Third Term Project: Upper Manya Krobo District, Eastern Region, Republic of Ghana

From June 2023 to May 2026, SHIONOGI and the Japanese Organization for International Cooperation in Family Planning (JOICFP) implemented a project in Upper Manya Krobo District, Eastern Region, Republic of Ghana, to improve the health of pregnant and postpartum women and children under five.

Through improvements to health facilities, community education and awareness-raising, and stronger systems supporting community health, we worked to improve the quality of maternal, newborn and child health services and establish mechanisms that enable communities to protect the health of mothers and children independently and sustainably.

Located in the West Africa, Ghana is a tropical country with hot and humid whether all year around.

The project site, the Eastern Region has the Lake Volta, and people sometimes need to travel 10 km or more to the opposite side of the lake, which may take two hours in some cases.  

It is also an area where traditional values are firmly in place.

Maternal, Newborn and Child Health Challenges in Upper Manya Krobo District (UMK District)

In parts of Upper Manya Krobo District, residents need to travel long distances to reach a health facility, and access to adequately equipped facilities is limited. Pregnant women and children therefore faced difficulties in obtaining the health services they needed. Water, sanitation and hygiene challenges also made diarrhea one of the threats to children’s health.

Rather than focusing only on infrastructure, we combined facility improvements with community education and awareness-raising, capacity building for health personnel, and support systems involving communities and government authorities.

1. Improving the Quality of Maternal, Newborn and Child Health Services

To enable pregnant and postpartum women and children to use safer, higher-quality health services, we constructed and improved health facilities and provided medical equipment and supplies. We also trained healthcare workers and conducted Mama-Papa Classes, strengthening both facilities and capacity.

Key activities

・Construction of a Maternity Waiting House and maternity wing in Akateng

・Construction of a CHPS compound and nurses' quarters in Sutapong

・Provision of essential medical equipment and supplies

・Establishment of an operational system for the MWH, including workshops and the Operation and Management Handbook

・Capacity building for healthcare workers, including Mama-Papa Class and Client-Friendly Care training

2. Promoting Community Knowledge and Behavior Change

To help community members gain accurate knowledge about maternal and child health and the prevention and management of childhood diarrhea, and put that knowledge into practice, we trained Community Health Volunteers (CHVs) and Over-the-Counter Medicine (OTCM) sellers.

Through home visits and community awareness activities, CHVs shared information on pregnancy and childbirth, postnatal health, family planning, exclusive breastfeeding, handwashing, and diarrhea management. They also referred mothers and children requiring health services to health facilities, helping connect communities with care.

Key activities

・Training for Community Health Volunteers (CHVs) and OTC Medicine Sellers on Community Health Education and Consultation Support

・Maternal and child health education through home visits and community activities

・Development of Educational Materials Based on the Communication Strategy, Including Knowledge on Diarrheal Disease Prevention

・Training on utilization of  Social and Behaviour Change Communication (SBCC) tools and community education activities

・Referral of mothers and children to health facilities

・Mama-Papa Classes conducted by healthcare workers

3. Establishing Sustainable, Community-Led Support Systems for Maternal and Child Health

To help maternal and child health activities continue after project completion, we supported capacity building for Community Health Management Committees (CHMCs), continued community-based health education and referral systems, and promoted income-generating activities. Representatives in each sub-district developed sustainability plans and Communication Action Plans. Community leaders who understand local conditions participated in planning and continued to monitor implementation through regular meetings.

Key activities

・Capacity building for CHMCs, including supportive supervision and income-generating activity training

・Development and implementation of sustainability plans in each sub-district

・Strengthening monitoring and evaluation systems

・Final dissemination workshop involving government authorities, healthcare workers and community stakeholders

Through improvements to the environment supporting maternal and child health services, education and awareness-raising in communities, and locally led systems, the project contributed to changes in the use of health services, community health practices and local implementation structures. The main changes over the three years are presented below with key indicators.

1. Improved Access to Maternal and Child Health Services

Through improvements to health facilities and accommodation for healthcare workers, together with training for healthcare workers, we worked to improve the quality of maternal and child health services and the environment in which they are used. Improvements were observed in several indicators, including births attended by skilled health personnel and use of family planning services.

*The figure exceeds 100% because service users from outside the project area are included.

2. Increased Community Knowledge and Behavior Change

Through continuous awareness-raising by CHVs and OTCM sellers, community knowledge of maternal and child health and childhood diarrhea improved. Changes were also observed in handwashing, exclusive breastfeeding, and referrals of mothers and children who needed health services.

3. Established Community-Led Systems for Health Activities

Community health activities and the delivery system for maternal and child health services were integrated into local government systems. By establishing arrangements for assigning responsible personnel and securing the necessary resources, a foundation was established for communities to sustain and further develop their own health activities.

Pick UP

Ghana’s First Maternity Waiting House and the Development of an Operating Model in Akateng

The project established Ghana’s first Maternity Waiting House (MWH). The MWH provides a safe and supportive environment where pregnant women approaching delivery can stay near a health facility and prepare for childbirth with peace of mind. It is also utilized as a space for learning and consultation on maternal and child health.

We also developed a handbook setting out how to operate and manage the MWH. The District Health Administration, healthcare workers and community members participated in the development process, which included multiple rounds of discussion and revision. Going beyond construction, the project translated local experience and evidence into an operating model for the MWH.

The project contributed to changes not only for pregnant women and families using maternal and child health services, but also for healthcare workers providing services, CHVs working in communities, and CHMC members serving as community leaders. The following are voices from people involved in the project.