Project News

The third Joint Coordination Committee (JCC) meeting was held on 17th December 2019 in Accra, Ghana. Twenty-eight participants from the Ministry of Health (MOH), Ghana Health Service (GHS) headquarter, Regional Health Directorate, Teaching Hospital, JICA Ghana office, Embassy of Japan and JICA Experts participated into the meeting. The main agenda of the third JCC meeting was to wrap up and evaluate the progress of the Project and to discuss the planned activities for year 2020 and 2021 and future directions of the Maternal and Child Health Record Book (MCH RB) Program after the completion of the Project.

Opening remarks

At the beginning of the meeting, Dr. Patrick Aboagye, Project Director, Director General of GHS, expressed gratitude for the continuous support from the government of Japan for the implementation of the Project. He acknowledged the significant achievement as well as the commitment and hard work in the implementation of activities of the Project from both the project members and GHS staff. He, however, expressed concerns regarding the current shortage of the MCH RB and he remarked that the JCC was the best opportunity to discuss sustainability of the MCH RB. Dr. Emmanuel Odame, Acting Director of Policy Planning Monitoring and Evaluation Division, MOH, remarked that MCH remains a priority to the Ministry as its core in the Ghana Universal Health Coverage Road Map. He continued that the promotion of the continuum of care is the key for health and wellbeing for all people in Ghana and concluded by reiterating the Ministry's commitment to ensure strengthened capacity building of all health workers and the financial sustainability of the MCH RB as a national program. Ms. Maki Ozawa, Deputy Resident Representative of JICA Ghana Office, expressed her appreciation for the leadership and commitment of the GHS headquarter and Ashanti Region for the smooth operation of the project and remarkable achievement. She continued that it is a good time to discuss how to disseminate the good practices of the project activities as well as the sustainability and the future directions of the MCH RB in Ghana.

Overall progress of the project

After the opening remarks, Ms. Esi Amoaful, Deputy Director, Nutrition, Family Health Division (FHD), GHS, presented the overall progress of the project highlighting major activities conducted and milestones achieved. This project has three main pillars: national rollout of the MCH RB, intensive capacity development in Ashanti Region and the institutionalization of MCH RB. Regarding the national rollout, following the recommendations of the first national monitoring and supervision (M&S) conducted in January to March 2019, the training for health workers at major hospitals have started. The first training was conducted with 37 participants from 7 hospitals in the Ashanti region. Also, the audio-visual learning material has been developed in order for health workers to learn by themselves. Eight scripts were developed and submitted to Social Behaviour Change Communication Committee for the approval of the production. As for the activities in the Ashanti region, after conducting the baseline survey and situation analysis and a workshop for developing guideline and training materials, the project started health worker training on MCHRB, Nutrition Counseling Service and Respectful care in 11 focus districts. Furthermore, in terms of institutionalization of MCHRB, a workshop on the management guide was held in May.

Activities in Ashanti Region

At the second year of the project periods, the activities in 11 focus districts, Ashanti Region is getting expanded.

Ms. Olivia Timpo, Regional Nutrition Officer, Ashanti Region, presented the progress of activities. The baseline survey and situation analysis were conducted in July 2019. (See the project news "Results of Baseline Survey and Situation Analysis for the intervention of the Project in Ashanti Region") In September, a consensus building workshop on integration nutrition clinic and respectful care in the roll out and implementation of the maternal and child health record book was held, and the basic concept of the guideline was agreed. (See the project news "Development of Operational Guidelines and Training Materials for Nutrition Counseling Services and Respectful Care") After the training of trainers, the health workers trainings have started in early October. (See the project news "Health Worker Training in 11 districts") The project trained 826 health workers at total 25 training in 11 districts and the 30 training will be completed with the total 990 trained health by January 2020. This training includes lots of hands-on practice for MCHRB recording, measurement and counseling skills at both training venue and health facility. The results of pre and post-test show a significant improvement of their knowledge.

Plan of activities for January 2020 to March 2021

Dr. Akiko Hagiwara, Chief Advisor, Ghana MCHRB Project, presented the proposed plan of activities for January 2020 to March 2021. Regarding the national roll-put, the project will continue the trainings for health workers at major hospitals in all regions. The second national M&S also will be conducted to assess the situation of national roll-out and support the onsite implementation. In terms of Audio-Visual learning material, after the pretest to obtain feedback from the intended target group on the storyboard, the shooting will be started. As for the activities in Ashanti region, the first M&S is going to start in 11 districts. Moreover, the project will start behavior change communication activities to spread information for better eating/feeding behavior and health behavior. In terms of initialization, the Management Guide will be finalized, and the existing committee will be taking over the function of MCHRB management at the project. Furthermore, the project will conduct workshops and field trips to share the experience of MCHRB roll-out internally and externally.

Discussion on sustainability

As DG of GHS and Deputy Residential Representative of JICA Ghana mentioned at the opening remarks, one of the most important discussion points at this meeting was the sustainability of MCH RB program. Dr. Isabella Sagoe-Moses, Deputy Director, Reproductive and Child Health, FHD, GHS, presented the draft guideline developed by a core team based on the inputs from the stakeholder meeting.

At the discussion, it was recommended to explore obtaining mid-term commitment from private entities or philanthropic organizations to support the printing of the book. Regional Director of Health, Upper East Region, stressed that the involvement of the private sector was the key for sustainability. He continued that the local government should be brought on board fully to support the printing of the MCH RB, and at the same time the printing itself should be centralized for efficiency and quality. Dr, Aboagye commented as part of the sustainability plans for the printing of the MCH RB, GHS is exploring contracting a private entity to lead the advocacy process and solicit for funds from cooperate organizations for the printing.

Way forwards

The project has entered the second half of the period. The project continues the monitoring and supervision at 11 districts as well as nationwide so that all trained health workers will be able to provide quality services with gained skills and knowledge. The project is going to finalize the management guide and also accelerate the efforts to strengthen the collaboration among local government, private sector, and international agencies. DG announced that the 4th JCC meeting will be conducted in June 2020.