The Health Vision of the U.S. Agency for International Development:
Health Status Improved.
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Program Overview | Success
Stories
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USAID is one of the largest health donors in the provision of quality health in Ghana and a major contributor to HIV/AIDS prevention and control, reproductive health, and child survival programs. In 2002, USAID made available nearly $19 million to increase access and provide improved health care through various activities in the country.
USAID's Improved Family Health Program contributed to an increase in contraception use and improvement in child health in 2002. The use of modern family planning methods has increased by 13%, exceeding the target for the year by 50%. This has been achieved by increasing access to quality family planning services through public and private sector facilities, and community-based distribution, especially in rural, under-served areas.
"Life Choices", a USAID-supported family planning awareness campaign focused on supporting community level activities and ensuring that appropriate messages reach the remotest communities. These public meetings enabled community members to discuss, pose questions, share ideas and seek clarification on family planning issues. The grassroots activities have contributed immensely to the reduction of misconceptions about family planning and HIV/AIDS transmission.
Another program that has enhanced family
planning in the country was the training of 556 nurses nationwide in family planning counseling. This has improved the quality of service that clients received from service providers and has also influenced the increase in the use of contraceptives in the country. Similarly, the training of 65 nurses in Norplant insertion had a significant impact on the acceptor rate, quality of service and number of sites providing such services. Norplant is a new birth spacing method. It is a long acting contraceptive that is inserted into a woman's arm surgically, and lasts for up to 5 years. But whenever the woman wants to get pregnant, it can be taken out. Over 10,000 women chose Norplant as their method of contraception, registering a 360% increase since 1999. With the sharp rise in the use of modern contraceptives, it has been suggested that donors increase spending on contraceptives.
USAID continued its support for the Community-based Health Planning and Services (CHPS) initiative to increase community participation and access to health care. The initiative supports communities and health authorities to fully own and drive the program. CHPS grew significantly this year with 96 out of the 110 districts beginning the process. Leaders of communities and civil society organizations as well as health workers at the grassroots in all the ten regions of the country have been trained in skills to enhance their capacity to mobilize communities to participate in health care delivery.
Under the CHPS initiative, USAID also funded the acquisition and installation of Motorola radio equipment in five CHPS districts to test the feasibility of adopting radios for all CHPS zones. The equipment is reported to be the most significant input for the smooth management of health care delivery at the grassroots. With this support, community health workers can now easily communicate with the district hospital, sub-district health center and other community health workers on health issues to improve the quality and efficiency of their services, reduce costs and save lives. USAID/Ghana's inputs such as communication equipment, training and other benefits contribute to health officers' motivation to serve in remote areas, and will help to sustain the program.
USAID has expanded its HIV/AIDS activities beyond prevention and control to cover care and support for people living with the disease. In 2002, Ghana launched a national compassion campaign for people living with HIV/AIDS (PLWA) with support from USAID. Christian and Moslem groups came together to launch it and will jointly conduct the campaign. Over 900 religious leaders nationwide will be trained for the program. At the launch in December 2002, the religious leaders presented a communiqué to Ghana's Vice-President outlining their commitment to initiate care for PLWAs and support the campaign activities.
The Health Program also extended its HIV/AIDS high-risk program to cover all the country's security services - Armed Forces, Customs, Immigration, Police, Prisons, and Fire. In addition, the first voluntary counseling and testing center was opened at the Police Hospital in Accra to serve the security services. USAID supported the training of counselors for the center to enable them effectively counsel clients on HIV transmission and its prevention, and to change from unsafe to safer sexual practices. Apart from this, USAID-supported workplace HIV/AIDS programs continued to expand over the period. Seventeen private companies were implementing the program and 16 mining companies were ready to start, with co-funding from the country's Chamber of Mines.
The HIV/AIDS high-risk group program for commercial vehicle drivers was extended from 20 to 24 transport centers using 550 peer educators. The peer educators used films produced on "Drive Protected" and sexually transmitted infections to educate over 10,000 people on HIV/AIDS. A serial radio drama is being produced to be played on local radio stations, at the transport centers and in buses.
Anti-retroviral treatment of HIV/AIDS is being initiated for employees of private sector companies such as Ashanti Goldfields, Coca-Cola, and Ghana Breweries. Ghana's Ministry of Health and Ghana AIDS Commission, with USAID support and co-financing by the Royal Netherlands Embassy, are exploring the initiative. In the public sector, USAID is assisting with anti-retroviral medication procurement for 200 patients at two sites. Services such as voluntary counseling and testing, prevention of mother to child transmission, and clinical management of HIV related conditions will be available under the USAID funded program.
USAID contributed to a successful Vitamin A supplementation campaign that helped in the formulation of a national strategy that integrated Vitamin A into routine child health services. Vitamin A supplementation assists children below the age of five years to have good health and reduces the mortality rate in children of that age who are deficient in Vitamin A. As of May 2002, the campaign coverage was 96%, exceeding the expected target of 90%.
Another remarkable project has been the promotion of exclusive breastfeeding. Many mothers in Ghana have adopted exclusive breastfeeding as a result of a USAID program, raising exclusive breastfeeding from 31% in 1998 to 77% in 2001. Health workers in the country benefited from in-service training schemes. As a pre-service capacity building measure, tutors from almost all the medical and paramedical training institutions in the country were trained in infant and young child feeding, management of breastfeeding and essential nutrition to enable them to train future health care providers with the requisite skills and knowledge.
The Mission also supported the development of guidelines for the management of childhood illnesses and has assisted in the expansion of the Integrated Management of Childhood Illnesses (IMCI) program from four to 18 districts. In addition, health workers have been trained to facilitate the dissemination of the guidelines on how to manage common childhood conditions of sick children at the household and community levels. To reach Ghanaian families nationwide with the messages, a radio drama series and magazine were also launched. The series, known as "He, Ha, Ho" (Healthier Happier Homes), were broadcast in six main local languages to enable listeners to clearly understand and follow the discussions in their local languages.
 s | USAID established a public-private partnership to market insecticide-treated-bed nets to reduce malaria-related sicknesses and death. These nets are being distributed, with a scheme being initiated to target the most vulnerable. The Mission has also provided assistance to step up surveillance for cases of key symptoms of polio infection as Ghana gets close to be certified as polio-free in 2005.
With technical assistance from USAID, communities and workers' associations in the country are gradually, but steadily, establishing sustainable health insurance schemes to provide their members with affordable health care. The number of schemes increased from 47 in 2001 to 200 in 2002. USAID is assisting the schemes in developing managerial, financial, and information systems needed to make the schemes function efficiently and effectively. It is also monitoring the impact of the schemes, identifying obstacles to their success, and suggesting adjustments where necessary. USAID organizes regular workshops for the schemes to share ideas and experiences.
The Health Program has already initiated course adjustments in its program to address critical shortages of health workers, rationalize the exploding interest in mutual health organizations, and pursue options for anti-retroviral treatment. The program has also begun the initial planning for the 2003 Demographic and Health survey to strengthen data for decision-making.
Activities in 2003
USAID's Health Program continued to support Ministry of Health's emphasis on health communication, private sector collaboration, and greater equity in health care access and provision. USAID supported programs in enhancing child health such as polio eradication, strengthening of immunization, improved nutrition, exclusive breastfeeding and vitamin supplementation.
With the rapidly increasing establishment of community-based health insurance schemes, USAID advocated for a nationwide scale-up and provided assistance to the Ministry of Health to coordinate such community initiatives.
The main focus on HIV/AIDS for 2003 was on preventive interventions, including behavior change communication and condom promotion. To create a wider outreach, USAID/Ghana expanded interpersonal communication and peer education activities through faith-based organizations and other private voluntary organizations. Access to voluntary counseling and testing was also expanded, and care as well as treatment programs for PLWA were initiated. The Mission also strengthened its focus on high-risk groups through interventions for commercial sex workers, and expanded the program for the security services, commercial vehicle drivers, and miners.
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