IS SOCIAL PROTECTION A RIGHT?

Dalinpuo, Eric

Excerpt

DEDICATION

I dedicate this work to my dear wife Noella Benongle and my lovely daughter, Ellis

Zunuo Dalinpuo for their support and encouragement. And also to my late father Mr.

Wilfred Dalinpuo.

TABLE OF CONTENTS

ABSTRACT ... i

ACKNOWLEDGEMENTS ... iii

DEDICATION ... iv

TABLE OF CONTENTS ... vi

LIST OF ABBREVIATIONS ... ix

LIST OF TABLES ... xi

LIST OF FIGURES ... xii

LIST OF PLATES ... xiii

CHAPTER ONE ... 1

1.0 Background of the Study ... 1

1.1 Problem Statement ... 5

1.2 Research Questions ... 7

1.3 Research Objectives ... 7

1.4 Delimitation and scope of the Study... 8

1.5 Relevance of the Study ... 9

1.6 Operational Definitions of key Concepts ... 11

1.6.1 Social Protection ... 11

1.6.2 Orphan ... 13

1.6.3 Vulnerability ... 14

1.6.4 Orphans and Vulnerable Children ... 15

1.7 Organization of the work ... 16

1.8 Summary ... 18

CHAPTER TWO ... 19

REVIEW OF RELATED LITERATURE ... 19

2.0 Introduction ... 19

2.1 The Theory of Social Rupture ... 19

2.2 The Theory of Social Resilience ... 25

2.3 A Right-Based Approach to OVC Social Protection ... 28

2.4 Social Protection in Ghana ... 34

2.5 Challenges of Social Protection Programmes ... 38

2.6 Summary ... 40

CHAPTER THREE ... 41

RESEARCH METHODOLOGY ... 41

3.0 Introduction ... 41

3.1 The Study Region ... 41

3.2 The Upper West Region ... 41

3.3 The Study Districts ... 43

3.4 Methodological Approach of the Study ... 44

3.5 Methods of Data Collection ... 46

3.6 Samples ... 47

3.7 Sampling Procedures ... 48

3.8 Selection of the Study Areas ... 49

3.9 Selection of the Research Participants ... 52

3.10 Sources of Data Collection ... 53

3.11 Data Collection Procedure ... 54

3.12 Data Management and Methods of Data Presentation and Analysis ... 55

3.13 Challenges Faced in Data Collection ... 55

3.14 Summary ... 56

CHAPTER FOUR ... 57

ANALYSIS, DISCUSSIONS AND PRESENTATION OF MAIN FINDINGS ... 57

4.0 Introduction ... 57

4.1 Socio-Demographic Characteristics of OVC Respondents ... 57

4.1.1 Sex of Caregivers and OVCs ... 57

4.1.2 Age of Respondents ... 60

4.1.3 Educational Background of Respondents ... 61

vii

4.1.4 Employment Background of Caregivers ... 63

4.2 Perceptions, Conditions and understanding of Vulnerability of OVC ... 64

4.2.1 Vulnerability ... 64

4.2.2 The conditions of OVC in Wa and Jirapa townships ... 69

4.3 The Care and Support Needs of OVC ... 72

4.3.1 Addressing the non-material needs of OVCs ... 75

4.3.2 Psychosocial support need ... 75

4.4 Succession Planning ... 77

4.5 Family Care versus Institutional Care for OVCs ... 78

4.6 Is social protection a right? ... 81

4.7 The impacts and challenges of SP interventions on OVC ... 83

4.7.1 Livelihood Empowerent Against Poverty (LEAP) ... 83

4.7.2 Conditions for Selecting Beneficiaries on the LEAP program ... 84

4.7.3 Selection of beneficiaries and how the services are rolled out ... 85

4.7.4 The Impact of LEAP program ... 88

4.8 Challenges of LEAP ... 91

4.8.1 Delay in release of funds ... 92

4.8.2 Pressure from communities to enrolled on the LEAP programme ... 92

4.8.3 Interference by "Politicians" ... 93

4.8.4 Inadequate resources for DSW ... 94

4.8.5 Targeting of beneficiaries ... 96

4.9 The Impact of National Health Insurance Scheme (NHIS) ... 98

4.9.1 Challenges of NHIS ... 100

4.10 Ghana School Feeding Programme (GSFP) ... 102

4.10.1 Background ... 102

4.10.2 The Impact of SFP... 102

4.10.3 Challenges of SFP ... 105

4.11.1 The Impact of Capitation Grant ... 107

4.11.2 Challenges ... 108

4.12 Impact of NGOs on the care and support of OVC ... 109

4.13 Challenges faced by NGOs in implementing strategies ... 110

4.11 Capitation Grants ... 107

viii

4.14 The need for harnessing synergies and institutional collaboration for SP provision ... 112

4.15 Avenues for improving Social Protection interventions in Ghana ... 114

CHAPTER FIVE ... 118

SUMMARY, CONCLUSIONS AND RECOMMENDATIONS ... 118

5.1 Introduction ... 118

5.2 Summary ... 118

5.3 Methodology ... 119

5.4 Key Findings ... 1 20

5.5 Conclusions ... 122

5.6 Recommendations ... 124

5.7 Implications for further research ... 130

REFERENCES ... 132

4.16 Summary ... 116

LIST OF ABBREVIATIONS

AIDS

Acquire

Immune

Deficiency

Syndrome

CRC

Convention on the Rights of the Child

DSW

Department of Social Welfare

GAC

Ghana Aids Commission

GHS

Ghana Health Service

GLSS

Ghana

Living

Standard

Survey

GNPA

Ghana National Plan of Action

GPRS

Ghana Poverty Reduction Strategy

GSFP

Ghana School Feeding Programme

HIV

Human

Immune

Virus

IDS

Institute of Development Studies

ILO

International

Labour

Organisation

LEAP

Livelihood

Empowerment Against Poverty

MESW

Ministry of Employment and Social Welfare

MMYE

Ministry of Manpower Youth and Employment

MOWAC

Ministry Of Women And Children

NGO

Non-Governmental

Organisation

NHIS

National

Health

Insurance

Scheme

NSPS

National Social Protection Strategy

NYP

National Youth Policy

ODI

Overseas

Development

Institute

OVC

Orphans and Vulnerable Children

SAP

Structural Adjustment Program

Social

Protection

UDHR

Universal Declaration of Human Rights

UNAIDS

United Nations Programme on HIV/AIDS

UNCRC

United Nations Convention on the Rights of the Child

UNDP

United Nations Development Programme

UNICEF

United Nations Children Fund

USAID

United States Agency for International Development

LIST OF TABLES

Table 2.1: Brief chronology of social protection in Ghana (selected data)...36

Table 3.1: Distribution of districts interviews...49

Table 3.2: Composition of survey communities...51

Table 3.3: Key stakeholders in the study area...53

Table 4.1: Distribution of OVC Respondents by sex...58

Table 4.2: Distribution of Caregivers by sex...58

Table 4.3: Age distribution of OVC...60

Table 4.4: Age distribution of Caregivers...61

Table 4.5: LEAP communities in study areas...84

Table 4.6: Responses of LEAP impact...88

Table 4.7: Fresh LEAP registration 2012 for Jirapa and Lambussie...99

Table 4.8: LEAP Renewal 2012 for Jirapa and Lambussie...99

Table 4.9: Estimated active members of LEAP 2012 of Jirapa and Lumbussie...99

Table 5.1: Distribution of respondents by gender and techniques used...119

xii

LIST OF FIGURES

Figure 4.1: Level of education-Caregivers...62

Figure 4.2: Level of education-OVC...63

Figure 4.3: Responses of LEAP impact...89

xiii

LIST OF PLATES

4.1 Beneficiary forum in LEAP Community...87

4.2 LEAP Cash payment in one community...90

4.3 Educational support to some OVC under LEAP...91

CHAPTER ONE

1.0 Background of the Study

Social protection over the years involves choices about whether the core principle

behind social provisioning will be universalism, or selectivity through targeting

(Mkandawire 2005). Under universalism, the entire population is the beneficiary of

social benefits as a basic right, while under targeting; eligibility to social benefits

involves some kind of means-testing to determine the truly deserving.

According to Mkandawire (2005), Policy regimes are hardly ever purely universal or

purely based on targeting, however; they tend to lie somewhere between the two

extremes on a continuum, and are often hybrid, but where they lie on this continuum

can be decisive in spelling out individuals' life chances and in characterizing the social

order

The subject of social protection throughout the world has gained prominence in the

international policy-making and developmental circles over the years (Greenblott,

2007). Social protection is widely seen as an important component of poverty reduction

strategies and efforts to reduce vulnerability to economic, social, natural and other

shocks and stresses (Jones, Ahadzie and Doh, 2009)

Omwa and Tetica (2011) note that social protection for children was initially developed

in the 1970s and as response to changes in family structure, composition, and gender

roles that have drastically increased the vulnerabilities and social risks experienced by

children in recent decades. In the 1980s, discussions emerged about Social Protection

as a right and this is cemented in the United Nations Convention on the Rights of the

Child. It has since been recognized as an effective strategy to mitigate the effects of

globalization, structural adjustment, and the HIV/AIDS crisis.

Extreme poverty is regarded as the world's greatest human rights issue and the United

Nation (UN) Universal Declaration of Human Rights, starts from the idea that all

human beings are born free and equal in status and rights. Under the international

human rights law, States are legally obligated to establish social protection systems for

their citizens.

Social protection within the traditional systems was based on kinship, through the help

and support of the extended family (Abebrese, 2011, Al-hassan and Poulton, 2009).

However, Chirwa (2008) notes that the traditional family system that used to be the

base for care and support is broken down and can no more take in orphans and other

vulnerable children and this transcend the obligation for care and support of OVC to

the state and this is what Chirwa terms "social rupture theory"

The Inter-Agency Task Team (IATT) (2008) has indicated that there is no single "right"

model of social protection and as such, each society must determine how best to ensure

the social protection of its members and these choices will reflect a society's social and

cultural values, its history, the structure and capacity of local institutions and overall

level of economic development.

The International Labour Organisation (ILO) affirmed social security or social

protection as a "basic human right" Considering the extensive human rights obligations

which States possess by virtue of the multitude of international human rights treaties,

and given that all UN agencies have committed to mainstreaming human rights

throughout the UN system, the lack of a systematic discussion of social protection from

a human rights perspective is problematic. States are subject to legally-binding

domestic and international obligations to ensure that human rights guide the design,

implementation, monitoring and evaluation of all public policies, and these obligations

must be applied to social protection programmes (Sepúlveda and Nest, 2012).

There is no doubt that the adoption of the Convention on the Rights of the Child (CRC)

and the African Charter on the Rights and Welfare of the Child, has resulted in policies,

services, programmes, and adult behaviour being more focused on the best interest of

the child. This focus on rights, and their enforcement, stems from a shift in

developmental ethos away from the traditional trickle-down approach of external

assistance from rich to poor, to an approach focusing on empowerment and

participation. Rights-based programmes support rights-holders, who are often the poor,

marginalised, and most vulnerable in society, to lay claim to their rights (Richter and

Rama, 2006).

Africa countries including Ghana after independence pursued social protection

measures which were not sustainable. This was in line with the `developmental state'

agenda after independence. These were found in area of education, health, housing,

transportation and public utilities. The debates on the provision of sustainable state

social protection often been fueled mainly by discussions within developing countries

where poverty and vulnerability are endemic (Greenblott, 2007).

According to Adesina (2010), policy attention focused on social protection instruments

after independence was to mitigate the impact of the adjustment - the so-called "social

dimensions of adjustment" issues. But in recent years, social protection focus has turned

to cash transfer (conditional and non-conditional) as policy instrument of choice for

addressing poverty and vulnerability.

Ghana has made some significant strides in the introduction of some social protection

measures for the protection of the poor in the Ghanaian society. The Ghana Poverty

Reduction Strategy (GPRS I) was introduced in 2002, the National Health Insurance

(NHIS) in 2003, Ghana School Feeding Programme (GSFP) in 2005, Ghana Growth

and Poverty Reduction Strategy (GPRS II) in 2006 and the Livelihood Empowerment

Against Poverty (LEAP) in 2008.

The issue of social protection for OVC in the context of HIV and AIDS is not only an

emerging issue but also an urgent one. Children made orphans due to HIV/AIDS are

often over burdened with the responsibility of caring for siblings or sick relatives. They

are engaged as casual labourers in order to earn incomes. Some also drop out of school

in order to provide income for the family. The spread of the disease itself, with growing

illnesses and deaths in many families, tend to increase morbidity and mortality among

AIDS orphans (Ministry of Women and Children, Ministry of Youth and Employment

& Ghana Aids Commission, 2006).

Children who have lost one or both parents due to AIDS suffer not only from

psychological trauma, but often from poverty and discrimination as well.

According to Richter and Rama (2006), all children in AIDS-affected countries must

have increased access to government-provided social protection in all sectors, including

health, education, and welfare provision. Some strategies implemented in Ghana

included the National Plan of Action for OVC, the National Social Protection Strategy

(NSPS), and the National Youth Policy (NYP) all providing social protection support

for orphans and vulnerable children. The Ghana SP interventions are heavily depended

on donor funding and donor ideology, thereby not being responsive to local

circumstances. This also underscores the question of sustainability of such programmes

which are key for poverty and social development of the nation.

While evidence suggests that, by establishing or strengthening social protection

systems, states could comply with their obligations to provide at least minimum

essential levels of basic economic, social, and cultural rights for those living in poverty,

the human rights framework also requires States to design, implement, monitor and

evaluate such programmes in accordance with human rights standards (Sepúlveda M.

and Nyst C 2012).

Substantial agreement exists amongst child-rights advocates that what is most needed

is a set of collective governmental and community responses to strengthen the

commitments of caregivers and households to the well-being of children. This should

all be supported by constructive national policies and the mobilisation of resources. It

is evident that the focus of programmes and strategic thinking must expand from the

many small, unlinked initiatives to a coordinated approach aimed at long-term,

universal benefits for all children (Richter and Rama, 2006).

1. 1 Problem Statement

In recent times, HIV and AIDS have generated a major livelihood crisis for OVC and

many families in Sub-Saharan Africa than ever. This situation calls for an urgent need

for state social protection (Sabates-Wheeler & Pelham, 2006). The consequences of the

disease have been devastating significantly reduced life expectancy, dramatic

weakening of livelihood systems, and a dramatic increase in poverty and vulnerability

for all categories of people, especially children (Ibid)

According to the World Health Organization (WHO), there were approximately 35

million people worldwide living with HIV/AIDS in 2013. Of these, 3.2 million were

children under 15 years old. An estimated 2.1 million individuals worldwide became

newly infected with HIV in 2013. This includes over 240,000 children under 15

years. Most of these children live in Sub-Saharan Africa and were infected by their

HIV-positive mothers during pregnancy, childbirth or breastfeeding.

The vast majority of people living with HIV are in low- and middle-income countries,

and according to the WHO, sub-Saharan Africa is the most affected region, with 24.7

million people living with HIV in 2013. Seventy-one percent of all people who are

living with HIV in the world live in this region (UNAIDS, 2014)

Ghana's national HIV prevalence has actually declined from 1.37 per cent in 2012 to

1.30 per cent for 2013 (GAC Sentinel Report, 2013). The report estimated that

currently, 224,488 persons are living with HIV in Ghana of which 189,931 are adults

and 34,557 are Children (15%). It explained that the 2013 HIV prevalence dropped

below 2 per cent for the first time in the history of GAC, Health Sentinel Survey;

reinforcing an overall declining epidemic trend in Ghana. New infections of 7,812 were

recorded out of which 2,407 were children under 14 years and 10,074 AIDS deaths of

which 2,248 were children from zero to 14 years. An estimated Children Orphaned by

AIDS is 184,168 (GAC Sentinel Survey Report, 2013).

The GAC (2013) report revealed that Upper West region has HIV infection rate of 0.8%

which is the lowest in the country. The study areas, of Wa and Jirapa townships also

recorded 0.9% and 0.6% respectively. And Jirapa also recording the lowest in Ghana

According to the Ghana statistical Service (GSS, 2007), the region did not only record

the highest incidence of poverty but also an increased from 84% in 1998/1999 to 88%

in 2005/2006. This situation has worsened the safety nets arrangements of households

and families for OVC and other vulnerable groups in the study region. Thus, the need

for social protection to address issues of social exclusion, inequalities and poverty

This study therefore seeks to examine the state social protection policy interventions

for OVC in Wa and Jirapa Townships in the Upper West region and also to examine

the human rights-based implications and outcomes of social protection which has over

the years become a significant analytical gap that must be filled.

1.2 Research Questions

The study addressed the following research questions:

(i)

What are the perceptions, conditions and understanding of vulnerability

of OVC?

(ii)

What are the impacts and challenges of SP interventions on OVC?

(iii)

Is Social Protection a right based policy?

(iv)

What avenues exist for harnessing synergies toward a holistic and

improved delivery of Social Protection?

1.3 Research Objectives

The study focused on four objectives which are outlined below:

(i)

To ascertain the perceptions, conditions and understanding of

vulnerability of OVC.

(ii)

To examine the impacts and challenges of SP interventions on OVC?

(iii)

To assess Social Protection as a right based policy.

(iv)

To identify avenues that exist for harnessing synergies toward a holistic

and improved social protection delivery.

1.4 Delimitation and scope of the Study

Social Protection in this study focuses on three broad based issues. 1) labour market

interventions such as employment services, job training, direct employment generation.

2) social insurance such as mitigating risk, disability, ill health, old age, health

insurance etc. and 3) Social Assistance as welfare and social services, cash or in-kind

transfers, subsidies.

The subject of the study is to examine social protection interventions as rights for

orphans and vulnerable children in Wa municipality and Jirapa township of the Upper

West region. The study was conducted in particular areas of the two townships such as

Kpongu and Wa municipal as well as Gbare, Duori and Jirapa township. The study

areas were chosen based on available statistics of HIV/AIDS and therefore OVC in the

two districts. Wa Township recording the highest while Jirapa district recorded the

lowest according to the 2013 sentinel survey report. Besides, given the limited time that

was available to do the field work, it was necessary to focus on few

districts/communities so as to be able to get an in-depth understanding of the issues.

Therefore, the conclusions made are based on the findings from the interviews and the

questionnaires administered. I recognize the fact that it could be problematic to

generalize the findings to the entire region.

In selecting the sample population, due diligence was taken to ensure that it covered

the range of respondents that matter in this study. The findings covered the OVC,

caregivers, social protection institutions and interventions. However, there is no claim

that this sample is statistically representative.

1. 5 Relevance of the Study

The United Nations Declaration of Commitment on HIV/AIDS

is particularly relevant

to children growing up without families. Articles 6567 of this Declaration clearly

spell out the obligations of states in relation to the care and protection of orphans and

other children made vulnerable by HIV/AIDS:

The Ministry of Gender, Children and Social Protection, the ministry of employment

and Social Welfare, National Development Planning Commission and Non-

Governmental Organizations (NGOs) interested in social protection especially for

children and vulnerable in society would benefit immensely from the findings.

The 1990's saw a number of African countries introduce various forms of social

protection measures to mitigate the effects of the Structural Adjustment Programmes

(SAP) that were introduced in the 80's. The SAP brought untold hardships on the

ordinary people as unemployment was at its peak because a lot of state workers were

retrenched, and poverty was heightened coupled with high inflation rates. The provision

of social protection was not only the duty of the states but Non-Governmental

organisations, (NGOs) as well as the UN agencies. Social protection interventions were

protection systems that were introduced by donors, were just to bring up issues in the

effectiveness in programs.

The current political momentum around social protection provides a unique opportunity

to reinvigorate the development agenda, which, despite the looming deadline for the

achievement of the Millennium Development Goals (MDGs) in 2015, has clearly

stagnated. At the same time, there remains a pressing need to further evolve the concept

of social protection to ensure that its full potential and impact on poverty reduction and

development is both understood and realized (Sepulveda and Nyst, 2012).

The Universal Declaration of Human Rights (1948) recognizes social protection as a

fundamental human right for all citizens. This right is as basic as for example the right

to education, child-oriented health services, and protection from abuse and exploitation,

but as yet far less recognized. According to Taylor (2008), adopting the values and

principles of a human rights framework for social protection implies that if a right

exists, governments have an obligation to make sure it is fulfilled. In a region where

the resources to redress rights are limited and where even material resources such as

food is scarce the political will and commitment to actualise rights to social protection

become critical.

Belonging to a family at risk, in conditions where care environment breaks down,

enlarges the need of a child for (external) care and protection.

Many factors make children vulnerable: poverty, HIV/AIDS, losing one or more

parents, low educational level of parents, age, and gender. All these factors may

increase the vulnerable position of children, putting them at risk such as becoming HIV

infected, living on the streets or being abused.

The United Nation's Children Fund (1998), argues that many HIV/AIDS OVC have

their rights infringed upon and therefore the need for a rights-based approach to

programming for OVC in Ghana, rather than the more conventional needs-based

approach as in the case of some social protection interventions. A key weakness of the

current social protection system in Ghana is the insufficient legal basis of social

protection provisions. Government should take measures to improve administrative

efficiency by enhancing coordination and cooperation among programmes. Synergies

could be created among programmes in such areas as communication and awareness

activities, community outreach, membership management, identification and

registration, delivery of benefits, data collection, monitoring and evaluation (ILO,

2014).

In line with these discussions among other things, social protection in Ghana is

universal but however targeted based on needs and so this study seeks to ascertain the

universal rights of OVC to social protection and also to examine the impact of some

current social protection interventions on OVC. The findings will enrich the wealth of

literature on the right to social protection for OVC and the impact of current

interventions on the lives of these orphans and vulnerable children in the Wa and Jirapa

townships of the Upper West region.

1.6 Operational Definitions of key Concepts

Concepts carry different meanings depending on the context in which they have been

used. Some particular concepts that have been used in this study have been given

definite meaning or definition with the view to minimizing ambiguity and

contextualizing meanings. These concepts are; Social Protection, Orphan, vulnerability,

and orphans and vulnerable children.

1.6.1 Social Protection

Existing literature shows that there are many and different understandings of the term,

social protection. Although social protection has recently become mainstreamed in

development discourse, it remains a term that is unfamiliar to many and carries a range

of definitions, both in the development studies literature and among policymakers

responsible for implementing social protection programmes (Devereux and Sabates-

Wheeler, 2004).

Sabates-Wheeler and Pelham (2006) describe Social protection as all public and private

initiatives that provide income or consumption transfers to the poor, protect the

vulnerable against livelihood risks, and enhance the social status and rights of the

marginalized; with the objective of reducing the economic and social vulnerability of

poor, vulnerable and marginalized groups. This definition seemed to be more accepted

in the international front as comprising the four pillars of protective, preventive,

promotive, and transformative social protection. This definition was also adopted by

UNICEF and IDS.

Operationally, this study refers to three targets of social protection outlined by ODI and

UNICEF (2009) as the set of all initiatives, both formal and informal, that provide:

· Social assistance to extremely poor individuals and households. This typically

involves regular, predictable transfers (cash or in-kind, including fee waivers) from

governments and non-governmental entities to individuals or households aimed at

reducing poverty and vulnerability, increasing access to basic services and promoting

asset accumulation.

· Social welfare services to groups who need special care or would otherwise be denied

access to basic services based on particular social (rather than economic)

characteristics. Services are normally targeted at those who have experienced illness,

death of a family breadwinner/caregiver, an accident or natural disaster; who suffer

from a disability, familial or extra-familial violence or family breakdown; or who are

war veterans or refugees.

· Social insurance to protect people against the risks and consequences of livelihood,

health and other shocks. Social insurance supports access to services in times of need,

and typically takes the form of subsidised risk-pooling mechanisms, with potential

contribution payment exemptions for the poor.

The vision of Ghana social protection programme targets an equitable society in which

ordinary and extremely poor and vulnerable citizens are protected from risks and shocks

and are empowered with improved capability, to overcome social, economic and

cultural challenges in order to realize their rights and responsibilities and to make

meaningful contributions to society.

1.6.2 Orphan

The concept of orphan has attracted several definitions depending on its use. Orphan

can either be defined based on the cultural environment or on social settings. From a

methodological point of view, the definition of the term, orphan, is generally

unambiguous, so that data on orphans can be more easily analyzed and compared across

countries. In contrast, from a substantive point of view, most studies have focused on

orphaned children as the most obvious and most dramatic consequence of the AIDS

epidemic in Africa. According to UNICEF (2004), an orphan is defined as a child under

the age of 18 who has survived one or both parents. UNICEF categorized orphans as

maternal orphans, an orphan with a surviving mother; paternal Orphan has a surviving

father and double orphans survive both parents. Research also revealed a concept of a

"social orphan" which was used by UNICEF to describe children whose parents might

be alive but are no longer fulfilling any of their parental duties, for example drug addicts

who are separated from their children with little chance of reunion, parents who are sick

or abusive or who, for other reasons, have abandoned or largely neglect their children,

such a child will best fall under the vulnerable group of children in this regards.

The definition of an orphan has not varied in terms of the cultural environment in

Ghana, especially in the Upper West region from the various definitions established.

1.6.3 Vulnerability

Smart (2003) revealed that vulnerability is a complex concept to define. Due to its

complexity in definition, according to Smart, local/communities have various

definitions of vulnerability, which often include disabled or destitute children; in policy

and support provision definitions, which list categories of children; and in working

definitions, which are used in various documents. The concept of vulnerability is not

only restricted to individuals, such as children, but is often used to refer to households

as well.

In conceptual terms, a vulnerable child is one who is living in circumstances with high

risks and whose prospects for continued growth and development are seriously

impaired. But UNAIDS refer to vulnerable children as children whose survival, well-

being, or development is threatened by HIV/AIDS (UNICEF/UNAIDS, 2004). It is

important to recognize that there is no commonly agreed definition for vulnerability as

indicated early. A common purpose across most definitions is to protect society's most

vulnerable members through the provision of certain goods and services, including

health, education and social services that provide financial, material, social or

psychological support to people who are otherwise unable to obtain it through their own

efforts and that is what this study seeks to establish.

1.6.4 Orphans and Vulnerable Children

It is important to note that the concept of OVC is very difficult to define. To some

researchers, the concepts of orphan and vulnerable child or children are social

constructions that vary from one culture to another and from one society to the other

(Kalaba, 2010). Hence, the issue of Orphans and Vulnerable Children (OVC) has

become central to the response to HIV because of the impact of the epidemic on

millions of families and children in Sub-Saharan Africa (UNICEF, 2008).

The study therefore conceptualized OVC from the perspective of the National Social

Protection Strategy of Ghana (NSPS) of 2007 which recognizes OVC as children under

the following circumstances:

Orphan

Children infected/affected by HIV/AIDS

Children abused or neglected

Children in conflict with the law

Children in need of alternative family care

Children with disabilities

Children in `hard to reach' areas

Children affected by worst forms of child labour

Children living on the streets

Children in need of care and protection.

1.7

Organization of the work

The thesis is organized into five chapters. Some details of each chapter are presented

below.

Chapter One: Introduction

This entails the introduction to the entire thesis and presents the context of the research.

It covers the background to the study, the statement of the research problem, the

research questions and objectives and the relevance or justification for undertaking the

research. The chapter also outlined the scope and meaning of some concepts that are

used in the study. These include the concepts of social protection, orphan, orphans and

vulnerable children, and the concept of vulnerability. The chapter therefore concluded

with the organization of the various chapters of the study and a summary of what

entailed in the chapter.

Chapter Two: Literature review

The chapter two is devoted to a review of literature related to theoretical issues

addressed in this study. The literature review covered two theoretical underpinning; the

social rupture and social resilience theories. The related concepts of right based

approach to social protection and social protection in Ghana are also presented. The

chapter looked at the challenges of social protection and concluded with a summary.

Chapter Three: Research methodology and methods

Chapter three first looked at the study region and study districts as well. The chapter

further looked at the methodological approach employed and the methods used to

collect data for the research. These methods included the qualitative and quantitative

approaches. The chapter also justified the selected sample and the sampling procedures

of identifying and selecting respondents. The construction of the research instruments,

the sources and methods of data collection for the study and a detailed account of how

the fieldwork was conducted are also reported in the chapter. Issues relating to data

management and methods of data presentation are and analyses have been discussed.

Challenges that were encountered during the data collection are captured in the chapter.

Finally, a summary of the entire chapter is presented.

Chapter Four: Presentation of main Findings and Discussions.

The chapter is in two folds. The first part presented the socio-demographic

characteristics of respondents in terms of gender, age, educational and employment

levels. The second part presented the findings in line with the objectives of the study.

The themes looked at included understanding the perceptions, the context of

vulnerability and conditions of OVC in the study. The right-based approach to social

protection, how to harness synergies for better improved SP as well as the impacts and

challenges of some social protection interventions such as the LEAP, NHIS, SFP and

Capitation grant are examined in the chapter. The chapter is concluded with a summary.

Chapter Five: Summary, Conclusions and Recommendations.

This is the last chapter which summarized the major findings of the thesis. The chapter

revisited the methodology, summary of major findings in the analysis and made

conclusions based on the analysis of the findings. The chapter made some

recommendations and concluded with some implications for further research.

1.8 Summary

This chapter provided a general background to the issues of social protection as a right-

based approach, the problem statement, the relevance of the study as well as some key

questions and objectives that need to be answered in the study. The chapter also defined

some concepts such are social protection, orphan, orphan and vulnerable children and

vulnerability in order to avoid ambiguity within the context of the study. The effect of

the 1980's structural adjustment programme saw the implementation of a number of

social protection interventions to ameliorate the hardships that the citizens faced. The

chapter concludes by indicating the contents of each of the five chapters of the thesis

and how they were organized. The next chapter looks at existing related literature that

is relevant to the study.

CHAPTER TWO

REVIEW OF RELATED LITERATURE

2.0 Introduction

There has been a lot of research on social protection in Ghana but literature on the right

based of social protection for OVC has been scanty. This research looks at social

protection as a right and to examine some of the interventions that have been

implemented. The chapter focuses on a review of related literature on the subject matter

of the research. The study adopted two theoretical underpinnings that explain the care

and support of children especially OVC in the context of Sub-Saharan Africa from the

perspective of the traditional systems or kinship and how the state is mandated at a point

to assume that responsibility. They include the Theory of Social Rupture and the

Theory of Social Resilience. The chapter reviewed literature under the following

conceptual frame work of social protection:

¾ A Right-Based Approach to OVC Social Protection

¾ Social protection in Ghana

¾ Challenges of social protection

2.1 The Theory of Social Rupture

One common observable theme in the OVC literature is the social rupture thesis (Omwa

and Titeca, 2011). The Social Rupture thesis argues about how there is a total

breakdown in traditional family structures and that the traditional social support

systems and safety nets of orphan care is overstretched and eroded and therefore not

able to cope with the burden and caring for orphans (Abebe and Aase, 2007; Abebe

2008). The support systems provided by the family and the communities are collapsing

at an alarming rate, due to the strain imposed by the ever increasing number of OVCs.

Consequently, the communities are confronted with an increased burden in terms of

care and support services for orphans (Chirwa, 2002; Omwa and Titeca, 2011).

Writing on social exclusion and inclusion and reacting to challenges of orphan care and

support, Chirwa, (2008) argues that there is total breakdown in social support systems,

safety nets are collapsing and increasing numbers of orphaned children are becoming

destitute. The Theory of Social Rapture understands that various governments should

put in place structures that will ease the plight of OVC in societies. Therefore the issue

of the need for social protection measures comes in that should respond to the situation

of OVC.

According to Richter and Rama (2006), families and communities are the first and

remain the vanguard, to take action against the worsening conditions of children, and

they provide the greatest support system to vulnerable children. Out-of-pocket spending

by households, most of whom are already very poor, is the largest single component of

overall HIV/AIDS expenditure in African countries; a stark reminder that the economic

burden of the disease is borne by those least able to cope. They argue that less than 10

per cent of affected children are receiving assistance from agencies beyond their

extended family, neighbours, church, and community (ibid).

Subsequently, the lack of or the inadequacy of social protection measures for OVC

especially HIV/AIDS orphans in Ghana, has created room for the sporadic orphaned

homes and caregiving centers to fill in. Traditionally, according to Richter and Rama,

the best place to raise a child is the family however, the breakdown of the family support

system led to the establishment of homes and NGOs to operate. Community care

strategies support informal, indigenous and traditional ways of caring for children in

need of care, most commonly by extended family or kinship members, usually a granny

or aunt. This form of informal care is widespread and a practice acceptable in most

cultures (ibid 2).

The Social Rupture Theory is best explained by Chirwa (2002) in a presentation from

the point of the organisation of the "traditional" childcare system, presented as

concentric circles of blood and other family relations. Orphan care is understood to fit

into this organization as presented below.

State

Source: Chirwa, 2002: (The "Traditional" Child care System P. 100)

Chirwa (2002) argues that the nuclear family is at the centre of the system, followed by

the extended family and the immediate community: the neighborhood, clan, tribe, and

society at large, indicating that the responsibility for the care of children primarily rests

with the immediate nuclear family but diminishes as the children grow up towards

greater and increasing independence from it. When the nuclear family becomes

incapable of providing care, say through disability, impoverishment, parental

incompetence, poverty or death, the responsibility is increasingly assumed by the

extended family through the "economy of affection" (ibid). Beyond the extended

family, comes the community which also has the responsibility for the care of children,

Society Community Nuclear Family