Accelerating reproductive and child health programme impact with community-based services: the Navrongo experiment in Ghana

Family Planning: Program Effects

“…Studying child survival, two experiments find that family planning programs are associated with substantial reductions in child mortality under the age of five (decreases between 30% and 50%) (Joshi and Schultz, 2007, Joshi and Schultz, 2013, Phillips et al, 2006. However, we emphasize that these programs bundled family planning services together with other health services -and in particular, ones targeting infant and child health, making it difficult to isolate the contribution of family planning services per se.…”

“…Although balance across arms was not achieved, treatment arms combining family planning service training and community outreach were associated with a 15% reduction in the total fertility rate among married women (Debpuur et al, 2002). Effects on parity progression persisted for 15 years (and have largely been attributed to the promotion of contraceptive use through community organizations) but have declined over time (Phillips et al, 2006, Phillips et al, 2012. Two other experiments integrated family planning services into existing programs: a microcredit program in Ethiopia (Desai and Tarozzi, 2011) and an HIV treatment program in Kenya (Kosgei et al, 2011).…”

“…Evidence on the direct relationship between family planning 33 Some research suggests that much of the reduction in child mortality in both Bangladesh and Ghana may have been due to child health and vaccinations programs (Koenig et al, 1990, Phillips et al, 2006. 34 As with maternal anthropometrics, mortality effects of family planning may bias anthropometric estimates downwards if marginal survivors are weaker (or have lower anthropometric indicators) than the average child.…”

“…The Navrongo experiment in Ghana studied 37 communities randomized across four treatment arms (Binka et al, 1995, Phillips et al, 2006. Although balance across arms was not achieved, treatment arms combining family planning service training and community outreach were associated with a 15% reduction in the total fertility rate among married women (Debpuur et al, 2002).…”

National level maternal health decisions : towards an understanding of health policy agenda setting and formulation in Ghana

“…For example, generating political will for safe motherhood in Indonesia (Shiffman, 2003), the state of political priority for safe motherhood in Nigeria (Shiffman and Okonofua, 2007), the emergence of political priority for safe motherhood in Honduras (Shiffman et al, 2004), and actors practise of power in a South African community health programme (Lehmann and Gilson, 2013). Most empirical research on maternal health in Ghana and other LMICs (Travis et al, 2004, Borghi et al, 2006, Adam et al, 2005, Gupta et al, 2011, Asamoah et al, 2011, Phillips et al, December 2006, Witter et al, 2009) focused more on implementation challenges such as scarcity of resources, shortage of skilled health personal, inadequate quality of care, and recommendations of potential policies that should improve maternal health, and less on how the implemented policies came onto the national agenda and formulated. Studying how those implemented policies were put on the agenda and formulated may give additional insights into why the policies face several implementation challenges.…”