41.6km) - Apedwa-Bunso (23km) - Bunso-Anyinam (11km) - Anyinam-Konogo (85km) - Konongo-Ejisu-Kumasi (53km) - Accra-Yamoransa (divided into two sections) - Accra-Kasoa - Kasoa-Wineba-Yamoransa (98.2km) - Accra-Aflao-Noepe (divided into three sections) - Tema-Sogakope (88km) - Sogakope-Akasti (22km) - Akasti-Aflao (56km) - Project-level implementation status excerpts (preserve wording and dates exactly): - Kwame Nkrumah Circle-Achimota – GoG awaiting World Bank authorization - Achimota-Ofankor – tender documents completed, no funding available - Ofankor-Nsawam – no funding as of April 2003 - Nsawam-Apedwa – appraised for possible funding by ADB - Apedwa-Bunso – 20% complete as of Feb. 2003 - Bunso –Anyinam – 30% complete as of Feb. 2003 - Anyinam-Konongo – funding secured, work expected to start Sept. 2002 - Konongo-Ejisu-Kumasi – evaluation of tenders in place, work expected to start Sept. 2003 - Snapshot of aggregated completion status (as reported): - 45% completed - Updated progress items (later status entries preserved verbatim): - Kwame Nkrumah Circle-Achimota - 15 % completed - Achimota-Ofankor – IDA Funding proposed - Ofankor-Nsawam – Contract signed on 20th January 2004 - Nsawam-Apedwa - Procurement of supervision consultant in progress. - Apedwa-Bunso – 62 % completed - Bunso –Anyinam – 100% completed - Anyinam-Konongo – 28% completed - Konongo-Ejisu-Kumasi – contractor mobilizing - Accra-Kasoa / Kasoa-Wineba-Yamoransa status items: - Accra-Kasoa – evaluation reports & draft tender documents forwarded to World Bank for authorization - Kasoa- Wineba -Yamoransa - Design for first section of road completed. Detailed design for 2nd section to be completed by Sept. 2004 - Accra-Kasoa – work started in December 2003 - Kasoa-Wineba–Yamoransa – The Kasoa-Ankuma(41km) section of the road began in December 2003 - Tema–Aflao corridor items: - Tema-Sogakope – work has commenced - Sogokope-Akasti – project yet to be funded by KfW.Funding dependant on GoG fulfilling some conditionalities. - Akasti-Aflao – project in early stages design and review. Contractor mobilizing - Later status: - Tema- Sogakope – 36% of physical work completed at the end of December2003 - Sogakope-Akasti – Draft contract for design review and supervision submitted to KfW for “No objection” - Akasti-Aflo – Awaiting “No objection” on proposal ### Construction/rehabilitation of rural-urban link roads (one good road linking Rural-Urban markets) - Ten listed rural-urban market road projects (as provided): 1. Navrongo-Chuchuliga-Kupuli 2. Wa-Han-Tumu 3. Hwidiem-Keyanasi No 1-Atonie-Suyani 4. Asokwa-Bodwesango-Gyadem-Ofoase-Juaso 5. Kpando-Worawora-Kete-Krachi 6. Twifo Praso-Dunkwa 7. Bawdie-Asankragua(34km) 8. Mpraeso-Adaweso-Donkorkrom 9. Fufulso-Sawla 10. Amasaman-Obeyeyie-Ayikai-Doblo-Odukponkpehe - Funding/implementation status for these 10 projects (preserve numeric values and wording): - 1. 2.4% funding (of estimated cost) secured - 2. 15% funding (of estimated cost) secured - 3. 36.5% funding (of estimated cost) secured - 4. 11.4% funding (of estimated cost) secured - 5. 20% funding (of estimated cost) secured - 6. 100% funding (of estimated cost) secured - 7. Began in December 2002 - 8. No funding secured yet - 9. 11.6% funding (of estimated cost) secured - 10. No funding secured yet - Physical progress notes (preserve wording): - Gravelling on Wa - Han section completed - 25% of Kpando-Worawora section completed - 48% completed (context: Bawdie-Asankragua noted earlier as Bawdie-Asankragua(34km)) - Programme summary: - Enhanced infrastructure Development — Access to market through improvements in farm roads to market through re-gravelling, spot filling - 54% of target completed (as reported) ### Trunk roads construction/rehabilitation: project list and percent completion (selected items) - Trunk roads listed with distances where given; implementation highlights preserved: - Wenchi – Sampa (30km) — Invitations advertised in national dailies; 70% completed - Wenchi – Bamboi — 32% completed - Tamale – Yendi (53km) — 27% completed - Abuakwa – Bibiani — 7% completed - Axim Junction – Tarkwa (62.4km) — Work began in June 2003; 9% completed - Jasikan – Brewaniasi (33km) (Dzindzinso-Dodo Papase section -Volta) — Work began in December 2002; 16% completed - Kwahu Tafo- Adawso — 15% completed - Bekwai – Kuntunase – Ejisu — 54% completed - Ejura – Nkoranza — 36% completed - Aframso–Sekyedumase-Nkoranza — 19% completed - Mankranso – Tepa (AshR) — 76% completed - Bole – Tinga — 22% completed - Bolgatanga – Bongo – Feo — 5% completed - Wa – Dorumum — 30% completed - Ayanfuri – Diaso — 50% completed - Bamboi - Bole (53km) — work began in December2002; 25% completed - Takoradi – Agona Junction — work began in July 2002; 100% completed - Bibiani – Abuakwa 1 (74km) — Work began in June 2003; 7% completed - Pantang-Mamfe(30km) — ADB’s no objection awaited ### Feeder roads and small bridge works: routine and periodic maintenance — targets and achievements - Routine and periodic maintenance aggregated figures (Table 4.7 data preserved exactly): - Routine maintenance - Target (km) 2002: 13,700 - Achievement (km) 2002: 10,459 - % of target 2002: 76.3 - Target (km) 2003: 17,100 - Achievement (km) 2003: 15,200 - % of target 2003: 89 - Periodic maintenance - Target (km) 2002: 5,750 - Achievement (km) 2002: 2,687 - % of target 2002: 46.7 - Target (km) 2003: 4,820 - Achievement (km) 2003: 4,278 - % of target 2003: 88.7 - Total - Target (km) 2002: 19,450 - Achievement (km) 2002: 10,459 - % of target 2002: 53.8 - Target (km) 2003: 21,920 - Achievement (km) 2003: 19,478 - % of target 2003: 88.8 - Additional small-bridges output (preserve wording): - Under the small streams bridge development programme, 14 composite bridges, 28 steel bridges and 11 box culvert bridges were constructed to improve access to farm gates and marketing centres in Western and Central regions. ### Enhanced access to urban markets — aggregate target and reported progress - Aggregate target and progress (preserve wording and numeric values): - The government’s programme of improving spatial access to urban markets by constructing and rehabilitation of one good road linking rural and urban markets is on course with a total of 1,092.5kms slated for construction over the 2002-2004 period. - In 2003 gravelling on the Wa-Han section of the Wa-Tumu road was completed, while 45% and 25% of the Bawdie-Asankragua and the Kpando-Worawora roads have been respectively completed. Rehabilitation works are expected to continue in 2004. ### Strengthened private sector — institutional actions, finance flows, and business facilitation (2002–2003) - Mandate and objectives (preserve wording): - One of the key objectives of the GPRS is to strengthen the private sector in an active way to ensure that it is capable of acting effectively as the engine of growth and prosperity. - The Ministry for Private Sector Development (MPSD) is mandated to cooperate with the various MDAs, NGOs, private sector entrepreneurs and other stakeholders in bringing into fruition the “Golden Age of Business”. - Focus areas for medium-term private sector development (preserve bullet items as provided): - Facilitating private sector access to long term finance at affordable rates; - Facilitating the reduction of bottlenecks in private sector development; and - Promoting Entrepreneurship. - Financial facilitation achievements (preserve amounts and currency/format exactly): - The Ministry of Private Sector Development has facilitated access to credit through the African Development Foundation (ADF), an Italian Credit facility of 10,000,000 Euros and a $17 million from the SOFITEL BANK of the USA. - Institutional and legal reform actions (preserve wording): - The Ministry has established an Institutional and Legal Reform Division to reduce bottlenecks to private sector development as well as facilitate the collaboration between the public and private sector towards the drafting of a number of reform bills (including the Companies Code, the Insolvency Bill, Money Laundering Bill and Insurance Bill). - Investment climate and administrative reforms (preserve wording and numeric changes): - The time bound implementation plan to remove key regulatory and administrative barriers for investment has been incorporated in the Medium Term National Private Sector Development Strategy (2004 – 2008). - Implemented items include: - The modernisation of customs operations; - The drafting of a development strategy for the financial sector; - The signing into law of a new Labour Act, amending and consolidating existing legislation and establishing a National Labour Commission with a mandate to address issues related to tripartite dialogue. - Other barriers reduced include the time to start a business falling from 129 to 85 days. ### Trade facilitation and port processing improvements - GCNET and turn-around times (preserve wording and times exactly): - The GCNET is in operation at the Kotoka International Airport (KIA) and the Tema Port. - Turn around time at the Tema Port is now between 24 to 48 hours whilst KIA is now 4 hours. - The GCNET has been extended to the Takoradi Port and is in the trial phase in other road borders. - A programme to install and operate another X-Ray Scanner at the Tema Port has been initiated. - Destination inspection and processing times (preserve wording and dates): - All the four destination Inspection companies have now implemented the Computerized Risk Management System (CRMS). - A Destination Inspection Scheme Technical Review Team ... submitted its recommendations to the Ministry of Trade, Industry and PSI on the 15th July 2003. Implementation of recommendations ... started on 20th July 2003. - The processing of Final Classification and Valuation Reports (FCVRs) by the Inspection Companies now ranges between 2 and 4 days. - CEPS offices at Tema Harbour and KIA are linked to the Transaction Price Databases (TPDs) of the Inspection Companies via the Internet. ### Trade, agro-processing and SME support — selected outputs and figures - Agro-processing and NBSSI-supported figures (preserve numeric values and formatting): - 378 entrepreneurs assisted with loans amounting to ¢209,729,000 under various financial schemes being operated by the NBSSI - Thirteen districts in Northern, Brong-Ahafo and Ashanti Regions have received Logistics, technical and financial support for Soya bean cultivation under HIPC support. - The Ghana Standards Board (GSB) is accredited to certify fish and fish products exported from Ghana into the European Union (EU) and other foreign markets - 1,175 high-risk goods were tested by GSB under the Destination Inspection Scheme to ensure consumer safety. - Under the PSI on Salt, community sensitisation programmes were organized for all salt producing areas while two workshops on capacity building were organized for 102 industry operators. In addition, six production zones were identified and fifteen production units were registered. - Rural enterprise and SME targets and outputs (preserve wording and numbers): - The Ministry indicated in 2002 that it would establish 4 agro-business zones in the Northern and Brong-Ahafo regions. An amount of ¢10 billion was allocated to this activity. Data obtained from the Ministry indicates that this target was not achieved in 2003. - The Rural Enterprises Development Programme (REDP) envisages the establishment of 3 businesses each in all the 110 districts. - NBSSI outputs: - 400 businesses were incorporated into the formal sector, - NBSSI facilitated the establishment of 120 new businesses, - An amount of about 210 million cedis of loans granted to 378 entrepreneurs. - Regional trade and market access notes (preserve wording and percentages): - About 25% of Ghana’s non-traditional exports go to destinations within ECOWAS. - The US Africa Growth and Opportunity Act (AGOA) ... duty-free and quota-free access to apparel assembled in Africa from US or African fabrics/yarns up to 1.5% of US apparel imports increasing to 3.5 percent. ### Gender, manpower development and skills training — reported outcomes - Women’s Development Fund (WDF) and related outputs (preserve numeric values and formatting and original possible typographical forms): - MOWCA established the Women’s Development Fund (WDF) with an initial sum of ¢21 billion out of which ¢10 billion was disbursed to 20,00 women farmers. - Financial support was also provided for women engaged in commercial activities, agricultural production and processing. - In all, 500,000 women have so far benefited from this fund with 50,000 new jobs created for women throughout the country. - Skills development and training outputs (preserve numeric values and wording): - The Skills Training and Employment Placement Programme (STEP) saw a total of 3,500 people throughout the country trained in various skills under the first phase of the programme. - The National Vocational Training Institute (NVTI) trained and tested about 10,000 students in Technical Vocational Skills in 2003. - The Opportunities Industrialization Centre trained One thousand youth in various vocational skills. - The Ministry spearheaded the dissemination of the new labour law. ### Recommended policy initiatives (preserve wording and numeric references) - Crop production and mechanisation: - To improve production the government will encourage private commercial farming based on proper mechanised and irrigation systems. - The Ministry of Trade, industry and PSI will encourage the establishment of industrial estates and clusters emphasizing agricultural machinery development. - Infrastructure and natural resource actions: - There will be an intensification of infrastructural development, especially in feeder roads rehabilitation, construction and maintenance to provide market access to rural agriculture. - For the re-aforestation of degraded lands will be an early commencement of the Phase II of the Natural Resource Management Programme at the Ministry of Lands and Forestry. - Minerals, tourism and ministry budget issues: - The Ministry of Mines has been detached from Energy and currently the budget is too small for the activities geared towards poverty alleviation. The government will assess the feasibility of using a percentage of the Mineral Development Fund as seed money outside GoG expenditures to finance poverty reduction projects and the Ministry‘s activities will be highlighted in the GPRS update. - Again, the activities of the Ministry of Tourism are not fully captured in the GPRS and will also be fully integrated in the GPRS during the update for the 2006-2008. - Agricultural data and rural enterprise emphasis: - Currently, the Ministry of Food and Agriculture captures data for only food crops. There is a need to expand the coverage of the Annual Survey to include non-food crops. The capacity to capture additional data is required. - In the area of processing of agricultural produce, the Ministry of Trade, Industry and Presidential Initiatives has not achieved much. The emphasis has now being shifted to the Rural Enterprise Development Programme, which involves the establishment of three enterprises each in all the 110 districts. *Source: _cr04207 - 1. Kwame Nkrumah* ### 5.2 E ### 5.2 E DUCATION SECTOR ### Overview - Goal: "the provision of relevant education for all Ghanaians to enable them acquires skills, which will make them functionally literate and productive to facilitate poverty reduction and promote wealth creation." - Main GPRS policy objectives: (a) enhance access to basic education, with special emphasis on gender and geographical equity; (b) improve the quality of basic education in terms of human, material and financial resources. - This section presents a verification review of policy actions in education in 2003, tracking and evaluating the status of various policy measures. ### Status and Key Indicators (2002–2003) - Gross Primary Enrolment Ratio (GPER) — National: - Indicator Level 2002: 79.5 - Status in 2003: 81.1 - Target (GPRS MTP): 88.5 - Progress: Not on track - Gross Primary Enrolment Ratio for Girls — National: - Indicator Level 2002: 77 - Status in 2003: 77.7 - Target: 88.5 - Progress: Not on track - Pupil:Teacher ratio (PTR): - Target 2005: 33.1 - 2000/2001: 32.9 - 2001/2002: 31.3 - Progress: Not on track - Percentage of trained teachers in primary schools: - 2000/2001: 68.6 - 2001/2002: 69.9 - 2002/2003: 73.5 - Progress: Exceeded - Pass rate for CRT at mastering level in public schools: - Maths: 2000/2001: 4.0% ; 2001/2002: 9% ; Target 2005: 6.4% - English: 2000/2001: 8.7% ; 2001/2002: 12% ; Target 2005: 11% - Notes: CRT pass rates remain very low; some figures listed as "n/a" for 2002/2003 in source table. ### Achievements in 2003 — Access and Equity - National GPER change: - Increased by 1.6 percentage points from 79.5% in 2001/2002 to 81.1% in 2002/2003. - Deprived Northern regions: - Northern Region GPER: 2001/2002: 64.8% ; 2002/2003: 67.7% ; Target 2005: 70% ; Progress: On track - Upper East Region GPER: 2001/2002: 69.5% ; 2002/2003: 72.2% ; Target 2005: 79% ; Progress: On track - Upper West Region GPER: 2001/2002: 63.1% ; 2002/2003: 69.6% ; Target 2005: 63% ; Progress: Exceeded - Girls’ enrolment (PGER): - National: 2001/2002: 77% ; 2002/2003: 77.7% ; Target 2005: 88.5% ; Progress: Not on track - Northern Region: 2001/2002: 55% ; 2002/2003: 59.1% ; Target 2005: 70% ; Progress: On track - Upper East Region: 2001/2002: 69% ; 2002/2003: 72.1% ; Target 2005: 79% ; Progress: On track - Upper West Region: 2001/2002: 63% ; 2002/2003: 70.3% ; Target 2005: 63% ; Progress: Achieved ### Achievements in 2003 — Infrastructure and Resources - Classrooms constructed/rehabilitated: - 685 3-unit classroom blocks constructed in 2003. - Funding disbursed: 39 billion cedis from HIPC fund and 14.9 billion cedis from GETFund for construction of an additional 440 six-unit classroom blocks. - Regional share: - Of 685 3-unit classrooms, 420 (61.3%) located in the three deprived Northern regions — exceeding the HIPC target of 30% in 2004. - Of 440 six-unit blocks under construction, 96 projects (21.8%) are in the three deprived Northern regions. - Model SSS upgrading: - 31 senior secondary schools selected for upgrading; work on the first batch progressing steadily in 2003. - Disbursed amount: 48 billion cedis. - Teacher accommodation and incentives: - 56 teacher accommodation units constructed in 2003; 23% located in the three Northern regions. - Material incentive packages distributed since 2002: 5,000 radio cassette players; 5,000 sets of cooking utensils; 14,400 bicycles. - Total teachers benefiting from incentives since 2002: 24,400; 25% of beneficiaries from the three Northern regions. ### Achievements in 2003 — Teacher Retention and Training - Study leave policy and distance education: - Criteria for paid study leave revised to favour teachers in deprived districts; two-year service in a deprived district introduced as condition for study leave with pay. - Teachers on paid study leave: 2003/2004 academic year: 5,000 ; 2001/2002 academic year: 6,033. - Target planned: 3,000 teachers in 2004/2005 academic year. - Distance Education and Sandwich programmes enrollment increased from 750 in 2001/2002 to 3,618 in 2003/2004. - Additional 4,500 students (mainly teachers) admitted into Cape Coast University and Winneba distance education programmes; allocation: 839.3 million cedis from GETFund. - District Sponsorship of Teacher Trainees Programme: - Admission rates: 2000/2001: 76% of teacher trainees admitted to the programme; 2002/2003: 91%; 2003/2004: all teacher trainees to be sponsored under the district programme. - Evaluation of FCUBE retention schemes (completed 2002) — key findings: - General satisfaction with the scheme. - Reduction in teacher absenteeism. - Increase in morale and motivation among teachers. - Improved attendance at school and meetings. ### Quality of Education — Status and Concerns - CRT mastery pass rates low: - Maths and English pass rates remain low (examples: 9% Maths and 12% English reported for 2001/2002 in one table). - PTR trend: - National PTR moving away from target rather than improving. - Trained teachers: - Percentage of trained teachers in primary schools rose from 69.9% in 2001/2002 to 73.5% in 2002/2003. - Factors negatively affecting quality: - Large number of trained teachers taking study leave annually. - Teacher attrition. ### Gender Equity Measures and Results - GETFund allocation for girls’ scholarships: - ¢8.885 billion from GETFund provided in 2003/2004 academic year to provide scholarships for girls in basic schools; fund not yet disbursed as of report. - Proposed disbursement formula (proposed for 2004): - 60% for girls in primary schools. - 35% for girls in Junior Secondary schools. - 5% for special needs such as the handicapped. - Material support for girls (2003 results): - 5,500 needy girls benefited from uniforms, bags, exercise books and pens, pencil erasers. - 24,169 basic schoolgirls benefited from distribution of food rations in exchange for school attendance. - 888 girls received bicycles; 80% of these to girls in the three Northern regions (additional 650 to benefit in 2003/2004). ### Skills Training and Employment Initiatives - GETFund allocation to vocational/technical schools: - ¢18.7 billion allocated for rehabilitation of workshops in vocational schools (2003). - Grants from poverty programmes for skills training: - ¢11.16 billion allocated to the Ministry of Manpower and Employment in 2003 for skills training and employment placement. - Number trained: 4,800 unemployed received training in various skills led by MMDE. - Note: Information on job placements not currently available. - Street children pilot: - Community based poverty reduction project (CPRP) pilot in 4 districts (Greater Accra, Northern, Ashanti, Western) to reintegrate street children through essential services. ### Efficiency and Equity of Education Financing - School mapping: - Target: school mapping in 10 additional districts completed by end of PRSC2. - Status 2003: mapping completed for 5 out of 10 targeted districts (Bolga, Bongo, Bawku West, Savelugu-Tatale, Zabzugu); remaining 5 expected by end March 2004. - Resources to deprived districts: - Budgeted Non-Salary (Items 2-4) to 40 deprived districts increased from 41,236 million cedis in 2002 to 57,886 million cedis in 2003 — a 40% increase. - Actual non-salary recurrent expenditure to 40 deprived districts increased from 73% in 2002 to 91% in 2003 — an increase of 18%. - Execution of recurrent non-salary expenditure: - Execution rate improved from 63.6% in 2002 to 91.1% in 2003 — exceeding the targeted 75% in 2003. - Tertiary financing policy: - Committee established to prepare a financial strategy; final proposals expected by end of June 2004. - Interim: university students contributing 26% of cost of goods and services as academic user fees (a 30% increase on previous year). ### Recommended Policy Initiatives - Continue current policies to ensure more equity in access, with an increased focus on quality in the next round of GPRS implementation. - Emphasize teacher retention as key to ensuring quality education and reducing school drop out. - Conduct regular impact assessments of teacher retention schemes to ascertain differential impacts of different schemes being implemented. *Source: Ministry of Education, 2003 Performance Report; MTPs – GPRS- 2003-2005; PRSC-2001-2004.* ### 5.3 H ### 5.3 H HEALTH SECTOR ### Overview and Medium-Term Objectives - Government objectives (medium term): - Enhancing efficiency in delivery and increased access to health services - Ensuring sustainable financial arrangements that protect the poor - Improving access to safe water in rural and peri-urban communities ### Status of Priority Health Indicators (2003) - From Table 5.9 (selected indicators and targets): - Infant Mortality - Target 2005: 50/1000 - 2002 Indicator Status: 57/1000 - 2003 Progress: 64/1000 - Status: Not on track - Under-five mortality - Target 2005: 95/1000 - 2002 Indicator Status: 108/1000 - 2003 Progress: 111/1000 - Status: Not on track - Child Malnutrition (underweight) - Target 2005: 20.0 - 2002 Indicator Status: 26.0 - 2003 Progress: 35.8 - Status: Not on track - Immunization coverage - Target 2005: 90.0 - 2002 Indicator Status: 62.0 - 2003 Progress: 69.4 - Status: On track - Proportion of supervised deliveries - Target 2005: 55.0 - 2002 Indicator Status: 44.3 - 2003 Progress: 47.1 - Status: On track - Number of model health centres provided/upgraded - 2003 Progress: 15 model health centres and 2 district hospitals were completed for use in 2003. Additional 15 started to be completed in 2004. - Status: On track - CHPS (Community Health Planning and Services) coverage - Target by end PRSC2: At least 20% coverage - 2003/2004 Progress: Out of 130 zones, only 47 are currently being covered in 2004 of which 28 are in the deprived areas - Status: Not achieved - National Health Insurance - 2003 Progress: Parliament passed the National Health Insurance Act; 45 districts have been piloting the scheme - Status: On track - Health expenditure (as % of total government expenditure) - Text: "Health expenditure increased from 5.7 in 2000 to 7% of total government expenditure in 2003" - Table entries: 7, 10.5, 11.8 - Status: Exceeded - Percentage of rural population with access to safe water sources - Target/2005: 54 - 2002 Indicator Status: 41.28 - 2003 Progress: 46.4 - Status: On track - Incidence of guinea worm reported - 2002: 5,545 - 2003: 8,000 (44.3% increase since 2002) - Status: Not on track ### Trends in Basic Health Indicators (1988–2003) - From Table 5.10 (1988 / 1993 / 1998 / 2003): - Infant mortality rate: 77 / 66 / 57 / 64 - Under five mortality rate: 155 / 119 / 108 / 111 - Immunization coverage (DPT3): 43 / 62 / 69.4 - Child malnutrition (underweight): 24 / 27 / 25 / 35.8 - Maternal mortality rate: 240 / 214 / 214 / n.a - Crude death rate: 17 / 12.5 / 10 / n.a - Life expectancy: 54 / 56 / 58 / 60 - Crude birth rate: 47 / 44 / 39 / n.a - Total fertility rate: 6.4 / 5.5 / 4.6 / 4.4 ### Access to Health Care (Regional Variation, 2003) - Table 5.11: Percent with access to health care by region (2003) - Western: 46.9 - Central: 67.2 - Greater Accra: 80.9 - Volta: 49.5 - Eastern: 60.1 - Ashanti: 69.0 - Brong Ahafo: 53.8 - Northern: 35.0 - Upper East: 26.7 - Upper West: 30.4 - National: 57.6 - National average access to health care: just over 50 percent; substantially lower in the three northern regions. ### Progress and Achievements (2003) - Infant and childhood mortality - Infant mortality increased from 57/1000 in 1998 to 64/1000 in 2003 (an increase of about 12.3 percent). - Under-five mortality increased from 108/1000 in 1998 to 111/1000 in 2003 (an increase of about 2.8 percent). - Potential contributors: poor access to health services, lack of money for health expenses, child malnutrition. - Child health and nutrition - Immunization: proportion of children 0 to 12 months fully immunized increased from 62.0 percent in 2002 to 69.0 percent in 2003. - Child malnutrition (underweight) increased by 10.5 percentage points over five years to 35.8 percent in 2003. - Regional malnutrition prevalence (2003): Ashanti 46%, Greater Accra 40.4%, Western 36.9%; malnutrition increased in all regions except the three northern regions. - Community-based Poverty Reduction Project (CPRP) pilot in four districts (Sefwi Wiawso, Bongo, Kadjebi, Komenda/Edina/Eguafo/Abirim): implemented in 40 communities; Community Nutrition Workers trained in 26 communities by end-2003; Local Initiative Fund (LIF) to provide small loans for income-generation to caregivers established as a sub-component. - Maternal health and supervised deliveries - Antenatal coverage: 69 percent in 2003 vs. 62 percent in 2002 (CWIQ, 2003). - Proportion of supervised deliveries: 47.1 percent in 2003 vs. 44.3 percent in 1998. - Regional supervised deliveries (1998 / 2003): National 44.3 / 47.1; Central 40.0 / 38.5; Northern 11.1 / 18.3; Upper West 22.1 / 27.8; Upper East 16.1 / 33.3. - Geographic disparities identified: three northern regions and Central region require focused attention. ### Policy Measures Implemented in 2003 - Enhance delivery and increase access - Model health centres and district hospitals - 2003 completions: 15 Health Centres and 2 District Hospitals (Bimbilla and Begro) completed with OPEC Fund and Ghana Government support. - Additional 15 health centres (Saudi Phase II) expected completed by January 2004; upgrades on Juabeso, New Edubiase and Nkwanta initiated for completion by June 2004. - High Impact Rapid Delivery Programme (HIRDP) - Completed for PRSC-2: MOH and UNICEF implementing HIRDP in Northern and Upper East regions (two deprived regions). - Community Health Planning and Services (CHPS) - PRSC-2 target: 20% coverage by end PRSC2. - Status: CHPS implemented in 47 zones (of 130), 28 in deprived regions; to meet 20% coverage an additional 83 zones required, of which 26 are in deprived areas. - Relocation and retention of health professionals - Programme finalized and approved by Cabinet; 55 deprived districts identified for interventions. - 2004 budget allocation: ¢22 billion cedis to provide salary incentives to health workers in selected districts. - Additional HIPC funds: ¢19 billion cedis to attract new health workers to districts. - Administration: District Assemblies to administer funds. - Concerns: salary incentives alone may be insufficient; suggested complementary incentives include good schools for children, availability of basic services (water, electricity), travel time to home districts, and funding for personal housing. - A monitoring and evaluation system will be established to assess effectiveness under PRSC-3. - Ensure sustainable health care financing that protects the poor - Measures emphasized in 2003: - Replacement of cash-and-carry system with National Health Insurance - Increase coverage of exemptions to include maternity delivery - Apply health expenditure allocation formula favoring disadvantaged regions - Increase health expenditure as share of government expenditure - Status of financing indicators (Table 5.14): - National Health Insurance: Parliament passed the National Health Insurance Act; 45 districts piloting the scheme (On track). - Financial analysis of national public health budget and national health insurance scheme: Completed by Ministry of Health in collaboration with ILO (Achieved). - Money disbursed for exemption fee: increased from ¢12.8 Billion to ¢24 billion; ¢17.2 billion provided as additional fund by Government to cover exemptions for maternity delivery in deprived northern and central regions (On track). - New recurrent expenditure formula: Completed and adopted in the 2004 budget (Achieved). ### Access to Safe Water and Sanitation - Percentage of rural population with access to safe water sources: - Target/2005: 54 - 2002 Indicator Status: 41.28 - 2003 Progress: 46.4 - Status: On track - Percentage of rural population with access to adequate sanitation: (no figures provided in source extract) - Guinea worm incidence: 2002: 5,545; 2003: 8,000 (44.3% increase since 2002) — Not on track *Source: MTPs and HIPC: GPRS 2003-2005, PRSC2: PRSC-2001-2004; DHS, WDR and health sector Program of Work in Ghana-Facts and Figures; CWIQ 2003 Preliminary Report; GSS-1997/2003 CWIQ report; 2003 Ministry of Health Performance Report* ### 5.7 in 2000 to 7% of total ### _cr04207 - 5.7 in 2000 to 7% of total ### National health insurance: implementation and pilots - Parliament passed the National Health Insurance Act during the year under review to replace the ‘cash and carry’ system with an Insurance Scheme. - 45 districts have been piloting the scheme: - 10 are managing benefits and claims - 15 are at the stage of registration of members and collection of contributions - 7 are coding streets and houses - 8 are sensitising their communities - 5 have started their stakeholder consultations - An amount totalling 41.6 billion cedis of HIPC funds was released to 108 districts, including 12 sub-metros in Kumasi, Accra and Sekondi-Takoradi to facilitate the implementation of 120 District Mutual Health Insurance Schemes. - Additional measures in 2003 to enhance implementation included preparation of instruments for accreditation of health institutions and stakeholder consultations on minimum benefit package for the scheme. ### Financial analysis of the national public health budget and the National Health Insurance Scheme - The Ministry of Health, in collaboration with ILO, completed financial analysis of the public health budget and the national insurance scheme. Key conclusions: - Possibility of public health expenditure growing rapidly over the next ten years. The expected increase in utilization of insured persons will lead to increase in overall expenditure that will outpace growth of resources and consequently create a financial gap. - To ensure financial equilibrium, government’s financial commitment to the health sector should not be reduced. New sources of revenues should be considered as additional resources. - In the longer term, the government may either have to bear a higher share of the public health expenditure or would have to introduce higher contributions to the district health insurance scheme. ### Exemption fees and recurrent budget - Recurrent budget spent on exemption increased from 12.8 billion cedis in 2002 to 24 billion cedis in 2003. - An additional amount of 17.2 billion cedis was provided by the Government to cover exemptions in the deprived Northern regions and the Central region. - Progress from this measure included: - releasing resources to the districts - setting up regional systems that spell out packages, amount to be granted for exemption and the procedure for reimbursement ### New recurrent expenditure allocation formulae - A new recurrent expenditure allocation formula to provide additional funding for health programmes in deprived areas was adopted and applied in the 2004 budget. - Expenditure allocation in the new formula is based on population adjusted for health needs (as measured by the levels of U5MR and IMR) and level of deprivation (as defined by population below the poverty line). ### Health expenditure as percent of total government expenditure (2003) - The proportion of non-wage recurrent expenditure on health increased from 10.5% in 2002 to 11.8% in 2003. - Thus the target of 7% set for the HIPC in 2003 was exceeded by 4.8%. ### Improve access to safe water and sanitation in rural areas: targets and outcomes - One strategy under the GPRS is improvement in rural population access to safe water and sanitation, with emphasis in Guinea worm endemic areas. - Table 5.15 indicators (selected items reproduced): - Percentage of rural population with access to safe water sources: - 1998 Indicator: 40% (2000) - 2003 Status: 46.4% - Target 2005: 46% - Progress: On track / Exceeded HIPC trigger - Percent of rural population with access to adequate sanitation: - 2003 Status: 55.0% - Target 2005: 45.8% - Progress: Slow progress - Incidence of guinea worm reported: - 2002: 5,545 - 2003: 8,000 (44.3% increase since 2002) - Target 2005: 0 - Progress: Not on track - Rural population with access to safe water increased from 40% in 2000 to 46.4% in 2003, exceeding the HIPC completion point target of 46%. ### Water facility delivery achievements (2002 and 2003) - New boreholes constructed: - 2002: 622 - 2003: 1290 - Boreholes rehabilitated: - 2002: 407 - 2003: 115 - New hand-dug wells: - 2002: 65 - 2003: 61 - Hand-dug wells rehabilitated: - 2002: 2 - 2003: 6 - Small community pipe systems completed: - 2002: 4 - 2003: 19 - Small town pipe systems completed: - 2002: 25 - 2003: 46 ### Incidence of Guinea worm - Reported cases: - 2001: 4,738 - 2002: 5,545 (17.0 percent increase from 2001) - 2003: 8,000 (44.3 percent increase from 2002) - In response, an amount of 29.2 billion cedis was released by the government in 2003 for the construction of 245 boreholes in guinea worm endemic areas. - Most affected regions: Volta, Northern and Brong Ahafo. ### Rural sanitation - National average access to adequate sanitation: just over 55 percent. - Access in the three northern deprived regions is around 20 percent or lower. ### Recommended policy initiatives (health, water, sanitation) - Review health sector priorities to account for recent increases in infant and childhood mortality rates. - Strengthen and expand child nutritional programmes due to positive correlation between child malnutrition and under-five mortality. - Identify and concentrate location of health facilities in the most vulnerable districts to maximize impact on health outcomes. - Enhance access to exemptions through better targeting of the poor; establish a system to identify the most poor. - Accelerate full implementation of the National Health Insurance Scheme to ensure poor people have access to quality health services; introduce a targeting system for subsidies to cover cost of premiums. - Investigate water quality concerns despite increased access to drinking water; ensure not only access to water but also access to quality water. - Prioritize sanitation issues in the next phase of GPRS implementation due to low national access. ### Governance: overview and selected progress (security and rule of law) - Governance objectives include accountability, transparency, participation and equity in resource distribution, and capacity at national and sub-national levels. - Security and Rule of Law outcomes (2003): - Recruitment of new police personnel, increased logistics, creation of neighbourhood watch committees and increased patrols contributed to reported reduction in crime rate across the country for robberies, stealing, rape and assault; marginal increases recorded for fraud and murder; sharp increase in defilement cases likely reflects increased reporting. - Regulatory and legal environment for public financial management enhanced by passage of the Central Internal Audit Bill. - Alternative Dispute Resolution uptake and free legal aid for the poor are positive developments. - Police support and logistics: - Provision of 470 new vehicles and communication equipment during the period. - Fleet of patrol vehicles increased from 100 in 2000 to close to 700 by the end of the period. *Source: 2003 Annual Report, Ministry of Health 2003 Performance Report, GSS- 1997 / 2003 CWIQ reports (content unit: _cr04207 - 5.7 in 2000 to 7% of total)* ### 2003. With a donor support of $1.0m the police have increased patrols in both urban and rural areas. This ### _cr04207 - 2003. With a donor support of $1.0m the police have increased patrols in both urban and rural areas. This ### Police presence, community engagement, and victim support - Donor support of $1.0m enabled the police to increase patrols in both urban and rural areas, improving police presence and increasing the response rate to distress calls. - Police encouraged and supported formation of Neighbourhood Watch Committees nationwide; support focuses on retraining members in effective patrols, crime combat and crime reporting. - Police opened a website: www.Ghanapolice.org to foster better interaction with the public and raise the profile of the force; the public can acquire and express opinions on police work. - The Women and Juvenile (WAJU) Unit expanded beyond regional capitals: - Opened new offices in Tema (regional) and a District office in Swedru. - Established WAJU desks in Dansoman and Odorkor. - Expansion brings help closer to more women and children suffering abuse at sub-regional levels. - National Governance Program (NGP) supported training for governance institutions including the Police Force; Registrars and bailiffs of CHRAJ trained in change management then trained 152 police station officers on upholding citizens’ rights. - Ghana Police Service staffing and targets as at December 2003: - Staff strength: 15240 - Recruited new personnel by end-year: 854 - Potential recruits on standby for training: 1,254 - Police–citizen ratio as at December 2003: 1:1121 - Target police/citizen ratio by 2004: 1:925 - International standard police/citizen ratio cited: 1:500 ### Strengthening the Attorney General’s Office and judicial support - Ministry of Justice activities to deepen rule of law included: - Computerisation and networking of the Registrar-General’s Department. - Organisation of Legal Aid Clinics by the Legal Aid Board in all regions to advise the poor. - Handling of 4500 cases in court for the poor. - Laying groundwork for publication and distribution of legal aid brochures in seven Ghanaian languages. - Training provided to Judges, Magistrates, Registrars, senior staff, regional accountants and administrative staff of the Judicial Service in: - Performance management, Alternative Dispute Resolution, Court automation, Case Management, and change management. ### Campaign against corruption: institution-building and outreach - Ghana Anti-Corruption Coalition (GACC) restructuring in 2003: - Acquired a permanent office, installed ICT equipment, strengthened staff by recruiting an Executive Secretary and full staff complement. - Undertook a follow-up survey to its initial Anti-Corruption study and published proceedings of its 5th Governance Workshop. - Initiated Anti-corruption Youth Clubs in schools to expand anti-corruption constituency. - Establishment of an Accountability Office in the Office of the President to advise on ethical compliance for political executive appointees. - Media role: interactive radio and television provided space for citizen participation in anti-corruption debates. - Central Internal Audit bill passed into law; implementation began with institutional setup, recruitment of critical staff, and audits on HIPC funds, GPRS and the Ghana AIDS Response Fund. - Audit Service actions: - Established new District offices, raising total to 67 offices. - Audited 21 Ghana Missions. - Conducted special audits in selected Districts including West Mamprusi District, averting loss of public funds. ### Support to Parliament and public dissemination - Under NGP: - 35 members of parliament trained in computing and change management. - Library officers of Parliament received upgrading training. - Office of Parliament supported with ICT equipment, user licences, library software and technology for proposed parliamentary radio station. - Ministry of Parliamentary Affairs disseminated government policies and programmes to unit committee levels to bring legislative business closer to ordinary citizens and promote accountability and informed choices. ### Recommended governance initiatives (policy recommendations) - Increase dissemination of information about policies, programmes and services to inform the public about rights, obligations and nature of services available. - Intensify public forums to discuss governance in relation to justice, accountability and security; regularise Peoples’ Assembly events at regional and district levels. - Continue and expand good governance enhancers such as the ‘Meet the Press’ series and greater use of mass media and existing civil society groups (including professional associations) in rural and urban areas. - Revise governance indicators to present a more comprehensive representation of all governance actors beyond law and order. ### Decentralisation: outcomes and implementation strategies - Objective: bring governance within reach of citizens through political devolution and administrative/technical de-concentration. - National Decentralisation Action Programme (NDAP) approved by Cabinet in September 2003 to: - Promote convergence of decentralisation efforts. - Consolidate processes of resource allocation and management. - Build capacities for poverty-targeted development and governance at local level. - Promote partnership and participation between local government, civil society, private sector and traditional authorities. - NDAP implementation strategies focus on: - Political decentralisation, Administrative decentralisation, Fiscal decentralisation, Decentralised development planning and public-private partnership in investments. - Progress and outcomes: - Political decentralisation: Electoral Commission initiated creation of 25 new districts and 30 constituencies in 2003; number of districts now stands at 135. - Administrative decentralisation: Direct transfer of HIPC funds from Controller and Accountant General to MMDAs; districts assume direct responsibility for fund allocation. - Fiscal decentralisation: Pilot composite budget preparation initiated in Dangme East, Dangme West and Akuapem North. - Capacity building improved District Assemblies’ service delivery and resource use; District Assemblies becoming more proactive and responsive; committees functioning and regular meetings held. - Local Government Service Bill passage raised staff morale by improving expectations of service conditions. - District Assembly–civil society relations: - Improved collaboration in HIV/AIDS campaigns, bush fire prevention and community water/sanitation programmes. - International NGOs and faith-based organisations supported district development planning (example: JICA’s Integrated Human Development Plan supported six Upper East districts). - Civil society budget advocacy (e.g., ISODEC) brought citizen voice into budget formulation; NDPC-supported training: 120 Assembly members and traditional rulers trained in peace resolution. ### Decentralisation recommended policy initiative - Conduct research to establish system-wide impact of policy measures on improved services by district assemblies. - Sustain support to district assemblies to deepen citizen participation in decision-making and ensure equity in resource allocation. ### Public sector reforms: outcomes, interventions, and recommendations - Outcomes: - Leadership of Civil Service (Chief Directors) being developed to be more forward-looking and performance-oriented. - Chief Directors entering into performance contracts with the Public Services Commission based on output targets. - Monthly meetings of Chief Directors institutionalised for cross-fertilisation of ideas and improved inter-sectoral policy implementation. - Census of public service staff expunged approximately 400 fake names from the payroll on non-subvented organisations. - Interventions: - Independent evaluation of previous reform efforts commissioned in March 2003 by Price Waterhouse Coopers; Advisory Group (AG) chaired by Senior Minister set up to guide reform agenda. - Reorganisation of Civil Service structure, reassignment and new hires of Chief Directors, procurement of training and new service incentives. - For subvented organisations: placing commercially viable services on the market, performance contracts to determine subvention levels; Subvented Agencies Reform Bill drafted for Parliament submission. - NDPC review of mandates and functions of MDAs to remove duplications and realign with decentralisation policy. - Census of public sector staff completed and electronic tracking systems established in Ministry of Finance and Economic Planning and Controller and Accountant General’s Department. - Recommended policy thrust: - Adjust central government structures and organisation to make central machinery more efficient, effective and private sector-friendly. - Strengthen government capacity to set development agenda and enable private sector and social partners to contribute fully to national development. ### Monitoring the GPRS and related recommendations - Outcomes: - National Development Planning Commission (NDPC) improved monitoring and evaluation responsibilities. - Dissemination of the 2002 Annual GPRS Progress Report improved public understanding and secured public interest in monitoring implementation. - Interventions: - NDPC submitted 2002 APR to Parliament and disseminated widely. - Commissioned five Poverty and Social Impact Assessments (PSIAs) nearing completion. - Subjected the GPRS to a Strategic Environment Assessment (SEA); SEA report is ready. - Policy recommendation on indicators: - Challenge remains identifying appropriate indicators to measure intangibles like improvements in the practice of democracy. - Stakeholder consultation planned to harmonise existing indicators with APRM of NEPAD and the MDGs, which must be reported on by virtue of state ratification. *Source: _cr04207 (2003).* ### INTRODUCTION ### INTRODUCTION ### Vulnerability and Exclusion: Definitions and Targets - Vulnerability: inability of the poor to withstand shocks or manage risks in physical, economic, social and environmental contexts. - Exclusion: marginalisation, voicelessness, powerlessness, and injustice suffered by the poor. - Policy objective: create opportunities for vulnerable and excluded groups to prevent or cope with risks and shocks. - GPRS identifies the most vulnerable and excluded as: women, children, people living with HIV/AIDS (PLWHA), persons with disability (PWDs), the chronically poor, and children orphaned by AIDS. - Programmatic focus areas: a) attainment of social justice, b) prevention and control of HIV/AIDS, c) recognition of rights of persons with disability. - Principal implementing MDAs for women and children protection: Department of Social Welfare (DSW), Ministry of Women and Children’s Affairs (MOWCA), Ministry of Health, Ministry of Education, Youth and Sports. ### Summary Status of Priority Indicators: Vulnerable and Excluded (Table 7.1 highlights) - Increased resources for protection of rights of women and children: - MOWCA received ¢¢6.709billion in 2002 - MOWCA received ¢9.669billion in 2003 - Progress: On track - Utilisation of Legal Aid Services: - 2002: 4225 - 2003: 4500 - Progress: Utilisation by poor increasing but not adequate - Population with information, counselling programmes undertaken: - Indicator Level 2002: 98% - Progress: On track - HIV/AIDS sentinel/prevalence and treatment: - HIV/AIDS Prevalence: 3.8% (citation context shows 3.6% elsewhere) - Sentinel treatment availability: 4 sentinel sites providing ART - Drug-based treatment: 4 Sentinel Sites are providing ART for PLWHA and 19 sentinel site are implementing a programme for the prevention of mother to child transmission - MDBS: Joint review of GOG response to pandemic finalised; Joint Review scheduled between 1st March 2004 & 9th April 2004 with a budget of $218,00 (funding from DFID, JICA, The Royal Danish Embassy, UNAIDS, USAID, UNFPA). ### Progress on Social Justice, Equity, HIV/AIDS and Disability (Section 7.2) - DSW provided services to more vulnerable persons on average in 2003 than in 2002; reductions in some services were attributed to reduced need following prior interventions, improved offender conduct, alternative dispute resolution, or resource inadequacy. - Comparative Welfare Services Provided by Year (selected outcomes, 2002 vs 2003): - Child Welfare Services: - Juvenile cases investigated: 2002 = 513; 2003 = 217 - Probation cases handled: 2002 = 630; 2003 = 662 - Juveniles handled in industrial school: 2002 = 61; 2003 = 100 - Remand Cases handled: 2002 = 291; 2003 = 315 - Children adopted by relatives: 2002 = 242; 2003 = 251 - Orphans adopted: 2002 = 53; 2003 = 53 - Day Care Centres supervised: 2002 = 2395; 2003 = 1176 - Day Care Centres registered: 2002 = 79; 2003 = 50 - Paternity cases disposed of: 2002 = 733; 2003 = 480 - Maintenance and custody cases disposed of: 2002 = 8493; 2003 = 1030 - Families reconciled and strengthened: 2002 = 2649; 2003 = 743 - Male un-adoptable children cared for: 2002 = 169; 2003 = 166 - Female un-adoptable children cared for: 2002 = 108; 2003 = 92 - Family tribunal cases handled: 2002 = 5956; 2003 = 1435 - Vocational Training for the Youth: - Boys provided with vocational training: 2002 = 431; 2003 = 548 - Girls provided with vocational training: 2002 = 434; 2003 = 549 - Street Children rehabilitated: 2002 = 413; 2003 = 466 - Integrating disadvantaged adults into mainstream society: - Prisoners provided with welfare services: 2002 = 2072; 2003 = 1185 - Paupers assisted with payment of hospital bills and related expenses: - Males 2002 = 937; Females 2002 = 842 - Males 2003 = 357; Females 2003 = 157 - Destitutes catered for: - Males 2002 = 23; Females 2002 = 3 - Males 2003 = 197; Females 2003 = 189 - Women’s groups assisted through Technology Capitalization: 2002 = 48; 2003 = 23 - Integrating Persons With Disability (PWDs): - PWDs provided with employable skills: 2002 = 593; 2003 = 653 - Trained PWDs assisted to be self-employed: 2002 = 80; 2003 = 102 - PWDs assisted in communities: 2002 = 104; 2003 = 69 - PWDs provided with inclusive education: 2002 = 63; 2003 = 19 - Unit Committees members sensitised: 2002 = 55; 2003 = 27 - Source: Department of Social Welfare. ### Gender-based Abuse Reporting Trends (Table 7.3) - WAJU (Women and Juvenile Unit) Ghana Police Service cases reported (January 1999 to July 2003) — selected types (annual totals by year): - Rape: 1999 = 23; 2000 = 34; 2001 = 58; 2002 = 134; 2003* = 100 - Defilement: 1999 = 154; 2000 = 181; 2001 = 204; 2002 = 533; 2003* = 509 - Assault: 1999 = 95; 2000 = 86; 2001 = 232; 2002 = 1456; 2003* = 1559 - Threatening: 1999 = 21; 2000 = 16; 2001 = 60; 2002 = 652; 2003* = 461 - Abduction: 1999 = 3; 2000 = 5; 2001 = 9; 2002 = 80; 2003* = 79 - Non child maintenance: 1999 = 523; 2000 = 1383; 2001 = 1047; 2002 = 1899; 2003* = 3024 - Other categories reported with year-by-year counts in Table 7.3. - Source: Accra WAJU. ### Empowered Women: Microfinance and Job Creation - Women’s Development Fund: - As many as 500,000 women improved income-earning opportunities through receiving a total of ¢10 billion from the Women’s Development Fund administered by the Ministry of Women and Children’s Affairs. - The Ministry has also created 50,000 new jobs for women across the country. ### Improved Access to Services: Water, Health and Education - Data indicate increases in the number of people with access to water, health services and education between survey rounds (Core Welfare Indicator Questionnaire 1997 & 2003). (Regional percentage charts presented in source.) ### Situation of Children and Street Children (Child Labour Survey 2003, ILO/IPEC & GSS) - About 39% of Ghanaian children between ages 5 years to 17 years are economically active. - A total of 2,314 children were selected from known sleeping places of street children for the survey. - Key findings on street children (from Child Labour Report): - About 10% of the working children interviewed were identified as street children (2,314) - 52% of street children were female; 48% were female (note: source text repeats "female") - 50% of street children were between ages 15-17 years - 50% of street children were in the Greater Accra Region - 40% of street children were of Mole-Dagbon origin - 32% of street children were of Akan origin - 2% of street children were married - 11% of street children were in school - 70% of street children aged 15-17 years could not read or write - 98% of the street children had been working for the past 12 months - 80% of the street children knew about HIV/AIDS - 30% knew about protection through condoms ### Nature of Interventions (Section 7.3) - Department of Social Welfare (DSW) main programme areas for the year: - Justice Administration - Child Rights Protection and Promotion - Community Care - DSW activities: limited field visits, advocacy, administration of justice; reach constrained by limited resources. - Support to Women and Children: - Women’s Development Fund established with an initial sum of C21 billion; C10 billion disbursed to 20,000 women farmers. - Financial support provided for women engaged in commercial activities, agricultural production and processing, and related ventures. - ‘Operation Bring the Children Home’ returned trafficked children from coastal communities and around the Volta Lake to their homes; assisted mothers to withdraw children and enrol them in schools; supported these women with over C825million as part of micro-finance programme under the Social Investment Fund. - Legal Aid Services to the Poor: - 2003: Legal Aid Board procured computers and networked offices; staff received ADR training under the National Governance Project and trained some police officers. - Legal Aid Board legal assistance: - 2002: about 4225 persons - 2003: above 5000 persons - LEGAL AID TARGET INDICATORS (selected statuses): - Legal Aid offices established in all 10 regions: Completed - District courts established country-wide: Done - Police provided with training in basic prosecution: The Board provided some training to the police. - Alternative Dispute Resolution promoted: Litigants are beginning to adopt ADR in conflict resolution - Small Claims Court established in all District Magistrate Courts: Not completed - Juvenile and Family Courts at the District Level reconstituted: Not done - Source: Legal Aid Annual Report 2003 - HIV/AIDS interventions by Ghana Aids Commission and partners in 2003: - Information, Education and Communication - Advocacy - Peer Education - Voluntary Counselling and Testing - Capacity Building for CSO - Care and support for PLWHAs - Training and technical support for beneficiary groups - Ministry of Health/GAC activities: - Increased awareness campaigns; Ghana Demographic and Health Survey (2003) results: - General awareness of AIDS nearly universal among men and women of reproductive ages - 96 per cent of women and 98 per cent of men are conscious of a range of methods of contraception to help avoid AIDS - Condom use varies by sex, age, marital status, residence, region and education: - Condom use with non-cohabiting partners rises from 11 per cent of women with no education to 48 per cent of women with at least secondary education. - VCT centers expanded in hospitals and clinics. - Prevention of mother-to-child transmission implemented in 19 sites. - ART provided at Korle Bu Teaching Hospital, Komfo Anokye Teaching Hospital, Atua Government Hospital and St. Martin De Porres Hospital, Agomenya. - World Bank data: of the 62,000 people who need ART, less than 1 percent (550 persons) is receiving treatment. - Sentinel site sero-prevalence: growth from 3.4 to 3.6 percent in 2003. - Recommendation in source: need for more vigorous and widespread IEC programme for high-risk groups in high prevalence areas; note high costs and limited sustainability of OVC programmes at scale. - Community responses: - Endemic communities use traditional institutional arrangements (extended families, Queen mothers’ Associations, traditional community groups) to provide shelter, nutrition, health, education to OVCs, reducing need for institution-based care. ### Recommended Policy Initiatives (Section 7.4) - Review logistics situation and service conditions of Legal Aid Board and Department of Social Welfare to expand services to vulnerable and excluded groups. - Enhance collaboration and mainstreaming: greater collaboration between social and economic sector agencies is required due to crosscutting nature of vulnerability and exclusion; Poverty Monitoring Groups offer an opportunity for cross-fertilisation. - Children in ‘difficult circumstances’: conduct studies to provide baseline data and indicators to enable effective tracking and future assessment. - Improve coordination of anti-HIV/AIDS campaign: - GAC should assume a more central role in coordinating the national response to HIV/AIDS and in partner coordination; seek ways to pool resources. - Strengthen monitoring and evaluation of partners to avoid dissipation of scarce resources through fraudulent deals. - Implement more vigorous proposal vetting and organisation screening arrangements when commissioning groups to provide services. - Make contracting more rigorous and enforce sanctions in the event of misapplication of resources. *Source: _cr04207 - INTRODUCTION* ### INTRODUCTION ### INTRODUCTION ### Overview - District Assemblies continued to implement poverty reducing programmes and projects in line with their district medium term development plans (DMTDP) and along the objectives of the GPRS and government’s own medium term priorities. - This section explores the performance of District Assemblies based on financial returns lodged with the Ministry of Local Government and Rural Development and the DACF Administrator’s office. - Financial reports do not clearly disaggregate figures to show amounts spent in the different priority areas of education, health, and water & sanitation. As a result, details of projects and programmes executed by districts with funds from all sources, as was available in the last APR, are not immediately available for this report. - Some detailed report and analysis of projects and programmes funded from HIPC savings to districts for the period 2002 to 2003 is given. ### Financial performance — data sources - Data for the analysis of financial performance of districts has been obtained from reports submitted by districts to the Ministry of Local Government and Rural Development. - Funds for the execution of district development plans came from the major established sources: 1. GoG support to districts for salaries and wages 2. The District Assemblies’ Common Fund, (DACF) 3. Central GoG funds for programmes in districts through MDAs 4. Districts own internally generated funds 5. Enhanced HIPC initiative relief funds 6. Funds from Development Partners ### Data limitations and implications - The lack of clear disaggregation in district financial returns restricts the ability to report amounts spent by districts in specific priority areas such as education, health, and water & sanitation. - Because detailed breakdowns by sector are not available from the submitted financial returns, comprehensive listings of projects and programmes financed from all sources (as presented in the previous APR) cannot be reproduced for this report. *Source: _cr04207 - INTRODUCTION* ### 7. Other grants ### 7. Other grants ### Sources of district funding and central government support - Major source: Resources from the central government flowing to districts through sector ministries (education, health, feeder roads, etc.) and budgetary support for salaries and wages. - GOG resources for paying wages and salaries in 2003: ¢103.9 billion. ### DACF releases and use in 2003 - District-reported cash from the DACF in 2003: ¢449.3 billion. - DACF administrator instituted strict sanctions for districts that do not submit monthly reports on time, resulting in improved financial management of the fund. - DACF expenditures by districts: education, health, water & sanitation, micro credit to groups for production & employment generation. Table 8.1: Some GOG Funds to District Assemblies in 2003 (regional DACF and GOG support to districts for salaries & wages – 2003) - WESTERN: GOG for salaries & wages – 8,480,262,834 ; DACF 2003 – 41,447,532,022 - CENTRAL: GOG for salaries & wages – 9,145,627,650 ; DACF 2003 – 49,956,562,420 - GAR: GOG for salaries & wages – 29,069,571,340 ; DACF 2003 – 30,984,717,707 - VOLTA: GOG for salaries & wages – 6,574,907,615 ; DACF 2003 – 37,161,809,982 - EASTERN: GOG for salaries & wages – 10,299,005,382 ; DACF 2003 – 61,944,890,265 - ASHANTI: GOG for salaries & wages – 13,907,412,968 ; DACF 2003 – 79,553,383,698 - BRONG AHAFO: GOG for salaries & wages – 12,224,859,548 ; DACF 2003 – 50,113,914,771 - NORTHERN: GOG for salaries & wages – 6,949,326,298 ; DACF 2003 – 53,869,937,928 - UPPER EAST: GOG for salaries & wages – 4,544,349,572 ; DACF 2003 – 27,053,858,496 - UPPER WEST: GOG for salaries & wages – 2,766,071,287 ; DACF 2003 – 17,200,721,889 - TOTALS: GOG for salaries & wages – 103,961,394,494 ; DACF 2003 – 449,287,329,178 - Source: Ministry of Local GRD ### Internally Generated Funds (IGF) – totals and regional trends - District IGF total for 2003: ¢178.7 billion (up from ¢155.1 billion in 2002). - IGF composition: mainly fees & fines, rates, lands and licences. - Districts’ primary IGF uses: recurrent expenditure and counterpart funds to donor-sponsored projects. Table 8.2: IGF collected by region, 2000–2003 - Western: 2000 – 7,321,403,738 ; 2001 – 8,942,905,281 ; 2002 – 17,315,653,021 ; 2003 – 23,991,651,610 - Central: 2000 – 3,627,480,097 ; 2001 – 5,030,190,224 ; 2002 – 6,750,070,251 ; 2003 – 7,654,058,042 - Greater Accra: 2000 – 30,750,047,304 ; 2001 – 41,355,335,942 ; 2002 – 52,023,798,596 ; 2003 – 61,841,312,418 - Volta: 2000 – 3,794,006,825 ; 2001 – 5,037,532,993 ; 2002 – 18,366,459,438 ; 2003 – 6,617,053,372 - Eastern: 2000 – 4,776,474,999 ; 2001 – 5,671,567,217 ; 2002 – 11,391,726,048 ; 2003 – 13,188,660,409 - Ashanti: 2000 – 10,543,317,235 ; 2001 – 14,959,976,423 ; 2002 – 22,763,216,633 ; 2003 – 30,154,271,768 - Brong Ahafo: 2000 – 4,788,926,093 ; 2001 – 6,505,537,139 ; 2002 – 10,375,344,273 ; 2003 – 22,663,441,950 - Northern: 2000 – 1,700,136,293 ; 2001 – 2,493,972,590 ; 2002 – 8,336,007,437 ; 2003 – 5,608,194,767 - Upper West: 2000 – 1,194,524,631 ; 2001 – 1,155,416,084 ; 2002 – 2,035,378,675 ; 2003 – 4,111,977,394 - Upper East: 2000 – 1,860,727,926 ; 2001 – 4,533,253,998 ; 2002 – 5,792,563,474 ; 2003 – 2,831,848,240 - TOTAL: 2000 – 70,357,045,141 ; 2001 – 95,685,687,891 ; 2002 – 155,150,217,846 ; 2003 – 178,662,469,970 - Source: Ministry of Local Government & Rural Development - Note: Revenue generation increased in all regions in 2002 but in 2003 there were marked declines in Volta, Northern and Upper East regions; investigation recommended. ### HIPC relief savings (section 8.3.1) and projected transfers - Total transfers into the HIPC Account in 2003: US$108.96 million (out of expected US$113.33 million). - Balance expected to be lodged: US$4.37 million plus savings for 2004. - Expected amount to be lodged in HIPC account for 2004, including the 2003 balance, is estimated to be US$150.33 million (MOF). - When the ‘completion point’ is reached in mid-2004 debt service will further reduce, allowing more resources for development. ### HIPC allocations to MDAs (Tables 8.3 & 8.4) — cumulative 2002–2003 - Cumulative HIPC transfers to 20 MDAs (2002–2003): ¢1,110,901,232,859 (Table 8.3 totals). - Table 8.3 — selected MDA allocations (Amt in cedis): - Ministry of Communication: 2003 – 5,854,565,000 ; CUMULATIVE 2002-2003 – 5,854,565,000 ; % – 0.5% - Ministry of Defence: 2003 – 846,901,072 ; CUMULATIVE – 846,901,072 ; % – 0.1% - Min. of Reg. Co & NEPAD (ESRP): 2002 – 9,922,500,000 ; 2003 – 550,000,000 ; CUMULATIVE – 10,472,500,000 ; % – 0.9% - Ministry of Education: 2003 – 188,653,275,075 ; CUMULATIVE – 188,653,275,075 ; % – 17.0% - Ministry of Energy: 2002 – 519,758,328 ; 2003 – 35,111,346,154 ; CUMULATIVE – 35,631,104,482 ; % – 3.2% - Ministry of Information: 2002 – 3,501,100,000 ; 2003 – 8,160,000,000 ; CUMULATIVE – 11,661,100,000 ; % – 1.0% - Ministry of Interior: 2002 – 2,491,435,000 ; 2003 – 18,941,264,192 ; CUMULATIVE – 21,432,699,192 ; % – 1.9% - Ministry of Land & Forestry: 2003 – 10,999,800,000 ; CUMULATIVE – 10,999,800,000 ; % – 1.0% - Ministry of Manpower Dev: 2003 – 7,610,000,000 ; CUMULATIVE – 7,610,000,000 ; % – 0.7% - Ministry of Mines: 2002 – 3,231,519,000 ; CUMULATIVE – 3,231,519,000 ; % – 0.3% - Ministry of Private Sector Dev: 2003 – 8,700,000,000 ; CUMULATIVE – 8,700,000,000 ; % – 0.8% - Ministry of Roads & Transport: 2003 – 87,168,558,128 ; CUMULATIVE – 87,168,558,128 ; % – 7.8% - Ministry of Tourism: 2003 – 5,807,469,479 ; CUMULATIVE – 5,807,469,479 ; % – 0.5% - Ministry of Trade, Industry & PSI: 2002 – 4,502,381,000 ; 2003 – 13,583,133,914 ; CUMULATIVE – 18,085,514,914 ; % – 1.6% - Ministry of Women & Children: 2002 – 14,966,362,500 ; 2003 – 12,000,000,000 ; CUMULATIVE – 26,966,362,500 ; % – 2.4% - Ministry of Work & Housing: 2002 – 3,010,128,603 ; 2003 – 105,123,147,119 ; CUMULATIVE – 108,133,275,722 ; % – 9.7% - Ministry of Local Gov & Rural Dev.: 2002 – 126,677,475,568 ; 2003 – 101,720,478,015 ; CUMULATIVE – 228,397,953,583 ; % – 20.6% - Ministry of Food & Agriculture: 2003 – 16,420,642,575 ; CUMULATIVE – 16,420,642,575 ; % – 1.5% - Ministry of Health: 2003 – 70,827,992,137 ; CUMULATIVE – 70,827,992,137 ; % – 6.4% - Office of the Senior Min: 2002 – 18,600,000,000 ; CUMULATIVE – 18,600,000,000 ; % – 1.7% - DOMESTIC DEBT PAYMENTS: 2002 – 81,400,000,000 ; 2003 – 144,000,000,000 ; CUMULATIVE – 225,400,000,000 ; % – 20.3% - TOTALS: 2002 – 268,822,659,999 ; 2003 – 842,078,572,861 ; CUMULATIVE – 1,110,901,232,859 ; 100% - Source: MOF / Controller and Accountant General’s Department / MDA reports, Feb 2004 - Table 8.4 — HIPC funds to MDAs (amounts in cedis) and purposes (selected entries): - BANK OF GHANA: 225,400,000,000 — DOMESTIC DEBT PAYMENTS - Ministry of Communication: 5,854,565,000 — Linking rural communities, SSS IT links - Ministry of Defence: 846,901,072 — Construction works-barracks; Construction works-Sunyani & Kumasi; Renovation-3BN Sunyani - Min. / Regional Coop & NEPAD (ESRP): 10,472,500,000 — Micro Credit to Farmers and Traders under the ESRP - Ministry of Education: 188,653,275,075 — Upgrading & Rehabilitation of 31 SSS; Subsidy for 2nd Cycle institutions; Youth empowerment programme - Ministry of Energy: 35,631,104,482 — Extension of electricity to communities; Payment for supply of HT poles; ECG subsidy for lifeline consumption of electricity - Ministry of Health: 70,827,992,137 — Health Insurance Schemes; Construction work for hospitals; Purchase of motorbikes; Health maternal deliveries - Ministry of Roads & Transport: 87,168,558,128 — Construction of feeder roads; Down payment for buses for the mass transportation programme - Ministry of Work & Housing: 108,133,275,722 — Water supply rehabilitation and expansion; Tamale Storm water drainage project; Korle Lagoon Ecological Restoration project; Resettlement of people at Keta; Access to safe water in guinea worm areas - Ministry of Local Government & Rural Dev.: 14,540,000,000 — Ministry’s HIPC programme in DAs (Bio-gas, Enviro-loo, WC toilets, Boreholes; Sanitation Containers) - [District Assemblies]: 213,857,953,583 — Sanitation in major cities; Provision basic services in DAs; Education, Health, & safe water - Office of the Senior Min: 18,600,000,000 — Micro credit to 43,156 farmers in all 10 regions - TOTAL: 1,110,901,292,859 - Source: MOF / Controller and Accountant Generals Department / MDA reports - Observations on HIPC distribution (2002–2003 cumulative): - Total HIPC funds transferred: ¢1,111 billion (One Trillion, One Hundred and Eleven billion cedis). - Largest proportion to Ministry of Local Government & Rural Development: 20.6% (¢228.4 billion), of which ¢213.9 billion went directly to districts and ¢14.5 billion used by the ministry for its own sanitation programmes. - Domestic Debt Payments: ¢225.4 billion, representing 20.3% of total HIPC relief. - Sectoral shares cited: Education 17.0%; Water and sanitation 9.7%; Roads & transport 7.87%; Health 6.47%. ### Release and use of HIPC funds at district level (8.3.3) - 2002 (first year): districts received bulk sums in two tranches; transfers averaged ¢1 billion per district. Metropolitan Assemblies: Accra ¢3.5 billion, Kumasi ¢2.5 billion, Shama Ahanta ¢2.0 billion; four Municipal Assemblies received ¢1.5 billion each. - 2003: allocations targeted selected projects and national programmes (District Mutual Health Insurance Schemes, exemptions for Maternal Deliveries). Ministry of Education used funds for basic education facilities, teacher accommodation, food subsidy for boarding schools, and upgrading selected schools. Cumulative distribution of HIPC funds by sector (2002–2003) — proportions shown in report: - Health: 6% - Roads: 8% - Water: 10% - Districts Assemblies: 21% - Domestic Debt: 20% - Education: 17% - Other: 18% Table 8.5: Proposed use of HIPC funds by District Assemblies — Proportion of Total HIPC Funds / Purpose - Education 6% — Infrastructure – classrooms & toilet facilities for basic schools and teacher accommodation - Health 7% — Infrastructure - health facilities, posts, accommodation for health personnel - Water 7% — Rural water – CWSA programmes - Sanitation 4% — Waste disposal and drainage in urban districts; Toilet facilities and drainage in rural districts - Disaster preparedness 1% — Funding for relief and emergency supplies - Source: MOF - Reported effect: HIPC funds increased development projects in districts; funds were readily available in District HIPC accounts enabling rapid execution and prompt contractor payments. However, process improvements are recommended to increase development impact. ### Types and counts of HIPC-funded projects (cumulative for 2002 and 2003) - Total projects nationwide: 1,516 projects. - Education projects: 609 (including 509 new classroom blocks; 22 districts procured classroom furniture; teacher accommodation constructed). - Education totals reported in table: Education Total — 509 (classroom blocks) plus other categories yielding Education Total counts in table entries. - Health projects: 194 projects; 78 district hospitals and health centres rehabilitated or constructed; 52 nurses quarters constructed; initiation of Mutual Health Insurance Schemes in all districts; funds used as exemptions for maternal deliveries. - Sanitation projects: 563 projects; constructed 436 toilets and 45 incinerators; refuse containers, drains, abattoirs, etc.; metropolitan and municipal assemblies made largest sanitation investments. - Water projects: 141 projects; 69 boreholes constructed; additional boreholes planned by CWSA under guinea-worm eradication programme. - Production & Employment: micro credit schemes and related programs; Office of the Senior Minister provided micro credit to 43,156 farmers in all 10 regions; Ministry of Women & Children’s Affairs provided micro credit to women farmer and trader groups and supplied food processing equipment. (Notes on Tab 8.6: table formatting in source is inconsistent; summary counts above taken from text and table headings preserving numeric totals.) ### Key issues & observations in management of HIPC funds and projects (8.3.5) Major categories: - Project Selection, Design & Costing - Issues: - MLGRD guidelines require projects be selected from District Medium Term Development Plans (DMTDP) aligned with GPRS, but many districts selected projects inconsistent with development plans. - Delays in project execution increased final costs; DAs had to find funds to cover differences. - Recommended policy initiatives: - Provide a clear-cut definition of project selection to ensure projects are chosen from the District Medium Development Term Plan. - Regional Coordinating Councils (RCCs) will represent the MLGRD at regional level to approve projects regionally to reduce length of approval process; RCCs will be better informed to carry out monitoring and coordinating roles. - Funds Transfer and Communication flow - Issues: - Some HIPC funds transferred to district accounts without accompanying directives about purpose (particularly transfers by MDAs). - Funds meant for particular districts sometimes mistakenly lodged into other district accounts, complicating retrieval if the recipient district has utilized funds. - Significant lack of information about HIPC processes at the district level; perception of ineffective national-level coordination. Unlike DACF, which has an Administrator, HIPC has several players, making timely information for DAs difficult. - Recommended policy initiatives: - Significantly improve communication and audit processes; establish a single point of contact to check and clarify funds due and transferred to Districts. - Establish a single national point of contact to coordinate HIPC communication. Provide detailed information on each project to beneficiary Metropolitan, Municipal or District Assemblies (project, implementing agency, purpose). - Micro Credit Support for Production & Gainful Employment - Issues: - Funds transferred to districts for micro credit management appear ineffective and fraught with difficulties (access, recovery, lack of transparency and equity); questions over DAs’ capacity to manage micro funds (identify beneficiaries, lend, collect). - Recommended policy initiative: - Channel funds through a local Rural Commercial Bank, paying the bank management fees to manage the process on behalf of the DA. Identify a Project Coordinator from the DA to manage the relationship and ensure micro credit poverty reduction objectives are achieved. - Involvement of the District Planning & Coordination Unit (DPCU) - Issues: - DPCU not actively involved in HIPC processes at district level despite expected critical M&E function to ensure projects impact poverty reduction. - Recommended policy initiative: - Document and communicate the role of the DPCU in HIPC M&E process to empower them to be formally involved. *Source: _cr04207 - 7. Other grants (IMF / extracted PDF content)_* ### 10.1 MACRO ### 10.1 MACRO ### Economic stability — overview - The government is committed to and has succeeded in maintaining macro-economic stability and intends in 2004 to maintain the macro-economic stability achieved in 2003. - Notwithstanding these efforts there are a few challenges that the government will face in 2004 including the delayed petroleum price adjustments. ### Policy measures and growth objectives - The government will, without losing control over macro-stability, simultaneously pursue more ambitious growth policies, which will propel the economy to a higher growth rate than hovering around 5%. - The government will use an optimum mix of appropriate fiscal and monetary policies to deliver on inflation and other macroeconomic targets and continue to strengthen public expenditure management. ### Debt, revenue, and financing measures - The government will continue to reduce the debt burden by increasing revenue collection through further improvements in the efficiency of the revenue collecting agencies. - The government plans to use the TOR Debt Recovery Fund, which is expected to yield 1.2 trillion cedis to partly fund the subsidies for the delayed petroleum price adjustments. - The government also plans to close the unplanned financing gap through fiscal adjustments which consist of: - curtailing discretionary expenditures but protecting poverty reduction expenditures; - reducing net domestic debt repayments from 2.2% of GDP to about 1.5%; - finding more sources of revenue (non-tax revenue) through accelerated divestiture and increased dividends from state-owned companies. ### Public expenditure, budgeting, and monitoring - Government expenditures generally reflected the GPRS priorities. - Published expenditures do not clearly show the extent to which the poor benefited, especially the deprived areas of Northern, Upper east and Upper West and Central Regions. - A more detailed breakdown of expenditure will be provided to forge a closer link between budget allocations and beneficiary targets. - The areas of budget formulation, execution and reporting still need upgrading and the link between the budget and GPRS would be strengthened further. - The Budget and Public Expenditure Management System will be expanded to six other MDAs by November 2004. ### Public Financial Management reform actions - As part of the Public Financial Management Reform Programme the Ministry of Finance and Economic Planning will operationalise: - the Financial Administration Act; - the Internal Audit Agency Act; and - the Public Procurement Act; - as well as enhance the activities of the External Audit Act. - The government expects timely disbursement of pledges by Development Partners and will encourage donors that are not party to the MDBS to join. ### Financial sector and growth link - The Bank of Ghana will work to diffuse the inefficient institutional structures in the financial sector to allow for a well-functioning financial sector which impacts on growth and thus helps to reduce poverty. ### Labour market information - The unemployment rate is a critical macro indicator of welfare but is not routinely reported on. - Government will work hard to ensure that labour market information be made available more frequently. *Source: _cr04207 - 10.1 MACRO* ### 10.2 PRODUCTION ### _cr04207 - 10.2 PRODUCTION ### Production & Gainful Employment - Progress made in the Production and Gainful Employment area, but additional policy initiatives could enhance the sector. - Current production characteristics: - Crop production is largely rain-fed and traditional techniques dominate. - Government intentions and planned measures: - Encourage private commercial farming based on proper mechanised and irrigation systems. - The Ministry of Trade, industry and PSI will encourage establishment of industrial estates and clusters emphasizing agricultural machinery development. - Intensify infrastructural development, especially feeder roads rehabilitation, construction and maintenance to provide market access to rural agriculture. - Early commencement of Phase II of the Natural Resource Management Programme at the Ministry of Lands and Forestry for re-afforestation of degraded lands. - Assess feasibility of using a percentage of the Mineral Development Fund as seed money outside GoG expenditures to finance poverty reduction projects; Ministry of Mines activities will be highlighted in the GPRS update. - Integrate Ministry of Tourism activities fully in the GPRS during the update for 2006-2008. - Expand the Annual Survey of the Ministry of Food and Agriculture beyond food crops to include non-food crops; capacity to capture additional data is required. - Shift emphasis in processing of agricultural produce toward the Rural Enterprise Development Programme, involving establishment of three enterprises each in all the 110 districts. ### Human Resource Development & Basic Services Education - Findings: - Increases in GPER nationally and reduction in disparity across regions and gender align with GPRS objectives. - Monitoring of quality-of-education indicators shows mixed results. - Government actions: - Continue current policies to ensure more equity in access. - Pay special attention to quality issues in the next round of GPRS implementation. - Conduct regular impact assessment of teacher retention schemes to ascertain differential impact of different schemes. Health - Findings and concerns: - Recent increases in infant and childhood mortality rates require review of health sector priorities. - Positive correlation observed between child malnutrition and under-five mortality; child nutritional programmes may need strengthening and expansion. - Targeting and access: - Need a system to identify and concentrate location of health facilities in the most vulnerable districts. - No current system to identify the most poor; addressing this quickly is important to enhance exemptions targeting. - Need to accelerate full implementation of the National Health Insurance Scheme to ensure poor people have access to quality health services. - Introduction of a targeting system would help ensure planned subsidies to cover premiums reach the most poor and vulnerable. Water and Sanitation - Findings: - Access to drinking water has improved considerably. - Incidence of guinea worm infections is on the rise, indicating safety concerns about rural water quality. - Government actions: - Investigate the contradiction between increased access and rising water-borne disease; take immediate action to ensure access to quality water. - Sanitation access remains very low and needs particular attention in next GPRS phase. ### Good Governance Security and Rule of Law - Measures to promote good governance: - Greater dissemination of information about policies, programmes and services to inform the public of rights, obligations, and available services. - Intensify public forums to discuss justice, accountability and security, including regular Peoples’ Assembly events at national, regional, and district levels. - Continue ‘Meet the Press’ and make greater use of mass media and civil society groups, including professional associations. - Governance indicators: - Governance indicators will be revised to present a more comprehensive representation of all relevant institutions beyond law and order. Decentralization - Observations: - Need research to establish system-wide impact of policy measures on improved services by district assemblies. - Communities increasingly empowered to demand accountability from public office holders at District Assembly level. - Policy direction: - Sustain support to district assemblies to deepen citizen participation in decision-making and ensure equity in resource allocation. Public Sector Reform - Main thrust: - Adjust central government structures and organisation to make central machinery more efficient, effective, and private sector-friendly. - Strengthen government capacity to set the development agenda and facilitate private sector and social partner contributions to national development. Monitoring & Evaluation - Challenge: - Multiplicity of GPRS indicators exists, but measuring intangibles like improvements in practice of democracy is difficult. - Planned action: - Stakeholder consultation to harmonise existing indicators with APRM of NEPAD and the MDGs. ### The Vulnerable & the Excluded - Service delivery and coordination: - Review logistics and service conditions of Legal Aid Board and Department of Social Welfare to expand services to vulnerable and excluded. - Mainstreaming of assistance for vulnerable cross-cuts sectors and requires greater collaboration between social and economic sector agencies; Poverty Monitoring Groups provide opportunity for cross-fertilisation. - Children and data gaps: - Children in “difficult circumstances” are especially vulnerable but no indicators exist to enable effective tracking; studies will be conducted to provide baseline data. - HIV/AIDS coordination and accountability: - Improve coordination between interest groups working on anti-HIV/AIDS campaign; GAC should assume a more central role in coordinating national response and seek ways to pool resources. - Recent allegations involving Ghana AIDS Commission (GAC) and NGOs highlight need for improved monitoring and evaluation of partners to avoid dissipation of scarce resources through fraudulent deals. - Consider more vigorous proposal vetting and organisation screening before commissioning groups; make contracting more rigorous and enforce sanctions for misapplication of resources. ### District Assembly HIPC Fund Utilization Policy Project Selection, Design & Costing - Provide clear-cut definition of project selection to District Assemblies (DAs) to ensure projects are chosen from the District Medium Development Term Plan. - Regional Coordinating Councils (RCCs) will represent MLGRD at regional level to approve projects regionally to reduce approval length and better enable monitoring and coordinating roles. Funds Transfer & Communication Flow - Improve communication process and audit processes. - Establish a single point of contact to check and clarify funds due and transferred to Districts. - Create a single national point of contact to coordinate HIPC communication. - Provide detailed information on projects and implementing agencies to beneficiary Metropolitan, Municipal or District Assemblies. Micro Credit Support for Production & Gainful Employment - Funds will be channelled through a local Rural Commercial Bank; the bank will be paid management fees to manage the process on behalf of the DA. - A Project Coordinator from the DA should be identified to manage the relationship and ensure Micro Credit poverty reduction objectives are achieved. Involvement of the DPCU - Document and communicate the role of the DPCU in HIPC M&E process to DAs to ensure formal involvement. ### HIPC Completion Point — Status Report (selected triggers and exact indicators) - Trigger 1: Preparation of a full PRSP and satisfactory implementation for at least one year as evidenced by the joint staff assessment of the country annual progress report. - Status: This trigger has been met. The GPRS was finalized in February 2003 and endorsed by the World Bank and the IMF. The first Annual Progress Report (APR) was completed in March 2004. - Trigger 2: Continued maintenance of macroeconomic stability as evidenced by satisfactory implementation of the PRGF-supported programme. - Status: A new three-year PRGF arrangement was approved in May 2003 and the first review completed in December 2003. Overall, indicators for macroeconomic stability registered continued progress in 2003. - Trigger 3: Use and monitor budgetary savings in priority areas; ensure timely publication of information for an annual public hearing and use information as input to annual progress report on the GPRS. The increase in total spending on these priorities must equal or exceed HIPC relief. - Status: Budget savings have been used for poverty reduction expenditures. Information is available in the 2004 Budget Statement and incorporated in the 2003 APR on the GPRS. Spending in poverty related activities exceeded HIPC relief. - Trigger 4: Procurement reform—establish new procurement code with regulatory oversight body. - Status: Regulatory oversight body put in place; new Procurement law passed by Parliament and gazetted. Position of Chief Executive of the Secretariat advertised; Members of the Public Procurement Board nominated and approved by the President and await concurrence of the Council of State. Inauguration of the PPB planned for June 2004. - Trigger 5: Strengthen capacity of the Internal Audit Unit through full staffing of existing internal audit positions. - Status: Existing positions have been fully staffed. - Trigger 6: Government expenditure reports published monthly in government gazette following implementation of a new reporting system. - Status: New reporting system implemented and reports are published in the gazette monthly. - Trigger 7: Establish functioning electronic expenditure tracking systems in the Ministry of Finance (MOF), the Controller and Accountant General’s Department (CAGD) and at least two other key Ministries. - Status: System installed and operational in MoF and CAGD. Actions underway to complete installation in Ministries of Health, Education, and Roads and Transport by mid 2004. - Trigger 8: Devolve responsibilities to local districts as evidenced by (i) submission to Parliament of a Local Government Bill and (ii) development district composite budgets in pilot districts. - Status: Local Government Bill submitted and passed in July 2003 and gazetted on 31/12/2003. District composite budgets prepared in 3 pilot districts: Dandme East, Dagme West and Akwapim North. - Trigger 9 (Education): Increase girls’ enrolment in primary schools from 72% in 2000 to 74%. - Status: Target of 74% in Gross Primary Enrolment Ratio (GPER) for girls exceeded; GPER of 77.7% recorded in 2003. - Trigger 10 (Health): Increase percentage of rural population with access to safe water from 40% in 2000 to 46%. - Status: Indications are that 46% target has been exceeded; rural population with access to safe water is now 46.38%. - Trigger 11 (Health): Recurrent health expenditure at district and lower level governments have risen from 42 percent of the total recurrent health budget in 2000 to 45 percent. - Status: Total recurrent health expenditure at district and lower level as proportion of total government recurrent expenditure reached 49.6 % in 2003. - Trigger 12 (Energy): Automatic price adjustment mechanism in petroleum sector implemented monthly to reflect changes in international market prices in local currency and include all taxes incorporated into the adjustment formula at end-March 2002. - Status: Price adjustment mechanism put in place in 2003 but has not been implemented. - Trigger 13 (Energy): Strategy for full economic pricing in electricity sector, including lifeline pricing for affordability. - Status: Strategy put in place and implemented since August 2002. PSIA on electricity pricing in progress and awaiting draft report. Lifeline protection measure instituted to protect low-income users. - Overall assessment: - Except for petroleum pricing, the triggers expected to be met prior to reaching the HIPC completion point have been fully met; in some cases exceeded. Reaching the HIPC completion point is considered a matter of time given reported compliance. *Source: _cr04207 - 10.2 PRODUCTION* ### 22. Health ### 22. Health ### Access to safe water in rural areas - Objective: Increase access to safe water in rural areas. - Baseline and result: - The percentage of households with access to safe water in rural areas increased from 40% in 2000 to 46% in 2004. - Target exceeded: CWSA recorded 46.38. ### Health recurrent expenditure at district and lower levels - Objective: Increase share of health recurrent expenditures at district and lower levels of government as percent of total recurrent health budget from 42% in 2000 to 45%. - Result: - District level share increased to 49.5% in 2003. - Status: Target exceeded. *Source: _cr04207 - 22. Health* ### PART 1: IMPROVING GOVERNANCE AND PUBLIC SECTOR MGT ### _cr04207 - PART 1: IMPROVING GOVERNANCE AND PUBLIC SECTOR MGT ### Decentralization and Local Government Reform - Local Govt Service Bill laid before Parliament; Local Govt Service Bill passed by Parliament on March 14 2003. - Completed comprehensive Action Plan for Decentralization (including fiscal reform) to be submitted to Cabinet. - National Decentralization Action Plan (NDAP) prepared and presented to DPs; joint response from DPs submitted to GoG. NDAP being revised for submission to cabinet for its endorsement. - NDPC M&E study report and Zero Draft of the implementation of the GPRS referenced. - MTDP have been prepared and in compliance with GPRS. - Translate GPRS priorities into plans and budgets at District levels: Medium Term Development Plans and Annual District Action Plans to be in compliance with GPRS guidelines & priorities. - Pilot district composite budget in 3 districts: Composite Budget initiated in 3 districts and Strategic plan developed. ### Public Sector Reform and Accountability - Policy objective: Cabinet issues a policy statement on a refocused Public Sector Reform, including Public Sector Pay and Employment, to define a time bound reform programme to improve governance and service delivery at national and local Levels. - Measure/Indicator: Cabinet Policy Statement; Public Sector Strategy sent to Cabinet; Implement a refocused Public Sector Reforms. - Improve external and internal auditing control: - Reduced time lag in the submission of annual audits to Parliament. - Auditor General submits 2002 audited accounts for the Consolidated Fund and MDAs; Audit reports in progress. - Freedom of Information and Whistle Blower legislation: - Final Draft of Freedom of Information Bill presented to Cabinet; Revision of Draft in progress. - Final Draft of Whistle Blower Bill presented to Cabinet; Revision of Draft in progress. - Strengthening capacity to monitor and evaluate the policy agenda: - Implement M&E plan for GPRS as evidenced by timely and public dissemination of 2003 annual progress report. - Dissemination of other Annual Progress Report 2002: 2002 APR disseminated. ### Public Expenditure Management - Further increase, compared to 2003 budget, in poverty reduction budgeted expenditures as share of domestically financed expenditures (including HIPC). - 2004 Budget Statement shows real increase in poverty reduction budgeted expenditures as share of domestically financed expenditures. - Strengthen budget execution and reporting formulation: - Prepare monthly budget execution Reports (Commitments and Expenditures) reconciled with BoG with no more than 8 weeks lag. - Monthly reports submitted by CAGD with no more than 8 weeks lag. Monthly reports are submitted with no more than 8 weeks lag. - Transparency and value for money in public expenditure: - Begin implementation of the new Procurement Bill enacted by Parliament by establishing and making operational Public Procurement institutions. - Implementation commenced as evidenced by: (1) Establishment of public procurement board (PPB) and secretariat. (2) Establishment of Entity Tender committees and Review Tender Boards. --- ### PART 2: PROMOTING GROWTH, INCOME & EMPLOYMENT — Improving the Environment for Business While Protecting the Poor ### Energy Sector and Deregulation - Government to continue with implementation of energy sector reforms previously approved by Cabinet. - Accelerate the programmes for Deregulation of the petroleum sector. - Sustain incremental efforts at achieving and maintaining full cost recovery in utility pricing as well as improving the efficiency of utility companies. - Pricing formulas for electricity and water to continue to be administered by the Public Utilities Regulatory Commission (PURC). - Functional National Deregulation Committee in place: National Deregulation Committee has been formed to oversee the deregulation process — In progress. ### Private Sector Development and Investment Climate - Approval by Cabinet of Medium-Term Sector Development Strategy with Action Plan and Monitoring and Evaluation Matrix. - Approved Medium Term National Private Sector Development Strategy for implementation. - Final Draft submitted to government on 29th Dec 2003, received Cabinet approval on 29th Jan 2004 and expected to be launched by end of March 2004. ### Ministry Strategic Planning and Rural Infrastructure - Begin implementation of MOFA Strategic Plan, costed with clear links to GPRS targets: - MOFA’s strategic plan 2003 – 2005 has been prepared and distributed. The cost tables are being reviewed for 2004 – 2006. - Rural sector performance — feeder and trunk road condition mix index: - Feeder roads 2002 (Good 33% Fair 19% Poor 48%) → 2003 (Good 36% Fair 26% Poor 38%). - Trunk roads 2002 (Good 26% Fair 27% Poor 47%) → 2003 (Good 29% Fair 30% Poor 40%). - Observation: Feeder roads improved and Trunk roads deteriorating. --- ### PART 3: IMPROVING SERVICE DELIVERY FOR HUMAN DEVT. ### Education — Basic Education Access and Completion - Objective: Increase access, completion and Quality in Basic Education, particularly in Northern, Upper East and Upper West. - Indicator: Improved Gross Primary Enrolment ratio in most deprived regions in 2003/2004 compared to previous years. - GPER increased in the 3 most deprived regions: - Northern: 62% to 70% - Upper East: 70% to 79% - Upper West: 56% to 63% - (2003) NR: 67.7 UE: 72.2 UW: 69.6 - Note: NR & UER were on track but UWR exceeded the target. ### Health — Maternal Health and HIV/AIDS Response - Improve maternal health — increase proportion of supervised deliveries for under-served regions: - Proportion of supervised deliveries greater in 2003 than 2002 figures in underserved regions (Northern, Upper East, Upper West, Central). - 2002 Baselines: CR: 40 NR: 11.1 UE: 22.1 UW: 16.1 - (2003) CR: 38.4 NR: 18.3 UE: 27.8 UW: 33.3 - NR, UER and UWR were on track but it reduced for CR. - HIV/AIDS pandemic response: - Joint Review of GoG response to pandemic finalized and key recommendations adopted with the aim of ensuring effective Implementation and achievement of the 5 expected outcomes of the Ghana strategy. - Adoption of joint review report by key organizations of the main recommendation — Not completed at the time of the report. Started in March 2004, Scheduled to be completed in April 2004. --- ### APPENDIX 4: SUMMARY REPORT OF THE POVERTY & SOCIAL IMPACT ANALYSIS (PSIA) STUDIES ### Overview - Five PSIA studies commissioned by Government through NDPC with support of Development Partners to assess impacts of specific policy reforms under the GPRS on stakeholders, especially the poor, vulnerable and excluded. - PSIA tools analyze distributional impacts and outcomes on welfare and recommend policy actions to address negative impacts. - Summaries of objectives, findings, conclusions, and policy recommendations of four completed PSIA studies are presented. Recommendations reflect researchers’ views and are not necessarily endorsed by NDPC, Government of Ghana or donors. ### 4.1 PSIA on Tackling Vulnerability and Exclusion in Ghana Objectives: - Determine nature and extent of vulnerability and social exclusion and identifying enhancing factors. - Identify determinants (conditions, events, trends) that present risks and exclude groups from participation. - Understand coping mechanisms of the vulnerable and how to strengthen them. Findings: - Poverty is multi-faceted; definition should go beyond basic needs to include access to education, health, and information. Denial of rights, lack of accountability, lack of opportunity to participate, lack of access to resources and other institutional barriers contribute to vulnerability and social exclusion. - Small-scale farmers are the leading vulnerable group due to multiple risks; two decades of SAP collapsed rural agricultural economy and rendered them uncompetitive. Link between gender and poverty: rural farmers who are mainly women are the poorest. - The 5.2% growth of the economy in 2003 was predicated on economic indicators and did not have a ‘trickle-down effect’. This is supported by the increase in the percentage of people who fall in the first poverty quintile to 19%. - Coping strategies include sale of assets, reducing food quality and quantity, migration, and child labour; these depend on availability of assets and services. Conclusions and Policy Recommendations: - Need for a clear definition of vulnerability & exclusion so policy decisions and interventions can be well targeted and monitored. - GPRS review should emphasize sectoral linkages to reach consensus on a set of indicators on vulnerability. ### 4.2 PSIA on Energy Sector Reform In Ghana: Electricity Tariffs Objectives: - Assess implications and effectiveness of current subsidy schemes to protect the poor. - Effects of recent tariff increases on residential consumers including changes in fuel mix. - Assess affordability of current tariffs and sustainability of cross-subsidies. - Propose key indicators for monitoring poverty impact of energy sector reform. Findings: - Electricity tariffs lag behind cost of production; gap to be filled through transition to full cost-recovery. - Lifeline programme assumes individual meter users; shared household meters and pre-paid meters make policy ineffective and poor people adopt various coping mechanisms. No consensus among stakeholders on reforming lifeline policy. - Shared meters create dynamics between landlords and tenants and add arbitrariness to distributional impacts; lifeline tariffs do not target the poor. - Increase in tariffs does not result in increases of revenue for utilities because of inefficiency and low collection rates. Conclusions and Policy Implications: - Despite lifeline policy, the poor do not have access to electricity. Consumers complain of high and increasing prices even though consumption behaviours have not changed; calls for communication and education to explain bill increases. - Ability and willingness to pay depend on factors besides income level; these factors must be considered in tariff policy decisions for each consumer band. ### 4.3 PSIA on Enhancing Capacity for Pro-Poor Decentralization Objectives: - Understand impact of policy reforms and public actions for pro-poor decentralization regarding resource mobilization, management and allocation at district level and capacity constraints in delivering pro-poor services. - Assess effects of alternative policy measures on target groups. - Examine impacts of increased resource availability at district level on local economy and social development. - Evaluate whether decentralization measures improve poverty reduction at local level and extent capacity constraints influence local government system. - Assess appropriateness of schemes for building capacity within local government. Findings: - District Assemblies (DAs) lack capacities (quality and quantity) needed to execute administrative, legislative and executive functions. - Main activity of the poor local population is agriculture and 77% of them are not aware of their DAs, indicating low participation in governance. Poor people have a negative perception of decentralisation. - No local organisations to stimulate participation of local people in development planning or choices. - Poor people lack adequate income and adopt coping mechanisms to provide for basic needs. Conclusions and Policy Implications: - Mount programmes to educate local people about decentralisation and its benefits. - Address lack of coordination and cooperation among sectors at district level; resolve institutional and administrative entanglement affecting execution of programmes and projects. - Examine implementing the preference that DCEs should be elected; in the interim strengthen accountability mechanisms at DAs. - Implement earlier policy consideration to increase the DACF from 5% to 7.5% to increase resources at the local level. - Pro-poor decentralisation is not merely creation of more districts; it should encourage strong participation of poor people and local groups and associations. ### 4.4 PSIA on Economic Transformation of the Agricultural Sector Objectives: - Determine whether Economic Transformation of the Agricultural Sector will compound or mitigate constraints facing smallholder/subsistence farmers. - Assess trade-offs between production-oriented and poverty-oriented agricultural policies. - Examine how food policies impact food security and vulnerability. - Evaluate whether guidelines for allocation of HIPC funds suffice for growth and poverty reduction aims. Findings: - Modernization of Agriculture targeted in GPRS: transforming traditional agriculture into commercial venture using technologies that maximise outputs and minimize damage. - Smallholder peasant farmers dominate Ghana’s agriculture; modernization policies targeting them will have widespread coverage. - Smallholder farmers need education on small-business operation to take advantage of created business environment. - Policies should focus on multiple impacts; technology should increase both employment and output. - Policies achieving small increases in output by smallholder farmers are better than those achieving large increases for commercial farmers; modernization policies directed at commercial farmers have sporadic effect on the poor. - Pro-poor agriculture modernization policies are better at reducing poverty than pro-growth policies. - Agriculture modernization policy has indirect impacts like creating employment opportunities and price stability. Conclusions and Policy Implications: - Form farmer-based organisations (FBOs) to ensure accessibility to services, incentive packages and participation in policy formulation. - Enable smallholder farmers to acquire knowledge and tools to benefit from conducive environments. - Re-examine agriculture modernization policy framework to make it more pro-poor to expand participation of small farmers and improve access to goods, services and incentive packages. ### 4.5 Common Issues from the PSIA Studies - Unclear definitions of concepts and terms (e.g. poverty, vulnerability). - Poor people are mainly in rural communities and are largely subsistence, smallholder, and peasant farmers the majority of whom are women. - Poor people lack access to basic needs including information and knowledge; they are not aware of policies meant for their benefit and do not participate. - Coping strategies include borrowing, sale of assets, pulling children out of school, and sending children into child labour. - Lack of capacity and other resource constraints at the DA level; lack of accountability, coordination, and institutional rivalry hamper delivery of services to the poor. - Poverty reduction will be enhanced by adopting pro-poor policies rather than pro-growth policies; proper targeting of policies to the poor is required to avoid or reduce leakages. *Source: _cr04207 - PART 1: IMPROVING GOVERNANCE AND PUBLIC SECTOR MGT* --- _Source: https://www.imf.org/-/media/websites/imf/imported-full-text-pdf/external/pubs/ft/scr/2004/_cr04207.pdf_