With the worldwide demand for food estimated to double by the year 2050, the need to prioritise wellbeing of the farmer has become even more crucial.
The Ghanaian farmer is a noble hard-worker, responsible for guarantying quality food supply to millions of households – but sadly, a crucial aspect of the farmer’s wellbeing appears to have consistently missed the attention of policymakers and key stakeholders.
A healthy farmer base equals a healthy, wealthy country. This assertion is a basic truism that requires little or no effort to comprehend. Ghana’s agriculture comprises millions of peasant farmers who together contribute a colossal amount of the agricultural produce that makes our budding agricultural industry tick.
Though large-scale agriculture is gradually gaining a foothold in Ghana, it is impossible to discount the crucial role played by peasant farmers who together account for more than 70% of agricultural produce that feeds Ghana and other parts of the globe through export.
Having established the monumental importance of Ghanaian farmers to sustenance of the country, it is regrettable that for the Ghanaian farmer a crucial necessity like health care remains a mirage.
Indeed, if the people who break their backs on farms across Ghana under the sweltering sunshine and other precarious working conditions are deprived of adequate healthcare, it will only be a matter of time before the huge investments being sunk into our agric sector are reversed to naught.
Sector overview
Agriculture is one of the principal sectors of Ghana’s economy. Despite a snail-paced progression in recent years, it still remains the foundation on which the country’s economy rests. In Ghana, the agricultural sector is predominantly dominated by small-scale farmers.
Among the arable crops in Ghana, cereals are the most widely-cultivated and consumed agric produce. Maize continues to lead as the most important staple food in Ghana. This is because maize is very important for improving food security and poverty reduction, as it is the staple food for most Ghanaians.
The spiralling population in Ghana and heavy dependence on agriculture for food means farmers are working ever harder to meet food demand. This means more exposure to occupational hazards that, sadly, we have done very little to mitigate – we have not instituted a sustainable health care policy targetted at the hardworking Ghanaian farmer.
Peculiar Risks
Agriculture is one of the riskiest occupations for the eyes due to the numerous ocular hazards on farms. The insatiable appetite for agro-chemicals coupled with the attendant mishandling of products by farmers greatly predisposes farmers to numerous life-threatening health hazards.
While all human endeavours have occupational health hazards of their own, the pivotal importance of agriculture to our economy coupled with the poor economic state of most farmers means there is a legitimate need to design and implement a sustainable health care policy that will seek to cater for feeders of the nation.
In a recent study seeking to examine ocular health among cocoa farmers at Mfuom, a rural community in the Central Region of Ghana, the authors found that cocoa farmers were at high risk for ocular injuries and farm-related vision disorders, and utilised eye-care services and ocular protection poorly. Ocular conditions identified were mainly refractive error (28.6%), cataracts (20.0%), glaucoma (11.7%), conjunctivitis (13%), pterygium (2.7%), and cornea opacity (2.2%).
In his conclusion, the author called for the introduction of an interventional eye-care programme to help address the ocular health challenges identified among the farmers. This, he explained, can be done through collaborative efforts by educational institutions, government and other key players in the agricultural industry to improve the quality of life for vulnerable cocoa farmers in rural Ghana.
Similar Examples
Outside our shores, there are brilliant examples from countries that have made a move to target farmers with health policies which Ghana could borrow a leaf from in addressing the healthcare of its teeming farming population.
In India, the central government has announced an ambitious health insurance scheme that is designed to be a safety net to cover millions of its rural population who are predominantly peasant farmers. It’s thought to be one of the largest such schemes in the world, and is likely to be popular with rural voters.
India presently spends a little over 1% of its GDP on public healthcare, one of the lowest in the world.
Finance Minister Arun Jaitley said the flagship health insurance scheme would cover more than 100 million poor families and provide US$7,825 (£5,520) in medical coverage for each family annually.
The Indian government hopes that this will boost agriculture and other allied industries like manufacturing and pharmaceutical sectors.
Similarly, in Nigeria the Kwara State local government has welcomed a Dutch-supported foundation ‘exporting’ private health insurance to Nigeria, selling a US$30 health-care package for US$3.
In Kwara State, a poor agricultural district in western Nigeria, health insurance is a rarity. Like 70% of Nigerians, most people survive on less than one dollar a day. If they visit a doctor at all, they have to pay out of their own pockets. However, this grim situation recently changed for one group of farmers.
They are not covered by Nigeria’s National Health Insurance Scheme (NHIS), which despite being set up more than a decade ago still only serves 3.73% of the population.
According to World Health Organisation statistics, total health expenditure in Nigeria is around US$33 per capita – 63.4% of which comes directly out of pocket. This suggests that the farmers of Kwara State might be ready to spend around US$20 annually – or slightly less, given the poverty of the region.
Hygeia has been offering the farmers a health-care package comprising comprehensive primary health care and limited secondary health care, including up to five days of hospitalisation, and maternal health care (including caesarian section) – a health-care package that HIF prices at US$30 a year – for slightly less than US$3.
Despite being tagged ‘unsustainable’ by critics, the support by Kwara State government has proved crucial to the project’s seamless take-off. According to a government source: “The state Governor has refurbished three public hospitals within the scheme, has committed to co-financing its expansion of the scheme, and will take over the subsidies over a five-year period”.
According to Dr. Peju Adenusi, chief executive officer of the Hygeia Community Health Plan, the farmers have been delighted with what they get for their money. “Utilisation in one clinic has jumped from 16 people per month before the programme was started to 1,500 people per month afterward,” she says. One woman was so grateful for the life-saving Caesarean section she received that she named her baby boy ‘Hygeia’.
Refreshing Examples
Though a health policy exclusively to dedicated to farmers is nowhere in sight, some stakeholders have shown admirable efforts in executing initiatives which have served to improve the health of Ghanaian farmers.
Recently, the Cocoa Board Senior Staff Association organised a free health screening exercise for cocoa farmers at Odeng Adeiso in the Eastern Region.
The exercise was rolled out as part of the Association’s Corporate Social Responsibility, and saw about 1,000 people from the community benefit from the exercise.
Beneficiaries were screened for blood pressure, sugar levels, malaria and breast cancer among other conditions.
Similarly, the Community Empowerment and Development System (CEDS-Ghana) – a civil society organisation with funding from Agri-Business and Development Service Company Limited (ADSEC) – recently screened farmers in the Savelugu/Nanton Municipality for diabetes, hypertension and Hepatitis-B as part of its Smallholder Farmers Support Project.
The exercise, according to its organisers, was also to create awareness of the need to prioritise preventive healthcare among farmers.
Conclusion
Access to healthcare in Ghana remains a critical challenge that even the introduction of the National Health Insurance Scheme has failed to exhaustively meet. While this scenario is bad enough, people in the hinterlands of Ghana, especially, endure the worst of the situation.
With a great percentage of our farmers still situated in our hinterlands, ostensibly to stay within farmland proximity, many are deprived of quality healthcare despite being involved in a very hazardous endeavour like farming.
This is a trend that needs to be reversed, because an unhealthy farmer population is bound to have an adverse effect on the painstaking gains made through a combination of efforts by successive governments and donor agencies.
Advocacy to develop an exclusive health policy for farmers in Ghana is important, as it will prove a precursor to a sustainable framework that will eventually culminate in a happy, healthy and productive farmer base in Ghana.
The efforts of some organisations which have taken to periodic health screening outreaches are very laudable, as indications from a cross-section of beneficiaries have proved that such gestures are colossal blessings to the noble Ghanaian farmer.
About the Writer:
Alberta Nana Akyaa Akosa is the Lead Consultant at Agrihouse Communications, the premier data-driven agro Public Relations, Media Relations and Events Management firm.She is also the Founder of Agrihouse Foundation, a non-governmental capacity building organiation with a special focus on agro-based youth mentorship and leadership grooming, agribusiness development through the organisation of exhibitions, training programmes, research, agri-trade relations and promotions.