Outline of the Project

Project Name

Project for Improvement of Maternal and Neonatal Health Services Utilising CHPS System in the Upper West Region

Target Country

The Republic of Ghana

Date of Signature (R/D)

April 4, 2011

Project Site

The Upper West Region

Period of Cooperation

From September 2011 to August 2016

Counterpart Organization

Ghana Health Service (GHS)

Background

In the Republic of Ghana, the Millennium Development Goals (MDGs) that address maternal and child health services, i.e., "reduce child mortality" and "improve maternal health", are major priorities for the country as a whole. Thus, in the MDG Acceleration Framework Country Action Plan published with the support of the UN, the Ministry of Health set MDG 4 "Reduce child mortality" and MDG 5 "Improve maternal health" as the top priority for the country.

From March 2006 to February 2010, JICA implemented the "Project for the Scaling Up of the Community-based Health Planning and Services (CHPS) Implementation in the Upper West Region". The Upper West Region is one of Ghana's three northern provinces where the income levels are particularly low and access to health services is limited. The project focused on capacity and systems development and equipment supply. Eventually, the project succeeded in establishing such schemes as the Community Health Officer (CHO) training system, facilitative supervision (FSV) and referral systems, Community Health Action Plans (CHAP), and Community Emergency Transport Systems (CETS). Based on the success of the project, the Government of Ghana requested the Government of Japan for a new technical cooperation project aiming at using the systems developed by the project to improve maternal and neonatal health services in the Upper West Region. This request was granted and led to the "Project for Improvement of Maternal and Neonatal Health Services Utilising CHPS System in the Upper West Region" (hereinafter the "Project").

In the Japanese Government's Country Assistance Program for Ghana, improving community health and strengthening health management systems is one of the highest priority after the improvement of basic life environment in poverty-stricken areas. "Japan's Global Health Policy 2011–2015", JICA's position paper on the health sector published in 2010, gives priority to cooperation in the field of maternal and child health.

The Project matches the new policy direction above. At first, a team was dispatched to conduct a feasibility study from September to October 2010 and obtained background information for formulating the content of the Project. Based on the result of the study, the R/D has signed in April 2011.

Objectives of the Project

Super Goal
Maternal and Neonatal Health (MNH) status in Upper West Region is improved.

Overall Goal
MNH services in Upper West Region are continuously improved.

Project Purpose

Improve MNH services utilising CHPS system in Upper West Region

Outputs

1. Capacity building on MNH services improved
2. Systems for MNH service strengthened
3. Community mobilization and support systems on MNH strengthened

Activities

Activities related to all outputs

• Introducing Good Practice
  • Documentation and dissemination of good practices
  • Conduct study tours
  • Organize forums
  • Create a library package (display materials) for good practice collection
• Coordination to the District Assembly
  • Set platform to discuss between Regional Coordinating Council(RCC), District Assembly (DA), Regional Health Management Team (RHMT) and District Health Management Team (DHMTs)
  • Support planning and implementation of collaborative activities
  • Support monitoring of the collaborative activities
• Baseline survey
  • Prepare and conduct baseline survey
  • Report and disseminate the results of the baseline survey
• End line survey
  • Prepare and conduct end-line survey
  • Report and disseminate the results of the end-line survey

Activities for Output 1:
Capacity building on MNH services improved

1.1.	Train Community Health Nurse (CHNs) as CHOs
1.1.1.	Conduct CHO fresher training
1.2.	Training CHOs on ANC, emergency deliveries, and PNC and newborn care
1.2.1.	Train CHOs in CHPS on focus ANC, protocols and standards
1.2.2.	Develop project specific checklist on ANC
1.2.3.	Establish birth preparedness plan for ANC clients
1.2.4.	Train CHO in emergency delivery skills and newborn care
1.2.5.	Train CHO in PNC
1.3.	Train Sub-district Health Team (SDHT) personnel on skilled delivery and newborn care
1.3.1.	Train midwives of SDHT on safe motherhood
1.3.2.	Train CHOs of CHNs in SDHT where there are no midwives on safe delivery
1.4.	Increase availability of some Basic Emergency Obstetric and Neonatal Care (BEmONC) equipment at SDHT
1.4.1.	Procure basic MNH equipment for SDHT
1.4.2.	Provide equipment for safe motherhood training

Activities for Output 2:
Systems for MNH service strengthened

2.1.	Strengthen referral and feedback
2.1.1.	Improve utilisation of referral register and referral formats
2.1.2.	Improve referral feedback of sick mothers and children
2.1.3.	Improve capacity of health facilities in referral feedback after delivery
2.1.4.	Strengthen function of referral coordinators
2.2.	Strengthen Facilitative Supervision (FSV)
2.2.1.	Capacity building on FSV Performance standard
2.2.2.	Modification of FSV monitoring tools, guidelines and manuals
2.2.3.	Capacity building on the revised FSV monitoring tools, guidelines and manuals
2.2.4.	Develop new database for revised FSV
2.2.5.	Strengthen utilisation of results of FSV
2.3.	Strengthen Maternal, Neonatal, Death Audit (MNDA)
2.3.1.	Facilitate MNDA related data dissemination
2.3.2.	Strengthen MNH service improvement using MNDA information

Activities for output 3:
Community mobilization and support systems on MNH strengthened

3.1.	Train CHOs on community mobilization
3.1.1.	Train CHOs/CHNs on promotion of CHAP
3.1.2.	Train CHOs/CHNs on facilitation of Community Health Management Committee (CHMCs) and Community Health Volunteer (CHVs) activity
3.1.3.	Train CHOs/CHNs on improvement access to health service
3.2.	Train CHOs on Communication for Development
3.2.1.	Develop IEC (C4D, Communication for Development) materials
3.2.2.	Train CHO/CHN on the promotion of MNH services utilising the IEC (C4D) materials

Inputs

The Japanese Side

• Experts
  Chief Advisor; MCH; Referral; FSV; Community Health Planning; IEC; Project Coordinator; Health Information; and others
• Equipment
  Medical equipment; vehicles; IEC equipment; office equipment; and training equipment
• Budget of operation

The Ghanaian Side

• Ghanaian Counterparts
  Regional health directorate; District health directorate; Sub district health teams; Community Health Officers; and regional and district hospitals
• Office Space
• Budget for operation