Project News

Project for Improving Continuum of Care for Mother and Children through the introduction of combined Maternal and Child Health Record Book, called Ghana MCH RB Project, started in April 2018 in collaboration of Ministry of Health, Ghana Health Service and Japan International Cooperation Agency.

Overall Goal: More women and children complete Continuum of Care (CoC)*.
Project Purpose:> More Women and Children utilize quality MCH services.
Expected Outputs:

1. MCH RB is developed and rolled out to nationwide.
2. Capacity of effective utilization of MCH RB is strengthened among health workers and mothers.
3. MCH RB is institutionalized and integrated into routine services for sustainability.

* Continuum of Care is a series of reproductive, maternal, new-born and child health care, including antenatal care, delivery with assistance of skilled birth attendant, prenatal care and child growth and development check.

Background

The Ministry of Health and the Ghana Health Service (GHS) developed an Integrated Maternal and Child Health Record Book (MCH RB) with technical and financial support from Japan International Cooperation Agency (JICA). The main purpose is to fill the gaps of maternal and child health services with better coverage of continuum of care (CoC). Ghana has been utilizing two separate home-based record books for mothers and children over the last few decades. However, there are various challenges to promote CoC as there is a crack between delivery/post-natal care and childcare. The main purpose for integrating record books is to fill the gaps of maternal and child health services with better coverage of CoC which neither maternal record book nor child record book covers.

The characteristic of the new combined MCH RB

There are several characteristics of the new combined MCH RB.

1. CoC card: CoC card lists essential CoC services at a glance and motivate and remind mothers to uptake CoC services
2. Nutrition messages: Various nutrition messages such as how to eat well during pregnancy and how to feed a child are included.
3. All information included: Early Childhood Development, Malaria, PMTCT and Immunization records and messages in one book
4. Illustrations: Health messages were provided in English with many illustrations, so that all mothers can easily understand health education messages, especially danger signs when the solid explanation is provided by health workers.
5. Health, nutrition and hygiene messages for family members, including males: The MCH RB will promote family support and male involvement by adding images of fathers in the book.
6. Space to be filled by parents: The MCH RB includes ‘Sweet Memories' where parents can take notes on their baby and a space of family picture.

Danger signs from the MCH RB

Development of the MCHRB

The effort to develop the MCH RB started in early 2016 before the project starts. Under the leadership of GHS and JICA, a series of meetings/workshops with key stakeholders, development partners, private sector, Malaria, TB, HIV, EPI programs. etc. were conducted. At the workshops, a conceptual framework was defined and essential information which should be included in the new MCH RB was collected.

Workshop

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Pretest

A pretest of the draft book was conducted in October 2016 in three different sites (Bongo, Bolgatanga, and Accra) to identify the levels of understanding, acceptance, socio-cultural acceptance, attractiveness and compliance/motivation for behavioral changes among mother, fathers and grandparents as well as utilization, acceptance and work efficiency among health workers. Understandings and acceptance of the book were relatively high among mothers, family members, and health workers and some recommendations were made by health workers to improve work efficiency. The draft book was modified according to the results of the pretest. A pilot version of the book was finalized at the beginning of 2017.

Providing antenatal care with MCH RB

Explain what is MCH RB and asking opinions from the community

Asking opinions from elderlies on the contents of the MCH RB

Pilot-test

A pilot test was conducted from June 2017 till February 2018 at 15 selected health facilities in six districts in three regions (Upper West, Ashanti and Central) to test if there are comparative advantages of MCH RB to on-going maternal health records and child health records and to test if the books are utilized effectively for all different service delivery points at all stages of care (antenatal care, delivery, postnatal care, child welfare clinic). The main finding of the study is that CoC completion rate among the intervention group was higher than in control (Intervention 76%, Control 63%). (See the project news ‘Pilot test of the new combined MCH Record Book was conducted in Ghana')

Monitoring of the MCH RB utilization at a pilot health facility (1)

Monitoring of the MCH RB utilization at a pilot health facility (2)

Monitoring of the MCH RB utilization at a pilot health facility (3)

Launching Ceremony

After two years of development and testing, the MCH RB was finally completed. HE Ms. Samira Bawumia, the Second Lady of Ghana, announced the launching of the book and handed over the first MCH RB to mothers on 2 March 2018 in Central Region.

Way forward

Finally, the MCH RB Project got started in April 2018. The Project will conduct Training of Trainers for effective use of MCH RB in 2018 as a first step of national rollout. Hope pregnant women, mothers and children enjoy healthier life with quality health services provided with MCH RB.