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RH STRATEGIC PLAN

RH STRATEGIC PLAN. Dr P. K. Aboagye. Rationale. Ghana’s revised population policy was first developed in the early 1990’s RH service Policy and Standards 1996, A revised 2nd edition was published in 2003.

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RH STRATEGIC PLAN

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  1. RH STRATEGIC PLAN Dr P. K. Aboagye

  2. Rationale • Ghana’s revised population policy was first developed in the early 1990’s • RH service Policy and Standards 1996, • A revised 2nd edition was published in 2003. • Gap between statements and documents on national RH and population policies and implementation plans • National strategic direction in RH services not clear

  3. SITUATION ANALYSIS

  4. Trends in Antenatal Care Coverage (at least one)

  5. Utilisation of services ANC

  6. Utilisation of services Supervised Delivery

  7. Utilisation of services Postnatal

  8. Fig… Regional distribution of TBA deliveries, N Upper East – 27% Upper West 44% KEY Northern - 50% > 40% 30-39% 20-29% < 20% Volta Brong Ahafo – 25% 4.5% Ashanti – 26.7% Eastern – 50% Western 9.7% 35.8% Central Greater Accra 32.7% 2 0 0 0 2 0 6 0 0 M i l e s

  9. TFR and use of any and modern contraceptive methods, Ghana 1988-2003

  10. Unmet Need for FP Unmet need refers to women who do not want to get pregnant for the next two to three years (spacing) or women who do not want to have any more children (limiting) but are not using any method. Unmet need is 34% higher in Rural area

  11. WHAT IS GHANA’S MMR? • National Sisterhood Survey (1993): 214/100,000 • WHO/Hill Estimates (1995): 586/100,000 • UNICEF Estimates (1996): 740/100,000 • WHO/UNICEF/UNFPA(2000): 540/100,000 (140-1000) • Health Institutions 2005: 196/100,000

  12. Trend in Institutional MMR:GHANA 1998-2004

  13. CAUSES OF MATERNAL DEATH

  14. Regional Trends of Institutional Maternal Mortality in Ghana 1999-2005

  15. Trends in Ghana’s childhood mortality ratesfor the five year periods preceding the DHS:CMR (12 – 59 months), Post-NMR (1 – 11 months) and NMR (< 1 month)Source: 1988, 1993, 1998 and 2003 DHS

  16. NEONATAL & INFANT MORTALITY RATES BY REGIONS

  17. MAJOR CAUSES OF NEWBORN DEATHS

  18. Situation Analysis • Reproductive health indices suggest that Ghana has made substantial progress in the priority areas of reproductive health. • Levels of awareness of both modern, and any, contraceptive methods is almost universal. • The desire to limit the number of children and to increase the time period between births has both increased. • Prenatal care services are very well attended. • The substantial majority of infants are breastfed for some period of time, and most infants are breastfed within the first hours of birth. • A majority of infants receive their first vaccinations during the neonatal period, and the majority are adherent to a full program of vaccination, leading to immunization status.

  19. Situation Analysis • knowledge of modern family planning methods is very widespread • A large unmet need for family planning services. • slowing of the pace of decline in the total fertility rate • urban and rural differences in fertility demonstrate marked differences. • Skilled attendance at childbirth and facility-based delivery is not available to all citizens in all regions. • The maternal mortality rate remains high; • The pace of decline in the infant mortality rate has slowed overall; neonatal mortality represents a substantial proportion (nearly two-thirds) of these deaths. Mortality rates are considerably and consistently higher in rural areas.

  20. PURPOSE OF STRATEGIC PLAN • To provide the framework for a programme of action and defines and clarifies the national strategic direction in RH services and activities for the next five years. • To bridge the gap between statements and documents on national reproductive health (RH) and population policies on the one hand, and implementation plans at the operational level • To serve as an reference document for RH service providers, collaborative public and private sector stakeholders, and interested community members. • Accelerate Ghana’s progress towards achieving the MDG’s

  21. Strategic Objective 1:Reduce maternal morbidity and mortality • Intermediate Objectives • 1a:Improve access to comprehensive and basic essential obstetric care • 1b: Improve the capacity of family and community members in home-based life-saving skills • 1c: Increase the proportion of deliveries conducted by skilled attendants • 1d: Increase ANC and PNC coverage, content and quality of services • 1e: Ensure the availability of comprehensive abortion care services as permitted by law

  22. Strategic Objective 2: Reduce neonatal morbidity and mortality • Intermediate Objectives • 2a:Increase knowledge of family and community members concerning care of the neonate, recognition of danger signs, and early care seeking • 2b: Increase capacity of neonatal care providers to implement appropriate measures for neonatal resuscitation • 2c: Increase the capacity of the service provider to manage the sick child and neonatal complications • 2d: Promote early initiation and continuation of exclusive breast feeding, and infant nutrition • 2e: Promote appropriate infant feeding for children with special needs • 2f: Promote the initiation of and adherence to a program of infant immunization and growth promotion

  23. Strategic Objective 3: Enhance and promote reproductive health • Intermediate Objectives • 3a: Reduce the incidence and improve management of reproductive tract infections including STI/HIV/AIDS including PMTCT of HIV • 3b: Promote and enhance sexual and reproductive health knowledge and healthy sexual and reproductive health behaviours for adolescents and vulnerable groups and communities • 3c: Ensure the availability of services for assessment, screening, and management of conditions related to the reproductive system • 3d: Reduce the incidence and manage the effects of harmful traditional practices that relate to reproductive health • 3e: Promote sensitivity to adolescent and gender issues within reproductive health

  24. Strategic Objective 4: Increase contraceptive prevalence through promotion of access to, and quality of family planning services • Intermediate Objectives • 4a: Promote and enhance knowledge and use of modern family planning methods by community members. • 4b: Develop and expand the cadres of family planning service providers • 4c: Ensure access to and availability of the full range of quality family planning commodities and services

  25. Strategic Objective 5: Develop and implement cross-cutting measures to ensure access and quality of reproductive health services Intermediate Objectives • 5a: Sustain and expand a program of continuous performance and quality improvement activities • 5b: Ensure intra- and inter-sectoral coordination and collaboration at all levels • 5c: Promote collaboration between the public and private sector institutions and service providers • 5d: Reinforce management and health information systems pertaining to RH services within an integrated health information management system

  26. Strategic Objective 5 (cont’d): Develop and implement cross-cutting measures to ensure access and quality of reproductive health services • Intermediate Objectives • 5e: Promote the appropriate legal environment to support RH services • 5f: Develop and implement policies and practices that enhance access to quality RH services for all sectors of the population • 5g: Develop a reproductive health research agenda

  27. Strategic Objective 6: Enhance and promote community and family activities and values that improve reproductive health Intermediate Objectives • 6a: Promote strategies that enhance a wide range of community activities that promote RH. • 6b: Expand community partnership and resources for RH • 6c: Promote community participation in RH service delivery

  28. Detailed Plans and Costing

  29. THANK U

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