JICA Ogata Research Institute


Policy Notes

No.4 Effective Continuum of Care for every mother and child: Implementation research in Ghana

Most maternal and child deaths occur during childbirth and in the first few days of life, and many of them happen at home. The concept of Continuum of Care (CoC) has been a core principle and framework underpinning strategies to reach them at crucial times and places but delays and drop outs have occurred frequently. JICA has conducted an implementation research study to find and examine practical suggestions for effective CoC implementation in Ghana (2012-2016). This policy note elaborates a set of policy recommendations based on the research findings to date:

1. Designing intervention packages that consider barriers and facilitators relating to access to health services at each stage of the CoC in the local context is essential;

2. Improvements in basic health facility infrastructure to improve service delivery capacity and quality, and strengthening the capacity of community health workers to link household and health facilities are required;

3. Insisting that proper health education and the empowerment of beneficiaries are indispensable for strengthening care in households and avoiding delays in reaching outside care;

4. Utilizing new technology and social innovations. Some of these are: 1) A CoC Card to visualize service schedules and uptake of both mothers and babies at a glance and to motivate mothers to achieve on time visits, and that this should be reflected in a new MCH handbook; 2) The effective use of free messenger apps on cellphones for timely action and coordination; and 3) Using the CoC Completion rate as an indicator to remind service providers to avoid “drop out” from the CoC process;

5. That impact evaluation/implementation research and utilization of evidence needs to be promoted.

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