ADRA/GHANA’S TITLE II FOOD SECURITY PROGRAM
MID TERM EVALUATION
FINAL REPORT
October 2004
Transfer Authorization Award No. FFP-A-00-02-00015-00
SO2: Increased effectiveness of FFP’s PVO and Mission partners in carrying out Title II
development activities with measurable results related to food security, with a primary focus on
household nutrition and agricultural productivity.
Dr. Regina O. Adutwum Ph..D
Dr K. Twum-Ampofo Ph.D
Dr. Matilda Pappoe MPH, PhD
Mrs. Anastasia Navele B,Sc. MPH
Table of Contents
Page
List of Acronyms 3
Executive Summary 5
I. Introduction and Background 11
II. Specific Objectives of Mid Term Evaluation 14
III. Evaluation Methodology 16
IV. Sustainability Issues 18
V. Program Management and Administration 20
VI. Monitoring and Evaluation of Program 21
VII. Monetization 23
VIII. Supplementary Issues and Questions 24
IX. Findings and recommendations 28
Appendices:
1. Scope of Work 50
2. Itinerary – Communities Visited During Field Work 57
3. Individuals Interviewed During the Evaluation 59
4. Questionnaires for Interviews 63
5. Water and Sanitation Facilities Checklist 67
6. List of Documents Reviewed 68
7. Direct Comments by community Members on Effects of Program 70
8. Results Highlight - A Case Study Of Success 74
9. Focus Group Discussions And Interviews Conducted By Health Team in
Northern Sector
75
List of Acronyms
ADCOM : Administrative Committee
ADRA : Adventist Development and Relief Agency
AEAs : Agricultural Extension Agents
ANRM : Agriculture/Natural Resource Management
ARR : Annual Results Report
BHR/FFP : Bureau for Humanitarian Response – office of Food For Peace
CSIR : Council for Scientific and Industrial Research
DANIDA : Danish International Development Agency
DAP : Development Assistance Program
DDHS : District Director of Health Services
DDO : District Development Officer
DHMT : District Health Management Team
DIP : Detailed Implementation Plan
FEAs : Field Extension Agents
FFP : Food-For-Peace
FGDs : Focus Group Discussions
FPOs : Field Project Officers
FY : Fiscal Year
GHS : Ghana Health Service
HAT : Health and Agriculture Teams
HIV/AIDS : Human Immuno-deficiency Virus / Acquired Immune Deficiency
Syndrome
HQ : Headquarters
IE&C : Information, Education and Communication
IRs : Intermediate Results
KEEA : Komenda Eguafo Edina Abirem
M & E : Monitoring and Evaluation
MOE : Ministry of Education
MOFA : Ministry of Food and Agriculture
MOH : Ministry of Health
MTE : Mid-Term Evaluation
NDPC : National Development Planning Commission
NGO : Non - Governmental Organisations
NRM : Natural Resource Management
PRO : Public Relations Officer
SAWS : Seventh-Day Adventist World Service
SHEP : School Health Education Programme
SO : Strategic Objectives
SOW : Scope Of Work
SPH : School of Public Health
SKC : Suhum Kraboa Coaltar
USAID : United States Agency for International Development
VIP : Ventilated Improved Pit Latrine
WATSAN : Water and Sanitation
WIAD : Women In Agricultural Development
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EXECUTIVE SUMMARY
Introduction
ADRA Ghana implemented a 5-year Title II funded Food Security Program in eight regions of Ghana
from October 1997 to September 2001. The Development Assistance Program (DAP) for Fiscal Years
(FY) 1997 – 2001 sought to enhance food security for 16,000 resource poor farmer households in
selected districts of the country. An evaluation of the program reported tremendous increases in food
crop yields and household income, improved nutritional status among children of targeted households,
reduction in sanitation related diseases and improved access to potable water in client communities.
As a result of that initial success, the agency received further funding for another 5-year program
(FY2002-FY2006) to build on and expand the content and coverage of the first program. The overall
goal of the current ADRA Ghana DAP is to improve food security for 30,000 rural dwellers(expected
beneficiary population of 300,000) domiciled in the Northern and Coastal Savanna, the Transitional
Zone and rural forest areas of Ghana by 2006. This goal is to be achieved through the following
strategic objectives:
(i) Improved agricultural production and income of targeted farmers through increased agricultural
production, increased access to markets, increased access to agric credit and improved natural
resource management practices.
(ii) Improved health and nutrition status of beneficiary communities through, improved nutrition and
preventive health knowledge and practice, increased access to potable water and increased access to
hygienic sanitation facilities.
In order to realize the above objectives a two-pronged strategy has been adopted. The strategy
provides farm inputs on credit, access to potable water and hygienic sanitation facilities. It also
promotes training and technical skills development in agriculture, natural resource management,
health and nutrition of the community members by ADRA staff and partner institutions in specific
activity areas of the two strategic objectives in order to strengthen community action in these areas.
This program is in its third year of implementation and in line with USAID’s Bureau for Humanitarian
Response-Office of Food for Peace (BHR/FFP) policies, a joint Mid-Term Evaluation has to be done
for the half-life of the DAP. The purpose of the mid-term evaluation is to determine the progress being
made in the implementation of the DAP. It is to serve as a management tool to refine program
activities, implement strategies and improve internal management of the program. The mid-term
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evaluation was a joint activity by the consultants, ADRA/Ghana, local partners and other stakeholders.
A participatory approach was used to encourage joint problem analysis and development of solutions
by program staff, other partners and consultants.
Program Management and Administration
ADRA staff members generally possess appropriate qualification and experience to effectively
manage program activities to achieve the desired goal. The organizational structure of the
support staff for program implementation makes logical sense. The field officers who provide
the technical support to the HAT and the farmers are adequately trained with relevant field
experience prior to joining ADRA. Most FPOs and FEAs said they had had on the job training
and refresher courses to enable them function efficiently. However, staff strength is extremely
low leading to high workload, especially for field staff, considering the remoteness of project
areas, number of farmers and communities involved. The FPOs complain of heavy workload and
this was obvious to the team. It is possible to streamline the supervisory chain in order to free
some time for the FPOs. The FPOs and FEAs interviewed felt logistics were adequate for their
work even though some of them complained about mal-functioning of certain office equipment.
From the analysis of ADRA project management, it appears, program activities are cost effective
considering the remoteness and large operational areas, the mode of delivery of program activities and
the impact of project on beneficiary farmers and communities. The engagement of the services of
collaborators and volunteers in executing certain program activities, as well as the use of experienced
local management staff and locally procured inputs reduces cost.
Quarterly and annual review meetings of all the ADRA program staff, combined with
completion and submission of monitoring and evaluation forms at all levels ensure effective
monitoring and evaluation of field activities.
Agriculture and Natural Resource Management
All the ADRA client farmers interviewed reported that they have now abandoned the traditional food
crop production practices in favor of the improved agricultural practices recommended by ADRA.
These improved practices have resulted in significant increases in agricultural production, especially
with respect to cereals such as maize. The team observed that farmers who were not ADRA clients
have began to adopt ADRA agricultural technological packages due to demonstration effect of
improved agricultural practices. The adoption of ADRA recommended improved agricultural
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practices coupled with regular supply of inputs have resulted in substantial increase in crop yields with
some regional variation. Increased crop yields have motivated farmers to increase acreage under
cultivation in areas where land is not limited.
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 With respect to land preparation, inadequacy of tractor and bullock services coupled with the high
demand of these services during the peak-planting season invariably affected food crop yields and the
ability to pay loans. The reliance on rain fed agriculture makes it critical for timely plowing of land.
Generally, farmers indicated that they were satisfied with the training/education on agricultural
production and natural resources management practices. However, in some communities, the training
and education on agricultural and natural resources management practices was not adequate since
downstream training sessions by HAT members and AEA’s are not well patronized.
ADRA has provided technical and financial support to client farmers to construct improved local mud
silos and cribs for grain storage. Focus group discussion with client farmers in communities where
these storage facilities had been constructed, indicated that post harvest losses have been drastically
reduced and in some cases eliminated. This together with the use of marketing information boards has
resulted in an increase in the volume of farm produce marketed. This has improved food security and
increased income as a result of selling produce at peak price period. Other marketing strategies
involved organizing farmers into viable marketing groups and linking them to marketing agencies or
companies.
ADRA through food-for-work program has supported some communities to rehabilitate farm-to￾market roads. However, the level of this program activity was found to be low. According to ADRA
additional road projects have been approved for implementation during the dry season or during the
period when farming activities are at a minimal.
Farmers expressed their appreciation and satisfaction with ADRA’s credit scheme as it has helped
them to acquire needed inputs which otherwise they could not afford on their own.
 Loan recovery rates depend on harvest (yield) and varied among communities ranging from a low
value of 9% to a high of 80% with an average of 65%. Some farmers attributed their inability to repay
loans to poor yield, which relates mainly to unfavorable weather (drought) and sometimes ill health,
which affect farm maintenance.
Few farmers have paid deposits and are waiting for delivery of processing equipment subject to
completion of equipment structures. Others are in the process of mobilizing the 30% down payment
required. It appears that not much has been achieved in this program activity.
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ADRA has encouraged school children, community volunteers and client farmers to undertake tree
planting around schools, churches, roads and water bodies and to intercrop them with their food crops
(agroforestry). Private tree nurseries supported by ADRA input credit facilities produced and
distributed fruit tree seedlings (mango, citrus cashew) and woody species (cassia, teak, eucalyptus) to
both ADRA and non-ADRA farmers and the communities.
Environmental protection and natural resources management practices appear limited in many
communities especially in the south where very few nursery operators were encountered. The team
observed that some nursery operators need further in-service training especially in vegetative
propagation techniques for fruit trees promoted by ADRA to achieve high budding and grafting
success.
The adoption of improved agricultural and natural resources management practices by ADRA farmers
has improved household food availability and access to food through increases in income. ADRA
farmers are now enjoying better standards of living as they can now afford to pay their children’s
school fees and health bills, buy clothing for the family, roof their houses with aluminum sheets,
purchase bicycles, marry, add livestock rearing to crop production and invest in the expansion of
farms. With the benefits being derived from the program, the objectives of Agriculture and Natural
Resources Management program on the whole are on course to being achieved. The activities and
strategies adopted by ADRA are adequate to achieve stated objectives for the ANRM program.
Health, Nutrition, Water and Sanitation
In the area of Health, Nutrition, Water and Sanitation, several activities have been initiated by
ADRA to improve nutrition and preventive health knowledge and practices of client
communities. Some community members (usually ADRA group members) are selected and
trained by ADRA as Health and Agriculture Teams in how to improve nutrition of children from
birth up to five years old, growth monitoring, prevention and first aid for diarrhoea, and other
water borne diseases, as well as personal and environmental hygiene. HIV/AIDS and malaria
were added in the current DAP. After the training sessions, HAT members are to transfer
knowledge and skills gained to community members through downstream training activities.
HAT members have used opportunities such as individual visits to homes and farms, community
durbars, small group discussions, visits to churches and funerals to talk about health and nutrition
issues, and cooking demonstrations involving whole communities for the downstream training.
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The work of the HAT is supported by video shows and radio discussions relevant to ADRA’s
activities by the Field support staff.
Through activities of the HAT community, members’ knowledge and practices in relation to
health and nutrition have been generally enhanced; specifically, knowledge concerning the
causes, prevention and first level management of common diseases like malaria and diarrhoea
and nutrition was fairly adequate with a few misconceptions in some communities.
According to community members they consider the following as indicators of success for
improved nutrition for the family: improved food security all year round with no hunger seasons
anymore; increased soybean utilisation in family dishes; improved cooking practices and
inclusion of fruits and vegetables in meals; improved child nutrition and exclusive breastfeeding.
In addition they said easy access to good drinking water, gives communities a lot of health as
they put it.
About a third of communities visited exhibited adequate appreciation of the importance of the
Child Health Record (growth monitoring card) although mothers claimed no explanation is given
them on the contents of the weighing cards, when they take children to child welfare clinics. A
few mothers could explain the significance of the plotting on the growth charts.
When community members were asked to indicate the ADRA initiated activity from which they
have benefited the most: clean water, toilets and “education on health to prevent diseases” were
among the top ranking on the list. One man summarized the importance of the health and
nutrition component in the following words: “If you get sick and die, all these orange trees and
maize farms will be useless to you”.
In most of the communities, members at focus group discussions showed reasonable appreciation
for links between the provision of potable water by ADRA and absence of diseases such as yaws,
diarrhoea, bilharzias and guinea worm and could illustrate with downward trends in incidence of
water borne diseases. The relationship between personal and environmental hygiene and disease
causation is fairly well appreciated in most communities. One woman testified to this when she
said: “since we got the borehole, yaws has become a thing of the past”. An appreciable level
of knowledge of health issues was also found among schoolchildren in schools through the
activities of the teachers who have been trained through ADRA. Moreover, community members
could appreciate the fact that good health would lead to the ability of the farmer to farm more
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and better and that this would in turn lead to more yields and more money for the family. The
catchwords “a good farmer has to be a healthy farmer,” was repeated in most instances.
The majority of HAT members encountered in the field know what they are about and have
confidence in their ability to help their fellow community members. For the minority of HAT
members, there is lack of confidence and/or interest in what they are expected to do. Where HAT
members are doing well, one found good working relationship and support from the community
leadership as well as from the ADRA collaborators such as the Environmental Health Officers
and WIAD. Where there are different factions in the community, it affected the work of the HAT
and WATSAN committees negatively.
Even though the HAT concept is very useful and much appreciated, several constraints have
been noted. Some community members are difficult to convince and factions were observed in
some communities thus making some members uncooperative. In many areas, communities are
scattered and HAT members stay far apart and therefore find it difficult to do effective
community mobilization. Even though cooking demonstrations are much appreciated by the
communities, the HAT members see getting adequate money for the food demonstration for
large numbers of people as a problem. Effective ways of mobilizing communities to contribute
ingredients needs to be debated and agreed on by communities.
For program activities to be implemented in such ways as to achieve program goals and
objectives in a timely manner it is recommended that, more of the trained and experienced field
officers are required for close supervision in fewer communities per FPO and FEA. Suggestions
for improvement include the need to formalize and strengthen collaboration with the Ghana
Health Service (GHS) and the Ghana Education Service (GES). Others are the increased
involvement of EHO’s in program implementation at the community level in all the operational
areas and strengthening of the HAT concept with regular refresher courses in critical subject
areas (e.g., assertiveness, time management, community mobilization and action planning skills).
It was obvious through the community visits and focus group interactions that ADRA has been
able to sensitize and educate client communities and households on the need for VIP latrines,
bathhouses with soak-away pits and other sanitation facilities. Communities appreciated the need
for such facilities and expressed the wish to own them during FGD.
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What ADRA needs to do if the set targets are to be reached by the end of the project period
include the following:
ADRA should explore the possibility for resource pooling (financial, technical etc.) with the
various agencies in community water provision in the districts. Discussions towards making this
possible must start at the national level. There is the need for flexibility in ADRA’s “packages”
to communities. For instance where potable water through hand dug wells and bore holes
presents a problem, ADRA may consider the option of adjusting to other options such as
connecting to pipe lines, wherever feasible. ADRA should also be more flexible with their
“offers” to communities in terms of technologies being transferred to communities. Technologies
must be socio-economically and culturally acceptable. Another area ADRA could reconsider is
the possibility of converting the required commitment fee for the VIPs into a loan or allow fee to
be paid in instalments so that more households can own them.
Farmers understand that the health and nutrition component is for the benefit of the whole
community, and it unites community members, their children and generations to come because
they are all becoming health and cleanliness conscious. One woman from a community, which
has high patronage of VIP latrines, said with pride. “Now when we get visitors from the big
towns, they can see that we are also civilized because we have nice toilets, thanks to ADRA”.
I.INTRODUCTION AND BACKGROUND
A. Introduction
ADRA is an international non-governmental organization (NGO) headquartered in Washington, D.C.
and represented in over 120 countries worldwide. ADRA operates in partnership with international
donor agencies to provide development and relief assistance to all people regardless of ethnicity,
gender, religious or political affiliation. The broadly stated goal of ADRA projects is to improve the
well being of poverty-stricken people through a participatory approach to project planning,
implementation, monitoring and evaluation.
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The roots of ADRA date back to the Marshall Plan for the reconstruction of Europe in 1945. ADRA
was formally registered in the United Sates as an autonomous charity in 1956 when it was known by
the acronym “SAWS” (Seventh-day Adventist World Service). In 1983 the agency’s name was
changed to “ADRA” to reflect the increasing inclusion of development initiatives in partnership with
USAID. The agency has continued to enjoy a close association with the United States government in
implementing relief & development projects throughout the world. Currently, ADRA is
implementing ten Title II projects around the world (six of which are in Africa).
B. Project Overview
ADRA Ghana implemented a 5-year Title II funded Food Security Program in eight regions of Ghana
from October 1997 to September 2001. The Development Assistance Program (DAP) for Fiscal Years
(FY) 1997 – 2001 sought to enhance food security for 16,000 resource poor farmer households in
selected districts of the country. The program used an integrated approach involving Natural
Resource Management, Agricultural production, Marketing, Agro-Processing, Nutrition,
Water/Sanitation, and Preventive Health Education to address the problems of food availability,
access and utilization in the targeted households.
An external impact evaluation of the program reported tremendous increases in food crop yields and
household income, improved nutritional status among children of targeted households, reduction in
sanitation related diseases and improved access to potable water in client communities.
As a result of that initial success, the agency received further funding for another 5-year program
(FY2002-FY2006), which seeks to build on and expand the content and coverage of the first program.
In addition to the first batch of 16,000 households from the first DAP who will receive support in
marketing and agro-processing, 14,000 new farmer households in 9 regions will also be assisted to
improve their food production capacity. The initial nutrition, water and sanitation education
component of the first program has also been expanded to cover HIV/AIDS and malaria prevention in
all client communities. A new strategy of targeting basic school children in the dissemination of
educational messages on nutrition and health has also been introduced. Tree-planting and
conservation activities are also being supported in the new program to help address issues of
deforestation, loss of bio-diversity, land degradation and depletion of underground and surface water
sources.
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This program is in its third year and in line with USAID’s Bureau for Humanitarian Response-office
of Food for Peace (BHR/FFP) policies, a joint Mid-Term Evaluation has to be done for the half-life of
the DAP.
 GOALS AND OBJECTIVES OF FOOD SECURITY PROGRAM
The overall goal of the current ADRA Ghana DAP is to improve food security for 300,000 rural
dwellers domiciled in the Northern and Coastal Savanna, the Transitional Zone and rural forest areas
of Ghana by 2006. This goal is to be achieved through the following strategic objectives:
(i) Improved agricultural production and income of targeted farmers through increased
agricultural production and processing, increased access to markets, increased access to agric credit
and improved natural resource management practices.
(ii) Improved health and nutrition status of beneficiary communities through, improved nutrition
and preventive health knowledge and practice, increased access to potable water and increased access
to hygienic sanitation facilities.
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The intermediate results for the strategic objectives are presented below:
SO1. Improved Agricultural Production and Income;
IR1. Increased agricultural production
IR2. Increased access to markets
IR3. Increased access to agric credit
IR4. Increased natural resource management practices
SO2. Improved Health and Nutrition Status
IR1. Improved nutrition and preventive health knowledge and practice,
IR2. Increased access to potable water
IR3. Increased access to hygienic sanitation facilities
A. Program activities include the following:
• Supply of agro-inputs on credit;
• Assisting in land preparation;
• Training and provision of agric technical assistance;
• Construction of improved storage facilities;
• Agro-processing;
• Rehabilitation of Farm to market roads;
• Linking farmers to marketing organizations;
• Community tree planting;
• Community education in agriculture, natural resources management, nutrition and 
preventive health;
• Construction and management of water and sanitation facilities.
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B. Strategy
In order to realize the above objectives a two-pronged strategy has been adopted. The strategy
provides farm inputs on credit, access to potable water and hygienic sanitation facilities. It also
promotes training and technical skills development in agriculture, natural resource management,
health and nutrition of the community members by ADRA staff and partner institutions in specific
activity areas of the two strategic objectives in order to strengthen community action in these areas.
Thus, the project strategy essentially involves for each community, the selection and training of a
5 member Health and Agriculture Teams (HAT). The HAT is made up of two members
responsible for ANRM (one of whom may be a member or chairperson of a client farmer group),
two for Health and Nutrition and the fifth member (usually a teacher), handling health education
with school children in the community, through the local school system. Members of the HAT in
each community are the principal activity facilitators in the communities.
Following the strategy of farmer-to-farmer information dissemination, it is hoped that the HAT
members trained will internalize the training, put it in practice and subsequently train others. This
process sustained will snowball and eventually see diffusion of appropriate technologies in most parts
of the community. The assumption implicit in the strategy is that by working closely with community
selected representatives the innovations taught by the project will diffuse throughout the community.
C. Purpose and Objectives of the Mid-Term Evaluation (MTE)
The purpose of the mid-term evaluation is to determine the progress being made in the
implementation of the DAP. It is to serve as a management tool to refine program activities,
implementation strategies and improve internal management of the program. It is expected to
determine the progress made during the first half of the project’s life in achieving its stated goals and
objectives. Based on evaluation findings, if necessary, the project shall redefine its goals and
objectives, re-organize its activities and adjust targets accordingly.
II. SPECIFIC OBJECTIVES OF MID- TERM EVALUATION
The MTE shall be done with the following specific objectives:
1) Determine progress ADRA/Ghana has made toward reaching its targets as defined in the
monitoring and evaluation system;
2) Review the appropriateness of DAP with respect to the problem analysis in the DAP;
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3) Identify constraints and difficulties plus successes in program implementation;
4) Assess the appropriateness and cost effectiveness of the strategies being used in the delivery of
interventions; and
5) Make recommendations to improve the management of the DAP performance as appropriate and
suggest discontinuance, modifications or adjustment of activities, strategies and targets.
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III. EVALUATION METHODOLOGY
A. General Introduction
ADRA Ghana prepared a comprehensive mid-term evaluation scope of work (SOW). This was then
sent to all key players in the MTE before the start of the MTE. In addition ADRA Ghana project staff
put together the necessary reports to respond to the issues listed in the SOW. The evaluation team
converged at the ADRA Ghana Head office in Accra on 20th September 2004 to start the evaluation
process. Following a review the SOW was revised and approved by the evaluation team. The team
also randomly selected the sample communities for the focus group discussions and field visits.
Some Focus Group Discussions were conducted with homogenous groups of women most of
whom had small children between four months and two years old. Discussions were also held
with community leaders, which were often men and women, on their knowledge, practices and
concerns on health, water and sanitation issues. Other discussions were held with school children
in primary and Junior Secondary Schools (JSS), the teachers who taught health in schools and
were also members of HAT members, FPOs, FEAs and district collaborators. (Refer to FGD and
interviews conducted in Appendix 7).
The mid-term evaluation was a joint activity by consultants, ADRA/Ghana, local partners and
other stakeholders. A participatory approach was used to encourage joint problem analysis and
development of solutions by program staff, other partners and consultants. The evaluation
employed both qualitative and quantitative information. It included participatory rapid
assessment techniques involving extensive interaction with management and technical staff at
the head office and the field offices. This process was complemented with the monitoring
information, which demonstrates the process and the progress being made to achieve stated
objectives and program goals. The methodology included but was not limited to the following:
literature review, key informant interviews, focus group discussions and observational field visits
B. Literature Review
First the evaluation team conducted a literature review of selected documents to identify Title II
Food program key issues. The evaluation team reviewed the information available at
ADRA/Ghana. In addition, the team obtained essential data regarding ADRA/Ghana’s individual
Title II program by reviewing the relevant documents. These included the monitoring and
evaluation reports, the Annual Results Report (ARR), the DAP, the DIP, the initial Needs
15
Assessment, the baseline and other survey reports. Refer to list of documents reviewed in
appendix 6.
C. Key Informant Interviews
The team interviewed ADRA/Ghana Management and Field Staff, other cooperating partners
including MOFA, MOH, MOE and Environmental Health Officers in the targeted districts, and
Community Leaders partnering/collaborating with ADRA in the DAP implementation.
Discussions were also held with relevant staff at USAID Mission in Ghana
D. Focus Group Discussions
The evaluation team also conducted focus group discussions with sample beneficiaries and
undertook observational field visits to obtain qualitative information on progress being made
towards the achievement of program goals and objectives.
Taking the SOW into consideration, the team formulated key questions for each component of
the project. The questions guided the team to place each component in the wider perspective of
the organizational culture, the differences in localities and people involved, and the Title II
program’s major goals. The questions also helped in filling any gaps in the information provided
by ADRA Ghana officers.
E. Selection of communities
A random sample of 45 communities representing about 10% of the 468 project communities
was selected for the fieldwork. All the project communities were listed alphabetically and the
Statistical Package for the Social Sciences (SPSS) was used for the random selection. The MTE
team was divided into two groups; a northern group and a southern group to accelerate the
process of FGDs. The groups spent 12 days in the field. A list of the project communities
indicating the selected communities and the respective Operational areas and Districts is
presented in the Appendix 2.
F. Observational Field visits
For every location, the MTE team visited farms of some selected farmers and activities at those
sites were observed and discussed with the farmers. These included crop farms, fruit tree
plantations and woodlots.
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A transect walk was conducted in all 29 communities visited by health teams to inspect the
compounds for cleanliness and sites of potable water and hygienic sanitation facilities: VIP
latrines, soak away, rubbish dumps were inspected with a checklist, which is included in the
appendix 5.
The findings of both groups of the MTE were discussed to identify similarities and contrasts in
the views of the respondents. Finally, all the findings were summarized as presented below. The
members of the MTE team, persons interviewed and itinerary are listed in the appendix.
G. Framework of Analysis 
Again, the Evaluation Team, taking into consideration this SOW, developed a framework for
analyzing program delivery based on the information collected during the literature review,
interviews, focus group discussions and survey results.
IV. SUSTAINABILITY ISSUES
Sustainability is crucial to the achievement of the goals of any program targeting the very poor in
society. Review of literature and discussions with government officials and partner institutions
revealed that the project has adopted a participatory and collaborative approach to planning and
implementation of most of the project activities, which is essential for project sustainability.
In addition, the needs assessment survey and the baseline study ensured that project initiatives
were based upon concrete needs of the communities.
One needs to ensure that while the program is not perpetrating a dependency syndrome, it leaves
structures and other tangibles that can continue to improve the welfare of the people when
ADRA leaves the scene. Communities as well as field collaborators have assured the evaluation
team that much of what ADRA is doing is sustainable.
Sustainability of the Agricultural and Natural Resource Management Program
The needs assessment survey and the baseline study ensured that project initiatives were based
upon concrete needs of the communities. Group discussions with community leaders and field
visits indicated that the cultural norms, patterns and practices were not being violated in the
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design and implementation of project activities. Farmers stated during these meetings that none
of the new technologies, methods or farming practices given or taught by the project was unusual
or contrary to their culture. This may explain the high uptake of project initiatives by the
beneficiaries.
ADRA farmers indicated their commitment to continue with the improved agricultural practices
after the exit of ADRA. The team observed that beneficiaries’ capacity to sustain project
activities has been built through training and education sessions organized by ADRA. Financial
benefits obtained from the adoption of improved agronomic practices, group savings which will
enable members to secure bank loans to purchase needed agricultural inputs and distribute to
farmers on credit, long-term income from plantation crops which will provide security for future
activities and the HAT who are expected to continue to work and link the farmers’
group/community to MOFA, will ensure sustainability. An area of concern however is whether
some of the MOFA extension agents who are no longer committed to the ADRA program
because of the withdrawal of allowances will be willing to assist the ADRA farmers if the need
arises or when the project ends.
Sustainability of Health and Nutrition, Water and Sanitation Component
As mentioned earlier, the evaluation team has been assured by communities as well as field
collaborators that much of what ADRA is doing is sustainable. A community in the Kwahu
South District of the Eastern Region, has been selected by the Global Fund for malaria control
activities, and is seen as a positive indication of the sustainability of the Health and Nutrition
component. In another community in the same Region the old ADRA clients have constituted
themselves into a Cooperative Society, which qualifies for a loan from the Agriculture
Development Bank. There is ample evidence from the field, which gives some assurance of the
sustainability of most of the program activities.
According to some field officers their work will continue in the communities even when ADRA
pulls out since some EHOs live in the communities, and because of the acquaintance,
communities will continue to come to them for assistance as some do now. The EHOs will
encourage non-ADRA communities to visit successful ADRA communities to emulate water and
sanitation facility construction, maintenance and general management by the community and
WATSAN members and other innovations in preventive health and good nutrition.
18
Some community leaders interviewed claim they will contribute and pay HAT members, or weed
their farms when ADRA is no more in their communities. They have also started contributing
money towards the water facility maintenance and will be used for maintenance when ADRA is
no more. The team observed that beneficiaries’ capacity to sustain projects is gradually being
built through training and education sessions organised by the HAT and supported by the field
staff and the impact of these will extend beyond the project life span.
However, the following areas in connection with the VIPs may need to be reconsidered:
Technology should be introduced according to their appropriateness. As much as the VIP and
bathhouses are serving essential purpose, the materials being used, in most cases, does not seem
sustainable to the team, in terms of cost. There is the need for ADRA to explore other materials,
which would be more affordable as well as sustainable, particularly considering the socio￾economic and cultural contexts within which such innovations are being introduced.
V. PROGRAM MANAGEMENT AND ADMINISTRATION
Adequate administrative systems have been instituted to effectively provide support for the
implementation of ADRA programs. Good working relationships exist among members of the
management team. There is a clear hierarchy and line of reporting and implementing program
decisions and activities. ADRA has cordial relationship with collaborating partners (MOFA, MOH,
and MLGRD) and they greatly assist program activities. Even though MOFA Extension Staff are now
being paid on contract basis, many of them show commitment to the ADRA programs even though
some do not.
The ADRA staff generally possesses appropriate qualifications and experience to effectively manage
program activities to achieve the desired goal. However, staff strength is extremely low leading to
high workload, especially for field staff, considering the remoteness of project areas, number of
farmers and communities involved.
ADRA’s plan of engaging National Service Personnel to assist the Field Project Officers in extension
activities is good but since these service personnel are generally inexperienced in practical extension,
they would require adequate orientation for a more effective delivery. Experienced FPO’s should
properly train them before embarking on field extension work for proper interaction with farmers and
communities.
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From the analysis of ADRA project management, it appears, program activities are cost effective
considering the remoteness and large operational areas, the mode of delivery of program activities and
the impact of project on beneficiary farmers and communities. The engagement of the services of
collaborators and volunteers in executing certain program activities, as well as the use of experienced
local management staff and locally procured inputs reduces cost.
ADRA proposes to support both new and old farmer groups in the current DAP but the nature of
support to the old groups is not very clear and in some communities, these farmers feel
abandoned by ADRA. ADRA needs to intensify the support it is providing the old farmer groups
so as to reduce this feeling of abandonment among them.
Logistics
There is a logistics department in ADRA with a manager who ensures that vehicles are assigned
to FPOs, motorbikes to FEAs and other office equipment in the 9 regions to facilitate work in the
communities. A replacement vehicle or motor is given when there is a problem as was seen in
Techiman during the Mid Term Evaluation.
FPOs and FEAs interviewed felt logistics were adequate for their work. Some of these field
officers complained about mal-functioning of certain office equipment. A few communities in
the northern region complained about late delivery of inputs for farming such as seedlings and
fertilizer.
The logistics manager interviewed alluded that this used to be a problem caused by late funding
from donors in 2003. If ADRA Ghana receives funding late, it affects the timeliness of certain
activities in the field. This problem has fortunately been resolved this year.
VI. MONITORING AND EVALUATION OF PROGRAM
For a program with a 5-year life span, which covers almost the entire country using different
levels of personnel in terms of technical expertise, activities such as supervision, monitoring and
evaluation become not only necessary but also essential. That this fact is appreciated by all
stakeholders of the ADRA program, is borne out by the existence of a Monitoring and
Evaluation Plan, which was drawn up at the same time as the DAP was being developed. It is
the understanding of the evaluation team that the M & E Plan in operation now is a refined
version of a draft submitted along with the DAP. The refined one had resulted from collaboration
20
between the ADRA management and the Food and Nutrition Technical Assistance – a consultant
firm commissioned by USAID to support M & E activities of its funded Programs.
The M & E Plan seems to be the working document of the M & E team made up of a
Coordinator and two (2) Officers one for the Northern sector and the other for the Southern
sector. A data management officer and a data entry clerk support the three (3) officers. The M
& E Plan, which has been in operation since 2003, follows the results Framework and details out
the two Program Strategic Objectives, the Intermediate Results and Activities and along these the
Performance Indicators. Annual detailed implementation plans covering activities, indicators,
targets and the time frame within which the specified targets are to be achieved, the budgetary
allocation for the specified monitoring and evaluation activities as well as the individuals and/or
agencies to carry out the specified activities are developed as a guide each year. In principle, the
Plan is well thought out and easy to follow. The evaluation team, nevertheless, tried to find out
the extent to which the Plan is being used for the purposes for which it has been developed.
The Monitoring and Evaluation Plan
Interviews with Program management and field staff indicated that the Plan is functional and, its
contents and requirements are known by staff at all the levels of program implementation. Parts
of the Plan (indicators/targets) have been incorporated into M and E forms for ADRA staff at all
levels to a point where each staff knows his/her role in making the Plan functional – in terms of
record keeping and data collection. A review of copies of quarterly and annual reports indicates
that the needed information had been collected from the field and the performance formats are
being completed, systematically.
Use of the Monitoring and Evaluation Plan
The M & E Plan is centrally managed and since the unit collects and collates information from
the field, it has been possible to use data so generated to revise and make adjustments to field
activities where indicated. Example: Field monitoring information indicated that agricultural
extension officers from MOFA were not visiting the farmers and HAT members as often as
expected. This resulted in a policy change, that made ADRA recruit, train and use its own
extension officers.
21
Moreover, based on the data generated by the M & E Plan, a Management Information System is
in the process of being developed. This would help track activities/results in the field and point
out problem areas for timely intervention.
The operational chain observed in the field seems to be matched with a supervisory and
monitoring chain. The Agency has made adequate provision for verification of figures forwarded
from every level so if these can be adequately verified, one would have the confidence to
conclude that the existing M & E system is generating the data required for decision - making as
well as for the improvement of program management.
Comments on the Monitoring and Evaluation Plan
1. As much as one appreciates that the HAT and WATSAN members are trained
community-based volunteers who require a lot of technical support and help, there seems
to be too many levels supervising this grassroots people (FPOs, FEAs and collaborators).
The FPOs complain of heavy workload and this was obvious to the team. It is possible to
streamline the supervisory chain so as to free some time for the FPOs. The FEAs in
collaboration with the other collaborators should be able to provide day-to-day
supervision of the HAT and the farmers, to be supported with a monthly region wide all
staff meeting at which activities are reviewed, ideas shared, new technologies introduced,
etc. Other additional FPO visits for specific technical purposes may be arranged.
2. The Plan indicates that for the Health and Nutrition Component, a sample school survey
is required on an annual basis in order to assess what the teacher and other HAT members
are doing with the school children. The usefulness of the information to be obtained from
such a survey is questionable. The Ghana Education Service requires teachers at all
levels of the school system to be integrating health related issues into their subject
teaching, anyway. A problem, which one can foresee is how one would be able to
distinguish between the effects of such teaching from the effects of inputs from other
sources. Baseline, mid term and final assessment should suffice for the purpose.
3. Quarterly and annual review meetings of all the ADRA program staff combined with
completion and submission of monitoring and evaluation forms at all levels ensure
effective monitoring and evaluation of field activities.
22
4. The evaluation team’s experience in the field underlines the need for the management of
ADRA to supply all supervisory and monitoring staff either with mobile phones or at the
least Recharge Units for their mobile phones, for timely communication. The phones of
some of the staff members were constantly in use, to ensure that planned meetings and
other evaluation activities proceeded as planned.
VII. MONETIZATION
ADRA /Ghana’s Title II Food Security Project is funded by USAID through the monetization of bulk wheat
under the PL 480 Title II monetization program. The local currency generated is used to support the
general implementation of activities defined in the DIP. On the basis of the Annual Estimate of
Requirements (AER) document submitted with the DAP, a total of 98,090MT of bulk wheat was
allocated to ADRA/Ghana’s FY 2002-2006 DAP to be spread over the 5-year period of the current
DAP.
Ghana’s current Title II Cooperating Sponsors (CS) are ADRA/Ghana, Catholic Relief Services
(CRS), and Opportunities Industrialization Center (OIC). To receive the wheat, each Cooperating
Sponsor issues its own call forward to USAID/Ghana Mission indicating the tonnage, the commodity
specifications, delivery date, port of discharge and consignee names. The buyer (flour mill) agrees to
pay the CSs for the cost of the wheat over 120 days in 12 equal installments on the basis of the cedi
equivalent of the US dollar value of the commodity at the cedi/ U.S. dollar exchange rate in effect at
the date of berthing. The buyers are also responsible for transporting the wheat to its silos. CRS as the
lead agent is responsible for contracting the sale, receiving and clearing the bulk wheat, arranging for
independent surveyor and receiving and disbursing the proceeds from the sale to the CS. Over the
years CRS has developed substantial internal capacity to manage the monetization process efficiently
Wheat is not produced in Ghana so it is exclusively imported and has no local substitutes. The wheat
sector is dominated by three major firms which process the wheat into flour before distribution for
sale. In general, the imported wheat is delivered directly to the flour mills and processed into wheat
flour before reaching the local market. The wheat flour is consumed mainly in the form of bread and
other baked products. Therefore the effect of wheat imports on domestic prices of other cereals and
tubers if any is low. The conclusion of the Bellmon Analysis indicates that the there is a good potential
for wheat monetization without any significant disincentive effect on local prices. In addition because
23
the bulk wheat is transported directly to the flourmills storage does not pose a problem in the
monetization process.
Despite the fact that sales takes place in an oligopolistic market, the Cooperating Sponsors
through group negotiations are able to strengthen their bargaining power to realize maximum
benefits and meet USAID cost recovery benchmarks. The terms of payment and the requirement
of a bank guarantee from the buyer to cover the cost of the wheat before taking custody ensure
the recovery of sales proceeds from the sale of the wheat and facilitate the availability of funds
for program implementation.
VIII. SUPPLEMENTARY ISSUES AND QUESTIONS
1.0 External and indirect factors influencing program implementation
Since ADRA does not operate within a tightly controlled environment, it is to be expected that
elements operating within the environment would have some effect on ADRA’s operations.
These factors are rightly classified under the economic, environmental, socio-cultural and change
in policy.
a. Economic factors
Although ADRA provides farmers with inputs, many of the farmers, despite having the knowledge
are unable to practice some of the new farming technologies they have learnt because they lack
adequate capital to acquire certain additional inputs especially agrochemicals for the control of
diseases and pests on their farms
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b. Environmental Factors
Water was identified as one of the major constraints to efforts aimed at increasing agricultural
productivity in the communities visited. The major environmental factor identified has to do with
the change in the rainfall pattern, which results in a drought like conditions, which in turn affects
the crop yields of farmers. Farmers reported that rainfall is unreliable and inadequate. Some
farmers felt that the long-term solution to this problem was to engage in irrigation, which is
currently not one of the activities in the project. Many farmers gave as a reason for the low loan
repayment rate the change in the rainfall pattern, which affected their crop yields. It is
anticipated the same phenomenon will occur at the end of the current farming season.
Another factor is the low yield of cashew. Many of the farmers, who are engaged in cashew
planting, at least within the southern savannah zone, complained about this problem. In some
communities where the trees are fruiting, the yields are so small that buyers are not attracted to
go to such places. It is the understanding of the evaluation team that this problem with cashew is
nationwide and may have something to do with the edaphic factors as well as planting material,
pests and attack by diseases. As a result of this problem, farmers’ interest in the crop is slowly
waning.
A third factor also related to the environment has to do with the salty nature of the underground
water, which is affecting potable water provision in some communities. There is the concern that
even if provided the water may not be used for drinking because of the taste. In another
community, the problem is with the level of the water table– that is so low as to make a hand dug
well and/or bore hole not feasible. At the same time potable water is required in such
communities. Although according to ADRA they have started in a very small way in providing
other options, these must be stepped up to include others such as rain water harvesting and pipe
borne water
c. Socio-Cultural Factors
Development needs to be placed within the socio-cultural context within which it occurs in order
to make sense to the beneficiaries. The ADRA “assistance” package for the Health and Nutrition
component included a specific type of toilet (VIP) and bathhouse using sandcrete blocks.
Discussions with some community members in Northern Ghana indicated that although they
appreciate a VIP and bathhouses as status symbols and would want to own them, the concept of
having such “fine” facilities while they themselves sleep in houses made of mud and sometimes
25
roofed with thatch, do not go well with them. It is believed that this cultural dilemma is affecting
the acceptance of the VIP and bathhouses, in some communities in the north. They would prefer
that their houses have the same status. In one particular community, a HAT member complained
that there is a traditional way of building bathhouses, which incorporates a drainage system and
which when improved upon and promoted would be less expensive
Another socio-cultural factor, which may be affecting program implementation, has to do with
the existence of factors within some program communities. In a community in the KEEA
District of the Central Region, half the population of the community do not patronize educational
activities organized by the HAT because of misunderstanding. This affects communal labour to
clean up the environment and maintain facilities. The negative effects of such situations on
program implementation are real, and such communities need to be sensitized about the possible
consequences, if peace cannot be made to prevail. In another community, HAT members are
perceived to have become more popular than the traditional head, and this has brought a friction
between the two sides, which is affecting the effective operation of the HAT.
A community in the Yilo Krobo District of the Eastern Region would not allow any
Environmental Health Officer to enter the community, due to an incident, which had occurred in
the community some 20 or more years ago. Meanwhile, the collaboration of such an officer is
required for the selection of suitable sites for the VIP. Such a situation is definitely affecting
program implementation and needs to be addressed.
d. Change in Policy
It became clear during the fieldwork that a change in policy involving the Ministry of
Agriculture, also affected the format of the collaboration between ADRA and MOFA at the
operational levels. It is understood that the Ministry of Food and Agriculture effected a change in
the use of extension officers – a change, which allowed for private participation in extension
work. This meant that ADRA could recruit, train and use its own extension officers, which
ADRA did. This appears to have affected a seemingly good collaboration between ADRA and
MOFA, in some communities. One District Development Officer who may not know how the
ADRA extension officers might have been recruited actually questioned the competence of these
extension officers.
Whatever the reason for the discontinuation of the first form of collaboration the decision was
not communicated to the MOFA staff at the operational level even though ADRA made every
26
effort, including organized meetings with the Regional and District MOFA Directors, to inform
them about the changes. This has led to some dissatisfaction among the MOFA staff, which
ADRA needs to know and address in order to forestall any further strain in the working
relationship. Contrary to the perception among some of the MOFA staff, ADRA FEAs are well
trained and experienced. Most of the FEAs ADRA recruited were also former MOFA extension
staff. ADRA management believes that this attitude of some MOFA staff now may be due to the
cut off of the regular allowances they were receiving from ADRA.
2.0 Unintended benefits
It was observed that farmers in two communities in the forest zone (Prasokuma in the Birim
North District and Abepotia in the Kwahu South District) have introduced bee keeping and
vegetable gardening, as offshoot activities from the citrus orchards. Though unintended this had
resulted from the flowering of the citrus trees and the farmers are earning money from the sale
of the honey harvested. In addition, at a certain height of the citrus trees, the farmers found the
atmospheric conditions conducive to vegetable gardening. Cabbage and other vegetables grown
under these conditions, have not only become a source of additional income, but they are also
used to improve the nutrition of the families involved. Farmers were very proud of these
positive developments.
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IX. FINDINGS AND RECOMMENDATIONS
The joint Health, Nutrition and Agriculture and Natural Resources Management teams started
the fieldwork on Monday, September 27, 2004, covering two communities each day. The Health
and Nutrition Teams combined covered twenty-nine communities - 17 in the southern sector and
12 in the northern sector. (Refer to itinerary for the evaluation visits attached in Appendix 2).
Through the field visits, review of available literature such as quarterly and annual reports, the
team was able to assess the extent to which field activities have already contributed and continue
to contribute to the achievement of improved nutrition and preventive health knowledge and
practices among beneficiaries. The summary of the findings and recommendations appear in
subsequent paragraphs under the two main components of the program i.e. Agriculture & Natural
Resources Management Practices and Nutrition/ Health Education and Water/Sanitation. Based
on the findings of the team, some recommendations have been offered for consideration under
the various sub-headings and/or as summaries at the end of the two main headings. These will
assist ADRA to achieve its objectives come the end of the program period:
A. AGRICULTURE & NATURAL RESOURCES MANAGEMENT PRACTICES
1.0 Community And Farmer Selection
ADRA identified target communities mostly through the Agricultural Extension Officers’ of the
Ministry of Food and Agriculture (MOFA). The communities are then educated, animated and
farmers interested in the project are selected, based on ADRA’s laid down criteria. Selected farmers,
usually in groups of 20 are intensively educated in order to understand the goals, objectives and
expectations of the program.
The evaluation team observed that, the criteria were being followed and farmers were satisfied with
the selection process. Furthermore, there was no evidence of social problems within the communities
as a result of the criteria used. However, non-ADRA farmers at focus group discussions expressed
interest and willingness to participate in the program due to impressive impact on production of food
crops.
2.0 Understanding Program Objectives
ADRA farmers had sound understanding of program objectives and expressed these in terms of
improved agricultural practices (higher agricultural productivity and increased income), improved
28
micro-environment through increased natural resources management practices (tree planting in
communities and management of watershed and rivers in order to enhance water security). However,
the farmers are not familiar with the overall goal of the project.
3.0 Agricultural Production
Ghana has a largely agrarian economy, yet it is a net importer of food. Domestic agricultural
production cannot feed the nation due to several problems including inappropriate farming practices
(slash and burn, shifting cultivation, annual bushfires) that have resulted in extensive environmental
degradation.
The ADRA food security program seeks to address these constraints by helping selected farmer
households adopt improved agricultural and natural resources management practices. The program
supports client farmers with inputs such as improved seeds (maize, soybean), tree seedlings (Cassia,
Albizia, Eucalyptus, Cashew, Mango and Citrus), bullock and tractor services and trains farmers in
the integration of tree crop and food crop farming. In addition, the program also helps participating
farmers construct improved storage facilities (cribs and mud silos) to reduce post harvest losses.
3.1 Cropping Pattern/ Farming Practice
All the ADRA client farmers interviewed reported that they have now abandoned the traditional food
crop production practices which include slash and burn, mixed cropping, haphazard planting of food
crops and trees in favor of the improved agricultural practices recommended by ADRA (minimal/ no
burning, line planting, intercropping with trees, use of improved seeds, crop rotation and mixed
planting in defined pattern).
These improved practices have resulted in significant increase in agricultural production, especially
with respect to cereals such as maize. The adoption of improved agricultural practices is the direct
result of ADRA and its collaborative partner (MOFA) training/ education in improved agricultural
practices coupled with farmers’ access to agricultural input-credit facilities.
The team observed that farmers who were not ADRA clients had began to adopt ADRA agricultural
technological packages due to demonstration effect of improved agricultural practices.
3.2 Land Preparation
ADRA assisted client farmers in land preparation through the hiring of the services of tractor and
bullock operators. In some communities, farmers visited encountered problems with land preparation,
which delayed planting of food crops. These were attributed to the inadequacy of tractor and bullock
29
services coupled with the high demand of these services during the peak-planting season. This
invariably affected food crop yields and the ability to pay loans. The reliance on rain fed agriculture
makes it critical for timely plowing of land.
Recommendations
ADRA should therefore address this issue in order to improve agricultural production. The number of
farmers assisted to own bullocks and ploughs could be increased (if resources are available), and in
conjunction with farmers arrange better tractor service.
3.3 Training/ Education
Generally, farmers indicated that they were satisfied with the training/education on agricultural
production and natural resources management practices. ADRA with its collaborative partner
(MOFA) provided training on methods of improving soil fertility, land preparation, plantation crop
management, bush fire prevention, bullock plough techniques, post harvest handling/storage and
construction of improved silos and cribs. However, in some communities, it was observed that farmers
were not adequately trained and educated on agricultural and natural resources management practices.
Downstream training sessions by HAT members and AEA’s are not seriously patronized due to lack
of confidence in some HAT members since they are local people. In some communities the ‘old’
farmers feel abandoned because they are excluded from direct input credit supplies and other training
programs.
 Recommendation
ADRA Field Project Officers should closely monitor downstream training organized for the farmers
by HAT and AEAs. Attendance at training sessions should be mandatory for client farmers and
possibly linked to agriculture input supply. Group training should be complimented by one-to-one on￾farm training if possible. Because the agriculture and NRM components complement each other, they
should be implemented and managed in an integrated manner.
3.4 Crop Yield per Acre
The adoption of ADRA recommended improved agricultural practices coupled with regular and
timely supply of inputs has resulted in substantial increase in crop yields. Maize yields have more than
doubled for all ADRA assisted farmers with some regional variation. In Northern region for example,
maize yields have increased from pre-program levels of 250kg/ac to 800kg/ac, while in Ashanti and
Brong Ahafo regions, farmers have recorded increases from levels of 400kg/ac to 1000kg/ac.
30
Similarly, yields of legumes (soybean, groundnuts and cowpeas), roots and tubers have also increased
as a result of the adoption of ADRA improved agricultural practices.
Increased crop yields have motivated farmers to increase acreage under cultivation in areas where land
is not limited. In some communities where loan recovery is very high ADRA has assisted farmers
with additional inputs – seeds and fertilizers.
Yields of cashew trees are not so encouraging as a result of disease and pest infestation. In addition
there was the problem of lodging especially in Brong Ahafo region where soils are moderately fertile
compared with Northern region and plants are more susceptibly to lodging. ADRA has recommended
staking to the farmers to reduce lodging problem.
Recommendation
ADRA in collaboration with MOFA should advise the farmers on possible acceptable chemical
control methods and seek expert advice on biological control from CSIR and other Research
Institutions.
3.5 Construction of Improved Storage Facilities
Improper storage facilities leading to post harvest losses of food and marketing of produce just after
harvesting are the major contributing factors to household food insecurity in project areas.
ADRA’s intervention in this respect involves training in pre and post-harvesting handling practices in
collaboration with MOFA and the provision of financial and/or material assistance in the construction
of improved storage facilities (mud silos in Northern regions and cribs in Brong Ahafo, Eastern,
Ashanti and the Coastal regions).
Results report (FY 2003) indicated that ADRA provided technical and financial support to client
farmers to construct improved local silos and storage cribs to store maize, soybean, cowpeas and
millet and exceeded the anticipated targets by 7%. Progress has however, been slow in FY 2004 and
in order to achieve targets in the fourth quarter, ADRA is training artisans in each community to assist
the farmers in storage facilities construction (3rd Quarter Report, FY 2004). Earlier on, ADRA had
relied on Agricultural Extension Agents to move round communities to assist farmers in this regard.
Focus group discussion with client farmers in communities where storage facilities had been
constructed indicated that post harvest losses have been drastically reduced and in some cases
31
eliminated. This has improved food security and increased income because of selling produce at peak
price period.
4.0 MARKETING
Improved crop yields due to improved agricultural practices coupled with the reduction in post harvest
losses (improved storage facilities) had resulted in an increase in the volume of farm produce
marketed. ADRA farmers indicated that they are now selling between 60 – 75% of their farm produce
(maize, soybean). However, for farmers with large households, the proportion marketed was between
30 – 40%.
ADRA had assisted farmers in marketing their produce through the setting up of marketing
information boards in client communities. These boards display prices of selected commodities
pertaining in different markets to serve as a guide for pricing their farm produce. According to
farmers, the boards have proved very useful, as it has kept farmers informed of current prices. It has
also enhanced their bargaining power with produce buyers who often capitalize on farmers’ ignorance
on price trends to buy their produce at low prices.
Other marketing strategies involved organizing farmers into viable marketing groups to market their
produce by linking them to marketing agencies or companies. However, in some communities the
farmers are interested in organizing themselves into marketing cooperatives but do not have the skills
to do so. Farmers had also been taught to properly store their produce after harvest and wait until
prices go up before they sell.
Recommendation
ADRA should assist communities to form marketing groups in areas where the farmers do not have
the skills to do so.
4.1 Road Rehabilitation
Farm to market roads played an essential role in efficient procurement of farm inputs and marketing of
farm produce. ADRA through food-for-work program had supported some communities to
rehabilitate farm-to-market roads, which has facilitated the transportation of agricultural inputs into
and marketed produce out of ADRA communities. However, the level of this program activity was
found to be low. The main reason for the activity lagging behind is the policy of the present
Government to improve access roads in the farming communities. In line with this policy, the
government has given out on contract or already rehabilitated a good number of the roads targeted for
32
assistance by ADRA (3rd Quarter Report – FY 2004). ADRA however indicated in the above report
that additional road projects have been approved and this activity will be implemented in the dry
season or during the period when farming activities are at a minimum.
5.0 AGRICULTURAL INPUT CREDIT
ADRA provides credit to farmers in the form of agricultural inputs supplied to improve agricultural
production. Inputs include improved seeds, tree seedlings, fertilizers, cutlasses, Wellington boots and
cash for plowing (bullock or tractor services). The value of inputs supplied by ADRA per farmer
ranges from ¢350,000 - ¢1,100,000($38.5 - $121).
Farmers expressed their satisfaction with ADRA credit scheme as it has helped them to acquire
needed inputs, which they otherwise could not afford on their own because they are poor. Farmers
who receive ADRA support are required to pay the loan with interest by the end of a stipulated period
(usually one year). Subsequent assistance depends on credit worthiness of the farmers’ group.
Repayment of loan varied among communities and depends on harvest (yield). It varied from a low of
9% to 80% with an average of 65%. Some farmers indicated that their inability to repay loans are
attributed to poor yield, which relates to bad weather (drought) and sometimes ill health, which affect
farm maintenance. The team observed that one-year payment period is short and some farmers would
want to delay payments till they can sell their fruits from tree crops.
Recommendation
ADRA Field Project Officers should intensify their education on loan recovery. In communities where
dry season vegetable farming is undertaken and profitable, and loan recovery rate is acceptable,
ADRA should consider assisting farmers through the provision of dug out wells and pumps, inputs
(fertilizer, manure and improved seeds) to increase production. Income obtained could be used to
service loans. Furthermore, ADRA in partnership with MOFA should provide extension services on
other crops e.g. yam, cowpea, sorghum, millet, groundnut and cassava for client farmers to increase
production, and income. This would serve as an insurance to loan repayment should farmers have
problems with ADRA assisted crops e.g. maize and soybean.
6.0 AGRICULTURAL PROCESSING EQUIPMENT
ADRA has provided information on how to access processing equipment in some communities,
however this has been linked to complete repayment of input credit by the farmers’ group. Few
members have paid deposits and are waiting for delivery of equipments subject to completion of
33
equipment structures. Others are in the process of mobilizing the 30% down payment required. It
appears that not much has been achieved in this program activity.
Recommendation
ADRA needs to double its efforts in loan recovery from farmers to enable other interested farmer
groups and communities to access this facility. Discussions with some ADRA field officers has shown
that where farmers are required to make payments on weekly basis, loan recovery rates are higher.
7.0 NATURAL RESOURCES MANAGEMENT PRACTICES
ADRA has encouraged communities and farmers to undertake tree planting around schools, churches,
roads and water bodies and also to intercrop them with their food crops (agroforestry). Strategies have
been put in place to ensure effective tree seedling production and delivery. Private Nursery Operators
were given refresher-training activities in seedling and nursery management. Private tree nurseries
supported by ADRA input credit facilities produced and distributed tree crops seedling (mango, citrus,
cashew) and woody species (cassia, teak, eucalyptus) to both ADRA and non-ADRA farmers and the
communities.
ADRA organized workshops to educate client and communities on environmental protection and
natural resources management practices, which in some communities appear limited, especially in the
south where very few nursery operators were encountered. In addition, agriculture and natural
resources management demonstration plots have been established to train farmers. The team observed
that some nursery operators need further in-service training especially in vegetative propagation
techniques for fruit trees promoted by ADRA to achieve high budding and grafting success.
8.0 IMPACT OF ADRA ANRM PROGRAM
The adoption of improved agricultural and natural resources management practices by ADRA farmers
has improved agricultural production. The increases in crop yields coupled with the reduction in post
harvest losses have improved household food availability and access to food through increases in
income.
ADRA farmers are now enjoying better standard of living. As revealed in the focus group discussion,
the farmers can now afford to pay their children’s school fees and health bills, buy clothing for the
family, roof their houses with aluminum sheets, purchase bicycles, marry, add livestock rearing to
crop production and invest in the expansion of farms. With the benefits being derived from the
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program, the objectives of Agriculture and Natural Resources Management program by and large are
on course to be achieved.
9.0 SUMMARY OF RECOMMENDATIONS
1. ADRA should address the problem of inadequacy of tractor and bullock services to facilitate
early land preparation to improve agricultural production. The number of farmers assisted to
own bullocks and plough should be increased and in conjunction with farmers arrange better
tractor service.
2. ADRA should intensify its monitoring system on downstream training by HAT and AEA in
some communities to have the desired impact on farmers.
3. In collaboration with MOFA, ADRA should advise farmers on possible acceptable chemical
control of diseases and pests on cashew and also seek expert advice on biological control
from CSIR and other Research Institution in the country.
4. Educational activities on marketing strategies for farmers and communities should be
intensified to improve marketing of farm produce, increase income and improve loan
recovery.
5. ADRA Field Project Officers should intensify their education on loan recovery by adopting
new and innovative methods. For example discussions with some ADRA field officers has
shown that where farmers are required to make payments on weekly basis, loan recovery
rates are higher
6. In communities where dry season vegetable farming is undertaken and profitable, and loan
repayment is acceptable, ADRA should consider assisting farmers through the provision of
dug out wells and pumps, inputs (fertilizer, manure and improved seeds) to increase
production. Income obtained could be used to service loans. Furthermore, ADRA in
partnership with MOFA should provide extension services on other crops e.g. yam, cowpea,
sorghum, millet, groundnut and cassava for client farmers to increase production, and income.
This would serve as an insurance to loan repayment should farmers have problems with
ADRA assisted crops e.g. maize and soybean.
7. ADRA in collaboration with appropriate institution (MOFA, CSIR) should organize in-service
training for Private Nursery Operators to build their expertise on some vegetative
propagation techniques to improve fruit trees seedling production.
35
8. ADRA should intensify the necessary process involved in the qualification and acquisition of
agricultural processing equipment for farmers and communities to increase income from
processed produce.
9. ADRA should address the problem of the ‘old farmers’ and include them in their training
programs where necessary especially training in plantation crop management
10. ADRA should accelerate the distribution of the marketing information boards to those
communities who have already paid for them and should assist communities to form
marketing groups in areas where the farmers do not have the necessary skills.
B. HEALTH, NUTRITION WATER AND SANITATION
1.0 IMPROVED NUTRITION AND PREVENTIVE HEALTH KNOWLEDGE AND
 PRACTICES
1.1 The Use and work of Community-based Volunteers
Since the beginning of 2003, some Community members (usually ADRA group members) have
been selected and trained by ADRA and collaborators as Health and Agriculture Teams (HAT).
Most teams met in the field were made up of two members responsible for Agriculture and
ANRM, two for Health and Nutrition and a fifth member (usually a teacher), who handles health
education with school children in the community, through the school system.
During the evaluation visits to the communities, team members met and interacted with the HAT
members in the communities visited. From such interactions, it became obvious that a
reasonable proportion of members could recall contents of their training without referring to the
manuals and did not only appreciate the concept of they being trainers but have actually been
training community members. Community members, at the Focus Group Discussions, attested
to this fact.
Methods used by the Nutrition and Health members of the HAT for the downstream training
include, individual visits to homes, community durbars, small group discussions, visits to
churches and funerals to talk about health and nutrition issues and cooking demonstrations
involving whole communities. In some of the communities visited in the south, a few of the
HAT members had not received any formal training. Instead they have been understudying their
36
colleagues who had received the formal training. In the northern sector, the few who had not
been trained were found to be unable to read or write.
1.2 Discussion of Findings Related To Improved Nutrition and Preventive Health
The use of trained community volunteers for education in health, nutrition, water and sanitation
by ADRA seems to be in the right direction. Generally, the strategy seems to be working; and
based on what was observed in the field and what was read the team was able to arrive at the
following conclusions:
Apart from a few motivators met, the Health and Agricultural Teams (HAT) have been in the
system for almost two years. The majority encountered in the field know what they are about and
have confidence in their ability to help their fellow community members. For the minority of
HAT members, there is lack of confidence/interest in what they are expected to do. Where HAT
members are doing well, one found good working relationship and support from the community
leadership as well as from the ADRA collaborators such as the Environmental Health Officers
and WIAD.
Generally, the HAT seems to be more active in the forest zones such as in the East Akim, New
Juaben, Birim North and Yilo Krobo Districts than in the Coastal districts such as KEEA and
AES. In the north, most HAT members seem active except in Mantukwa, Kpabuso and
Achubunyor. Where there are different factions in the community, the work of the HAT and
WATSAN committees are affected, negatively.
In principle the program appears to have the potential to achieve its health and nutrition targets
and impacts on the beneficiaries, come 2006 judging by the structure put in place for program
implementation (i.e., ADRA field officers working through HAT and WATSAN members at the
grassroots level and with the collaboration of Environmental Health Officers and other health
care providers).
The use of community-based “volunteers” with the collaboration of like-minded public agencies
like the Ghana Health Service and the Environmental Health Service, as well as the Women in
Agriculture Department of MOFA, in the district seems to be a cost-effective way of providing
the health and nutrition education services to the program beneficiaries. However through the
FPOs and FEAs, ADRA needs to institutionalise inter-collaborative meetings with all the
37
collaborators, so that they became results oriented. Some of the collaborators complained that
ADRA is so results oriented and time-bound, that the tendency is to “ignore” their collaborators.
“The time pressure works against involvement of collaborators in critical activities”, said one
interviewer.
1.3 The effect/impact of the work of the HAT
From the interactions, the team had with community members and the HAT members, it became
clear that downstream training had actually taken place in most of the ADRA communities.
Focus group discussion participants were able to display knowledge acquired on diseases such as
malaria, diarrhoea and HIV/AIDS with pride and confidence. It became obvious, also, that
community members found HAT education on water and sanitation as well as nutrition,
particularly the use of soya beans, very useful.
The team also observed that the majority of children seen in the communities looked healthy,
which indicated that knowledge acquired from the HAT members on balanced diet and good
nutrition for children of the various ages, was being put into practice. Most mothers with young
children were actually observed breastfeeding such children, during the visits. In fact, about one
third of mothers interviewed with children under five years of age, could appreciate the
importance of the Child Health Record (Road to health card) because some HAT members had
educated them on this. However, the majority of nursing mothers complained that the contents
of the card are not explained to them, when they take their children to the Child Welfare Clinics.
It was observed, further, that even though the germ concept was not appreciated, there was
understanding in most groups, that there is a relationship between personal and environmental
hygiene and disease causation. One woman illustrated this understanding when she said: “since
we got the borehole, yaws has become a thing of the past”. Similar assertions were made in
other communities about the disappearance of guinea worm, and bilharzias from their
communities because of the introduction of either a hand-dug well or a borehole.
However, in 4 out of the 29 communities visited, the team learnt that HAT activities had been
adhoc and minimal. This is because either the H AT concept had not been accepted by a faction
in those communities and therefore some members refuse to patronize their activities or the HAT
had a conflict with the community leadership, who refuse to work with the team. In one
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community, the people have not accepted the chief and therefore he could not mobilize the
people to patronize activities of the HAT members.
Members of the evaluation team were impressed by community members’ understanding and
appreciation of the relationship between food security and the health and nutrition components of
the project. When community members were asked to indicate the ADRA initiated activity from
which they have benefited the most, clean water, toilets and “education on health to prevent
diseases” were among the top ranking on the list. As one man summarized the importance of the
health and nutrition component during the interaction, “If you get sick and die, all these orange
trees and maize farms will be useless to you”. Other key benefits mentioned include: making
soya dawadawa and giving only breast milk (and colostrum) to 0-6 months old babies.
` 1.3 Integration of Project Activities
In principle, the beneficiary communities as well as the ADRA field staff consider the
components of the program as being properly integrated and which make logical sense to them.
As mentioned, earlier. in most of the 29 communities visited, participants at discussions were
able to appreciate and illustrate the following linkages:
i. Availability of potable water and absence of diseases such as yaws, diarrhoea, bilharzias and
guinea worm.
ii. Good health leading to the ability to farm more and better, which in turn leads to more yields
and more money for the family. The concept of adding health and nutrition to improved
agricultural methods and inputs is appreciated, almost universally, and the catchwords: “a
good farmer has to be a healthy farmer,” were repeated in many instances.
 One farmer expressed his appreciation of the nutrition education of the HAT in the following
words, “We are no longer bored with the same meals, cooking demonstrations have shown
our wives how to make a wide variety of meals with the local foodstuff available, enriched
with soya beans.’’ The program appears to have the potential to achieve its health and
nutrition targets and impacts on the beneficiaries, come 2006
1.4 Training background of the Health and Nutrition Staff
The organizational structure of the monitoring and supervisory staff in relation to the staff at the
program implementation level, makes logical sense. Not only are the staff members at the Head
39
office technically qualified in health and nutrition but also the field officers who provide the
technical support to the HAT and the farmers are adequately trained with most having relevant
field experience prior to joining ADRA. Moreover, most FPOs and FEAs interviewed in the field
have had on the job training and refresher courses, which enable them function effectively and
efficiently. Nevertheless, the team observed a constraint in their numbers. Due to inadequate
numbers, all field staff interacted with complained of heavy work load. Although the Field
Officers for the Health and Nutrition component were found to be covering wide areas,
community members in all places visited attested to the frequency with which they are visited by
the officers. This could mean that the officers are putting in extra effort to ensure adequate
coverage of their communities.
Recommendations
Based on the above findings of the team, the following recommendations are offered for
consideration, if ADRA is to achieve its objectives come the end of the program period:
1. There is the need to lighten the workload on the field staff by reducing the area
covered by one Field Officer. During the field visits, it was observed that a team of Field
Program Officers were covering large areas spanning districts and this means a lot of
travelling. The travel time alone is likely to reduce the time effectively left for technical
work. Since the ultimate goal of this recommendation is to reduce the workload on the
officers, one option to achieve this would be to recruit more of the trained and experienced
field officers. Another option would be to recruit and train more community-based
volunteers while at the same time strengthening the collaboration with the other sectors, e.g.
the Environmental Health Officers. The latter option would enhance the level of capacity
building at the community level and strengthen linkages with other workers at the
community level thus enhancing program sustainability.
2. ADRA may need to formalize and strengthen its collaboration with the Ghana Health
Service (GHS) and the Ghana Education Service (GES), which seems to be on personal and
adhoc basis. It is imperative that HAT activities are sustained, when and if ADRA pulls out of
the communities. Teachers at the basic education level are expected to incorporate some health
issues into the subject areas, and a formal link with the GES could delineate the value the ADRA
program is adding to the status quo. Moreover, most of District Health Management Teams
(DHMTs) members interacted with seemed not to know enough about ADRA and expressed the
40
need to know more about ADRA activities. They also expressed the desire to share quarterly and
yearly reports in order to improve the effectiveness of the collaboration.
3. Closely related to a recommendation above is the need to revisit and strengthen the HAT
concept. To make the HAT members more confident and up to date in information and to be
more proactive, refresher courses in critical subject areas (e.g. time management, community
mobilization) need to be injected at periodic intervals. There is also the need for these
community volunteers to be properly resourced and empowered as already articulated in an
earlier section.
2.1 INCREASED ACCESS TO POTABLE WATER
Review of program documents indicates that ADRA was to assist communities in the
construction of hand-dug wells and boreholes. Boreholes were to be constructed in communities
where the water table was below 40 feet and having a minimum population of 500. To qualify
for a hand-dug well a community had to have a population of not less than 300. ADRA was to
provide the technical expertise, the water pumps and accessories, cement and PVC pipes and iron
rods while the beneficiary communities would contribute sand, stones and the labour required for
the construction. Moreover, communities were to arrange to have households make financial
contributions to a community fund, so as to ensure continuing maintenance of the facilities. It is
anticipated that by the end of the program period (2006), 300 water facilities will have been
constructed and 60 percent of households in ADRA communities will have all year-round access
to potable water facilities. The following sections present the findings of the evaluation team, as
far as increased access to potable water in the ADRA communities are concerned.
2.1.1 Provision and Management of Water Facilities
There is a water and sanitation committee in each community visited where hand-dug well or
borehole has been provided, but in some communities visited it was observed that this committee
was not under the supervision of the ADRA field officer because the water facility had not been
provided by ADRA. It was observed, also, that some HAT members were also members of the
WATSAN committees.
In many of the communities visited, potable water has been provided by other agencies and
NGOs – e.g. World Vision, DANIDA, Community Water and Sanitation Agency, District
Assembly, Catholic Mission etc. Even where there were such facilities, communities were
41
asking for more, so as to reduce the distances walked to fetch water. Wherever there is no
potable water and ADRA had constituted a WATSAN committee, the committee was
collaborating with the HAT, to educate community on how to treat available water for drinking
and on proper storage of water. Examples of such communities, i.e. without potable water but
with education on drinking water management are Maafi Wenu and Maafi Alavanyo in the North
Tongu District in the south and Paga-Sakaa and Tigboro in the north.
The taste and mineral content of underground water seem to present a problem in certain client
communities. In such communities, either the ground water is salty, such as is found in Maafi
Wenu (North Tongu), or the water is salty and “hard”. Where a borehole had been provided with
such a problem, community members tend to resort to unrecommended sources of water for
either drinking and or domestic chores such as washing of clothes. No community visited was
satisfied with adequacy (quantity) of the available water, and would want ADRA to provide
more bore holes and/or hand-dug wells.
Based on the information collected from the field and from document reviews, one concludes
that ADRA may increase access of some beneficiary communities to potable water but will not
reach targeted number of communities. However, there are ways through which ADRA may
enhance the rate at which it can provide potable water to its client communities and these are
presented as recommendations.
Recommendations
ADRA is to explore the possibility for resource pooling (technical and financial), with the
various agencies in community water provision in the districts. DANIDA, World Vision,
Community Water and Sanitation Agency, World Bank, USAID, District Assembly, and
Religious Bodies in the communities are some of the names one came across. Since ADRA
ascribes to the policy of complementarity such discussions towards possible resource pooling
should not be difficult and must necessarily start at the national level.
There is the need for flexibility of ADRA “packages” to communities. Where potable water
through hand dug wells and bore holes presents a problem, ADRA may consider the option of
adjusting to other options such as connecting to pipelines, where feasible. Some of the client
communities visited in the Gomoa district appear to be situated along the main water line and
monetary allocations for water provision for such communities may be pooled together to
42
facilitate connecting to the pipe line. The same recommendation may apply to other “problem”
communities, such as in the Dangbe East/North Tongu, where ground water is salty and/or hard.
ADRA FPOs in Health and Nutrition need to explore and identify other agencies providing water
to communities in their coverage areas. There is something to learn from such contacts, which
may inform ADRA, with regards to options. There is a particularly urgent need to forge a closer
collaboration with Community Water and Sanitation Agency. Since this collaboration already
exists, it needs to be strengthened and made more operational so as to enhance the rate of
implementation of this program component.
2.2 INCREASED ACCESS TO HYGIENIC SANITATION FACILITIES
According to the DAP, ADRA was to assist 2,000 client households to construct ventilated
improved pit latrines (VIP), within the program life span. In addition, client households were to
be encouraged and sensitised to accept to construct soak-away pits for the disposal of wastewater
from their bathhouses. The soak-away pits are to prevent standing water and therefore the
breeding of mosquitoes. ADRA was to sensitise and educate communities on the need for
improved disposal of household solid waste, in the form of communal labour to clear refuse
disposal sites on periodic basis. Environmental Health Officers (EHO) from the District
Assemblies have been mobilized to work with ADRA staff and the HAT at the community level,
to educate households and community members on environmental and personal hygiene.
Field visits by the evaluation team was able to assess the extent to which field activities are
contributing to the achievement of the objective of increasing client communities’ access to
hygienic sanitation facilities. The findings from the visits as well as a review of program
documents, are presented in subsequent sections of the report. Interactions with HAT and
WATSAN committee members underscored the importance of personal and environmental
sanitation education as an integral component of the work of the HAT and WATSAN members.
This fact was corroborated by assertions of community members as well as some ADRA
collaborators.
About 75 percent of communities visited were observed to be clean, and all Environmental
Health Officers interviewed (District Level Collaborators) testified that ADRA communities are
“usually cleaner than other communities in which they work”. They reported, further, that
neighbouring communities praise ADRA communities for their compounds, which are usually
43
well weeded, swept and show no standing water behind the bathhouses. The evaluation teams
also found this to be true.
All community members expressed the desire to own household toilets. The main constraint for
not owning a VIP is that many households cannot afford to pay the commitment fee, which has
been reduced from three hundred cedis (¢300,000.00) to one hundred cedis (¢100,000.00). For
one community, which did not have any VIP latrine the constraint, is land: this happens to be a
settler community; members complained that landowners would not allow them to build toilets
on the land. ADRA FPOs promised to look into this. The number of VIPs per community
ranged from 0 – 34. All community members appeared pleased with the VIP latrines, expressing
relief that they are free from snakes, scorpions especially in the night (associated with the use of
public toilets usually located away from the community), and caved in public toilets, which used
to kill people.
The visits showed that there are more household VIPs and bathhouses in communities in the
forest zones than the coastal communities, with the exception of communities in which DANIDA
had already provided some toilets. Even in communities in which DANIDA had provided
household toilets, community members expressed a preference for the ADRA type toilets, which
they say is free of odour. The southern team observed that the rate of uptake of household VIPs
is faster than that for the bath houses. It was observed, however that more households have
added soak-away pits onto their old bath houses. A community in the north, (Bihee) alone has
constructed over one hundred (100) soakaways for their locally built simple bathhouses.
Although in a few communities, the HAT members complained of apathy on the part of
community members, particularly the non-clients, when it comes to communal labour, in the
majority of communities assessed, community mobilization for communal labour has never been
a big problem. In the minority of cases, the non-client members of the community believe only
ADRA clients should do communal labour, since they are deriving benefits from ADRA.
Recommendations
Based on findings from some client communities and some collaborating institutions, it seems
ADRA may need be more flexible with their “offers” to communities. Technologies being
transferred to communities must be socio-economically and culturally acceptable. Some
communities find it difficult to accept the concept of building toilets and bathhouses with,
44
sandcrete blocks while sleeping in mud houses. An indigenous technology for constructing
“bathhouses” which incorporated an internal drainage system, was observed at a village
(Mampehia – Ga District), which can be studied by ADRA and easily improved upon and
promoted.
Closely related to the previous recommendation is the perception of a few that ADRA is not
consulting adequately with community members, and that “packages are imposed on group
members”, more often than not. Although this may be just the perception of a few, it is good for
ADRA to be aware of such feelings so as to take action to mitigate them so as to maximize the
impact of program activities.
The effect of inter-agency collaboration is appreciated more in this component than in any other
component. Most environmental health officers interviewed, agreed that ADRA is adding value
to their work, since without ADRA their work is reduced to mere “talk shows”.
ADRA must make the most of this collaborative spirit so as to make the personal and
environmental sanitation activities of the HAT and WATSAN committees truly sustainable.
In spite of the fact that ADRA has had to considerably reduce the commitment fee for the VIPs,
it was obvious that many households cannot still afford the amount. The poverty levels of some
households are so high that they cannot even afford the cost of digging the trench for the VIP.
ADRA may have to reconsider this and consider the possibility of converting the commitment
fee into a loan or allow payment in instalments.
2.3 IDENTIFIED COMMUNITY FELT NEEDS
It was interesting to note that in communities where there were old as well as new clients, the old
clients seem to have moved up the ladder in the hierarchy of needs. While the new clients were
requesting additional assistance from ADRA in terms of chemicals and spraying machines, the
old clients were asking for assistance with housing schemes and building materials. This is an
indication of the success of ADRA’s interventions in the communities. The following sections
present some needs expressed by the communities, during the interactions, and presented as
expressed by community members. It must be noted that these needs cut across and therefore
includes needs other than health or nutrition.
2.3.1 Samples of felt needs expressed by communities in the south
45
Maafi Alavanyo – North Tongu District
- Rehabilitation of the road to the community
- Machine to facilitate irrigation
- ADRA to be involved in School – related activities.
• Rehabilitation of building
• First Aid Box
• Books and other teaching/learning materials
- Community KVIP for those who cannot afford the household VIPs.
Pleyo – Yilo Krobo District
- Dry season farming means more money and improved food security – More
inputs needed during minor season.
- Animal husbandry and livestock keeping
Akyekeso – New Juaben District
- Oil palm seedlings
- Tree planting around the watershed
- Power tiller
- More appropriate spraying machine – to reach height of current citrus trees.
Prasokuma – Birim North District
- School building in a deplorable state – help of ADRA needed.
- Introduction of improved breeds of sheep
- Community KVIP for households unable to afford VIP
- Old clients to be considered for higher needs – e.g. improved housing.
Abepotia – Kwahu South District
- Formation of another group to cater for interested non-clients in community.
- More boreholes needed to supplement World Vision provided ones.
- Improvement of Primary School Building
- Housing Scheme for old clients.
Akwansa Kokodo – Mfantsiman District
- Assistance for rehabilitation of Primary School Building.
- Fertilizer loan scheme for old clients
46
- Assistance for house improvement to bring them to the standard of the toilets to
resolve conflict between “mud houses versus sandcrete block toilets”.
Dawurampong – Gomoa District
- Credit facility for land preparation.
- Food processor for oranges, to overcome poor prices from buyers.
- Chemicals for killing weeds in farms.
4.2 Samples of key felt needs expressed by communities in the north:
- Provision of equipment (cutlasses wheelbarrows, rakes, etc.) for clean up
exercises.
- Regular refresher training for HAT and WATSAN members.
- ADRA should build a dam for dry season gardening.
- ADRA should provide tractor for early ploughing.
- Needs a nutrition rehabilitation centre.
5.0 CROSS CUTTING ISSUES EMERGING FROM FIELD DATA (source:
communities, collaborators and field staff)
In the discussions with client communities, ADRA field staff and ADRA collaborators, the team
tried to identify new areas where ADRA can make an input when an opportunity presents itself.
The following are collated comments and suggestions which are being presented for the
information of ADRA:
1. “It is impossible to promote tree crops without the necessary inputs – appropriate chemicals
and mist blowers are required.” This comment suggests that where ADRA has introduced tree
crop cultivation to farmers, there is the need for further support, in terms of loans for appropriate
chemicals and mist blowers.
2. “There are certain areas (e.g. the ‘overseas areas’ in the Dangme East District), which must be
entered, by ADRA for impact”. This comment comes from an ADRA field officer, who believes
that a challenging situation exists in that part of the Dangme East District referred to as the
‘overseas’. The officer believes that ADRA is capable of turning the situation around in those
areas. ADRA must take up the challenge, to help the people in such areas in subsequent future
planning.
47
3. “There is the need to decentralize ADRA operations, in terms of allocation and disbursement
of funds and other resources” – the person who made this suggestion is of the view that the
proposed decentralization would make for more effective and efficient use of resources and
would make the “decentralized” staff and other structures more responsive to client needs.
4. “The presence of other NGOs and development agencies in some communities presents
‘conflict of interest’ to communities.” ADRA staff members need to look at these agencies more
as development partners and therefore find more innovative ways to collaborate with these
organizations, at the national level, to facilitate pooling of resources, so as to make provision of
facilities more affordable and ‘comfortable’ at the community level. DANIDA is in several
ADRA communities providing water and sanitation facilities but with different conditions – a
situation which tends to create confusion/conflict for communities.
5. “Food security on a rain fed basis is difficult – irrigation is a must for proper food security
program.” This comment, also from a field officer, underscores the need for some form of
irrigation system in some of the areas in which ADRA is working if food security is to be
achieved at a sustainable level.
6.0 SUMMARY OF RECOMMENDATIONS : THE HEALTH, NUTRITION,
WATER AND SANITATION COMPONENT
1. There is the need for refresher as well as continuing training for HAT members,
particularly in skills that would maximize their potential to effect positive change in the attitudes
and behaviour of community members. Skills in assertiveness could benefit those members
who seemed to lack the confidence to impart what they had acquired through training to others.
Field visits identified the need to use the Road to Health card as a teaching tool for HAT
members. This could form an aspect of the recommended refresher courses, since there are a lot
of things mothers, grandmothers, fathers and other members in the communities can learn from
those booklets.
2. The ADRA field officers need to identify those HAT members who are not performing to
expectation so that these are replaced.
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3. In a few communities visited, there seemed to be some conflict of some sort, which was
either affecting the work of the HAT or the collaboration with other sectors. Effective
community participation is essential for the achievement of ADRA goals and objectives and field
officers are to be quick at identifying and addressing any faction which may undermine their
efforts in the communities.
4. Motivation is essential in volunteering work, particularly in areas where people are either
relatively poor or are in need of social recognition. HAT members expressed the need for such
motivation in the form of food ration, T-shirts, identification symbols such as badges and tool
kits such as wheelbarrows and rakes for clean-up exercises. Additional teaching and learning
aids such as leaflets, posters and other IEC materials may also enhance the work of HAT
members in the communities. As part of the effort at motivation and also to recognize hard
work, it is recommended that best HAT member awards are instituted,.
5. ADRA is to explore the possibility for resource pooling (technical and financial), with the
various agencies in community water provision in the districts, e.g. DANIDA, World Vision,
Community Water and Sanitation Agency, World Bank, USAID, so as speed up making
potable water accessible to more of its targeted communities.
6. There is the need for flexibility of ADRA ‘packages’ to communities. This is more so in the
area of the provision of potable water to communities. Where potable water through hand
dug wells and bore holes presents a problem, ADRA may consider adjusting to other options
such as connecting to pipe lines, where feasible.
7. ADRA needs to forge closer collaborative working relationships with organizations such as
the Community Water and Sanitation Agency, The Ghana Education Service and the Ghana
Health Service at all levels. This will not only enhance the implementation of program activities
but also make for sustainability of activities, when and if ADRA is to pull out of the operation
areas.
8. The communities in which ADRA is working constitute the most important of ADRA’s
partners. There is thus the need for continuous consultations with client communities to make
for effective community participation in all aspects of the work so as to dispel the perception of
the few that ADRA imposes ready made “packages” on communities.
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7.0 DIRECT COMMENTS BY COMMUNITY MEMBERS ON EFFECTS OF
PROGRAM
Overall, the team was generally impressed with the activities carried out so far even though some
of them need fine tuning if ADRA is to meet most of her objectives by the end of the DAP
period. Some of these have been indicated under the various recommendations but the list is by
no means exhaustive and some may require various follow-ups.
However, the most striking evidences of the outcomes and impact of the project were provided
by the clients themselves. This report has tried to capture some of the verbatim statements of
how the beneficiaries really feel about the program in the following quotes attached as Appendix
7. These have been grouped under what they recognize as success (Indicators of Success of
ADRA), difficulties and constraints (Difficulties and Constraints Faced by Hat and Watsan
Members in Carrying Out Their Duties). They also include what they would like ADRA to do
differently (What Communities Would Like ADRA to do Differently) and their
recommendations for improvement (Suggestions for Improving the Activities of ADRA). Lastly,
a case study of a beneficiary of the program has been included as an example of how the targeted
population have benefited from the program.
50
VIII. LIST OF APPENDICES
APPENDIX 1: SCOPE OF WORK
MID – TERM EVALUATION SCOPE OF WORK FOR ADRA/GHANA’S TITLE II
FOOD SECURITY PROGRAM (SEPTEMBER 2004).
INTRODUCTION
ADRA implemented a 5-year Title II funded Food Security Program in eight regions of Ghana
from October 1997 to September 2001. The Deve
lopment Assistance Program (DAP) for Fiscal Years (FY) 1998 – 2001 sought to enhance food
security for 16,000 resource poor farmer households in selected districts of the country. The
program used an integrated approach involving Natural Resource Management, Agricultural
production, Marketing, Agro-Processing, Nutrition, Water/Sanitation, and Preventive Health
Education to address the problems of food availability, access and utilization in the targeted
households.
An external impact evaluation of the program reported tremendous increases in food crop yields
and household income, improved nutritional status among children of targeted households,
reduction in sanitation related diseases and improved access to potable water in client
communities.
As a result of that initial success, the agency received further funding for another 5-year program
(FY2002-FY2006), which seeks to build on and expand the content and coverage of the first
program. In addition to the first batch of 16,000 households from the first DAP who will receive
support in marketing and agro-processing, 14,000 new farmer households in 9 regions will also
be assisted to improve their food production capacity. The initial nutrition, water and sanitation
education component of the first program has also been expanded to cover HIV/AIDS and
malaria prevention in all client communities. A new strategy of targeting basic school children
in the dissemination of educational messages on nutrition and health has also been introduced.
Tree-planting and conservation activities are also being supported in the new program to help
address issues of deforestation, loss of bio-diversity, land degradation and depletion of
underground and surface water sources.
This program is in its third year and in line with USAID’s Bureau for Humanitarian Response￾office of Food for Peace (BHR/FFP) policies, a joint Mid-Term Evaluation has to be done for the
half-life of the DAP.
PURPOSE AND OBJECTIVES OF THE MID-TERM EVALUATION (MTE).
The purpose of the mid-term evaluation is to determine the progress being made in the
implementation of the DAP. It is to serve as a management tool to refine program activities,
implementation strategies and improve internal management of the program. It is expected to
determine the progress made during the first half of the project’s life in achieving its stated goals
and objectives. Based on evaluation findings, if necessary, the project shall redefine its goals
and objectives, re-organise its activities and adjust targets accordingly.
51
Utilizing baseline/other surveys, annual, semi-annual and quarterly reports, and other qualitative
and quantitative information, the MTE shall be done with the following specific objectives:
1) Determine progress ADRA/Ghana has made toward reaching its targets as
 defined in the monitoring and evaluation system;
2) Review the appropriateness of DAP with respect to the problem analysis in
 the DAP;
3) Identify constraints and difficulties plus successes in program
 implementation;
4) Assess the appropriateness, cost effectiveness and efficiency of the strategies being
used in the delivery of interventions; and
5) Make recommendations to improve the management of the DAP performance as
appropriate and suggest discontinuance, modifications or adjustment of activities,
strategies and targets.
METHODOLOGY
The mid-term evaluation will be a joint activity by ADRA/Ghana and other stakeholders like
local USAID Mission and ADRA International. A participatory approach will be used to
encourage joint problem analysis and development of solutions by program staff, collaborators,
clients and all other partners.
The evaluation will have a more formative nature using both qualitative and quantitative
information. It will use participatory rapid assessment techniques involving extensive interaction
with management and technical staff at the head office and the field offices, clients and
collaborators. This process will be complemented with data from other surveys and other
monitoring information which will demonstrate the process and also the progress being made to
achieve stated objectives and program goals, and it will contribute in helping to understand
relationships and suggest modifications to project design, if any.
The methodology shall include but not limited to the following:
Literature Review - The evaluation team should conduct a literature review of selected
documents to identify Title II Food program key issues. The evaluation team should also review
the information available at ADRA GHANA Head Office and USAID Local Mission. In
addition, the team should obtain essential data regarding ADRA/Ghana’s individual Title II
program by reviewing the DAP, annual and other reporting documentation, the initial Needs
Assessment, the baseline and other survey reports.
Key Informant Interviews – The team would interview officials involved with Title II at ADRA
Head Office, USAID Mission in Ghana, ADRA/Ghana Field Staff and other Public and Private
Agencies and Community Leaders partnering/collaborating with ADRA in the DAP
implementation.
 Focus Group Interviews and Observational Field Visits - The team should also conduct focus
group interviews of sample beneficiaries and observational field visits for qualitative information
on the progress being made in the program and the achievement of program targets and impacts
52
Use of Quantitative data - the evaluation team should also use any data (IPTT Info) M and E
data quantitative available at ADRA at the time of the evaluation to complement the
qualitative information.
Develop a Framework of Analysis – The evaluation team, taking into consideration this SOW,
shall develop a framework for analyzing program delivery based on the information collected
during the desk, and field reviews.
In the field reviews, the team will examine the specific goals, objectives and activities of each
component of the program as stated in the official document and formulate key questions for
each component as it proceeds in the evaluation. The questions are for guiding the team to place
each component in the wider perspective of the organizational culture, the different localities and
people involved and the Title II program’s major goals which are improving household food
availability, access and utilization.
MANAGEMENT AND PROGRAM ACTIVITIES/ISSUES TO BE EVALUATED.
The overall goal of the current ADRA/GHANA DAP is to enhance food security for 30,000
clients farmer households(expected beneficiaries of approximately 300,000) in the targeted areas.
This goal is being achieved through the following strategic objectives(SOs) and intermediate
results(IRs).
SO1. Improved Agricultural production and income;
IR1. Increased agricultural production,
IR2. Increased access to markets,
IR3. Increased access to agric credit,
IR4. Increased natural resource management practices.
SO2. Improved Health and Nutrition Status;
IR1. Improved nutrition and preventive health knowledge and practice,
IR2. Increased access to potable water,
IR3. Increased access to hygienic sanitation facilities.
Program activities include:
Supply of agro-inputs on credit,
Assisting in land preparation,
Training and provision of agric technical assistance,
Construction of improved storage facilities,
Agro-processing,
Rehabilitation of Farm to market roads,
Linking farmers to marketing organizations,
Community tree planting,
Community education in agric, natural resources management, nutrition and
preventive health,
Construction and management of water and sanitation facilities.
Based on suggested key evaluation questions and other relevant questions the mid-term
evaluation should determine whether:
• Program Management is effective and efficient;
• The program is likely to achieve its targets and impacts on the beneficiaries in
terms of its specific objectives and intermediate results;
53
• Program activities are being implemented in a timely and cost-effective way;
• Program activities are integrated and properly linked to the achievement of the
program goal and objectives;
• The training and other intervention strategies are having the desired impact of
building beneficiary capacity to sustain program activities when the DAP ends;
• The Monitoring and Evaluation(M&E) system incorporates FFP Title II generic
indicators and that all indicators have clear links to program SOs, IRs and
activities. The M&E system should also be checked that it ensures the collection
of the appropriate data, that targets are realistic with specific measurement units,
indicators are being objectively measured and addresses people-level effects and
impacts;
• An effective logistics plan has been developed and if there are identified
logistical problems and what steps are in place to address them if any;
• The impact of monetization commodities on local production are as documented
in the Bellmon Analysis, including whether the procedures for monetization
facilitates funds availability for program implementation.
KEY EVALUATION QUESTIONS TO BE ADDRESSED.
Program Objectives
Are there clear objectives?
Are the original objectives still appropriate in the light of lessons learned from the past two and
half years, current intervention strategies, and changes in external environments, if any.
What should be the appropriate objectives in view of current situation, if changes are needed?
Relevance of current Activities
How has the work developed over time and what factors have influenced the changes, if any?
Are the stated activities in the DAP the best way to achieving the objectives and if not, what
alternative options, and what are the implications for each option?
Program Management
Are the existing management structures well defined and adequate?
Is the staff strength sufficient to effectively manage the program?
Do program staff have the appropriate qualifications for their job placements?
Are the activities being carried out effectively and efficiently?
Are the stated activities carried out according to principles of good practices; i.e. Current
innovative agricultural technologies available in country.
How can performance be improved in all areas of interventions?
What problems have arisen? How have they been addressed? How else might they
 be addressed?
What improvement have been made in the management and technical areas to support
 the food security program implementation?
What forms of collaboration/partnerships exist and how have they facilitated or impeded
program implementation?
Is there a logistics plan in place and being followed/used?
Are there any logistics problems and how are they being solved?
Monitoring and Evaluation(M&E)
Is the monitoring and evaluation plan being used?
54
Is the M&E system generating the required data for decision making?
How is information from M&E being used to improve program management?
Cost-effectiveness/Sustainability of the program
Is the cost of the project reasonable for what has been achieved so far
Is it possible to achieve the same benefits at less cost
How realistic would it be to replicate the project in other areas and also make it sustainable?
Are the program interventions making significant impacts on the life of the beneficiaries?
What capacity building initiatives are in place and are they working to enhance program
sustainability?
How is the program building the capacity of local partners?
External and indirect factors influencing program implementation
What are some of the external factors influencing the work
Economic, social and environmental factors Changes in the policy and practices of USAID,
ADRA HQ and local government ministries, departments, agencies, and other partners.
Generic Evaluation Questions
From the evaluators point of view and given the current DAP scope of work, budget and
intervention strategies, could there have been a better way of achieving a similar result
(assuming the present results are satisfactory)?
From your observations and findings, are there unintended positive or negative results of this
program that the program Donor, planners, and managers did not foresee?
The Evaluation Team is also free to comment on anything that will be of help in the future to the
Donor, planner, and managers of this Program.
REPORT FORMAT
The Mid-Term evaluation document will be written using the following outline:
Title Page.
The title page will state the name and program number, names and titles of consultants,
and date and name of the document.
List of Acronyms.
Unusual or obscure acronyms should be identified at the beginning of the report.
Executive Summary.
The executive summary synthesis should be no more than two pages in length and will
include: background of program, evaluation methodology, accomplishments and impact
of the program, concerns and recommendations:
Table of Contents.
The table of contents should outline each major topic section, appendices, figures, maps,
tables, etc.
Body of the evaluation.
The body of the evaluation report will include the following in sequential order:
55
Introduction and background
The introduction and background will include at a minimum: justification for
awarding grant, goals and objectives of the grant, implementation methods, and
the purpose of the evaluation.
Evaluation Methodology.
The evaluation methodology will include at a minimum: description of data
collection methods and evaluation sites selection processes.
Sustainability Issues:
The section on sustainability issues will include sequential responses to the
sustainability questions and any other relevant issues outlined in the evaluation
questions.
Program Assessment:
This section will focus on the process of program implementation.
The evaluation team will use information gathered to assess
progress towards achievement of objectives, determine whether
interventions are sufficient to reach desired goals and outcomes
and finally identify barriers to the achievement of objectives.
Supplementary Issues and Questions.
This section will address in sequence the supplementary issues and questions
outlined in this Scope of Work.
Findings and recommendations
The team should clearly spell out its findings both positive and negative, if any,
and provide concrete recommendations to the program staff as to how to proceed
in the final half of the program’s life.
Results Highlight (optional)
If possible at all and if there exists an interesting human
interest story related to some aspect of the program, supply a two page
(maximum) narrative with supporting data, that may be used as a communication
piece for ADRA or USAID to distribute or to post on the Office WebPages.
Appendices
The appendices included will be at the discretion of the evaluation team. However, the
appendices must include the scope of work, itinerary for the evaluation visit, list of
individuals interviewed/surveyed during the evaluation, surveys and interviewer
questionnaires, references cited, and maps. Additional appendices such as case studies,
etc. may be included as determined appropriate by the evaluation team.
56
COMPOSITION OF THE EVALUATION TEAM
The evaluation team will consist of the Director of Evaluation at ADRA International and two
Ghanaian Consultants each for Agric/Nat. Res. Mgt. and Health/Nutrition and the Food Security
Program Management Team in ADRA/Ghana(Find the details on page 9 of this document).
ADRA-GHANA
MID-TERM EVALUATION 2004
LIST OF TEAM MEMBERS – EVALUATORS AND ADRA TEAM MEMBERS
PARTICULARS OF EVALUATORS
NAME ADDRESS TELEPHON
E
EMAIL AREA
ALLOCAT
ED
Dr. Regina O.
Aduttwum
N.D.P.C.,
Accra
0244-487399 radutwum@yahoo.com SOUTH
Dr. Matilda
Pappoe
S.P.H.,
University of
Ghana, Legon
021-500388 mpappoe@sph.ug.edu.gh
matildapappoe@yahoo.co.uk
SOUTH
Anastasia
Navele
Health
Management
Consultant,
Tema
021-761658,
024-3168433
atnavele@yahoo.com
atnavele@hotmail.com
NORTH
Dr K. Twum￾Ampofo
Institute of
Renewable
Natural
Resources,
KNUST
0244-277217 ktampofo2001@yahoo.co.uk NORTH
PARTICULARS OF ADRA TEAM MEMBERS
Seth Abu￾Bonsrah
ADRA￾Ghana, P.O.
Box 1435,
Accra
021-220779
0243-108205
sabubonsrah@yahoo.com SOUTH
Abigail
Abandoh-Sam
ADRA￾Ghana, P.O.
Box 1435,
Accra
021-220779
020-8174165
abigailsam@yahoo.com SOUTH
Simon Soale
Saaka
ADRA￾Ghana, P.O.
Box 1435,
Accra
021-220779
020-8163633
simonsaaka@yahoo.com SOUTH
Victoria Daaku ADRA￾Ghana, P.O.
Box 1435,
Accra
021-220779
020-8118583
vicdaaku@yahoo.com NORTH
Tweneboana
Adu-Sarkodie
ADRA￾Ghana, P.O.
Box 1435,
021-220779
0244-698331
ksarks@yahoo.com NORTH
57
Accra
Anthony Mainoo ADRA￾Ghana, P.O.
Box 1435,
Accra
021-220779
020-8162555
mainooatony@yahoo.com NORTH
58
SCHEDULE OF ACTIVITIES
Activity Timeline Person(s) Responsible
Submission of Documents to Consultants Thursday: Sept
16
M&E, Planning &
Program Officers
Discussion of Remuneration, negotiations,
signing of contracts and Logistics
Friday: Sept 17 ADCOM/Consultants
Review of Documents and Finalization of
SOW Document
Monday: Sept
20 -
Tuesday: Sept
21
Consultants
Design of Data Collection Instruments Wednesday:
Sept 22
Consultants
Meeting with USAID to:
• share Data Collection Instruments
• select Sample Communities
Thursday: Sept
23
ADRA Management
Staff/ Consultants
Finalizing of Data Collection Instruments Friday: Sept 24 Consultants/ADRA
Field Work Sunday: Sept 26
–
Thursday: Oct 7
Consultants/ADRA
Report Writing - First Draft Friday: Oct 8
Friday: Oct 15
Consultants
De-briefing/Presentation of Draft Report Monday: Oct 18 Consultants
Final Report to ADRA-GHANA Wednesday: Oct
20
Consultants
Submit Report to ADRA/International Friday: Oct 22 ADRA Country Director
Feed back on final Report from
ADRA/International
Friday: Oct 29 ADRA/I Director of
Evaluation
Submit Report to USAID Monday: Nov 1 ADRA/International
59
APPENDIX 2: ITINERARY
Communities visited/assessed by the Health and Nutrition Evaluation Team: Southern
Sector
Community District Region
1. Konkon No. 1*
2. Maampehia*
3. Gbantana
4. Detsekope*
5. Wenu
6. Maafi Alavanyo
7. Nkurakan
8. Pleyo
9. Akyekyesu
10. Sokode-Juaso
11. Nkontrodo*
12. Akwansa K*okodo
13. Dawurampong
14. Nyankoma
15. Agbodzi
16. Prasokuma
17. Abepotia
Ga
“
Dangbe East
“
North Tongu
“
Yilo Krobo
“
New Juaben
East Akim
KEEA
Mfantsiman
Gomoa
West Akim
“
Birim North
Kwahu South
Greater Accra
“
“
“
Volta
“
Eastern
“
“
“
Central
“
“
Eastern
“
“
“
*Visited together with ANRM Team.
COMMUNITIES VISITED IN THE SOUTH: AGRIC SECTOR
Community District Region
1. Nyavime-Avie Ketu Volta
2. Danormadi Ketu Volta
3. Obawale 1 Yilo Krobo Eastern
4. Adormer Dzomoa Manya Krobo Eastern
5. Otoase SKC Eastern
6. Awutu Kwei AES Central
7. Ayirsu AES Central
8. Mallam Nkwanta Kwabibirem Eastern
9. Afabeng West Akim Eastern
60
Communities visited in the northern sector by both health and ANRM teams
DATE COMMUNITY DISTRICT REGION
27-09-04 Woraso* Sekyere West Ashanti
27-09-04 Teacherkrom* Sekyere West Ashanti
28-09-04 Mantukwa (H) Offinso Ashanti
28-09-04 Baafi (H) Nkoranza Brong Ahafo
28-09-04 Nyame Bekyere (A) Offinso Ashanti
28-09-04 Dandwa (A) Nkoranza Brong Ahafo
29-09-04 Kpabuso (H) Central Gonja Northern
29-09-04 Achubunyor (H) West Gonja Northern
29-09-04 Tom (A) Nkoranza Brong Ahafo
30-09-04 Mpaha (A) Central Gonja Northern
1-10-04 Bihee* Wa Upper West
1-10-04 Tigboro (H) Jirapa/Lambusie Upper West
1-10-04 Jonga (A) Wa Upper West
4-10-04 Bimpella (H) Bawku East Upper East
4-10-04 Nangodi (H) Bolga Upper East
4-10-04 Kobdema (A) Builsa Upper East
4-10-04 Kazugu (A) Kassena Nankana Upper East
5-10-04 Paga-Sakaa* Kassena-Nankana Upper East
5-10-04 Pusu-Namongo* Bolga Upper East
H=Health Team only; A=ANRM Team only; * = Both H and A Teams
61
APPENDIX 3: INDIVIDUALS INTERVIEWED DURING THE EVALUATION.
Name Position Organization
Mr. Tony Akuamoah
Mr. Frank Abima
Mr. Benson Abutiate
Mr. Maclean Laryea
Mr. Elvis Bosumprah
 -
Mr. Thomas Gator
Mr. Felix Adotey
Ms. Charlotte Botchway
Mr. Peter Thompson
Mr. Isaac Kumah
Mr. Nicholas Adjakli
Mr. William
Mr. Samuel Tetteh-Out
Mr. S. Odoi-Danso
Mr. E. Yawlue
Ms. Mercy Anim
Ms. Juliana Dzirasa
Mr. Francis Nutakor
Mr. Geophrey Sam
Mr. Raphael Numon
Ms. Roberta Kumassah
Mr. John Nketiah Gyenfie
Mr. Moses Banfo
Dr. Opare
Dist. Environmental Health Officer
Environmental Health Inspector
District Dev officer
District Development Officer
Agric. Extention Agent
Headteacher
D D O
A E A
District Environmental Health Officer
Assist. Dist. Environmental Health Officer
 “
District Coordinating Director
District Development Officer
Agric Extension Agent
D D O
Principal Environmental Health Insp. Assist.
Environmental Health Inspection Assistant
 “
Health Inspection Assistant
District SHEP Coordinator
District Agric Officer
District Development Officer
Dist. Environmental Health Officer
Public Health Nurse (DHMT)
District Director
D D O
D D H S
Dangbe East Assembly
 “
MOFA – Dangbe East
 “
Amlakpo Presby Prim. School
MOFA – North Tongu
 “
North Tongu Assembly
 “
 “
 “
MOFA – North Tongu
 “
 “
Yilo Krobo Assembly
 “
On secondment: DANIDA
East Akim Assembly
Gomoa Dist. Education Office
MOFA: Gomoa District
 “
 “
Reproductive Health Unit AES
MOFA – Kwahu South
 “
GHS: Kwahu South
II ADRA FIELD STAFF
Name Position and Coverage Area
Mr. Richard Boateng
Mr. Akwasi Agyeman
Mr. Divine Dogbe
Ms. Miriam Tetteh-Attaah
Mr. Akyem-Peprah
FPO : Health and Nutrition - Winneba
FPO : Greater Accra Region
FEA : Volta Region
FPO : Health and Nutrition Koforidua/Nkawkaw
FPO : ANRM – Nkawkaw
62
Mrs. Victoria Tettey FPO : Health and Nutrition, Cape Coast
LIST OF PERSONS INTERVIEWED BY HEALTH AND NUTRITION TEAM
NORTHERN SECTOR
DATE NAME TITLE ADDRESS Telephone
27-9-04 Miss Elizabeth Kuma FPO Nutrition and
Health
C/o FOR A-Ghana, Mampong￾Ashanti
020-8160882
27-9-04 Alex Boahen
Fridua Elijah
Janet Adjei
All are classroom
(pupil)Teachers
Woraso L/A Prim. School
P.O. Box 95,
Mampong-Ashanti
28-9-04 Mr. Owusu Safo
Emmanuel
Post Mid. Sch.
Teacher (Head) and
Head Teacher and
GNAT member
T.I. Admadiya Prim. Sch.
Teacherkrom
0244-132492
28-9-04 Ernest Amoansah Field Extension
Agent
ADRA-Ghana
Techiman
0653-22337
020-8123490
28-9-04 Yaw Boakye
Taah John
Donkor
Joe K.
Yelviel
HAT members Mantukwa, Offinso
28-9-04 George Gumah Sch. Health Teacher Baafi L.A. Prim.
Box 176, Baafi, B/A
28-9-04 Evelyn Cofie Adjei FPO Nutrition and
Health
ADRA Ghana
Techiman
0653-22337
020-8170664
29-9-04 Musah Ali Sch. Health Teacher
for JSS
Kpabuso L/A JSS
Kpabuso, N/R
29-9-04 Eunice Odoom FPO Nutrition and
Health
ADRA Office
Box 883, Tamale
071-22887
0244-740416
30-9-04 Mr. Seidu Osman District Hygiene
Officer
E.H.O,
Water & Sanitation Office,
Box 27, Damongo, NR
0717-22005
30-9-04 Mr. Issahaku Jamani District Rural Water
Technician
Team Leader
DWS Team
E.H.O,
Water & Sanitation,
Box 27, Damongo, NR
0717-22005
30-9-04 Ms. Ramatu Braimah District P.H.N. D.H.D.
Box 7, Damongo, NR
0717-22046
30-9-04 Akosua Sumani Nutrition Assistant D.H.D.
Box 7, Damongo, NR
0717-22046
30-9-04 Mamata Hamidu Principal Nutrition
Officer
D.H.D.
Box 7, Damongo, NR
0717-22046
30-9-04 Regina Siebebale P.H.N. P.H.N.
West Gonja Hospital
Box 18, Damongo, NR
0717-22001
30-9-04 Mr. Siberi Kwame District MOFA MOFA
P.O. Box 25, Damongo, NR
0717-22008
0244-024879
1-10-04 Ms. Esther Peace
Aakye
Nutrition Tech.
Officer Grade 1
Nutrition Rehabilitation Centre,
Box 321, Wa, UWR
0756-22008
1-10-04 Amma Vaa-ib Field Technician Nutrition Rehabilitation Centre,
Box 321, Wa, UWR
0756-22008
2-10-04 Priscilla Nubata WIAD
Snr. Tech. Officer
MOFA
Box 21, Wa, UWR
0756-22139
2-10-04 Mr. Felix Amofa FPO/Health and ADRA – Ghana 0756-22106
63
Nutrition P.O. Box 154, Wa, UWR
5-10-04 Clement Akansi
Atuah
Field Ext. Agent of
Bimpella/Bawku
West/East
ADRA Bolga
Box 135, Bolga
072-23452
0244-105932
6-10-04 Ms. Beatrice Gandaa
Pastor Isaac Yen
Prin. Tech. Officer
Nutrition
E.H.O.
Municipal Health Administration
P.O. Box 26, Bolga, UER
072-22127
6-10-04 Dr. Alexis Nang￾Beifubah
Municipal Director
of Health Services
idem
E-mail address:
bedha@africaonline.com.gh
6-10-04 Dr. Yakubu
Bayayinah
District Director of
Health Services
D.H.D. Talensi-Nabdam
P.O. Box 26, Bolga, UER
072-22127
6-10-04 Rhoda Mbimadong FPO – Nutrition and
health
 ADRA Bolga
Box 135 Bolga, UER
072-23452
0244-511104
6-10-04 Asamani Cletus District
Environmental
Officer
Municipal Assembly
P.O. Box 36, Bolga, UER
6-10-04 Grace Anafo District WIAD
Officer, Bongo
MOFA, Box 23, Bongo, UER 0244-409728
7-10-04 Ms. Mathilda Acquah Reg. Dev’t Officer,
WIAD
WIAD
P.O. Box 3820, Kumasi
0244-618790
7-10-04 Margaret Aboligu Municipal PHN Municipal PHN
P.O. Box 109, Techiman
0244-776817
7-10-04 Mr. Charles Kwakey
Siwa
Municipal Nutrition
Tech. Officer
Municipal Nutrition Tech.
Officer,
P.O. Box 109, Techiman
020-5092079
7-10-04 Mrs. Evelyn Coffie
Adjei
FPO Health and
Nutrition
ADRA Techiman
P.O. Box 486, Techiman
0653-22337
7-10-04 Abudu Karim Issifu
Seidu
Municipal Env.
Health Officer
P.O. Box 30,
Techiman, BAR
0244-478869
7-10-04 Paulina Ansogba Municipal Focal
Person
MOFA, Box 257,
 Techiman, BAR
7-10-04 Marian Frimpong
Lerewanu Grace Mary
B.
District PHN District
NT
District EHO
District PHN
Box 237, Offinso, AR
05120329
05120334
PERSONS INTERVIEWED BY THE NORTH ANRM TEAM NORTHERN SECTOR
NAME TITLE DISTRICT
Mr Nketiah fRED FPO Mampong
Samuel M. Agumadu FPO Techiman
Dan Kyei FPO Kintampo
Mr Kwame Okyere Boadu FPO (team leader) Tamale
Mr K. Fordjour FPO(team leader) Wa
Mr Stephen Awuah FPO(team leader) Bolgatanga
Mr C..A. Adda AEA (MOFA) Pusu￾Namango/Bolgatanga
Mr K. Bio AEA (MOFA) Wa-BiHee
Stephen Manu Private nursery operator Bonsu-Nkoranza
Mr Iddrisu Private nursery operator Busa Nursery￾Bolgatanga
Mr Paul Alhassan Env. Health (officer) Kobdema
64
PERSONS INTERVIEWED BY THE SOUTH BY ANRM TEAM
NAME TITLE DISTRICT
Mr Kwasi Agyeman F.P.O (Agric) Dangbe East
Mr Maclean Laryea District Development
officer, MOFA
Ketu
Mr Albert Havor District Development
officer, MOFA
Ketu
Mrs. Doris Kubi HAT member
(Health and
Sanitation)
SKC
Mrs Grace Osei
Asibey
Senior Field Project
Officer (Health)
Oda officer ADDRA
Mr Yao V. Dotse District Director of
Agric
SKC
Mr Amenu District Development
Officer,MOFA
SKC
Mr Stephen Opoku
Okyere
District
Environmental
Officer
SKC
Mrs Rebecca
Tswasam
HAT member Dangbe East
Mr Kankam
 Isaac
FPO(Agric) Winneba-ADDRA office
Mr Timothy Field Extension
Agent
AES
65
APPENDIX 4: QUESTIONNAIRES FOR INTERVIEWS
QUESTIONNAIRE FOR MID-TERM EVALUATION (ANRM)
Introduction
1. How did you come in contact with ADRA?
2. What is ADRA doing for the community?
3. How did you become a member of the ADRA farmer’s group?
4. Are you satisfied with the farmer’s membership selection process?
5. What do you hope to achieve by participating in all ADRA activities?
Agricultural production
6. What agricultural packages did ADRA provide you?
• Inputs – seeds/ seedlings, fertilizers/ manure, land preparation, Wellington
boots, cutlasses, food rations, food-for-work (delivery, quality, quantity and
distribution)
• Agricultural processing equipments – cashew crackers/ roasters, corn mills,
cassava processors (delivery, quality, quantity and distribution)
• Training – Agricultural production i.e. methods of improving soil fertility,
plantation crop management, bush fire prevention, bullock plough techniques,
post harvest handling/ storage, construction of improved silos and cribs
(training satisfaction, methodology, material, quality and time)
• Training – NRM i.e. seedling production and nursery management, education of
farmers on natural resources management practices, (educational materials,
training satisfaction, methodology, material, quality and time)
• Training- Agricultural Processing i.e. equipment handling, environmental
cleanliness, (educational materials, training satisfaction, methodology,
material, quality and time)
7. What changes in crop yield /type have occurred with ADRA assisted farmers
• Acreages cultivated
• Yield per acre
8. How many months do you have food in the household during a year?
Marketing
66
9. In what ways has ADRA facilitated the marketing of your agricultural produce?
10. How satisfied are you with the marketing information and strategies?
11. What proportion of your produce do you sell? e.g. Bags of maize
Credit
12. How important is it to you to pay your loan?
13. Why do you think some people pay their loan on time and others don’t?
14. For those not paying on time, how can we make them to pay?
15. How satisfied are you with the ADRA credit scheme?
Impact
16. Do you see any change in your welfare in terms of:
(i) production
(ii) consumption
17. Has other members of the community adopted ADRA introduced ANRM practices?
18. Which of the ADRA activities have benefited you and your household most?
19. Is there anything you want ADRA to do differently?
20. What are some of the problems/ difficulties experienced with ADRA’s activities?
Sustainability
21. When ADRA leaves, what would you keep doing that would improve your
agricultural production?
22. How would you link with Government agencies (MOFA) when ADRA leaves?
ADRA FIELD STAFF
1. FPO (Field Project Officers – Agric. & Natural Resources, Health & Nutrition)
2. Field Extension Agents
QUESTIONS
1. What type of support do you give to clients?
2. What are the objectives of the program?
3. Are they clear?
4. Should any be changed?
5. What strategies are used and with what effect/ impact (for the beneficiaries)
6. What are your qualification and experience? Is your training adequate for your
position?
7. How do you find the workload/ logistics? Is it adequate?
8. Are there any gaps in the program? List them and explain how they could be filled.
67
9. Are activities integrated and properly linked to the achievement of program
objectives?
10. Whom do you collaborate with?
11. What are the difficulties associated with the collaboration?
12. Any suggestions for improving the activities?
PARTNERS (DISTRICT LEVEL)
QUESTIONS
1. How is the collaboration with ADRA?
2. How often do you interact with ADRA Staff and the beneficiaries?
3. What do you think are the successes and challenges of ADRA activities?
4. Is there anything you would like ADRA to do differently?
5. How would you continue to collaborate when ADRA pulls out?
6. What suggestions can you make for improving the activities of ADRA?
FGD GUIDE: NUTRITION, WATER AND SANITATION
1. GENERAL QUESTIONS
a. What are some of the activities (health,water and sanitation) of ADRA that you or
your family are involved in?
b. Of all the ADRA introduced activities, which have benefited you and your family
most/least? Give reasons why?
c. What are some of the difficulties/challenges and successes encountered with regards
to ADRA initiated activities
d. Is there anything that you would like ADRA to do differently? What would that be?
Give reasons why?
e. How could ADRA improve upon its activities?
2. NUTRITION
a. How can you tell if a child (0-5years) is growing well? (Inspect growth monitoring
cards of 10 children) percentage of children under 3 years who show a normal
Wt.for Age; & Ht. for age)
b. What did you feed your child the first 6 months? Give reasons for your answer.
c. What did you feed your child after 6 months onwards till 2 years?
d. List ways in which you have changed in your method of food preparation and
utilization since the teaching of ADRA? (for both adults and children).
3. WATER AND SANITATION
a. Mention all the things that you do to keep yourself clean
b. What are the major constraints which prevent you from practicing the above?
c. What do you do to keep your environment clean?
d. Why do you have to keep yourself and your environment clean?
68
e. What practices should be adopted to prevent the outbreak of diseases in the home?
f. What new behaviors have you adopted as a result of inputs from ADRA e.g. potable
water, VIP latrine, soak away, rubbish dump, increased food availability in your
home?
4. DIARRHOEA
a. What is diarrhea? What causes diarrhea?
b. What do you do if a child has diarrhea? Why?
c. What are the signs of dehydration?
d. When should you send a child to the clinic when he/she has diarrhea
e. How can diarrhea be prevented?
5. MALARIA
a. What is malaria? What causes malaria?
b. What do you do when a child has malaria (what about the Adults)? Why?
c. In which ways can malaria be prevented?
d. What measures have you taken to prevent malaria in your home?
6. HIV /AIDS
a. Name two ways a person can be infected with HIV/AIDS
b. Name 2 ways to protect one self from HIV infection
NB: Inspect VIP latrines, soak away pits, rubbish dumps, hand dug wells, boreholes
7. Management
a. What difficulties / problems do HAT members face in carrying out their duties?
b. What are the main problems in your community in relation to the operation of water
and sanitation facilities (boreholes & wells, soak away, VIP latrines rubbish dump)
c. How can they be solved?
d. What recommendations can you make for improving the management of ADRA
initiated activities?
8. Sustainability
a. How does the community plan to manage, maintain, replace old facilities when
ADRA is no more in the community?
b. What would you continue to do when ADRA is no more in your community?
c. Have other members of the community adopted ADRA introduced/initiated nutrition,
health and sanitation practices? Which ones? Why?
69
 WATSAN MEMBERS
1. What are some of the topics you learnt during the training?
2. Which topics did you find useful.? Give reasons why.
3. What would recommend for improving the training? (content / methods)
4. What are some of the problems / difficulties with regards to the operation of wells &
bore holes, VIP latrines, soak away etc. (management, maintenance, replacement of
parts, sustainability)
5. How are these problems solved?
6. What difficulties/ problems do WATSAN members face in carrying out their duties?
 SCHOOL CHILDREN
1. What types of health programs are organized in your school?
2. What have you learnt about the following :
a. Malaria prevention
b. HIV / AIDS prevention
c. Personal hygiene
d. Environmental hygiene
e. Food hygiene
f. Diarrhea
g. Nutrition
3. Which of these topics did you find most beneficial? Give reasons why.
4. Are there other topics you would be interested in learning?
TEACHERS
1. What were the topics on health you taught the school children?
2. What problems / difficulties did you face during the training of the children?
3. To what extent do you think the children are practicing what was taught?
4. Recommendations for improving the training of the children
5. How do you hope to continue with the school health program after ADRA has left?
6. Whom do you collaborate with as regards the school health program apart from
ADRA?
7. What problems/ difficulties did you face during your (Teacher) training?
8. What recommendations did you have for improving your teacher training?
70
APPENDIX 5: WATER AND SANITATION FACILITIES CHECKLIST
WATSAN INSPECTION CHECKLISTS
№ VIP latrine good satisfactory poor remarks
1 Location/sitting
2 State of superstructure
3 Anal cleansing materials disposal
4 Cleanliness of latrine
5 Fly and odour control
6 Hand washing facility (suitability,
soap available)
7 Are they covered
8 Vent pipe with screen in relation to
other houses
9 Do children use the latrines
10 Total # in community
CHECKLIST
№ Rubbish dump good satisfactory poor remarks
1 Number present in community
2 Location/sitting
3 Cleanliness of rubbish dump
4 Fly and odour
5 Used as toilet or not
6 Are they burnt
7 Do they cut the grass
CHECK LIST
№ Soak away pits good satisfactory poor remarks
1 Number present in community
2 Location/sitting
3 Does water flow into pit and soak
away
4 Weeding around pit
5
CHECKLIST
№ Wells good satisfactory poor remarks
1 Used by community
2 Location/sitting
3 Cleanliness of site
71
4 Weeding of site
5 Receptacle for waste water
6 Mngt. committee in place
7 Activities to prevent contamination
of water
8 Maintenance activities
9 Water transportation : containers
CHECKLIST
№ Bore holes good satisfactory poor remarks
1 Location/sitting
2 All parts functional
3 Used by community
4 Cleanliness of site
5 Weeding of site
6 Receptacle for waste water
7 Mngt. committee in place
8 Activities to prevent contamination
of water
9 Maintenance activities
10 Water transportation : containers
11
General:
Physical appearance and cleanliness of community members:
Physical appearance and cleanliness of environment:
72
APPENDIX 6: DOCUMENTS REVIEWED FOR MID TERM EVALUATION
1. ADRA/GHANA FOOD SECURITY PROGRAM
FY 2002 – FY 2006
PROJECT STATUS REPORT
OCTOBER 1, 2001 – MARCH 31, 2002
2. ADVENTIST DEVELOPMENT RELIEF AGENCY GHANA
FY 2002 – FY 2006
DEVELOPMENT ASSISTANCE PROGRAM
PROGRAM ADDENDUM
3. ADVENTIST DEVELOPMENT RELIEF AGENCY GHANA
FY 2002 – FY 2006
INITIAL ENVIRONMENTAL EXAMINATION
4. ADVENTIST DEVELOPMENT RELIEF AGENCY GHANA
FY 2002 – FY 2006
MONITORING AND EVALUATION PLAN
(ADRA GHANA, DAP 2002 – 2006)
5. ADVENTIST DEVELOPMENT RELIEF AGENCY GHANA
FY 2002 – FY 2006
INDICATOR PERFORMANCE TRACKING TABLE
(ADRA/GHANA DAP 2002-2006)
6. ADVENTISIT DEVELOPMENT RELIEF AGENCY GHANA
FY 2002 – FY 2006
BASELINE SURVEY REPORTS
7. ADVENTIST DEVELOPMENT RELIEF AGENCY GHANA
FY 2002 – FY 2006
SCHOOL HEALTH SURVEY REPORTS
8. ADVENTIST DEVELOPMENT RELIEF AGENCY GHANA
FY 2002 – FY 2006
RESULTS REPORT
FY 2002
9. ADVENTIST DEVELOPMENT RELIEF AGENCY GHANA
FY 2002 – FY 2006
RESULTS REPORT
FY 2003
10 ADRA/GHANA FOOD SECURITY PROGRAM
FY 2002 – FY 2006
73
PROJECT STATUS REPORT(SAPR)
OCTOBER 1, 2001 – MARCH 31, 2002
11. ADRA/GHANA FOOD SECURITY PROGRAM
FY 2002 – FY 2006
PROJECT STATUS REPORT (SAPR)
OCTOBER 1, 2002 – MARCH 31, 2003
12. ADRA/GHANA FOOD SECURITY PROGRAM
FY 2002 – FY 2006
PROJECT STATUS REPORT (SAPR)
OCTOBER 1, 2003 – MARCH 31, 2004
13. QUARTERLY PROGRESS REPORTS
SECOND QUARTER FY 2004
(OCTOBER – DECEMBER 2003)
14. QUARTERLY PROGRESS REPORTS
SECOND QUARTER FY 2004
(JANUARY – MARCH 2004)
15. ADRA/GHANA FOOD SECURITY PROGRAM
FY 2002 – FY 2006
QUARTERLY PROGRESS REPORTS
THIRD QUARTERLY FY 2004
(APRIL – JUNE 2004)
16. ADRA/GHANA FOOD SECURITY PROGRAM
FY 2002 – FY 2006
MID-TERM EVALUATION SEPT 2004
SCHEDULE OF ACTIVITIES
17. FINAL REPORT, ADRA/GHANA FOOD SECURITY ASSESSMENT
COMMUNITY NEEDS ASSESSMENT FOR THE PREPARATION OF DAP FOR
FISCAL YEARS, 2002 – 2006, PAD DEVELOPMENT CONSULTANTS
LIMITED, TEMA
74
APPENDIX 7.0: DIRECT COMMENTS BY COMMUNITY MEMBERS ON
EFFECTS OF PROGRAM
7.1 INDICATORS OF SUCCESS OF ADRA, ACCORDING TO
 COMMUNITY MEMBERS:
 Nutrition:
• Soybean dishes giving a lot of health
• Fruits from citrus crops for food and sale
• Easy access to water-boreholes
• Good drinking water
• Increased awareness on soybean utilisation.
• Improved food security (women now use money for farming rather than for expensive
funerals)
• Improved cooking practices (use of clean equipment)
• Improved child nutrition and exclusive breastfeeding
• Women now send their babies for weighing
• Storage cribs for maize storage
Water and Sanitation:
• Construction of soakaways is preventing mosquito breeding.
• House to house education by HAT and WATSAN.
• Community members’ adoption of latrines introduced by ADRA.
• Keeping wells/bore holes surroundings clean.
• Reduction in open defaecation practices.
• Reduction in diarrhoea outbreaks
• Improved cleanliness in the community.
• Availability of soakaways – no more grounds for breeding mosquitoes
• No more bilharzias (with the use of boreholes)
• Reduced cholera outbreak
75
• Lessened incidences of malaria
• Communities are now generally clean
• Boiling of water before drinking where there is no potable water
• Good health for many families
ANRM
• Planting of trees
• Access to manure and fertilizer for crops
• Improved dialogue between community and ADRA staff.
• Women empowerment (can now use marginal lands for production of crops).
• The granting of loans to community women and other members.
ANRM & Gender Sensitization
• Planting of trees has given women especially in the north access to firewood for
cooking and for sale
• Women empowerment (can now use marginal lands for production of crops).
• Funerals:- women used to waste their profits on funerals but through ADRA’s
organized educational session, they use their profits for the welfare of their families.
• The specific targeting of women in granting of loans to community members has
improved access to credit for women in the project.
 
7.2 DIFFICULTIES AND CONSTRAINTS FACED BY HAT AND WATSAN MEMBERS
IN
CARRYING OUT THEIR DUTIES:
 A. Difficulties and constraints faced by HAT Members:
• Frequency of meetings (twice or five times a week)
• Members stay far apart and difficult to mobilise
76
• Coverage: large number of people come for cooking demonstrations
• How to get money for cooking demonstrations
• Difficult community members (community members are hard to understand)
• How to get community together for activities.
• Some community members do not know the activities of HAT.
• Plenty weeds in some communities
• “Free range” due to lack of toilets for some members even though they now cover it
• Late supply of fertilizer
• Lack of transportation for effective visitation of communities by HAT members especially in
the north
• Religious and cultural beliefs that sickness is from gods and not due to poor sanitation.
• Down streaming should be improved.
• Failure of loan beneficiaries to meet set dates.
 B. Difficulties and constraints faced by WATSAN Members:
• Getting community to go in turns to clean the borehole sites
• Getting community members to contribute towards soak away and VIP latrine construction
• Money to pay for digging of VIP latrines and soak away pits.
• People are always overcrowded at water site.
• Water level (table) falls during the dry season.
• Toilets and wells are not many
• Scarce resources - ¢100,000 deposit/commitment fee for the construction of VIP latrines
• How to assist more people to build VIP latrines and soak aways.
• Clayey nature of some community soils makes soak away construction difficult.
 C. Difficulties and problems faced by both WATSAN and HAT Members:
• Community expects money before they participate in communal activities.
• Some community members do not come for activities because they are busy.
• Community members need repetition before adoption of practice
• Difficulties in collecting loans
• Insults and disrespect from some community members
77
• Lack of motivation and equipment (e.g. Wellington boots etc.)
• Water transportation (carried without cover).
• Reluctance of the whole community to meet for discussions and activities.
• Some communities overly dependent on ADRA: see ADRA as “Father Christmas”
WHAT COMMUNITIES WOULD LIKE ADRA TO DO DIFFERENTLY
• Introduce other income generating activities e.g. soap-making.
• Should go more into tree planting.
• Strengthen the collaboration on production.
• Help community members complete VIPs in blocks.
• Increase the number of people receiving VIP latrines.
• Provide public latrines for those who cannot afford household ones.
• Introduce different styles of VIP and bath houses using mostly local materials
 7.3 SUGGESTIONS FOR IMPROVING THE ACTIVITIES OF ADRA
 A. From community leaders:
• Increase coverage of soya bean utilisation in communities.
• Increase use of radio programmes especially in the evenings.
• ADRA should have regular review meetings with farmers.
• Improve communities’ ability to meet to discuss issues before leaving the
community.
• Increase the number of communities receiving VIP and water facilities.
• Support communities to construct VIPs with PVCs and also for soakaways.
78
B. From Partners/Collaborators:
• Organise frequent refresher workshops with partners.
• Improve collaboration with DHMT and plan with all other collaborators
• Give motorbikes to partners to facilitate their work and quicken the payment of
allowances.
• Send outline of activities to District Assemblies
• Share quarterly and annual reports with Collaborators
• Improve the home situation with smokeless stoves, washing basin, mini beds.
APPENDIX 8: RESULTS HIGHLIGHT - A CASE STUDY OF SUCCESS
Ajanaba Abanisui and Ajemmeh Abanisui are an exemplary family from Banyono near Paga￾Sakaa in Upper East Region. The couple has five children; three males and two females.
Francis who is a cousin of Madam Ajanaba, is both a HAT and WATSAN member who
practices what he preaches. Madam Ajanaba is the treasurer of ADRA client group and also a
community volunteer who assists in the weighing and immunization sessions in the
community. They live in a beautifully constructed local mud house. The couple has
constructed a VIP latrine, bath house and soakaway pits which are some of the numerous
ADRA initiated teachings. The two sanitation facilities don’t smell, attract flies nor
mosquitoes since there is no standing water behind the bath house, thanks to the well covered
soakaway which swallows waste water in its bowels. They have a well-built granary in their
compound with kind words of appreciation to ADRA to store dried foods. Madam Ajanaba
has a creeping spinach plant on their compound, which adorns and provides vegetables for
the family even during the dry season. Their compound is neat and welcoming to neighbors
who are trying to emulate what the couple has learnt from ADRA.
PASTE PHOTOS
APPENDIX 9: FOCUS GROUP DISCUSSIONS AND INTERVIEWS CONDUCTED BY HEALTH TEAM IN NORTHERN SECTOR
REGION District Community Women FGD Community Leaders School Ch
ildren
Teachers DHMT/
Others
DA
EHD
MOFA
WIAD
EPD
EFO
HAT
WATSA
N
Inspection
of
Facilities
Sekyere Woraso x x x
Ashanti West Teacherkrom x x x
Offinso Mantukwa x x xx xx xx xx x
Brong
Ahafo Nkoranza Baafi x x x x x x
Central
Gonja Kpabuso x x x x Northern West
Gonja Achubunyor x x x x x x
Wa Bihee x x x x x Upper
West Jirapa Lambusie Tigboro x no school no school x
Bawku
East Bimpella x x x x
Nangodi x x x x x x Bolga Paga-Sakaa x x x Upper East
Kassena
Nankana
Pusu￾Namongo x x
5 11 4 3 4 5 4 7 Many 12