Alliance for Reproductive Health Rights(ARHR), non-governmental organisation, has launched a report on Millennium Development Goals 4, 5 and 6 to enable stakeholders to monitor Ghana’s progress towards achieving the health MDG’s. The report, which is the third in participatory monitoring series, is aimed at documenting the perceptions and health care experiences of poor and vulnerable rights holders in the country. This would help government and civil society to support the poor and vulnerable in their quest to demand improvement in the allocation of health resources as well as in a way in which health services are delivered and managed. The report captured the findings of a participatory health monitoring study undertaken in four districts involving 12 communities was launched by Madam Vicky Okine, Executive Director of ARHR on Friday in Accra. The districts covered are Agona East, Bongo, Builsa and Komenda Edina Eguafo Abrem. According to the report, maternal health markers had improved across the monitoring districts and family planning clinics were perceived to be well run with confidential counseling and affordable supplies of contraceptive commodities. As compared to the previous years, the statistical indicators suggested improvements in ante-natal care completion and supervised delivery rates. It indicated that patients under the National Health Insurance Scheme (NHIS) were given less preferential treatments by facility staffs as compared to cash-paying patients. In addition, NHIS subscribers were not receiving refunds for prescriptions which facilities could not supply. It also revealed that children were unable to receive free treatment if they had not individually been registered as subscribers and some subscribers were also penalized heavily for late payment by some service providers in the health insurance industry. It indicated that these negative practices and insensitiveness had contributed to the avoidance of NHIS by many poor people who have opted for alternative and dubious treatments when they fall sick. The report also showed that adolescent sexuality and reproductive health were forbidden matters to be discussed in homes resulting in most young people acquiring information from peers, older siblings and the Media. “Overall, the quality of reproductive health information actually available to adolescents is low and, many cases, plain dangerous”, the report said. It mentioned some of the causes of increasing incidence of under-age pregnancy in the communities visited as sensual dress codes, sexualisation of the female body, electronic pornography and the constraining impact of stigma on access to counseling services. The report said most remote communities were able to access formal healthcare due to transport and bad roads. “These notwithstanding, in each of the study districts, outpatient attendance rates are rising steadily both in absolute and relative”, the report added. Midwives and nurses were also assessed to be more patient and sensitive than their younger counterparts and the poor and the illiterate also perceived themselves to be treated less humanely. The report observed that most people were satisfied with the effectiveness of facility-based treatment because it helped to recovered faster and complete from illness especially when prescribed by ‘older doctors’. In order for Ghana to achieve health MDG’s by 2015, the report said the country needed to redistribute health human resources to ensure more equity in health delivery. The report suggested that health authorities should institute and apply appropriate sanctions to deter unethical behaviours among health workers. It called for insurance subscriptions to be sold for subscribers accompanied by proper education on their rights, privileges and remedies under the NHIS and consistency in implementing ‘free maternal care’ policy. The report suggested the urgent need for appropriate sex education for adolescents to enable them to appreciate and manage their sexuality more responsibly and safely. Madam Okine commended Ghana’s progress in achieving health MDG’s by 2015. She said reports had shown that under- age- five mortality had decreased from 111 per 1000 births in 2006 to 80 per 1000 births in 2008. She expressed doubt whether the rate could reach the 40 per 1000 births target within three years. According to her, Ghana’s was tottering on the brink of not realizing MDG 5 by 2015 even though maternal mortality had reduced from 540 per 10000 live births in 2006 to 350 per 10000 live births in 2008. “The reduction is estimated to be at a rate of 3.3 per cent annually compared to 5.5 per cent annual decline required to attain MDG five target of 185 per 10000 by 2015”, she added. Madam Okine called on policy makers to institute strategies to accelerate Ghana’s efforts towards achieving the MDGs by 2015