Publication: Using the Community-Based Health Planning and Services Program to Promote Skilled Delivery in Rural Ghana: Socio-Demographic Factors that Influence Women Utilization of Skilled Attendants at Birth in Northern Ghana
Loading...
Files in English
326 downloads
Published
2014-04-10
ISSN
Date
2015-11-30
Editor(s)
Abstract
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.
Link to Data Set
Digital Object Identifier
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Is There Any Role for Community Involvement in the Community-Based Health Planning and Services Skilled Delivery Program in Rural Ghana?(BioMed Central, 2014-08-11)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.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 Increased Coverage of Maternal Health Services among the Poor in Western Uganda in an Output-Based Aid Voucher Scheme(World Bank, Washington, DC, 2016-06)Vouchers stimulate demand for health care services by giving beneficiaries purchasing power. In turn, health facilities’ claims are reimbursed for providing beneficiaries with improved quality of health care. Efficient strategies to generate demand from new, often poor, users and supply in the form of increased access and expanded scope of services would help move Uganda away from inequity and toward universal health care. A reproductive health voucher program was implemented in 20 western and southwest Ugandan districts from April 2008 to March 2012. Using three years of data, this impact evaluation study employed a quasi-experimental design to examine differences in utilization of health services among women in voucher and nonvoucher villages. Two key findings were a 16-percentage-point net increase in private facility deliveries and a decrease in home deliveries among women who had used the voucher, indicating the project likely made contributions to increase private facility births in villages with voucher clients. No statistically significant difference was seen between respondents from voucher and nonvoucher villages in the use of postnatal care services, or in attending four or more antenatal care visits. A net 33-percentage-point decrease in out-of-pocket expenditure at private facilities in villages with voucher clients was found, and a higher percentage of voucher users came from households in the two poorest quintiles. The greater uptake of facility births by respondents in voucher villages compared with controls indicates that the approach has the potential to accelerate service uptake. A scaled program could help to move the country toward universal coverage of maternal health care.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.
Users also downloaded
Showing related downloaded files
Publication Philippines Conditional Cash Transfer Program : Impact Evaluation 2012(Washington, DC, 2013-11)The specific objectives of the program are to: a) keep children in school, b) keep children healthy, and c) invest in the future of children. It reflects the Government's commitment to promoting inclusive growth by investing in human capital to improve education and health outcomes for poor children and pregnant women. The program is based on the premise that poverty is not about income alone but is multi-dimensional, and factors such as access to basic social services and social environments matter. This report presents the findings from an analysis that assessed program impact by comparing outcomes in areas that received Pantawid Pamilya with outcomes in areas that did not receive the program. The impact evaluation applied two analytical methods: 1) Randomized Control Trial (RCT), which compared randomly assigned program areas and non-program areas to assess program impact, and 2) regression discontinuity design, which compared the outcomes of poor households who received the program with similar poor households just above the poverty line. This report presents the findings from the RCT component only. It should be noted that although 2.5 years of program implementation is generally considered enough time to observe impacts on short-term outcomes, it is not long enough to assess impacts on long-term outcome measures. The program is also achieving its objective of enabling poor households to increase their investments in meeting the health and education needs of their children. Although the study found that the cash grants were reaching beneficiaries, the study did not find an overall increase in per capita consumption among the poor benefiting from the program, although there was some evidence that poor households are saving more in certain provinces.Publication Natural Disasters, Poverty and Inequality(Taylor and Francis, 2021-10-28)Conventional risk assessments underestimate the human and macroeconomic costs of disasters, leading to inefficient risk management strategies. This happens because conventional assessments focus on asset losses, neglecting important relationships between vulnerability and development. When affected by a hazard, poor households take longer to recover from disasters and are more likely to face long-term consequences. Forced to manage trade-offs between essential consumption and reconstruction, these households are more likely to face persistent health or education costs. This chapter proposes a review of existing research into the natural disaster-poverty-inequality nexus and the various metrics that can be used to measure disaster impacts, such as recovery times, economic (income or consumption) losses, poverty incidence, inequality, and welfare or well-being losses. Each of these metrics provides a different perspective on disaster costs and suggest different spatial and sectoral priorities for action. Focusing on the concepts of well-being losses and socioeconomic resilience, this chapter shows how more comprehensive accounting of disaster impacts can better inform disaster risk management and climate change adaptation strategies and support their integration into development and poverty-reduction policies.Publication Digital Africa(Washington, DC: World Bank, 2023-03-13)All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countries’ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africa’s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africa’s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomes—in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet services—and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earnings—dampen people’s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africa’s countries must implement complementary and mutually reinforcing policies to strengthen both consumers’ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforce—one projected to become the world’s largest by the end of this century.Publication Policy Options to Mitigate Political Risk and Attract FDI(World Bank, Washington, DC, 2020-08-12)Political risks covers a wide range of issues, and this note focuses on a subset of political risk: the risks that arise from government actions, whether political or regulatory, that can affect the profitability of an investment in a foreign country. Policies adopted and implemented by governments can directly mitigate these risks. Bad governance and economic crises are two big drivers of political risk. Both are currently prevalent globally, but especially in developing countries. The purpose of this note is to summarize how political risk caused by government actions can impact foreign investment, and what tools countries can use to manage and mitigate such risks.Publication Unbreakable(Washington, DC: World Bank, 2017)“Economic losses from natural disasters totaled $92 billion in 2015.” Such statements, all too commonplace, assess the severity of disasters by no other measure than the damage inflicted on buildings, infrastructure, and agricultural production. But $1 in losses does not mean the same thing to a rich person that it does to a poor person; the gravity of a $92 billion loss depends on who experiences it. By focusing on aggregate losses—the traditional approach to disaster risk—we restrict our consideration to how disasters affect those wealthy enough to have assets to lose in the first place, and largely ignore the plight of poor people. This report moves beyond asset and production losses and shifts its attention to how natural disasters affect people’s well-being. Disasters are far greater threats to well-being than traditional estimates suggest. This approach provides a more nuanced view of natural disasters than usual reporting, and a perspective that takes fuller account of poor people’s vulnerabilities. Poor people suffer only a fraction of economic losses caused by disasters, but they bear the brunt of their consequences. Understanding the disproportionate vulnerability of poor people also makes the case for setting new intervention priorities to lessen the impact of natural disasters on the world’s poor, such as expanding financial inclusion, disaster risk and health insurance, social protection and adaptive safety nets, contingent finance and reserve funds, and universal access to early warning systems. Efforts to reduce disaster risk and poverty go hand in hand. Because disasters impoverish so many, disaster risk management is inseparable from poverty reduction policy, and vice versa. As climate change magnifies natural hazards, and because protection infrastructure alone cannot eliminate risk, a more resilient population has never been more critical to breaking the cycle of disaster-induced poverty.