October 30, 2017
On October 27, the Japan International Cooperation Agency (JICA) signed a Record of Discussions with the Government of the Republic of Ghana in Accra for the Project for Improving Continuum of Care for Mothers and Children through the Introduction of Combined MCH Record Book, a technical cooperation project.
This project aims to improve the accessibility to continuous high-quality healthcare services for mothers and children by introducing new Maternal and Child Health (MCH) Record Books throughout Ghana and establishing an environment in which the MCH Record Books can be effectively used.
In Ghana, the improvement of the health status of mothers and children is considered a high priority. Despite great efforts made to address this issue, the neonatal, and under-five and maternal mortality ratios remain high at 28 per thousand live births, 62 per thousand live births and 319 per 100,000 live births, respectively . Furthermore, the institutional neonatal mortality rate and institutional maternal mortality ratios have been reported as worsening . With economic growth, geographic disparities have increased in the health status of residents and access to health services. Maternal and child health needs to be improved by eliminating these gaps across the country based on the concept of universal health coverage (UHC) . Good health in infancy and childhood influences the health status for life and thus maternal and child health is considered to be an important start to UHC.
In response to these issues, the Government of Ghana positioned the health sector as one of its priority areas in the National Medium-Term Development Plan (2014–2017). It has set up policy targets for improving access to and the quality of healthcare services in order to achieve UHC in the National Health Sector Medium-Term Development Plan (2014–2017).
A study  conducted with support from JICA in Ghana under the Ensure Mothers and Babies Regular Access to Care (EMBRACE) model  advocated by the Government of Japan shows that 1) a continuum of care for mothers and children is effective in improving maternal and child health. In order to promote the continuum of care (CoC) in Ghana, the EMBRACE research highlights the importance of 1) linking a mother’s her child’s records 2) providing an enabling environment and 3) educating and involving mothers in the promotion of CoC. Although Ghana has had maternal record books for pregnant women and child health record books, the books were not targeted for mothers to read. Moreover, neonatal care was not well promoted or captured in either of the books. The new combined MCH Record Book is strategically designed to promote CoC, empower women, engender family support, especially male involvement in maternal and child healthcare, and also make recording by health workers more efficient.
This project is expected to contribute to UHC and improve maternal and child health by facilitating high-quality CoC for mothers and children throughout Ghana. It will also strengthen individualized health and nutrition counseling for mothers and children, and develop educational materials which will help health workers provide such services.
1: Source: “The State of the World’s Children 2016,” UNICEF
Ghana is 35th from the worst in terms of the under-five mortality rate.
2: According to the “The draft Holistic Assessment of 2016” distributed in the Annual Health Summit by the Ministry of Health, the institutional maternal mortality ratio rose from 142 per 100,000 live births to 150 and the institutional neonatal mortality rate increased from 5.34 to 6.28 per thousand live births.
3: All people can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
4: In collaboration with the University of Tokyo and the Ministry of Health of Ghana, JICA carried out the EMBRACE Implementation Research in Ghana, a research project with the objective of verifying the EMBRACE model.
5: At the United Nations High-level Plenary Meeting on the Millennium Development Goals held in September 2010, the Government of Japan announced new global health initiatives, and advocated the Ensure Mothers and Babies Regular Access to Care (EMBRACE) model with a focus on protecting the lives of mothers and children by ensuring uninterrupted care before and after childbirth.
|Country||Republic of Ghana|
|Project title||The Project for Improving Continuum of Care for Mothers and Children through the Introduction of Combined MCH Record Book|
|Planned implementation period||December 2017 to November 2020|
|Executing agency||Ghana Health Service|
|Target region, facilities||Throughout Ghana (with some project activities targeting certain focus areas)|
|Specific project details (provisional)||Activities at the national level include: distribution of MCH Record Books; capacity building of health workers on the effective use of the Book; and institutionalization and integration of the Book into routine services for sustainability. Activities in six target districts (to be selected after commencement of the project) are: development of training materials, provision of practical training for effective use of the Book, development of health education materials and strengthening nutrition counseling|