Audit of USAID/Ghana"s population activities

Audit report covers the period 4/91-2/96. USAID/G has exceeded its strategic objective for population. Per the 1993 Demographic and Health Survey, the fertility rate had decreased to 5.5 births per woman vs. The Mission"s target of 6.1 -- a significant achievement for a sub-Saharan country. The Mission has also generally exceeded its performance indicator targets, without, however, adjusting targets that have already been achieved. For example, targets established for 1996 for the fertility rate and for the number of Ministry of Health (MOH) outreach sites offering family planning (FP) services were already surpassed by 1993. USAID/G has also exceeded or is progressing towards output targets established in its population project papers. For example, the Mission was 15,236 couple-years ahead of its planned amount of couple-years of protection for 1994 of 378,000 couple-years and had exceeded by 88 (1.8%) its planned number of private sector delivery points offering family planning services. Further, USAID/G had exceeded its planned achievements to increase the number of (1) surgical contraceptive centers and (2) participating NGOs. Although USAID/ Ghana has, overall, been successful in achieving its population objectives, it has not closely monitored and reported on the return-to-project fund, which was considered critical to the project"s sustainability. This fund represented a portion of the monies recovered by the MOH from the sales of USAID-supplied contraceptives. As of 3/31/95, the MOH had recorded a balance in the fund of 60 million cedis ($56,100), but it should have contained 88 million cedis ($82,600). Further, although the return-to-project fund was listed as critical in the project paper, it was never reported on in the Mission"s Semi-Annual Portfolio Reviews (SPR). A review of select performance indicators reported in the SPRs revealed that the Mission had inaccurately reported the usage of oral rehydration salts and that contraceptive sales reported by the MOH were not always supported by sales records at the clinic level. The Mission concurred with the audit findings and has taken steps to implement its recommendations, which are considered resolved.