The Ghana Coalition of NGOs in Health (GCNH) is a reputable not for profit Civil Society Organization (CSO) established in 2000 as an umbrella and coordinating body of activities of all registered NGOs/CBOs in the health sector in Ghana. GCNH currently has a membership of over 400 registered local CSOs with regional branches and offices in all 10 regions. Its mission is “to provide public health and safety interventions across the nation through evidence-based advocacy, empowerment of members, innovative programming, organizational development and behavioral change communication”. The objectives of the coalition include:
- Promoting health sector research for sustainable health development in Ghana
- Empowering member organizations to deliver standard public health services in communities
- Providing a forum for NGOs/CBOs in health sector to carry out evidence-based advocacy and campaign for the improvement of quality health for all.
As a coordinating body, all project activities are implemented through its member organizations and the National Secretariat provides technical and supervisory roles to ensure projects are implemented in strict compliance with agreed policies, procedures and guidelines of the donor partners and in line with GCNH’s working documents.
Project 1: SRHR PROJECT BY HRAC
The Human Rights Advocacy Centre (HRAC) in partnership with Coalition of NGO’s in Health and Civil Society Organizations (CSO’s) is working on a project, on Strengthening Civil Society Advocacy and Monitoring on Sexual and Reproductive Health Rights in Ghana; with funding from RFSU – Riksförbundet for Sexual Upplysning (Swedish for Sexuality Education).
The purpose of the project is to work with representation of frontline CSOs on national spaces and to equip them to demand accountability from State institutions responsible for providing meaningful comprehensive reproductive health services in Ghana.
The main objective is to:
- Develop a uniform national Monitoring and Evaluation Tool on SRHR
- Build the capacity of CSOs to integrate the SRHR monitoring and evaluation tool into SRHR programming
- Establish a dialogue with CSOs and government on how CSO can actively participate in national decision-making on government’s SRHR interventions.
Currently consultative meeting have been organized with relevant stakeholders in all the regions to discuss issues concerning collective intervention on Sexual and Reproductive Health Rights (SRHR) and also to develop a reproductive health and rights monitoring evaluation tool for CSO’s in Ghana. Again, to build a picture of current accessibility and availability of SRHR evaluation in each sector and to view the current status of CSOs as a whole and what are some the impacts that they have made so far.
Project 2: SOCIAL MOBILISATION ACTION ON EBOLA PROJECT
The Ebola outbreak in December 2013 in West Africa created a lot of social, public and political leadership challenges which exposed the inadequacies of the health systems of many countries especially those in the Sub-region. The weaknesses in the health systems of countries were very evident in the way the Ebola disease did spread and claimed lives.
Ghana has been identified and used as the centre to EVD response to the affected countries within the West Africa Sub-region and it has been playing its role as a member state of ECOWAS. As part of health system strengthening, Ghana through the Ministry of Health is to also set up an Ebola response centre which has been done
What has been missing is the recognition of Civil Society (CBOs/NGOs) in the response efforts. CSOs apart from its policy review dialogues and engagements, research and evidence generation, have also been noted to be specialized in disaster and relief responses, community mobilization and public education. It is in vein that GCNH received funding from UNAIDS to embark on social mobilisation on Ebola which spans for 6 months (Dec 2015 – June -2016). The project aim at raising awareness in Ebola prone-districts and build the capacities of community leaders and CSOs to undertake peer education in all target districts that shares borders with Ghana’s West African neighbours. It is our aim also to work with the media to educate general public about EVD preparedness and response to reach at least 10 million people.
The project is been implemented in Greater Accra, Eastern, Central and Western region.
Some of the key results/ outcomes of the project;
- Stakeholders who participated in the initial meeting identified their roles in ensuring the success of the project
- Communities and stakeholders showed great enthusiasm about the project and a strong willingness to support the project.
- Citizens are informed and well prepared to respond to symptoms of Ebola
- Negative cultural and traditional beliefs and practices are identified and addressed
- Easy contact tracing is enhanced
- Clarity of Misconceptions
- In all 553 people were educated and 600 Ebola IE&C materials were distributed. Male……. 132
Female ….421 Lessons learnt;
- Very good collaboration and partnership between SRs and the community guarantee success
- Adequate training on the project is important. It ensures quality project implementation Involvement of Traditional and religious leaders in project implementation was beneficial since it offered some of them the opportunity to appreciate the health needs and challenges in the communities.
Project 3: GLOBAL ALLIANCE FOR VACCINES AND IMMUNISATION (GAVI) HEALTH SYSTEM STRENGTHENING (HSS) ROJECT
Supporting civil society participation in Health System Funding Platform (HSFP) falls under Global Alliance for Vaccines and Immunization (GAVI) strategic goal of contributing to strengthening the capacity of Integrated Health Systems (IHS) to deliver immunization by resolving health systems constraints, increase the level of equity in access to services and strengthening Civil Society Engagements in the health sector. Through the GAVI Type B Funding, CSOs played a key role by increasing demand for immunization services in selected 100 most deprived and hard to reach communities in Central and Volta regions which contributed to increasing immunization and RCH coverage in those districts in Ghana
Based on the above achievements, CSOs propose to scale up to 20 districts (2 districts per region) with Penta3 coverage below 70% with 2014-2017 HSS support. This will enable CSOs to contribute to achieving the national EPI goals and GAVI’s strategic goal 2 of “strengthening the capacity of integrated health systems to deliver immunization. This GAVI HSS project is currently being implemented in 9 municipals/districts within six regions; Central, Volta, Greater Accra, Eastern, Ashanti and western regions across Ghana. The districts were selected among the 20 lowest performing districts in terms of the 90% national coverage targets for immunization of children under
- The project beneficiary districts include Nkwanta North, Ho, Akatsi, Hohoe (Volta Region), Gomoa East, Assin North (Central Region), Asokore Mampong (Ashanti region), Sekondi Takoradi (Western Region), La Dade–Kotopon, Ga South (Greater Accra), East Akim (Eastern Region.)
GAVI seeing the tremendous efforts of Civil Society platforms especially in community mobilization and Public Education/ Awareness raising, advocacy and large results produced under the GAVI Type B funding, has further supported the Government of Ghana (GoG) through GHS and Catholic Relief Service (CRS) in engaging the GCNH for another 5 year period (2014 -2018).
- Project Aims and Objectives of the Project:The 5- year project dubbed GAVI-HSS project was initiated by the GCNH through its selected registered member organizations to generally increase immunization coverage in the 20 project districts from the various individual district baseline and overall average coverage baseline of 89% in 2013 to at least 90% by end of 2018.
Women within the reproductive age group and children below 18 months, under 5 years and their Care givers are the primary project target groups. They are being mobilized through the use of the Community Register and were sensitized to access and complete their immunization and RCH Services/ schedules to ensure every infant/ child is vaccinated on schedule in the project area.
Community leadership and identified women, youth and men groups and community volunteers are the secondary target groups. They are being mobilized, sensitized, trained and empowered in community mobilization, advocacy, lobbying, peer education, skills and communication skills for regular, quality immunization and CWC services in their communities to promote child survival and maternal health in target communities. The community Volunteers have been trained as immunization advocates in the project area.
The common activities undertaken in all the 10 beneficiary districts were:
- Held Separate Consultative Meetings with key stakeholders (MM/DHDs, MMDAs
- Conducted Community entry activities to sensitize the community leadership about the GAVI – HSS Project
- Trained Community Volunteers (Champions) and CHNs and officially launched the project in individual districts
- Community Volunteers conducted baseline survey to collect data on children under
1year and 18 months using the Community Register
- Organized a total of 100 Community Durbars and Advocacy Sessions (Awareness creation and sensitization on Immunization)
- Marked the World/Africa Immunization week celebration with Community durbars, public fora and public education on radio stations
- Organized two National press conferences on importance of immunization and the need for a national sustainability plan for EPI.
- Comprehensive technical and financial monitoring.
2.0 SOME KEY PROJECT OUTCOMES/ ACHIEVEMENTS
- Communities that are far from the CHPS compounds have held their CWC services regularly since the inception of the GAVI project due to the monthly monitoring activity as well as facilitating the transportation of some the CHNs to their respective satellite communities.
- Through proper community education programmes held, men have received confidence and empowerment to bring their children for weighing since it is the responsibility of both parents
- The Production of Project T-shirts for the Community Health Committees, Community Health Volunteers and Health Facilities’ Nurses to advertise the project and facilitate Implementation Activities
- Community leadership have been sensitized and trained as advocates for immunization in their communities as well as using their authority for social mobilization to promote immunization among children under 5 years
- Received commitment and full support from the DCE and DHD on the project
2.1 Sampled Success Stories
Success story 1 – East Akim District:
Anyinasin is one of the project communities in the East Akim District with a population of about 4,159. The expected number of children under 5 years expected to be immunized in the year 2015 is 265. Prior to the commencement of this project, community health officers organized child welfare clinics on weekly bases at vantage points within the community and mothers or care givers were expected to bring their children or wards to these selected sites to be immunized.
With the commencement of this project, SSG trained and equipped volunteers with necessary logistics and a community register, where the volunteers are required to enter every household within their community and record information on every child under 5 years into the community register. They are expected to educate community members on the importance of immunization, identify defaulters and encourage them to attend Child Welfare Clinics.
The trained volunteer from the Anyinasin community Mr Otoo, began this exercise on March 1, 2015 and records from the Anyinasin CHPS shows great improvement in CWC attendance as at end of March 2015. In February 2015, the facility recorded a total attendance of 95 and this increased to 137 at end of March 2015.
The Officer in charge at the Anyinasin CHPS, Madam Obedina Ansah attributed the increase in CWC to work of the volunteer and indicated with continuous education, the community will be able to achieve its target for 2015. Audio recording of Obedina Ansah is attached as an Appendix
Success story 2 – Gomoa East District
Gavi project saves the life of little Regina
Regina is 3 year old girl who lives with her mother at Fetteh Kakraba. The mother is jobless whiles Regina’s step father is also a jobless laborer who has given birth to another child who is also 2 years old. Money to take care of these children is extremely difficult. Through the house to house activities of HERO Network trained volunteers at Fetteh Kakraba came across Regina who is seriously malnourished. 3year old Regina cannot walk due to her condition. She is most of the time left in the house alone at the mercy of the weather according to neighbours and has no proper motherly care to change her situation for better. HERO-Network drew the attention of district nutrition officer for necessary intervention to save the life of this poor innocent young girl. The district health directorate through the nutrition officer has donated some nutritious foods to the volunteer to be given to the child. HERO-Network is now taking care of the child under temporary care of our trained volunteer until Regina’s condition improves. The neighbours were very grateful for the intervention of HERO Network to save the life of little Regina because her life was in serious danger.
A photograph of little Regina now under temporal care of HERO Network through our CBHV at Fetteh Kakraba
Success story 3 – Nkwanta North District
- Due to a good collaboration between the District Health Directorate and GLOWA project implementation team, the directorate often offered their Toyota 4-wheel pickup and personal Tundra pickup of the District Accountant (Health) to be used to convey the project team to some of the very-hard-to reach project communities
- One media publication was made in the Daily Graphic (Wednesday 25th March 2015 page 20) on the project with the caption “NGO Launches Immunization Campaign for Nkwanta-North” (Find scanned copy attached)
- The Nkwanta North District Chief Executive Hon. DCE Mr. Kudor Martin for the first time in the history of the District Health Directorate honored and participated actively in the project’s consultative meeting and training program. He pledged to support and complement the efforts of GLOWA to increase Immunization coverage in the entire district programme particularly the 10 least covered communities’ coverage in the district to meet both the district and national set targets. He also promised to put measures in place to remove some of the bottlenecks the CHNs face and ensure uninterrupted CWC outreaches to reduce neonatal and infant mortality and morbidity rates in the district.
- Addressing the difficulty of the project team getting an outboard motor and a boat that would carry the team to the project satellite communities located across the OTI river bank the Hon. DCE at the meeting introduced an opinion leader – Mr. Boateng Adangbe to the Project team and CHNs of Kabonwule CHPS zone to transport the team to Suruku 1 &2 and Teacher-Kope. This was done which has facilitated the monthly CWC outreaches in these communities which before the inception of the project were hardly visited by the CHNs.
GLOWA project team enroot to Suruku 1&2 and Teacher-kope communities along the Volta River in Nkwanta-North District on the Immunization outreach program (28th Feb. 2015)
2.2 Common Best Practices:
Some of the common best practices that run through the activities and reports of the IPs included:
- Team building and partnership with the right NGO is very key to harness efforts to influence key duty bearers positively. IPs partnership with SRs is a good strategy that must be maintained and expanded in future to embrace more like minded NGOs/CBOs/media platforms to achieve project results
- Involvement of the various stakeholders (DHD, EPI Officers, CHNs, chiefs, opinion leaders, community volunteers and MMDAs) at the initial stage of the project
- The use of CHNs and Disease Control Officers as co-facilitators during training workshops, community entry, durbars and other outreach activities
- Holding separate consultative meetings with the key stakeholders such as the community leadership, the District Health Directorate, the District Assembly and the Community Health Nurses
- Introduction of Incentive packages (fuel, stipend, etc.) to motivate community champions (volunteers) and CHNs to work in the areas they previously do not go.
- Development of press statements on the project(samples published in the Ghanaian daily papers) provides more awareness on the project implemented and results to the wider public
- The public sensitization on immunization at K-fm during World/Africa Immunization Week helps to sensitize the communities who are not part of the project.
- Branding and projecting project donor and partners such as GAVI Alliance, Ghana Coalition of NGOs in Health and Ghana Health Service in our project documentations and engagements with the DHMT, DA, communities, and media gave the project high level of importance and credibility. Each project document produced by IPs had the three main partners’ Logo. It also facilitated the Project Implementation Team’s advocacy efforts and achievement of results during the period under review.
- Collaboration with health officers: This facilitated implementation of project activities which led to the achievement of measurable project objectives
- The use of the community information centres for public education and announcements on immunization: SSG developed an agreement between chiefs/ opinion leaders, operators/ owners of information centres and health staff for the use of information centres for public education and announcements at no cost. Previously health officers were charged anytime they use the information centre for either public education or announcement .
- The use of Social Media to Increase Immunization Coverage:
- The Gomoa East District Health Directorate is making good use of social media to help increase immunization coverage. The district disease control officer has created a WhatsApp group for community health nurses in the various health zones. After receiving monthly report on child immunization, the disease control officer analyses the reports into percentage coverage per vaccine per health zone and put them on the WhatsApp platform for observation and comments.
- This platform serve as a challenge to health workers because it offer other community health nurses the opportunity to see their performance and compare it with others to check if they are doing well or not. It also helps the nurses to communicate and share ideas on how to improve performance.
This social media platform help generate a lot of positive comments and innovations at the end of every month and HERO-Network is in full support of this innovation and hope that it will help in the effort to increase immunization coverage within the district and the nation as a whole.