“Reduce Child Mortality” and “Improve Maternal Health” had been set forth as the United Nations’ Millennium Development Goals (MDGs), and also incorporated as one of the Sustainable Development Goals (SDGs) that were adopted in 2015. While some improvements have been made in the infant mortality rate and the maternal health, there remains high in some countries in Sub-Saharan Africa and Asia. There has also been an imbalance in terms of the progress of these improvements between urban and rural areas within developing countries. Against this backdrop, the Japanese government announced a new Global Health Policy 2011-2015 in September 2010 comprising a new model assistance program called EMBRACE (Ensure Mothers and Babies Regular Access to Care) that focuses on protecting the lives of mothers and babies.
The EMBRACE model aims to ensure seamless (regular access) and appropriate treatment and service to mothers and babies. In addition to providing this model, the Japanese government announced plans to implement evidence-based policy making and its support. In accordance with this policy, JICA Research Institute (JICA-RI) has conducted research with University of Tokyo, Ghana Health Service (GHS), JICA Human Development Department and the JICA Ghana Office aiming at developing and establishing an effective and evidence-based assistance package for achieving Continuum of Care (CoC) in order to embody the EMBRACE model.
During the first year of the project (June 2012 to March 2013), there were three activities implemented in this research; workshops were held with joint research teams composed of researchers from Japan and Ghana, surveys as formative research on issues and incentive structures which community health officers (CHOs) faced, and surveys on the social relationships between mothers and spouses, local residents and CHOs. During the second year of the project (April 2013 to March 2014), the research team conducted a current state analysis survey on CoC for mothers and children and developed an intervention package. During the third year of the project (April 2014 to March 2016), the research team actually implemented the package in three different regions of Ghana, using CoC cards to promote the CoC for pregnant women or nursing mothers, educating health service workers about CoC, and conducting home visits for postnatal examinations. Furthermore, in two of these regions, mothers and infants were allowed to stay in hospital for 24 hours after delivery.
The research team has analyzed the results of these interventions, and reported at academic and international conferences and contributed in academic journals.