Ghana

Abstract

Ghana’s Covid-19 experience and responses to the same are situated in a pre-existing macroeconomic structure of debt distress, high unemployment, and a high informal sector. In addition, geographical, gender and generational inequalities, and vulnerabilities determined how people experienced the pandemic. The chapter examined Ghana's Covid-19 responses with a particular focus on three social groups, namely Chorkor community residents and migrant head porters in Accra and market traders in Bolgatanga. The analysis highlights the ambivalences and ambiguities of Covid-19 measures and the implications and impacts for some of the most vulnerable social groups with little access to public services and social protection. The reflections on the findings show a weakness in social policy and unavailability of robust data on socioeconomic and social protection programmes to protect the vulnerable adequately. Tackling fallouts of (health) crises crucially depends on a robust political structure that distributes infrastructure, social services and resources equitably and transparently.

Introduction

Ghana announced its first cases of Covid-19 on March 12, 2020. The country’s experience with Covid-19 occurred when it was preparing for the eighth Presidential and Parliamentary elections since the commencement of the Fourth Republic Constitution in 1992. The December 2020 elections passed with some constatations that led to violence and court actions. However, there was a consensus among political actors and civil society organisations that Ghana's electoral management systems are adequate (CDD-Ghana, 2016), although mistrust of the electoral management body has plummeted since 2012 (Afrobarometer Surveys, 2016–2020); and electoral choices of the majority of Ghanaians are issue-based (Harding, 2015; Lindberg & Morrison, 2008). In addition, Ghana's voter turnout has been relatively high, averaging 71% between 1992 and 2016 (Afram & Tsekpo, 2017).

Two political parties, namely the National Democratic Congress (NDC), a centre-left social democratic party and the New Patriotic Party (NPP), a centre-right and liberal, conservative political party, have dominated the political scene since the return to constitutional rule in 1992. Patronage politics and hyper-partisan competition between the two dominant parties means that access to services and resources is sometimes politically determined rather than based on technical or developmental considerations. As a result, the state tends to systematically redistribute resources towards members of the government, the ruling party, and influential leaders while weakening the political and economic bases of (real or perceived) members of the political opposition.

This structure also affects Ghana's decentralisation governance system, embedded in the 1992 Constitution and the Local Government Act (Act 462) of 1993. Under Ghana’s decentralisation system, legislation, policies, and guidelines determine the relationships between central- and local government entities. The central government maintains the policymaking role and a vertical relationship with local government institutions. The sub-national governments (Metropolitan, Municipal, and District Assemblies (MMDAs)) act as implementing entities and have primary responsibility for planning, financing, and delivering services to local people. However, the central government retains most of the spending power and determines where developmental programmes are situated. The Municipal governments remain poorly equipped in budget planning, preparation, execution, and accounting, with many demonstrating weak compliance with regulatory frameworks, including procurement and contract management (World Bank, 2018).

In terms of Ghana’s economic standing, while the country achieved Millennium Development Goal 1 by halving poverty ahead of the 2015 deadline, inequality continued to increase, and since 2012, the reduction in poverty rates has stagnated (GSS, 2018). In 2016/17, nearly a quarter (23.4%) of the Ghanaian population was classified as poor persons, with as many as 2.4 million Ghanaians (8.2%) considered extremely poor (GSS, 2018). Despite improvements in both income and non-income dimensions of development, inequality has been rising, a situation that speaks to Ghana's growth rate not being inclusive (Oduro et al., 2018). Ghana’s Gini coefficient increased consistently between 1991 and 2016, from 38.4 to 43.5 (although there was a drop of 0.4 points between 2005 (42.8) and 2012 (42.4)) (World Bank, 2020).¹ However, Ghana has a relatively low Gini coefficient compared with other sub-Sahara African countries. The alarming issue with Ghana is that it is one of the few countries on the continent where income inequality has systematically increased over the last three decades (UNDP, 2017).

It has been argued that the following six factors have driven Ghana’s growing inequality. These are jobless export-driven growth with low job creation and world market price vulnerabilities, poor public financial management fraught with corruption, significant regional and rural–urban disparities, unequal access to and quality of public services; gender inequality; and political capture and corruption (UNDP, 2017; Oduro et al., 2018). In addition, before Covid-19, Ghana was already under high debt, which has implications for spending and the reach of support programmes.

This chapter analysed the impact of Covid-19 responses of state and non-state actors on the well-being of Ghana's poor and vulnerable, which is analysed through four dimensions of well-being, namely material well-being operationalised as work and income as well as access to essential services (notably education, water, and electricity), relational well-being operationalised as social relations and social capital, subjective well-being operationalised as the subjective evaluation of the quality of life (prior and post-Covid-19) and collective well-being operationalised as political empowerment.

Methodology

The research was conducted in line with existing Covid-19 restrictions and protocols. The research team analysed vital government policies, presidential speeches, reports from CSOs, NGOs and development partners, and media output on response to the Covid-19 crisis. In addition, literature review of existing studies and surveys on the impact of COVID-19 in Ghana was conducted. The secondary data was then complemented with key stakeholder interviews with government officials at national and district levels, NGOs, development partners, local Civil Society Organisations (CSOs), trade unions, and workers associations. Lastly, to understand the impact on the well-being of the poor, the research team conducted focus group discussions and interviews with head porters (Kayayei) in Accra, residents of Chorkor and market women in Bolgatanga. The research consisted of the following phases (a) socioeconomic and political context analysis, (b) mapping of Covid-19 mitigation responses by state and non-state actors, (c) identification of specific vulnerable groups for in-depth case studies of social and spatial equity issues, namely head porters (Kayayei), residents of Chorkor, market women/cross-border traders in Bolgatanga, and (d) equity assessment which interrogated how the identified policies/programmes have affected the well-being of the identified vulnerable groups in the short term. Moreover, it also examined how the identified policies/programmes have affected work and income, access to basic services and political empowerment of the poor and vulnerable in the longer term.

Theoretical and Analytical Framework

There has been a rise in scholarship and policy attention on inclusive development and the importance of addressing poverty and inequality (see e.g., Piketty, 2014; Bourguignon, 2015; OECD, 2014). However, the concept of equity in secular philosophy dates to ancient Greece with Plato, who pointed out the dangers of inequality for political stability (Attinc et al., 2006, p.76). Since the 1970s, the focus was shifted from looking at final welfare to creating equality in liberties (Rawls), opportunities (Roemer, Dworkin), and capabilities (Sen) (Attinc et al., 2006, p. 77). In a nutshell, social equity based on Rawls, Sen, Dworkin, and Roemer's theories roughly entails an equal starting point or equal set of opportunities or capabilities. However, creating a level playing field or equal opportunities still does not always result in more equal societies. Firstly, by taking the gaze away from the result, equality of opportunity theories has been used to justify inequality, as it is argued that existing inequality results from differences in individual effort or merit or lack thereof (Natasnon, 2016). Secondly, when translated into policies, focusing on equality of opportunities often implies creating “universal” basic services such as public healthcare or free basic education. Although egalitarian in theory, such programmes often overlook structural inequalities that discriminate against certain people from accessing these public goods. In the context of Covid-19 and related policy responses, such “egalitarian” approaches have been widely adopted, excluding certain groups of citizens.

We have re-centred the result in the analysis to explain the extent to which the Covid-19 policies have taken equity into account. More precisely, rather than only looking at the design of policies, which in theory could seem egalitarian, we will focus on their impact on the well-being of the poorest and most vulnerable. Our conceptualisation of well-being is drawn from McGregor and Pouw (2017, pp. 1134–5), who portray well-being as a multidimensional concept consisting of material well-being (e.g., income, housing), relational well-being (e.g., social relationships), and subjective well-being (or a person's evaluation of the quality of life). This allows the research team to analyse the impact of Covid-19 and related state and non-state responses on (1) income and other material sources of well-being such as housing and access to basic services (e.g., water); (2) social support networks and safety nets as well as associations and organisations of the (working) poor; (3) the individual perceptions of the impact on well-being and; and lastly (4) the collective well-being of the vulnerable groups we have identified (Fig. 4.1).

Fig. 4.1

Source Developed by authors based on McGregor and Pouw (2017)

Analytical framework.

To understand why certain groups of people are more vulnerable to the current crisis and their differentiated nature of resilience, the research team adopted an intersectionality lens in the analysis. The intersections of existing economic, political, and social inequalities allow the research team to understand why specific groups of people are especially vulnerable to the Covid-19 health and related socioeconomic crises (Chaplin et al., 2019).

Mapping Ghana’s Mitigation Measures and Policy Responses

It is important to note that Ghana’s Ministry of Health (MoH) started public health promotion exercises before the first case of Covid-19 was recorded in the country. In its Press Release on January 31, 2020, six weeks prior to Ghana recording its first case, the Ministry of Health (MOH) advised the public to observe the following measures regular washing of hands with soap and water.

• (i) Use alcohol hand rub when available.

• (ii) Avoid touching of nose, eyes, and ears when one encounters a sick person or potentially infected surfaces; and

• (iii) Seek immediate treatment if the symptom is suspected, among others ((MoH, 2020).

On March 12, 2020, Ghana recorded its first two cases of COVID-19. Public health, health sector, and socioeconomic responses were announced and implemented in a swift response. As a result, the responses were graduated and eased with increase and decrease in cases.

Public Health Responses

Restriction on movement and social distancing was the first public health response to contain the virus following the confirmation of the two cases of Covid-19. Accordingly, all public gatherings, including conferences, workshops, funerals, festivals, political rallies, sports, and church/mosque activities, were banned. These were announced at the President’s Covid-19 status update briefing on March 15, 2020. Others include school closures, work from home and rotational work regimes, decongestion of markets, travel restrictions on inbound passengers to Ghana, and their attendant quarantining orders.

Restrictions on the number of passengers in public transport were coordinated by the Ministry of Transport in collaboration with private and public transport unions and operators to ensure enhanced hygienic conditions in all commercial vehicles and terminals, and transport unions agreed to reduce the number of passengers per commercial vehicle to allow for social distancing. Bonful et al. (2020) found that the majority (80%) of lorry stations in Accra had at least one Veronica Bucket with flowing water and soap, but the number of washing places at each station was inadequate.

Similarly, the Ministry of Local Government and Rural Development (MoLGRD) worked with the MMDAs to ensure enhanced hygiene conditions in the country’s markets. As a result, some marketplaces in urban areas were sanitised, but the government did not provide WASH materials on a structural basis (Amankwaah & Ampratwum, 2020).

The Imposition on Restrictions Act (Act 1012) was passed by Parliament on March 21, 2020, under a certificate of urgency. The Minority in Parliament critiqued it for giving too much power to the executive. The MPs argued that the Act could be used to encroach on the freedoms of citizens. The Act gives legal backing for imposing restrictions on persons in the event of a disaster, emergency, or similar circumstances, for public safety and protection with no specific mention of Covid-19. The President cited that the Bill was consistent with Sect. 169 of the Public Health Act, 2012 (Act 851), but critics have argued that the Constitution and other Acts (e.g., Public Health Act, Immigration Act and National Disaster Management Act) have adequate provisions to cover such situations and therefore a new law was not necessary. Indeed, these existing laws had guided Act 1012 (FAAPA, 2020).

In his third National Address on March 28, 2020, the President of Ghana announced a partial lockdown of the Greater Accra Metropolitan Area, including Kasoa in the Central Region and Greater Kumasi Metropolitan Area, effective March 30, 2020, to contain the spread of the virus. Travel between regions was banned to prevent the virus' importation from affected regions. The lockdown was introduced when the country recorded 141 cases with five (5) fatalities and evidence of community spread. Security agencies were deployed to strategic locations within Accra, Kumasi, and Kasoa to ensure compliance. There were reports of the use of force which in some cases led to abuse of civilians. For instance, about 171 Kayayei disguised as cargo travelling from Accra to northern Ghana were intercepted and returned to Accra (CNR, 2020).

The lockdown ended three weeks after the imposition as the government reiterated that the decision was supported by science. However, this was received with mixed reactions. Civil society and professional groups, including the Ghana Medical Association, reacted in shock to the President’s decision noting the rise in cases from 141 to 1024. In addition, there was evidence of community spread as 82% of 1024 cases had no travel history and, therefore, the belief that easing the lockdown could spark further spread. In a study conducted by the CSO Platform on SDGs (August 2020), most respondents reported that the government's restrictions were adequate to contain the spread of the virus and should not have been relaxed.

On the other hand, the restrictions were lifted with excitement by vulnerable groups, including people living in slums, head porters (Kayayei), and small- and medium-scale business owners. The Trade Union Congress and persons in academia called the decision progressive, highlighting the dire consequences of a prolonged lockdown on the economy and vulnerable people, including informal sector workers who survive on daily earnings.² The ease of restrictions on movement and social and economic activities continued amidst public anxiety. By September 2020, all restrictions had ended except for partial closure of schools, closure of land borders and social centres such as nightclubs and beaches.

Contrary to suggestions that the relaxation of the restrictions was going to cause hikes in cases, Ghana continued to record high recoveries and lower new cases. By November 4, 2020, Ghana had less than 1200 active cases, dropping further to less than 900 in December, creating a false sense that the pandemic was nearly over (see Fig. 4.2).

Fig. 4.2

Source Our World in Data, 2020

Daily new Covid-19 cases in Ghana.

With the sharp rise in new infections since late December 2020, the government re-introduced some measures, as shown in Table 4.1. The second wave of the virus appears more deadly, with over 80 fatalities in January 2021 alone and more severely ill persons, which could have a detrimental effect on Ghana's already vulnerable health system. By January 31, 2021, the country’s active cases stood at 5515, with a total case count of 67,782 and 424 deaths since March 2020 (GHS, 2021).

Table 4.1 COVID-19 protocol ease timelines

Awareness of the measures has been relatively high. For example, an online survey conducted by Lamptey et al. (2020) to assess the public knowledge, risk perception and preparedness to respond to the pandemic in the early stage of the outbreak in Ghana found that 62.7% had “good” knowledge about the outbreak. Saba et al. (2020) have equally found that the knowledge and preparedness were high in the Northern Region of Ghana, although differences existed between awareness levels in rural and urban areas.

Health Sector Responses

In collaboration with other government departments (e.g., Customs and Immigration), the Ghana Health Service (GHS) trained and provided resources (e.g., thermometers) to screen travellers at the ports of entry.³ Travellers who recorded temperatures of more than 37 degrees Celsius were further screened. Before the closure of all borders, all international travellers were put under mandatory quarantine and tested at a cost to the taxpayer, which enabled early detection, isolation, and treatment of cases. The GHS Helplines required citizens who showed symptoms to call and be picked up by an ambulance to be transported to Isolation Centres for screening. While this process was smooth initially, it became fraught with challenges as the number of cases surged over time. There were instances where patients transported themselves using modes that violated the Covid-19 protocols (e.g., using public, commercial transport) after waiting in vain for an ambulance. This was no surprise as Ghana has less than 400 functional ambulances for a population of 30 million. A team of contact tracers were recruited and trained to complement Ghana Health Service internal capacity to undertake enhanced contact tracing. This process of enhanced contact tracing was minimised when the partial lockdown was eased.⁴

Health infrastructure also improved. At the onset of Covid-19, only two laboratories, namely the University of Ghana Noguchi Memorial Institute for Medical Research in Accra and the Kumasi Centre for Collaborative Research of the KNUST existed. However, the facilities increased to sixteen, with four private ones. Fourteen of the facilities are in Southern Ghana, mainly Accra, Kumasi, Ho and Takoradi. Only two are sited at the northern Ghana, precisely Tamale and Navrongo (GHS, 2021).

Covid-19 case management Apps were invented during the period. They include the Covid-19 tracker App launched by the Ministry of Communication, Covid-19 TECHBOT developed at the Kwame Nkrumah University of Science and Technology (KNUST), and the Covid Connect App developed by the University of Ghana Medical Centre (University of Ghana, 2020). However, the uptake of these Apps remains unknown. Recruitment of more health sector workers, including retired health professionals, boosted the personnel numbers, although this was still inadequate.

The government implemented several support measures to mitigate the fallouts from the pandemic. Health workers received tax incentives in the health sector to recognise their frontline vulnerability. Economic specific measures include a stimulus package for small and medium-scale enterprises and another package for private schools, and other tax incentives. Universally applied schemes such as water and electricity subsidies were implemented short-termly. Reduction in communication tax was also applied while food distribution to vulnerable street dwellers in some cities and final year pupils in Junior High Schools was also implemented. The programmes have been critiqued for the continuum of transparency, accountability, non-targeting, inadequacy, and corruption. Thus, the following section analysed the Covid-19 mitigation measures and their accompanying socioeconomic support programmes using equity assessment tools.

Equity Assessment of COVID-19 Measures

The measures were taken to contain the spread of Covid-19, and those designed to mitigate the negative socioeconomic consequences have differentiated effects on Ghanaian citizens, with some being especially vulnerable due to the intersectionality of their socioeconomic and political identities. We used three vulnerable social groups, namely residents of Chorkor in Accra, Kayayei, a northern migrant head porters on the streets of Accra and market traders in Bolgatabga, to demonstrate the differentiated impact of Covid-19 on vulnerable social groups. The selection is based first on geography, where two case studies were picked from the South, where the highest numbers of Covid-19 cases were recorded and the Upper East characterised by structural inequalities and higher poverty rates. Second, we focused on gender issues where female workers were deliberately included as they were especially vulnerable due to their dual work-family responsibilities, both affected by Covid-19. The third element is age, where young and older informal workers were included to reveal differentiated vulnerabilities. Table 4.2 summarises the background characteristics of the three social groups selected.

Table 4.2 Vulnerable groups selected for equity assessment

Background Characteristics

Chorkor is a densely populated fishing village falling under the constituency of the Accra Metropolitan Assembly (AMA). Most residents are from the Ga-Dangme ethnic group or migrants from other areas in Ghana or neighbouring countries. The Ga-Dangme are a minority group in Ghana and the Greater Accra Region indigenes. Chorkor is an important fish landing site and is famous for its smoked fish (the neighbourhood gave the name to the chorkor oven), but fish populations have been decreasing, resulting in residents now also engaging in other livelihood activities such as petty trading. Chorkor is especially vulnerable to Covid-19 due to high population density making social distancing difficult; informal housing which generally lacks connection to water pipelines or electricity; and the halt of economic activities during the lockdown in Accra.

Kayayei are female head porters who work in Ghana’s large cities such as Kumasi and Accra and are predominantly migrants from Ghana’s Northern regions. The women are often young and see head porterage as a temporary livelihood strategy to save money to get married, enter skill training, finish their education or start their businesses. Their work involves carrying goods for market women to and from their stalls or shoppers at the market. They often group at specific places in front of the market, and they share rented apartments in the city (in Accra, many live in Aglogbloshie) or sleep on the street (Yeboah et al., 2015). The Kayayei’s lives are intertwined with movement between the city and their home villages, where they sometimes leave their children with relatives. A Kayayei earns approximately 30 Ghana Cedis a day or the equivalent of 5 US dollars.

The Kayayei were especially vulnerable during the Covid-19 pandemic due to: a decrease in economic activity during the lockdown and afterwards because of the “slowness” of the market; impossibility to travel back home due to restrictions of mobility between regions; poor housing situation, which did not allow them to benefit from government water or electricity subsidies; predisposition to various types of abuse due to existing gender inequalities.

The market women in Bolgatanga were specifically vulnerable to Covid-19. They experienced a decreased income due to prolonged border closures with Togo and Burkina Faso. Furthermore, the informality of their businesses leaves them without social protection. In addition, the Covid-19 social protection measures, such as food distribution, did not reach the Northern regions. Also, since most lived in rented houses, they did not benefit from electricity or water subsidies. As women, they are affected by school closures and related halt of the school feeding programme, limited representation and political marginalisation as citizens of Northern Ghana.

Despite the importance of Ghana’s markets in terms of employment creation and economic activity, market women are still in many ways discriminated against and excluded from policymaking on local and national levels (Osei-Boateng, 2019).⁵ While there are considerable differences between market women in terms of socioeconomic status, ethnic backgrounds and levels of education, the informal nature of their work underpins their shared vulnerability. The structural issues make them vulnerable to shocks as social protection programmes do not cover them. Although market women most often do not fall into the category of the extreme poor, they are among a group who “fall between the social protection gap”.⁶ The Central Market in Bolgatanga is a critical economic hub for cross-border traders (Burkina Faso and Togo) as well as trade with the Southern regions of the country. It is open every three days.

Equity Assessments of Covid-19 Measures

Covid-19 has impacted the material and relational well-being of social groups. Its impacts manifest both in the short and long term. Similar to previous studies, the research team found that the pandemic has had a more significant economic than health impact on all three vulnerable groups included in the research (see e.g., Durizzo et al., 2020; Rahman & Matin, 2020, Sumner et al., 2020). A decrease in income was a share impact cited during Focus Group Discussion sessions held with the three groups at separate locations. The following statements reiterated the impact of Covid-19 on the groups studied,

Even though we can now work, it is not like before. The market is not as busy as before, and the few shoppers are not engaging us. We roam from morning till evening but barely go home with GHS5-10 per day. Before Corona, we could go home with between GHS20-40 per day (Kayayei, Agbogbloshie, Accra)

We barely make GHS40-50 a day compared to GHS200 pre- Corona. People are afraid of catching the virus and so are avoiding street food. So, I have stopped hawking (Chorkor resident, Accra)

During the three-week lockdown in Accra, Kayayei and most of the residents of Chorkor engaged in this research could not go to work. Even those that could sell, such as food vendors, closed for two weeks due to low patronage. Many of the respondents in Chorkor mentioned they used up all their savings, and some had to shift to buying goods on credit and repaying once they made their sales. Our findings are similar to other findings from surveys conducted by GSS (2020) and IPA (2020). GSS found that 47.4% of respondents relied on their savings as coping mechanisms, while IPA (2020) stated that almost half of the respondents had to deplete their savings to cover basic needs and up to 58.6% in the Upper East. For Kakayei, the situation was even bleaker as most do not have savings to fall back onto as they live from hand to mouth. In Bolgatanga, where lockdown was not imposed, some market women were relocated to allow for more social distancing, while others had to close their shops because they had no goods to sell due to border closures. They were also forced to increase their prices due to the increased cost of goods which slowed down the market. Due to fear of contagion, there were also significantly fewer buyers in markets, with many women complaining that their sales had dropped significantly. Most women also stated they fell back on their savings, and some have shifted to roaming or street vending because they could no longer afford their market stall. Not only did the border closure prevent traders from buying new goods, but some women who had already purchased goods could not retrieve them, resulting in a considerable loss of income. A trader reiterated some of the concerns,

My shop is empty, and I have used all my money to feed my family. Now I have nothing again. I used to have a small place to sit, but now I do not sit anymore but roam (Market woman, Bolgatanga, Upper East).

Covid-19 has affected not only poor people in economic terms but also their relational well-being. The contagious nature of the virus and preventive measures such as social distancing, wearing of face masks, restriction of mobility and closures of school to name a few, have also changed people's social relations at work and home or among friends. While Kayayei is used to gathering to work and share living spaces with up to 18 colleagues, the confinement in their tiny apartments during lockdown was extremely hard on them. The movement restrictions between regions severely affected their relations with their family and children and is highlighted in the following statement,

On a typical day, everyone is out working and only comes back at night. However, because we could not go out during the lockdown, all of us were crowded in the room with no space to move. It was traumatizing ( Kayayei, Agbogloshie, Accra)

Some Kayayei tried to return home clandestinely in cargo trucks. However, they were captured and sent back to Accra, raising public discontent, and initiating the government to provide food support to the urban poor, of which ironically, only three out of twenty-six Kayayei interviewed benefitted. Moreover, those that were able to return home were confronted with other difficulties as their parents and families (who usually rely on the meagre income they sent from the South) now found themselves with more mouths to feed.

The focus groups with Chorkor residents mostly raised the impacts of school closures on children, including children loitering and the issues of security, teenage pregnancy and increasing child labour, among others. However, some were happy about school closures because they could not pay school fees. In Chorkor, people generally send their children to low-cost private schools due to the lack of public schools. Respondents were generally not open to discussing their lives at home and personal relations. In the North, the stigmatisation of Covid-19 patients was also raised. A woman lamented that a market woman who had recovered from Covid-19 had been bullied out of the market. Furthermore, stones had been thrown at her children.

Subjective Well-being

The impact on the material and relational well-being of the people interviewed resonates in the way people feel about their lives. For example, the market women in Bolgatanga stated their lives improved a year before Covid-19. However, in a self-assessment of their situation, they referred to a reversal of fortunes compared with the previous year. Since most have depleted their saving, they do not know what to do again. This uncertainty was also found in that conversations with Kayayei, who stated they were only doing this work for survival. These findings resonate with the research by Durizzo et al. (2020, p. 5), who conducted a telephone survey of 1034 urban poor in Accra, of whom 37% stated they were feeling down, depressed, or hopeless. The additional stresses include the presence of children at home and the cost of feeding them. A market woman in Bolgatanga emphasised this by saying, "the children are at home. We feed them from morning to evening”.

“We were excited that the lockdown was lifted early so we could go out and feed ourselves and get away from the crowded rooms” (Kayayei, Agloboshie, Accra).

The pandemic, however, did not wholly dent their aspirations. Among the market women in Bolgatanga, traders and fishers in Chorkor, and Kayayei in Agloboshie, there was forward-looking energy with all groups hoping for government or philanthropic support for their economic activities.

Besides the direct short-term impact on the well-being of the poor, Covid-19 or the measures taken to manage the health crises will have long-term implications on existing inequalities in Ghana. The analysis below focuses on the longer-term impact on work and income, access to essential services and political empowerment.

Access to Basic Services

Ghana’s inequalities have been most accentuated in access to basic services, and it is also here where the government has made the least consideration in terms of equity. The government's mitigation measures in education, water, and electricity were all blind-sighted in terms of the realities of the poor.

The subsidies for water were only primarily accessed by households connected to the national water pipeline, while the same counts for electricity. Water tankers were deployed in Chorkor and other communities in the South, but this did not occur in the North. Even if water tankers were provided, many residents did not want to go through the hassle of getting water due to the large crowds. For the older adults, this was certainly out of the question. Although government officials stated that people selling water would be fined, many respondents stated they paid the same or even higher prices for water. Those using public washrooms saw no reduction in charges despite accessing free water.

Similar issues occurred with the electricity subsidies. Almost all the poor people interviewed lived in rented houses, of which their electricity bill was added to their monthly rent. None of them noted a decrease in rent due to the electricity subsidies. It implied that house owners were sharing in on the subsidies at the expense of the vulnerable. It demonstrates the unequal power relations between landlords and tenants and the lack of legal protection for the poor.

The government’s response to school closures also exemplified the disconnection between policy makers/implementers and poor and vulnerable populations. Whereas the government rapidly broadcasts a 24-hour learning television channel, the fact that it was only available on digital TV was regrettable considering that many poor households either had no television or satellite dishes to access the digital channels. While significant lobbying by CSOs resulted in the introduction of the radio programme, the content and continuity were disappointing, demonstrating a lack of political will. The North–South inequalities were also very apparent here as the connectivity to television, internet or even electricity was significantly lower in the Northern regions. In addition, the school feeding programme was abandoned entirely because of school closures was regrettable as many parents counted on these daily meals during “normal” times and now, faced with economic hardship, had to feed much more mouths on a smaller family budget.

Political Empowerment

Even though aspirations for the opposite, Covid-19 seems to have strengthened existing unequal power relations rather than addressed them. The northern regions of the country have been very much disadvantaged by the governance of the government’s responses. Although one might argue this to be natural since the spread of Covid-19 was much higher in Accra and Kumasi, the reality is that poor people in the North, too, have suffered a lot in both material, relational, and subjective terms. Nevertheless, minimal measures were made available to them. The disappointment towards the government and politicians in Bolgatanga was rampant, and the distrust was very high. Some market women in Bolgatanga state that they demonstrated to voice their concerns but added that nobody listened. Others said they did not see the advantage of demonstrating on an empty stomach, and it was often mentioned that "others" got some support, but they did not get anything. The long-term political implications of this sense of exclusion cannot be underestimated as it feeds into the Northerners’ deep story, a term Hochshild (2016) of political neglect, which in other countries has led to the rise of right-wing extremist regimes. A participant reiterated the neglect by saying, "The Gender Ministry came here at the onset of the pandemic to write names of vulnerable people, including pensioners but never came back"(Household of two pensioners, Chorkor).

This sense of voicelessness was also found among the Kayayei and Chorkor residents. There was a shared perception that nobody would listen if they were to voice their concerns. The exception was the fishers who were part of an association. They mentioned they attended a meeting at the Accra Metropolitan Assembly to discuss the pandemic issue but added that only a few of their concerns were taken seriously, and little was implemented. Similarly, the Minister of Gender, Children, and Social Protection visited Chorkor to request a list of the elderly, but later nothing more was heard from them. The association of Kayayei was also asked to compile a list of possible beneficiaries but never heard back from the ministry. These unfulfilled promises also resonated in Bolgatanga with market women expressing how politicians only come to promise things during election campaigns and later only think of their own “stomachs”.

Conclusion

Like many African countries, Covid-19 impacts on Ghana have been more in economic terms than health-wise. The pandemic has seen the worsening of deprivation for the extremely poor and vulnerable groups due to the disproportionate economic impacts and failure to provide inclusive social protection. For some people, this has meant exhausting the little savings or going to bed on an empty stomach, while others have been pushed into precarious employment for survival, and this has been the case for informal sector workers such as traders in Bolgatanga, residents of Chorkor and Kayayei in Ghana’s capital Accra.

While we argue that that the mitigation measures were appropriate, we also emphasis the fact that some of them could have been modified over time to target the most vulnerable. For instance, the prolonged closure of land borders has affected the economic activities of small-scale traders, particularly women in the northern parts of the country, and has exacerbated their already vulnerable conditions. In addition, the closure of schools significantly increased inequality. The question is whether instituting Covid-19 prevention infrastructures in schools and border-crossings would not have been more equitable.

Given the large informal sector in Ghana, the social cost of a longer lockdown would have been too high. Similarly, hardships imposed by the restrictions to curtail the spread of the virus have been high without effective social interventions to mitigate the same. The government’s attempt to mitigate the impact of these measures on the poor and vulnerable has been affected by existing structural inequalities, the lack of data on the poor and Presidential and Parliamentary elections held in December 2020, among others. The results have been further alienation of the most vulnerable and political mistrust among those who needed the interventions the most, particularly among populations far removed from the centre, like market women in Bolgatanga. Perhaps, political considerations were more paramount in the decision to centralise governance of response than the fact that Accra was an epicentre, but the effect has been less involvement of District Assemblies and CSOs closest to the citizenry.

The measures were poorly targeted, and a centralised approach further affected service delivery. In 2018, about 81% of Ghanaians had access to electricity, according to the World Bank. However, even those who had access lived in rented houses with landlords as gatekeepers who decided on whether to grant the subsidy to their tenants. The study established that Kayayei and some residents of Chorkor and market women in Bolgatanga paid rent inclusive of electricity usage during the period the subsidy was implemented. Again, residents of Chorkor, market women in Bolgatanga and Kayayei reported buying water due to lack of access or inadequate supply even when the state continues to provide free access. Due to structural inequalities, the water and electricity subsidies benefitted wealthier households and not the poor.

Recommendations

With the above analysis of Ghana’s Covid-19 responses, we recommend the need for:

• Strong institutional structures to collect robust data which should be used for targeting of beneficiaries of social protection programmes which consider gender, generational, geographical, and occupational differentiated vulnerabilities. By this, the Ghana National Household Registry (GNHR) should be strengthened to expand its reach and scope of data collection.

• Bottom-up approach to crisis management and support system programme implementation through decentralised structures and the involvement of community members and CSOs.

• Promote savings among low-income earners and ensure regulations that build citizens’ confidence in the banking system.

• Stimulate the creation of workers and community-based associations which at least provide governments with a conversation partner and opportunity to voice concerns (e.g., in the case of the Kayayei Association and fishers association) even though they do not often lead to a change in policies.