Developing Ministry Capacity and Partnerships for Sustainability and Scale

1. Developing Ministry Capacity and Partnerships
for Sustainability and Scale
-thecaseofUSAIDfundedMaternalandChildSurvivalProjectinRuralGhana
Mohammed Ali, Health Program Manager – CRS Ghana
CORE Group Meeting – Portland USA
May 18, 2016

2. Introduction
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• Project Title: EPPICS, USAID
funded
• Goal: Contribute to
reduction in maternal/child
mortality
• Partner: Ghana Health
Services
• Location: East Mamprusi
district
• Target: 51,000 direct
beneficiaries
East
Mamprusi

3. The Problem Analysis
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Baseline MCH Indicators
EM, NR and National- 2010/11
East
Mamprusi
Northern
Region
Ghana
Antenatal
visits (1st
trimester)
30 49 55
Antenatal
visits(4+)
46 58 78
Supervised
deliveries
43 38 46
IPT2+
51 33 44
ITN use 36 45
Institutional
MMR
275 95 68
Under 5
Mortality
Rate
138 137 80
Poor uptake of MCH
services → High morbidity
and mortality
Low Government capacity
→poor service delivery
Poor community
engagement→ low
patronage of services

4. How did we partner with MoH?
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5. Partnerships
 CRS maintains partnership at multiple level with the Government
- National, Regional, Districts --- across varied sectors
 Key for pooling resources to facilitate cost effectiveness
 Revolves around defined roles and responsibilities
 Build on mutual trust, respect for each other and long term
relationships
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6. EPPICS Partnership Framework
.
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Project success
and sustainabilitySUPPORTIVE
Technical, Resources,
Funds etc
ACCOMPANIMENT
Implementation
&MEAL
Promising strategies
for scale-up
COLLABORATIVE
Joint Assessment &Consultations
for Project Design

7. EPPICS Partnership Framework –cont.
1. Collaborative- consultative - (assessments/design)
a) Identify core, immediate and underlying causes
b) Formulate goals and strategies
2. Supportive/Facilitative - Technical, Resources
funds/logistics)
a) Training of Trainers – stepdown for CHOs &CBAs,
MEAL/IQAT
b) Fuel, motorbikes, tools including equipment
3. Accompaniment (Implementation & MEAL)
a) Joint implementation with GHS as lead
b) Joint monitoring and evaluation
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8. Facilitators in partnering with MoH
 Trust/relationship built over time
 Track record cultivated over time
 Shared goal/objectives including theory of change
 Technical capacity- CP, Regional and HQ
 Appreciate roles/responsibilities – including strengths and
weaknesses
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9. Key Outcomes
 38% increase in exclusive breastfeeding
 43% increase in adoption of improved feeding practices
 60% increase in skilled assisted deliveries
 97% increase in post-natal visit within 2 days of delivery
 130% increase in Essential Newborn Care
 109% reduction in institutional maternal mortality
 131% reduction in institutional infant mortality rate
 80% reduction in neonatal mortality rate
 37% improvement in quality antenatal care
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10. Impact: Mortality based Indicators from 2010 - 2015
• .
10
295
131
76
47
57
51
62
44
25
19
13 13
7 8 5 5 4 3
2010 2011 2012 2013 2014 2015
Figure 1: Indicators of Mortality in East Mamprusi District (2010 -
2015)
Institutional Maternal Mortality Rate Infant Mortality Rate Neonatal Mortality Rate

11. Mechanisms for sustainability and scale
Sustainability
 MoH led- right from the design stage
 Transfer of knowledge and skills – ripple effect
 Existing Systems and structures strengthened
 Tools and guidelines developed to guide replication
scale
 Already scaled up into five additional districts
 MoH sourcing funds to replicate in 5/10 regions of
Ghana
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12. Challenges to Partnerships
 Health worker attrition- transfers
 Delayed Government subventions
 Many partners - one Government (Push – Pull
factors)
 Late submission of activity and financial reports
 Clash of values – Artificial contraceptives
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13. Conclusions
 In resource poor settings, partnership is key to achieving results
 Public private collaboration is needed to enhance achieving the
objectives of community-based maternal and child health
interventions
 Pooling resources and working together is the surest way of making
difference in interventions
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14. .
Funding for this project was made possible by
USAID
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15. THANK YOU