Bridging the gap between evidence-based innovation and national health-sector reform in Ghana

Abstract

Although experimental trials often identify optimal strategies for improving community health, transferring operational innovation from well-funded research programs to resource-constrained settings often languishes. Because research initiatives are based in institutions equipped with unique resources and staff capabilities, results are often dismissed by decisionmakers as irrelevant to large-scale operations and national health policy. This article describes an initiative undertaken in Nkwanta District, Ghana, focusing on this problem. The Nkwanta District initiative is a critical link between the experimental study conducted in Navrongo, Ghana, and a national effort to scale up the innovations developed in that study. A 2002 Nkwanta district-level survey provides the basis for assessing the likelihood that the Navrongo model is replicable elsewhere in Ghana. The effect of community-based health planning and services exposure on family planning and safe-motherhood indicators supports the hypothesis that the Navrongo model is transferable to impoverished rural settings elsewhere. This finding confirms the need for strategies to bridge the gap between Navrongo evidence-based innovation and national health-sector reform.

The relationship between antenatal provider type and maternal care in rural Ghana: a cross‐sectional study

“…The negative association between increased wealth and education and maternal report of CHO antenatal providers supports other studies that have found this decade‐old mid‐level workforce to be successful in reaching the clientele for which their provider type was designed: poor, rural women (Awoonor‐Williams et al . ; Binka et al . ).…”

“…Our findings are supported by studies linking community‐based providers in Ghana and other low‐ and middle‐income countries to increased maternal services and reductions in child mortality (Awoonor‐Williams et al . ; Binka et al . ; Lassi et al .…”

“…Structural barriers to care, such as availability, affordability, and accessibility to diagnostics and therapeutics, are fundamental to a health worker's ability to provide quality care (WHO , Awoonor‐Williams et al . , Agyepong ). Another possible explanation for the lack of difference in maternal report of IPT and receipt of HIV test results may be acceptability of provider type.…”

The Long‐Term Fertility Impact of the Navrongo Project in Northern Ghana

“…Indeed, when early results were disseminated at a national conference in 1998, policy deliberations focused on developing mechanisms for scaling up operations. A series of replication studies were subsequently launched in other districts, generating evidence that the experimental strategies could work in settings that lacked Navrongo Health Research Centre research resources and scientific leadership capabilities (Awoonor-Williams et al 2004;Nyonator et al 2005; Awoonor-Williams, Vaughan-Smith, and Phillips 2010). In 2000, the government of Ghana launched a national policy for fostering the scale-up of the Navrongo experiment (Nyonator et al 2007).…”

Lessons learned from scaling up a community-based health program in the Upper East Region of northern Ghana

“…In response, the GHS sponsored additional replication projects so that each region of Ghana would have learning localities where CHPS could be implemented using the Nkwanta scaling-up strategy. In each replication district, the community-based care model increased contraceptive prevalence, participation in antenatal and postnatal care, and childhood immunization coverage 34 , 36 …”