Gender
Pregnant women advised not to shy away from referrals
Mr Freda Alowri, a Senior Midwifery Officer (SMO) at the Zorko Health Centre in the Bongo District of the Upper East Region, has admonished expectant mothers to promptly adhere to referral orders from lower to higher health facilities to prevent complications.
She said referrals, especially from health facilities in rural areas made to higher facilities for further management, should be taken seriously without delays especially in pregnant women since that could result in complications and possible deaths.
“Pregnant women in rural areas are usually reluctant to go on referrals to higher facilities and if there is an issue those of us in the deprived communities cannot handle.”
“It is not all the cases that those of us in derived areas can handle, and so if we detect such cases and refer, they should not delay, but go immediately,” she said.
Ms Alowri, who has decades of work experience in the rural community, gave the advice in an interview with the Ghana News Agency (GNA) after she was awarded the 2024 Best Midwife by the District Health Directorate of the Ghana Health Service (GHS).
The Directorate at its 2024 annual health performance review meeting held in Bolgatanga, recognised Ms Alowri’s “Outstanding skills and expertise in the domain of maternal and neonatal care”.
The Directorate said her commitment to delivering high-quality care, mentorship and adherence to best practices had profoundly influenced maternal health in the district.
The midwife advised women in rural areas to immediately visit the nearest health facility if they missed their menstrual cycle and suspected pregnancy.
She said early Ante-Natal Care services in the first trimester of pregnancy was the surest way for safe delivery and insisted that “Pregnant women should try to visit the nearest health facility early for good maternal services.”
For midwives who refused postings to rural areas to work, Ms Alowri said there was much experience to gain at health facilities in rural areas, and urged midwives, especially junior staff to accept postings to any part of the district where their services were needed, and work diligently to uplift the image of the GHS.
Ms Estella Abazesi, the District Director of the GHS, who presented the award to the midwife, told the GNA that staff motivation was important to the directorate as a means to urge them to deliver their best.
She said staff nominated among themselves, those they thought deserved awards, and management also considered key performance indicators of the various facilities for the awards.
“The indicators carried 70 per cent performance and 30 per cent for the nomination. That was what we did for both individual and for the facility level,” she said, and encouraged her staff to continue to work hard to improve service delivery.
The directorate, apart from Ms Alowri, recognised and honoured nine other staff under various categories namely: Mr Mohammed Abu, Mr Michael Awia Achuliwor, Madam Cynthia Lariba Apemjobey, Mr Maxwell Kamah Alagnona, Mr David Adongo, Madam Gloria Wulug, Madam Rihanna Akugre Awudu and Madam Agnes Aloyine Atibila.
Three Community-based Health Planning and Services (CHPS) compounds; the Beo Tankoo CHPS, Kadare and Nayorigo CHPS together with the Namoo, Soe, Valley and Zorko sub-district zones were awarded.
The GHS also honoured WaterAid Ghana, a non-governmental organisation, for its contributions to healthcare delivery in the district. -GNA
Across many farming communities in Northern Ghana, women routinely carry their infants on their backs while engaging in strenuous farm labour. This practice, though rooted in necessity and resilience, exposes both mothers and their babies to significant health risks, particularly musculoskeletal strain and developmental concerns.
For these women, the decision to take babies to the farm is rarely optional. It reflects the absence of affordable childcare, entrenched gender roles, and persistent economic pressures that compel women to combine farming, childcare, and household duties simultaneously.
Everyday Reality
In many rural communities in Northern Ghana, women begin their day before sunrise, balancing farm work with domestic responsibilities such as fetching water and firewood, cooking, and caring for children. Carrying infants on their backs, strapped with cloth, enables them to breastfeed and monitor their babies while going about their farming activities.
The use of outdated tools increases the risk of sprains and strains. Exposure to pesticides, extreme heat, and zoonotic infections further endanger women, especially those who are pregnant or breastfeeding.
Effects on Mothers
Dr. Enoch Harvoh, a Senior Medical Doctor at the Tamale Teaching Hospital, explained in an interview with GNA that the primary health risks stem from prolonged physical strain. He identified several key concerns, including musculoskeletal pain, postural changes, chronic fatigue, injury risk, and other hazards such women face.
Dr. Harvoh explained that musculoskeletal issues such as chronic lower back, upper back, neck, and shoulder pain are common among women who farm with babies on their backs. He added that back-carrying alters spinal alignment, increasing pelvic tilt and causing abnormal curvature of the spine, medically described as cervokypholordotic posture.
The combination of farming, domestic work, and childcare leads to severe physical exhaustion and stress, while frequent bending, squatting, and lifting further contribute to physical strain.
Effects on Infants
While back-carrying supports bonding and infant safety, prolonged exposure in farm environments presents risks to infants. These include:
- Lower limb development concerns
- Restricted movement and visual stimulation
- Potentially affected sensorimotor development
- Exposure to farm hazards including chemicals, machinery, and excessive heat
According to Dr. Harvoh, some studies link extended back-carrying to changes in leg alignment, such as genu valgum (knock-knees), though these are often within normal clinical limits.
Labour and Time Constraints
Women face chronic labour shortages, especially during peak farming seasons. Combined with unpaid domestic work and childcare, this creates extreme physical and mental strain.
Madam Saada Abdul, a farmer from Kpadjai in the Kpandai District, told GNA that she regularly carries her baby while weeding, harvesting, transporting crops, and cooking. “The work is very hard, and the baby’s weight adds to the pain in my back and waist. I hardly get time to rest compared to my husband,” she said.
Similarly, Madam Ramatu Iddris from the Nawuri community explained that women often prioritise labour on their husbands’ farms, reducing productivity on their own plots. Limited access to tractors, credit, extension services, and market information forces many women to rely on manual labour while carrying their babies.
These compounded challenges heighten women’s vulnerability to climate shocks such as drought, erratic rainfall, and economic downturns.
Intersecting Challenges
The practice of carrying babies to farms is embedded within broader structural inequalities. Customary inheritance systems largely favour men, leaving women with limited access to land. Many women farm on their husbands’ plots or borrow small, less fertile parcels of land, discouraging long-term investment and access to credit or extension services.
Women account for more than half of Ghana’s agricultural labour force, particularly in subsistence farming in the Northern Sector, yet much of their work remains informal and undervalued, with limited recognition in economic planning and policy frameworks.
Resilience and Coping Strategies
Despite these hardships, Northern women farmers demonstrate remarkable resilience. Common coping mechanisms include forming women’s farming groups to access training, credit, and inputs. Livelihood diversification, such as engaging in shea butter processing, poultry rearing, petty trading, charcoal production, and seasonal migration, can help supplement income.
Recommendations
Stakeholders in agriculture, health, and local governance must prioritise targeted interventions to reduce the physical burden on women farmers. Key recommendations include:
- Establishing community-based childcare centres to reduce the need to carry babies to farms
- Providing practical ergonomic training on safe lifting, posture, and culturally appropriate baby-carrying techniques
- Improving access to appropriate farm tools and small-scale mechanisation
- Strengthening workplace protections through rest breaks, access to potable water, and protective equipment
- Formally recognising women’s unpaid care and agricultural labour in national and district development planning
Health professionals also recommend targeted strengthening and stretching exercises for the lower back and pelvic muscles to mitigate long-term physical strain associated with combined farming and childcare responsibilities.
Conclusion
Women farmers are indispensable to Ghana’s food security and rural livelihoods. Yet their contributions come at a high personal cost due to systemic inequities, limited support services, and entrenched gender roles.
Addressing the health and productivity challenges faced by women who farm with babies on their backs is not only a matter of equity but a critical investment in national development, public health, and future generations.
—GNA
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A training and capacity-building workshop was held on Thursday for the media to intensify coverage on gender-based issues to support women’s participation in leadership and governance in Accra.
The workshop, held under the theme ‘Strengthening Advocacy for the Implementation of Ghana’s Affirmative Action (Equity) Law, 2024 – The Case of the Media’, brought together journalists from selected media houses.
The Convener of the Affirmative Action (AA) Law Coalition, Ms Sheila Minka-Premo (Esq.), stressed that the media has a critical responsibility to educate the public on the importance of the Affirmative Action Act, noting that sustained and informed reporting would strengthen advocacy and support the effective implementation of the law.
While commending both the Legislature and the Executive for the passage and presidential assent of the Affirmative Action Bill into law, the AA Law Coalition Convener appealed to government to address existing gaps. These include the constitutional provision of 30 per cent women’s representation in politics, inadequate policy frameworks to advance affirmative action, and weak compliance by state institutions.
She charged the media to highlight and promote the role of women in leadership and to actively support a smooth and effective implementation process of the Act.
In her welcome address, Executive Director of ABANTU for Development, Dr Rose Mensah-Kutin, said the training sought to strengthen journalists’ advocacy skills to enable them to educate the public on the provisions and significance of the law.
Dr Mensah-Kutin commended ActionAid Ghana for supporting the advocacy efforts, urging the media to prioritise the law to ensure its sustainability.
The Affirmative Action (Gender Equity) Act, 2024 (Act 1121) was passed by Parliament in July 2024 and received presidential assent in September 2024, following years of sustained advocacy by women’s rights organisations, gender activists, and other stakeholders.
By Linda Abrefi Wadie
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