Publication: Is There Any Role for Community Involvement in the Community-Based Health Planning and Services Skilled Delivery Program in Rural Ghana?
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2014-08-11
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2014-08-11
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In Ghana, between 1,400 and 3,900 women and girls die annually due to pregnancy related complications and an estimated two-thirds of these deaths occur in late pregnancy through to 48 hours after delivery. The Ghana Health Service piloted a strategy that involved training Community Health Officers (CHOs) as midwives to address the gap in skilled attendance in rural Upper East Region (UER). CHO-midwives collaborated with community members to provide skilled delivery services in rural areas. This paper presents findings from a study designed to assess the extent to which community residents and leaders participated in the skilled delivery program and the specific roles they played in its implementation and effectiveness.
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Publication Using the Community-Based Health Planning and Services Program to Promote Skilled Delivery in Rural Ghana(BioMed Central, 2014-04-10)The burden of maternal mortality in sub-Saharan Africa is enormous. In Ghana the maternal mortality ratio was 350 per 100,000 live births in 2010. Skilled birth attendance has been shown to reduce maternal deaths and disabilities, yet in 2010 only 68% of mothers in Ghana gave birth with skilled birth attendants. In 2005, the Ghana Health Service piloted an enhancement of its Community-Based Health Planning and Services (CHPS) program, training Community Health Officers (CHOs) as midwives, to address the gap in skilled attendance in rural Upper East Region (UER). The study determined the extent to which CHO-midwives skilled delivery program achieved its desired outcomes in UER among birthing women.Publication Can Community Health Officer-Midwives Effectively Integrate Skilled Birth Attendance in the Community-Based Health Planning and Services Program in Rural Ghana?(BioMed Central, 2014-12-17)The burden of maternal mortality in sub-Saharan Africa is very high. In Ghana maternal mortality ratio was 380 deaths per 100,000 live births in 2013. Skilled birth attendance has been shown to reduce maternal mortality and morbidity, yet in 2010 only 68 percent of mothers in Ghana gave birth with the assistance of skilled birth attendants. In 2005, the Ghana Health Service piloted a strategy that involved using the integrated Community-based Health Planning and Services (CHPS) program and training Community Health Officers (CHOs) as midwives to address the gap in skilled attendance in rural Upper East Region (UER). The study assesses the feasibility of and extent to which the skilled delivery program has been implemented as an integrated component of the existing CHPS, and documents the benefits and challenges of the integrated program. We employed an intrinsic case study design with a qualitative methodology. We conducted 41 in-depth interviews with health professionals and community stakeholders. We used a purposive sampling technique to identify and interview our respondents.Publication It Takes a Village : Community-based Organizations and the Availability and Utilization of HIV/AIDS-related Services in Nigeria(Taylor and Francis, 2013-06-09)Community-based organizations (CBOs) have emerged as a vital part of the response to HIV/AIDs in Nigeria. The evaluation, on which this article is based, conducted in 28 communities in 6 states and the Federal capital Territory in Nigeria, assessed the effects of the CBO engagement on a set of outcomes related to HIV/AIDS knowledge, attitudes, beliefs, and practices, stigma, service availably and utilization and social capital. It consisted of three components: a household survey conducted in all 28 communities, qualitative data collected from CBO staff and key informants (KIs), and a funding allocation study (qualitative interviews and the funding allocation study were conducted in a subset of 14 communities). This article focuses on the association between CBO engagement and reported availability and utilization of HIV/AIDS-related services. It shows that CBO engagement has a potential to add value to the national response to HIV/AIDS by increasing the awareness, availability, and utilization of HIV/AIDS-related services, especially in the area of prevention, care and support. The CBOs in the evaluation communities focused on prevention activities as well as on providing support for people living with HIV/AIDS (PLWHA) and prevention and care and support were the highest expenditure categories reported by CBOs. Respondents in communities with a stronger CBO engagement were more likely to: (1) be aware of any HIV/AIDs-related services, (2) report that prevention and care services were available in their communities, and (3) have used any HIV/AIDS related services, prevention-related and care-related services than respondents in communities where CBO engagement was weaker. The association between service awareness and service use and CBO engagement was stronger in rural than in urban areas.Publication Obstetric Care in Poor Settings in Ghana, India, and Kenya(World Bank, Washington, DC, 2007-11)Women are at much greater risk in childbirth in developing countries than in developed countries. This report explores why maternal mortality continues to be so high in developing countries, and why emergency obstetric services are little utilized, through research carried out in poor areas in Ghana (Kassena-Nankana district), India (Uttar Pradesh state), and Kenya (Nairobi slums). The study employed both quantitative (household surveys, verbal autopsies, and health facilities surveys) and qualitative (focus groups and in-depth interviews) methods. Among the three settings, maternal mortality ratio was highest in the Nairobi slums, followed by Uttar Pradesh, while the Kassena- Nankana district had the lowest. It is intriguing that among the three settings, Nairobi slums had the highest proportion of women (70 percent) who sought professional assistance during delivery and yet the highest maternal mortality. One possible explanation is the different extent of legality of induced abortion in these three countries. Of the major causes of maternal mortality, the largest contrast among the study areas involved complications of abortion, which were almost four times higher in the Kenya slums than in the north of Ghana or in Uttar Pradesh. A large proportion of health facilities assessed in the three study areas were not capable of providing all six elements of basic emergency obstetric care.Publication Community-based Maternal and Child Nutrition and Health Interventions in Nigeria : A Comparative Case Study Analysis on Best Practices(World Bank, Washington, DC, 2011-02)This study discusses how to effectively engage in community-based nutrition and health programs aimed to improve maternal, newborn, and child nutrition and health outcomes, particularly in Northern Nigeria. It provides the comparative synthesis of four case studies, each of which included a community action component for improving nutrition and health outcomes. It provides a normative base for designing and planning government programs that support reforms in outcome-based programming for maternal, newborn, and child nutrition and health through program support and investment lending. Central to the report is the discussion on the roles played by various stakeholders - state and local government, NGOs, traditional and religious leaders, and communities themselves - in creating and sustaining community mobilization. The factors considered essential or useful contributors to community mobilization are analyzed. The history of government s role in Nigerian health care is discussed, as well as the current situation and future possibilities, especially at the state and local level.
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