Outline of the Project

Project Name

Project for Improving Continuum of Care for Mothers and Children through the introduction of Combined MCH Record Book

Subject

Health

Country

Ghana

Date R/D Signed

Oct. 27, 2017

Project Site

Nationwide

Term of Cooperation

April 10, 2018 to January 8, 2022

Implementing Organization

Ghana Health Service

Background

The Maternal and Child Health Record Book (MCH Record Book) is a home-based health record of mothers, newborns and children which contains essential information to promote and maintain their health and their family's health. The book aims to promote Maternal, Newborn and Child Health (MNCH) through the Continuum of Care (CoC). CoC refers to continuity of individual care on time from pregnancy to childhood and between service delivery points. Evidence from various sources shows that improved continuum of key packages of interventions for MNCH is the pathway to reduce maternal and neonatal mortality and morbidity. For example, an evidence presented by Ensure Mothers and Babies Regular Access to Care (EMBRACE) Implementation Research Project which showed increased completion of all the CoC after introduction of CoC Card and CoC orientation for health workers was incorporated into the development of Record Book.

The new combined book intends to address a current gap in uptake of care between delivery and postnatal care in the country and encourage completion of all the components of CoC. It was also developed with strong focus for mothers and other family members to enhance understanding of the CoC services as well as important health and nutrition information.

The Ministry of Health and the Ghana Health Service have developed the Integrated "Maternal and Child Health Record Book" with technical and financial support from Japan International Cooperation Agency (JICA). The work to develop the book started in early 2016 followed by a pretest of the draft book, and a pilot test was carried out in three regions (Upper West, Ashanti and Central) in 2017 to assess the effective utilization of the book in all the different service delivery points. The book was launched for national distribution on March 2018.

The Overall Goal

More women and children complete Continuum of Care (CoC)

Project Purpose

More women and children utilize quality MCH services.

Output

1. MCH RB is developed and rolled out to nationwide
2. Capacity of effective utilization of MCH RB is strengthened among health workers and mothers.
3. MCH RB is institutionalized and integrated into routine services for sustainability.

Project Activities

For project management:

0-1.	Collect and compile baseline/end line data
0-2.	Monitor the progress of the project periodically
0-3.	Share the results of monitoring with MoH and modify the project approach when necessary
0-4.	Compile evaluation report reviewed by MoH

For output 1

1-1.	Develop MCH RB and authorize it as national standard Home based record
1-2.	Conduct pilot test and evaluate results
1-3.	Develop procurement plan for national rollout
1-4.	Develop User Guide and training materials
1-5.	National facilitators train regional facilitators (ToT)
1-6.	Regional facilitators train district facilitators (ToT) and conduct monitoring and follow ups in 10 regions
1-7.	Regional facilitators train health workers at regional hospitals and teaching hospitals and conduct follow ups
1-8.	Regional facilitators conduct sensitization in 10 regions
1-9.	District facilitators conduct district sensitization at six focused districts
1-10.	District facilitators train health workers at six districts and conduct follow ups
1-11.	Print and distribute MCH RB
1-12.	Procure equipment for MCH RB for one region
1-13.	Conduct media campaigns of MCH RB for advocacy

For Output 2

2-1.	Conduct rapid assessment of target districts before and after the training
2-2.	Develop training materials on nutrition clinic, client-centered services and BCC as standard
2-3.	Develop BCC materials for health workers and mothers
2-4.	National facilitators train regional and district facilitators (ToT)
2-5.	District facilitators train health workers in six districts
2-6.	District health workers conduct sensitization at six districts
2-7.	Health workers provide services of nutrition clinic, client-centered and BCC for mothers
2-8.	Conduct monitoring at selected health facilities with coaching approach
2-9.	Conduct national MCH RB review at Annual Performance Review

For Output 3

3-1.	Appoint MCH RB focal persons at GHS and regional levels
3-2.	GHS promotes CoC completion rate, distribution and retention rate of MCH RB to be monitored with District Health Information Management System II (DHMIS II)
3-3.	Develop Management Guide
3-4.	Conduct seminar on MCH policy
3-5.	Support development of national Mid-term Procurement Plan of MCH RB
3-6.	Identify most suitable existing mechanism for stakeholder coordination
3-7.	GHS advocates MOH on the use of RB in all health facilities including teaching hospitals, CHAG, and private hospitals and facilities
3-8.	MOH and GHS promote the training on MCH RB to be integrated into the pre-service training programs for health worker
3-9.	Promote effective collaboration with NHIA, MoE, DAs and others to ensure sustainability
3-10.	Participate in international/regional conferences to share experiences

Inputs
[Japanese side]

1. Experts(tentative):
   - Chief Advisor (Short-term based)
   - Maternal and Child Health
   - Nutrition
   - Community Health
   - Project Coordinator
   - Other Short-term experts as required
2. Printing and distribution cost for MCH RB
3. Participation in international/regional conferences etc.
4. Machinery and Equipment:
   - Equipment for MCH RB training
   - Vehicles
   - Office equipment
5. Running expenses

Inputs
[Ghanaian side]

1. Assignment of Counterparts
   - MOH, GHS
2. Printing and distribution cost for MCH RB
3. Arrangement of the office spaces and utility cost for the Project offices
4. Running expenses