Carolyn Blake1, Nii Ankonu Annorbah-Sarpei2, Claire Bailey3, Yakubu Ismaila4, Sylvia Deganus5, Samuel Bosomprah4, Francesco Galli6, Sarah Clark7. 1. Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland. Electronic address: carolyn.blake@unibas.ch. 2. Alliance for Reproductive Health Rights, Accra, Ghana. 3. Department of Social Statistics and Demography, University of Southampton, Southampton, UK. 4. School of Public Health, University of Ghana, Legon, Ghana. 5. Ghana Health Service, Accra, Ghana. 6. Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland. 7. School of Public Policy, University College London, London, UK.
Abstract
BACKGROUND: With the limited availability of quality emergency obstetric and newborn care (EmONC) in Ghana, and a lack of dialogue on the issue at district level, the Evidence for Action (E4A) program (2011-2015) initiated a pilot intervention using a social accountability approach in two regions of Ghana. OBJECTIVE: Using scorecards to assess and improve maternal and newborn health services, the intervention study evaluated the effectiveness of engaging multiple, health and non-health sector stakeholders at district level to improve the enabling environment for quality EmONC. METHODS: The quantitative study component comprised two rounds of assessments in 37 health facilities. The qualitative component is based on an independent prospective policy study. RESULTS: Results show a marked growth in a culture of accountability, with heightened levels of community participation, transparency, and improved clarity of lines of accountability among decision-makers. The breadth and type of quality of care improvements were dependent on the strength of community and government engagement in the process, especially in regard to more complex systemic changes. CONCLUSION: Engaging a broad network of stakeholders to support MNH services has great potential if implemented in ways that are context-appropriate and that build around full collaboration with government and civil society stakeholders. Copyright Â
BACKGROUND: With the limited availability of quality emergency obstetric and newborn care (EmONC) in Ghana, and a lack of dialogue on the issue at district level, the Evidence for Action (E4A) program (2011-2015) initiated a pilot intervention using a social accountability approach in two regions of Ghana. OBJECTIVE: Using scorecards to assess and improve maternal and newborn health services, the intervention study evaluated the effectiveness of engaging multiple, health and non-health sector stakeholders at district level to improve the enabling environment for quality EmONC. METHODS: The quantitative study component comprised two rounds of assessments in 37 health facilities. The qualitative component is based on an independent prospective policy study. RESULTS: Results show a marked growth in a culture of accountability, with heightened levels of community participation, transparency, and improved clarity of lines of accountability among decision-makers. The breadth and type of quality of care improvements were dependent on the strength of community and government engagement in the process, especially in regard to more complex systemic changes. CONCLUSION: Engaging a broad network of stakeholders to support MNH services has great potential if implemented in ways that are context-appropriate and that build around full collaboration with government and civil society stakeholders. Copyright Â
Keywords:
Emergency obstetric and neonatal care (EmONC); Evidence for Action (E4A); Ghana; Maternal health; Neonatal health; Quality of care; Scorecards; Social accountability
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