Alliance for Reproductive Health and Rights
Bridging Gaps for Malaria (B4M)
The Western region of Ghana has the second highest prevalence of malaria in children under five across the country. Health system weaknesses include poor organisation at the health facility level, stocks out of essential drugs, and the availability and competence of staff.
This project was designed to directly benefit pregnant women, nursing mothers, women of reproductive age and children under-5 years living the Western region. Although these target groups have some knowledge of malaria, evidence suggests that health access issues are still a barrier to seeing improved malaria outcomes for them overall. Ghana’s 2014 Demographic Health Survey stated that many women of reproductive age have limited knowledge about malaria services, and their rights and responsibilities to accessing these services.
Through education and awareness raising, this project aimed to empower communities to improve prevention and management of malaria; to learn about their health rights, to demand better services and to hold service providers accountable for providing malaria services.
ARHR also worked with partners to advocate for the improved delivery of primary health care services at national level, using malaria as an entry point for this dialogue. By using a community scorecard approach, ARHR aimed to mainstream the use of malaria data for decision making at national and sub-national levels by key stakeholders.
Key successes and learnings
Strengthened community participation and partnerships
This project revived community ownership and participation in health service delivery in the project areas. Community members say they are more likely to contribute to health decision making processes as they have a better understanding of the challenges in service delivery at the primary health care level. For example, in the Apewosika community, community members purchased a refrigerator for the health facility to support the storage of essential drugs and medicines including malaria drugs.
Improved accountability and responsiveness
There is evidence that district health management teams and the local government system are using the results of ARHR’s scorecard assessment to inform decision making. For example, in terms of service delivery, project facilities which did not have some equipment, like ventilation bags and weighing scales, to deliver basic quality care. In Mpohor, the District Assembly provided the district health centre with a bore-hole water system after the assessments revealed this gap was causing sanitation issues.
Improved community knowledge of health rights and responsibilities
Over the project period, about 64,800 pregnant women, other women of reproductive age, mothers of children under five years, men, and adolescents were reached with information on malaria prevention and treatment, health rights, responsibilities, and other government commitments.
Working with other partners on key research
ARHR collaborated with partner organisations to investigate the implementation of the National ‘Test, Treat and Track’ policy in Ghana. ARHR disseminated the findings of this research to national decision makers for review and have continued to advocate for more support for health providers and community members at local level to help the policy rollout. ARHR has also led an inquiry into the use of the District Assembly Common Fund that is meant to be used to supply malaria services at district level.