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Working for the Sexual and Reproductive Rights of Vulnerable Girls and Women in Northern Ghana

John Lazame Tindanbil, Executive Director of MABIA-Ghana, is a recipient of the 2020 Aspen Nurse Innovator Grant in collaboration with Johnson & Johnson Foundation. The grant recognizes nurse/midwife innovators for their innovative practices to provide healthcare access to marginalized communities.
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For John Lazame Tindanbil, a nurse and public health practitioner in Ghana, bridging the widening development gap between the north and the south has much to do with addressing the health needs of women, young girls and children.

Growing up in Talensi, one of the country’s remote impoverished northern districts, Tindanbil was familiar with the social stigmas and cultural beliefs widely held across communities in the region. But when he began working as a nurse, he personally encountered the deep injustices rooted in these harmful and obsolete practices that were costing women and young girls their very lives. It hit home early in his career when doctors at the hospital he worked at were unable to save the life of his “sister”—a young girl from his village—who died from abortion-related complications.

“Young girls in high numbers are sexually active in our communities but are unaware or do not utilize family planning services for cultural reasons,” says Tindanbil. “When they become pregnant, they hide their pregnancies and try to end it by drinking unsafe concoctions or going to quack doctors. A good many of them die.”

What Tindanbil soon realized was that doctors, nurses and midwives lacked the training to provide family planning services, including on how to safely terminate pregnancies. Unsafe abortions contribute significantly to maternal deaths in Ghana, especially among vulnerable women and girls in the three remote northern districts.

After working as a general nurse for five years, Tindanbil enrolled at the university for a degree in population and family life, and later pursued a master’s degree in public health. That led to a project officer role with Pathfinder International training healthcare professionals and building awareness about unsafe abortions at the community level. As that project came to a close, Tindanbil founded MABIA-Ghana in 2011 to advocate for sound reproductive health policies especially for women, young girls and children who were socially and economically excluded and outside the reach of mainstream services and support.

With little funding in its early days, MABIA-Ghana found creative ways to do this work like teaming up with hairdressers and barbers, for example. “What was our plan? We were supplying them with condoms to give to their clients. We began doing all these innovative things even before we had any funding,” recalls Tindanbil.

Today, with support from various partners, MABIA-Ghana works in every major area of reproductive health, providing a wide array of sexual and reproductive health information, services and products to women and young girls in underserved communities throughout the three northern regions. Working closely with Ghana’s Community-based Health Planning and Services (CHPS), MABIA-Ghana is ensuring that CHPS frontline health workers provide integrated reproductive and family planning services along with routine health services.

MABIA-Ghana also works with two local midwifery training colleges to provide quality preceptorships to trainee midwives as they begin working in the field. “Our students are learning some of the things that sometimes even qualified midwives and nurses do not learn how to do,” notes Tindanbil. “The lifesaving work we are doing is the first of its kind here.”

In addition to training midwifery students, MABIA-Ghana trains peer educators and community champions who provide education and awareness at the community level about sexual and reproductive health. A 2020 Aspen New Voices Fellow, Tindanbil’s lifechanging work was recognized with the 2020 Aspen Nurse Innovator Grant in collaboration with Johnson & Johnson Foundation. The grant has allowed MABIA-Ghana to scale up its community champions program to four communities.

“Lack of access to family planning and inability to negotiate safe sex means more unwanted pregnancies, more unsafe abortions and more women dying,” says Tindanbil. Also, he adds, “women giving birth younger, and more frequently, put children who do survive at higher risk of poverty, malnutrition and other disabilities that prevent them from reaching their full mental and physical potential.”

From flooding rivers that block access to remote communities to fears of COVID-19 that keep women from accessing services, the challenges he faces are many. But Tindabil is steadfast in his work to fight for reproductive justice for vulnerable populations.

“Women are abused in various ways, and abortions are yet another way women are being abused,” says Tindanbil. “Some of the men who claim they can help the women tell them they have to perform sex for the cervix to dilate before the abortion can be performed. These are some of the various forms of abuse that are happening at the community level that we are trying to end.”

With limited opportunities to continue his education after secondary school, joining nursing training school presented Tindanbil a “respectable” career route. The journey it has led to has become nothing less than his life’s mission.