Dr. Patrick Aboagye – Dep. Director RCH Dr. Juliana Ameh ......Dr. Patrick Aboagye – Dep....
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GHANA
Transcript of Dr. Patrick Aboagye – Dep. Director RCH Dr. Juliana Ameh ......Dr. Patrick Aboagye – Dep....
GHANA
Dr. Patrick Aboagye – Dep. Director RCH Dr. Lorna Renner - Paediatric Soceity Dr. Juliana Ameh - Paediatrician Dr. Eric Quarshie - Ob&Gynaecologist Dr. Daniel Yayemain - Child Health Specialist Dr. Ernest Opoku - MNH Specialist
Maternal Care Indicators
82
40
86
58.9
44
89
62.3
44
92
69.4
47
95
78.2
59
96.7
84.7
68.4
0
20
40
60
80
100
120
ANC from health professional, at least one
visit
ANC from health professional, 4 or more visits
Skilled assistance at delivery
Per C
ent
GDHS 1988 GDHS 1993 GDHS 1998 GDHS 2003 GDHS 2008 MICS 2011
PNC for Mother And Child – MICS 2011
88 88
95
72
88 87
72
64
75 77
83 88
91 96
73
87 86
74
66
76 80
83
0
10
20
30
40
50
60
70
80
90
100
Western Central Greater Accra
Volta Eastern AshanN Brong Ahafo
Northern Upper East Upper West Total
Percen
t
PNC for Mother PNC for Newborn
Use of Modern ContracepNves -‐ MICS
13
17
22 21
17 16
22
6
14
21
17
24
29 27
16
26 23
27
13
19 22 23
0
5
10
15
20
25
30
35
40
45
50
Western Central Greater Accra
Volta Eastern AshanN Brong Ahafo
Northern Upper East
Upper West
Total
2008
2011
Neonatal mortalityInfant mortalityUnder-‐5 mortality1983-‐1987 77 1551989-‐1993 41 66 1191994-‐1998 30 57 1081999-‐2003 43 64 1112004-‐2008 30 50 80
4130
4330
7766
57 6450
155
119108 111
80
1983-‐1987 1989-‐1993 1994-‐1998 1999-‐2003 2004-‐2008
Trend in Neonatal, Infant and U5MR
Neonatal mortality Infant mortality Under-‐5 mortality
16
11 10
16 16 15 18 18
22
8
33
0%
5%
10%
15%
20%
25%
30%
35%
8/6/13 7 GHANA EMONC ASSESSMENT 2010
0 5 10 15 20 25 30 35 40
Area Rural Urban
Mothers educa;on No educa;on
Primary Middle/JSS Secondary +
Wealth Quin;les Poorest Richest
33 30
28 36
34
28
35 24
Major Causes of Newborn Deaths
Birth Asphyxia 41%
Neonatal Sepsis 15%
Preterm/LBW 15%
Others 29%
Scaling Up Newborn Health – Policies Na;onal Maternal and Newborn strategies • ReproducNve Health Policy and Standards • Safe motherhood protocols • Under-‐five Child Health Policy • Under-‐five Child Health Strategy • Job-‐aids for maternal and newborn health • InternaNonal Code on MarkeNng of Breastmilk subsNtutes raNfied in Ghana as Breas`eeding PromoNon RegulaNons 2000
Scaling Up Newborn Health – Health Systems
• DecentralizaNon health services • Community Based health planning and services – deployment of CHNs in communiNes
• Free antenatal, delivery and post-‐natal care including free care for newborn up to 3 mths
• Early postnatal visit (48 hrs) • Maternity ProtecNon Law • Free Birth registraNon for all infants
COVERAGE OF INTERVENTIONS Scaling Up Newborn Health –
On-‐going RMNCH IniNaNves
• MDG acceleraNon framework – focusing on SD, FP and EmONC
• Community based newborn care services (acNve in three regions will be scaled up naNonwide by end 2013)
• IMNCI • Ghana Newborn Health Program – Funded by CIFF with support from PATH, in 3 regions
Leadership and governance - Inadequate coordination of activities among different stakeholders
Finance Human resources
Insufficient Human resource Insufficient knowledge/skills among health workers
Commodity security Health service delivery/quality of care
Inadequate health facility infrastructure and equipment
Demand for care (under utilisation of services) Non use of information for decision making
95%
35% 35%
58% 58%
21%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
COMMODITIES: Proportion clinical
primary health centre with no stock-outs of
oxytocin last 6 months
HUMAN RES: Proportion clinical
primary health centre with at least 2
midwives
ACCESS: Proportion pregnant living within
1 hr. of clinical primary health centre offering
24 hrs. delivery
UTILISATION: Proportion of births assisted by a skilled
provider
CONTINUITY: Proportion of live
births delivered by an SBA in a health facility
EFFECTIVE COV: Proportion of all
deliveries in a facility with partial BEOC or
better
90%
43%
30%
21%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
COMMODITIES: % of DH with ambu bags and face masks
HUMAN RES: % availability of midwives with full knowledge of
essential NBC
ACCESS: % district hospitals able to provide BEOC
UTILISATION: % deliveries conducted in facilities capable of
providing at least partial BEOC
62% 64% 63%
47%
27%
20%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
COMMODITIES: Proportion EmONC facilities with safe
blood supply
HUMAN RES: Proportion of EmONC facilities with staff
qualified for anaesthesia and C-Section
ACCESS: Proportion of population living 2 hr. of
EmONC facilities
UTILISATION: Deliveries by C-Sections as proporiton of
deliveiries requirung C-Section
CONTINUITY: Deliveries by C-Sections in 24 Hr. EmONC facilities as proporiton of
deliveiries requirung C-Section
EFFECTIVE COV: Deliveries by C-Sections in 24 Hr. EmONC
facilities practicing maternal death audits as proporiton of
deliveiries requirung C-Section
