Developing a Culturally Appropriate Family Planning Program for the Navrongo Experiment

Abstract

This article describes the first six months of the strategic planning process to develop a culturally appropriate community health and family planning program for a traditional community in a district of northern Ghana, served by the Navrongo Health Research Centre. To explain the context within which fertility decisions are made, this article describes the district's severe ecological, social, economic, and health constraints to family planning. It discusses related programmatic obstacles and presents the strategies developed to respond to them. A system of care has been developed that is closely coordinated with traditional leaders and communication networks. Management systems support outreach workers by emphasizing the importance of peer leadership, supervisory support, and community liaison in the implementation of village-based services. A large-scale experiment will be fielded to test the demographic impact of this approach.

Who Is Being Served Least by Family Planning Providers? A Study of Modern Contraceptive Use in Ghana, Tanzania and Zimbabwe

“…This reflects social and economic underdevelopment in rural areas relative to urban areas. 25 Some socio-economic indicators were not appropriate for identifying those being served the least. In particular, there was little evidence that a woman's educational level or occupation was associated with modern contraceptive use.…”

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

“…Chiefs, elders and women's groups were involved in discussing practical means of developing leadership of operations to deliver comn n munity health care services. 12 Particular attention was directed to mechanisms for fostering community contribution of labour and materials for constructing the health compounds to which nurses were to be assigned. The mechanics of launchn n ing this programme and listening to its stakeholders generated practical insights into ways of changing programmes from clinicnfocused services to communityn based care.…”

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

“…Research scientists conducted qualitative research to determine the form of social interaction necessary for simplifying health communication and program mobilization processes and for facilitating volunteerism, consensus building, and ideational change. Qualitative research also identified gender issues and possible strategies for addressing them, 22 including how to offset gate-keeping constraints in seeking health care, 23 how to engage the support and participation of men in reproductive health promotional activities that they might otherwise resist, 24 and how to sustain worker accountability for responsible service delivery 17 . Focus group discussions were conducted quarterly to understand health worker and community reactions and to revise and tailor program operations.…”

“…During Phase 1, the project clarified, documented, and translated operational details of mobilizing zurugelu and community health officer activities into practical and culturally appropriate implementation plans 17 . See Box 2 for key lessons learned during the first phase.…”