Jhpiego - About Us - Where We Work - Ghana Country Profile

Ghana has made major strides on key socioeconomic fronts in recent years, and plays an important role in promoting political and economic stability in the West African region. Ghana is a strong proponent of world peace, ranking seventh among global contributors to United Nations peacekeeping efforts. Many challenges remain, however, in Ghana’s road to a better future. A large proportion of Ghanaians live in extreme poverty, exacerbating the country’s heavy burden of disease. Maternal mortality is among the highest in the world, and infant and under-five mortality rates have increased in recent years. At a prevalence of 3.1%, HIV/AIDS still poses a major threat in Ghana. Malaria is also a problem, accounting for more than 44% of reported outpatient visits and an estimated 22% of under-five mortality.

Since the early 1990s, Jhpiego has collaborated with the Ministry of Health (MOH) and other Ghanaian organizations to help meet these challenges. Jhpiego’s relationship with Ghana began by supporting the MOH in the development of family planning trainers. Since then, Jhpiego has assisted Ghana in developing human capacity in a wide range of technical areas along the the entire facility-to-community continuum. For example, Jhpiego joined forces with the Nurses and Midwives Council (NMC) to strengthen education at all 12 midwifery and nursing schools in Ghana; and assisted the Ghana Health Service (GHS) and NMC in revising Ghana’s nursing education curriculum to include preparation of community health officers to care for the most underserved populations. Jhpiego also brought innovative programming for cervical cancer prevention to Ghana, with funding from the Bill & Melinda Gates Foundation. In addition, to address the problem of HIV in Ghana, Jhpiego joined forces with Ghana’s Family Health Foundation to provide HIV voluntary counseling and testing (VCT) and related services to high-risk, marginalized populations, using innovative outreach strategies. Finally, as a partner of the Malaria Action Coalition (MAC), Jhpiego has provided technical expertise to strengthen Ghanaian capacity to train providers in intermittent preventive treatment of malaria in pregnant women.

Program Highlights

Strengthening Nursing and Midwifery Education and Ghana Health Services

As a key partner in the Quality Health Partners (QHP) program in Ghana, Jhpiego is taking the lead in an exciting initiative aimed at strengthening nursing and midwifery education in the country. Beginning in June 2004 and ending in June 2009, this five-year, USAID-funded program has the mandate to improve health outcomes for Ghanaians, particularly in the areas of reproductive and child health. The QHP team—EngenderHealth, Jhpiego and Abt Associates—provides evidence-based support to the Ministry of Health/Ghana Health Service and a range of private institutions at the national, regional, district and sub-district levels in 30 of Ghana’s most deprived districts. Jhpiego is working closely with the NMC to improve clinical practice by updating the national curricula and conducting regional orientations and technical updates for all cadres of nurses and midwives. These activities cover a range of key technical areas, including maternal and neonatal health, malaria, HIV/AIDS, child health, reproductive health and family planning.

Another key component of Jhpiego’s role in QHP is collaborating with the Ghana Health Service to improve the Human Resource Management System (HRMS) for health professionals in the country. This effort began with a national assessment of the system, led by Jhpiego, to identify priorities and needs. The QHP team is now working with the relevant professional bodies to identify national priorities and strategies for HRMS planning, improve the performance appraisal system and track HRMS activities across regions. The processes and systems developed as part of these activities will be integrated with national HRMS policies and procedures.

ACCESS Ghana: Repositioning Safe Motherhood

ACCESS Ghana, which is funded through the ACCESS Program, builds upon current maternal and neonatal health (MNH) activities being carried out by the QHP program (as described above). Drawing on Jhpiego’s efforts through QHP to improve pre-service education of health care providers, ACCESS Ghana aims to ensure the quality of MNH services in health facilities, as well as improved community awareness of birth preparedness and danger signs, to strengthen the household-to-hospital continuum of care (HHCC). To do this, Jhpiego/ACCESS is working to translate existing national and regional life-saving skills trainings, which are supported by QHP among others, into facility-level interventions in target districts, by:

Developing the capacity of one district-level hospital and two health centers of the Ghana Health Service to “perform to standard” in selected essential emergency obstetrical skills, immediate newborn care and neonatal resuscitation;

Strengthening the skills of clinicians in the hospital and health centers, who will serve as MNH experts and clinical instructors in their facilities; and

Improving community knowledge of birth preparedness and recognition of danger signs in newborns and their mothers in the target district communities, through coordination with USAID-funded partner organizations, other local nongovernmental organizations, and the District Health Management and Quality Assurance Teams.

The lessons learned from this pilot project will inform efforts to scale up the HHCC model from one district in one region to achieve regional and then national coverage.

Reducing Maternal Mortality and Morbidity

Jhpiego is working with Population Council in Ghana to update tutors in 14 midwifery schools and interns in two medical schools on long-acting (LA) methods of contraception and postabortion care (PAC). The project team will focus on skills that have not been covered in the existing curriculum and, after updating the tutors and interns, will work with the NMC to incorporate the updated content into the curriculum. Jhpiego is also working on an LA method and PAC learning package on CD-ROM, which is highly interactive and does not require any software, as an accompaniment to workshops and coaching efforts. This innovative training approach will allow students to pace their learning and view movie clips of procedures.

Key Accomplishments

Recent highlights resulting from Jhpiego’s work in Ghana include the following:

As part of Jhpiego’s work with the NMC, Jhpiego developed an RH Clinical and Classroom Activity Guide: A Supplement to the Midwifery Curriculum. This has become the standard training resource in Ghana’s nurse/midwifery schools.

As a result of Jhpiego’s efforts in the Ghana Health Service’s Community-Based Health Planning and Services (CHPS) Initiative, about 500 new community health officers graduated in 2005.

Through its cervical cancer prevention demonstration project, Jhpiego trained eight nurse-midwives who were able to screen 17,662 women between 2001 and 2005. Of these, 1,452 received treatment—lives potentially saved. Also, as a result of the project, the MOH officially incorporated cervical cancer prevention into the National Reproductive Health Service Delivery Guidelines, and cervical cancer services have been expanded from Accra to Kumasi.

Through Jhpiego’s work with Family Health Foundation, 24 counselors were trained in VCT and related services. Over a 20-month period, 4,189 clients received VCT services at the Agbogbloshie site, exceeding the life-of-project target of 3,000 by nearly 40%.

Partners and Donors

Jhpiego has a long history of working closely with the MOH in Ghana and NMC in a variety of pre-service education interventions.

As a partner in QHP, Jhpiego is working with EngenderHealth and Abt Associates, as well as Family Health International and Initiatives Inc. QHP, which is funded by USAID, collaborates with MOH/GHS and other counterparts at the national, regional, district and sub-district levels.

Jhpiego’s partners through the ACCESS Program, which is also USAID-funded, include: Save the Children, American College of Nurse-Midwives (ACNM), Academy for Education Development (AED), Constella Futures and Interchurch Medical Assistance.

Jhpiego’s partners through the Population Council in Ghana are Ipas and NMC.

Next Steps

Through QHP, Jhpiego is preparing to:

Move from revising national curricula to updating national procedure manuals,

Improve implementation of HRMS benchmarking across the regions, and

Engage corporations in improving public sector services in Ghana.

As a result of Jhpiego’s pioneering work in cervical cancer prevention in Ghana, the MOH is planning to scale up the program to other regions of the country using its own financial resources and trainers developed by Jhpiego.

Jhpiego also hopes to continue the newly formed partnership with Population Council in Ghana to continue strengthening pre-service education in Ghana.

Country Profile

Ghana

Background

Program Highlights

Strengthening Nursing and Midwifery Education and Ghana Health Services

ACCESS Ghana: Repositioning Safe Motherhood

Reducing Maternal Mortality and Morbidity

Key Accomplishments

Partners and Donors

Next Steps