John Koku Awoonor?Williams|Ayaga A. Bawah|Frank Nyonator|Rofina Asuru|Abraham Oduro|Anthony Ofosu|James F. Phillips
The Ghana essential health interventions program: a plausibility trial of the impact of health systems strengthening on maternal &amp; child survival
Ghana Health Service|Columbia University|Ministry of Health|Ghana Health Service|Navrongo Health Research Centre|Ghana Health Service|Ghana Health Service|Columbia University
abstract background 1990s researchers navrongo health research centre northern ghana developed highly successful community health program keystone navrongo approach deployment nurses termed community health officers village locations trial showed compared areas relying existing services alone approach reduced child mortality half maternal mortality 40 fertility nearly birth total fertility rate 55 five years 2000 government ghana launched national program called communitybased health planning services chps scale navrongo model however chps scaleup slow districts located outside upper east region navrongo experiment first carried paper describes ghana essential health intervention project gehip plausibility trial strategies strengthening chps especially areas maternal newborn health generating political scale program strategies faithful original design description intervention gehip improves chps model 1 extending range quality services newborns 2 training community volunteers conduct world health organization service regimen known integrated management childhood illness imci 3 simplifying collection health management information ensuring use decision making 4 enabling community health nurses manage emergencies particularly obstetric complications refer cases without delay 5 adding 085 per capita annually district budgets marshalling grassroots political commitment financing chps implementation 6 strengthening chps leadership levels system evaluation design gehip impact assessed conducting baseline endline survey research computing heckman difference difference test under5 mortality three intervention districts relative four comparison districts core indicators health status survival rates elucidate results hierarchical child survival hazard models estimated incorporate measures health system strength survival determinants adjusting potentially confounding effects parental household characteristics qualitative systems appraisal procedures used monitor explain gehip implementation innovations constraints progress discussion demonstrating practical means strengthening realworld health system monitoring costs assessing maternal child survival impact gehip expected contribute national health policy planning resource allocation needed accelerate progress millennium development goals