Community Ownership of Interventions Key for Attaining Health MDGs

The Regional Director of Health Services for Upper East Dr. John Koku Awoonor-Williams has said community participation and ownership of health interventions are crucial for sustaining gains made in maternal and child mortality and other health-related goals of the MDGs.

The Regional Director’s observation comes in the wake of recent unfortunate developments in some communities in the region specifically Bongo District where criminals have targeted health facilities leading to the loss of two Motor-King ambulances provided by the regional health directorate for free transportation of maternal and child health emergencies. The two Motor-King ambulances at Gowrie and Dua Clinics were stolen in February this year. The Ghana Police Service is still investigating the theft.

Dr. Awoonor-Williams who made the comment while addressing participants at the 2014 Annual Health Sector Performance Review in Bolgatanga noted that, it may not be worth it, if after expending a lot of resources in implementing interventions that are saving lives; communities do not take complete ownership of these interventions for the benefit of the population.

The Regional Director was extremely disappointed that the theft will have negative consequences for maternal and child health outcomes in the affected communities. Apparently there are no facility-based ambulances in the entire Upper East region and even if there were any, there are no good roads to drive them hence pregnant women in labour and children under five who need emergency referrals to health facilities have to be carried on bicycles, donkey carts and motorbikes.

The recent introduction of the Sustainable Emergency Referral Care initiative by the Ghana Health Service under the Ghana Essential Health Intervention Program (GEHIP) therefore brought huge relief to communities. But in the face of the present attacks on health facilities, if communities are not able to arrest and expose what seems to be a network of Motor-King ambulance thieves who go for these vital community resources, the lives of pregnant women and children will be put at risk.

Dr. Awoonor-Williams reckoned that the Sustainable Emergency Referral Care initiative is one of the region’s many high-yielding innovations. He mentioned other major innovations and initiatives that have positively affected health care delivery as the Bottleneck Analysis (BNA) Framework Tool, Leadership Development Program (LDP), Newborn Care (NBC), Still Birth Audit, Maternal Death Audit and Conference, Free Family Planning pilot, Schedule Health Commodity Delivery, Knowledge Management, Community-based Management of Acute Malnutrition (CMAN) among others.

Commenting on the region’s performance on key service indicators for the period under review, Dr. Awoonor-Williams said, through a strict implementation of the new malaria policy and other interventions, the region in 2014 made significant progress in reducing caseload of malaria from 45.8% in 2013 to 20.0% in 2014. This contributed to a drop in OPD per capita from 2.0 in 2012 to 1.8 in 2014 and hospital admissions from 81.5/1000 in 2012 to 65.2/1000 in 2014.

Similarly, other important indicators including supervised delivery, postnatal coverage, EPI coverage, and still birth rate have all witnessed significant improvements. He indicated that still births for the period came down from 17.9 in 2012 to 15.7% whiles supervised delivery increased from 68.6% in 2012 to 73.5%. On the other hand, postnatal coverage went from 76.4% in 2012 to 80.5 in 2014 and the rate of HIV prevalence registered a decline from 2.2 to 1.7 for 2012 with many of the ART clinics in the region rated among the best performing in the country.

While commending staff for their hard work, the Regional Director lamented the drop in drug availability at the regional medical stores from 96% in 2012 to less than 40% in 2014, stressing that the unfortunately situation has come about largely as a result of the cycle of indebtedness created by delays in NHIS reimbursements. He appealed to the NHIA for rapid payment of claims, insisting that no health service can function effectively without medicines.

Dr. Awoonor-Williams, further challenged health staff to work hard and improve on other health indicators that recorded downwards trends over the 2014 period under review. Some of the areas he mentioned included; maternal mortality, family planning, TB treatment success rate and malnutrition. On maternal mortality, he said 37 maternal deaths were recorded in 2012. In 2014 however, the number shot up to 47. This situation, he noted was worrying. He however disclosed that recommendations from a recent maternal health conference will be implemented as part of measures to reduce the trend.

The Regional Director said in 2014, a total of 21 people died in the region through outbreaks of notable communicable diseases including CSM (7), Anthrax (5) and Cholera (9). He acknowledged the Public Health Division of the health directorate for a good work on disease surveillance and charged the unit to continue to provide effective surveillance and epidemic preparedness especially against new threats like Ebola.

Dr. Awoonor-Williams dedicated the progress of the health sector in the region to the support of many stakeholders and health partners including UNICEF, UNFPA, WFP, CRS, World Vision, and the Coalition of NGOs in health, the Doris Duke Foundation, Comic Relief, the Red Cross Society of Ghana, and MalariaCare among others.

A special guest of honor at the review, a former Regional Secretary of the then Upper Region and a one-time Director at the Ministry of Health, Dr. Awudu Tinorgah charged the leadership of the health sector in the region to remain committed in utilizing the numerous health innovations in the region to improve the health status of the population.

The performance review forum is a bi-annual event used by the health sector to take stock of performance and chart new ways for improving health indicators. The 2014 regional review for the Upper East was on the theme “Improving Documentation of Best Practices: Key for Attaining MDGs 4, 5 and 6”.