IS SOCIAL PROTECTION A RIGHT?
AN EXAMINATION OF SOCIAL PROTECTION POLICIES AND STRATEGIES FOR HIV/AIDS ORPHANS AND VULNERABLE CHILDREN IN WA AND JIRAPA TOWNSHIPS OF THE UPPER WEST REGION OF GHANA
					
	
		©2015
		Academic Paper
		
			
				155 Pages
			
		
	
				
				
					
						
					
				
				
				
				
			Summary
			
				Social protection involves choices about whether the core principle behind social provisioning will be universal or selective through targeting. Extreme poverty is regarded as the world’s greatest human rights issue. The 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, especially the vulnerable and at risk. Social protection in Ghana assumes three main targets for poverty reduction; the first target looks at labour market interventions in terms of employment services, job training, and direct employment generation. The second target deals with social insurance that targets risk mitigation, disability, ill health, old age, health insurance, and the third target is social assistance that provides welfare and social services, cash or in-kind transfers, and subsidies. The interventions under these targets are either universal or targeted. This study is concerned with the right base of social protection for OVC and examines the impact and challenges of some social protection interventions. For this purpose, three categories of participants made up of 53 OVC, Caregivers, SP interventions and institutions as well as Non-Governmental Organisations (NGO) were selected across the two townships of Wa and Jirapa for the study through systematic random sampling. Close ended questionnaires were administered to the OVC and their care-givers, while open ended questionnaires were administered to managers of some selected SP interventions, SP institutions and NGOs. Cross-sectional design was used and purposive sampling technique was employed to sample out the two townships. Methodologically, the study applies qualitative and quantitative instruments of data collection.
			
		
	Excerpt
Table Of Contents
iv 
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.  
v
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 
vi 
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
ix 
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 
x 
SAP 
 Structural Adjustment Program 
SP 
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 
xi
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 
1 
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 
2 
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 
3 
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 
4 
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. 
5 
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 
6 
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 
7 
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. 
8 
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. 
9 
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 
designed by the states however, many of them were not sustainable. Those social 
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 
10 
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 
11 
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 
12 
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. 
13 
· 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 
14 
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. 
15 
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: 
x
Orphan 
x
Children infected/affected by HIV/AIDS 
x
Children abused or neglected 
x
Children in conflict with the law 
x
Children in need of alternative family care 
x
Children with disabilities 
x
Children in `hard to reach' areas 
x
Children affected by worst forms of child labour 
x
Children living on the streets 
x
Children in need of care and protection. 
16 
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 
17 
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.  
18 
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. 
19 
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 
20 
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 
21 
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 
Details
- Pages
 - Type of Edition
 - Erstausgabe
 - Publication Year
 - 2015
 - ISBN (Softcover)
 - 9783960670056
 - ISBN (PDF)
 - 9783960675051
 - File size
 - 1.2 MB
 - Language
 - English
 - Institution / College
 - University for Development studies – Department of African and General Studies
 - Publication date
 - 2016 (February)
 - Grade
 - B
 - Keywords
 - Ghana Upper West Region Social Protection HIV AIDS Orphan WA Jirapa Social provisioning Vulnerable Children OVC
 - Product Safety
 - Anchor Academic Publishing