Elements of Family Planning Success

In July 1999, a process was initiated to document the impact of PRIME interventions on access to and the quality of care in Ghana, as part of the Evaluation, Documentation and Dissemination (EDD) initiative of the PRIME Research and Evaluation Unit. The determination of PRIME’s contribution to changes in access and quality of care was done through the identification of the chain of events which have taken place in Ghana with the assistance of PRIME. Using a semi-structured interview technique based on the EDD Impact Interview Guide, key actors involved with PRIME interventions in Ghana were interviewed. Those interviewed were key Government officials, representatives of funding agencies, program managers as well as midwives working in private midwifery homes in Ghana. The PRIME project, initiated in 1995, started in Ghana at a time when several changes were taking place in the country that were providing an enabling political and policy environment for the country. A new Population Policy had been put in place in 1994. The Ministry of Health of Ghana had come out with a Medium-Term Health Strategy, which clearly outlined several reproductive health priorities, and
USAID had signed an agreement with the Government of Ghana to provide substantial financial assistance for the Population and Health programs of Ghana. Under this project known as the Ghana Population and AIDS Project (GHANAPA Project), USAID offered the Government of Ghana $41 million in assistance over a period of five years. UNFPA and other donors had also offered substantial assistance to help the Ghana program forge ahead. In that period PRIME worked with the MOH and the Private sector to improve quality of care and access to Reproductive Health services by assisting Ghana to develop a State of the Art Reproductive Health Policy and Standards Protocols.
PRIME helped to promote public-private sector collaboration through the  development and application of the policy and standards and protocols and the CBD strategy. In addition, PRIME helped to develop training materials based on training needs assessments. A component of the package was the introduction of the Self-Directed Learning approach, an innovative way of learning for service providers in
hard to reach areas. PRIME assisted in getting midwives into the mainstream of providing Postabortion Care and pushed towards sustainability by assisting to decentralize Postabortion Care in Ghana.
Almost everyone interviewed expressed satisfaction with PRIME interventions. Some policy makers hailed the Reproductive Health Policy and Standards as a great breakthrough. The training of midwife assistants to work as CBD agents had clearly improved quality and access. The self-Directed Learning process was praised as the way for the future. The LSS/PAC program was praised as excellent. There, clearly, is room for continued PRIME interventions in helping move Reproductive Health in Ghana. Given the extent of PRIME work in the country and its strategic technical expertise, many of the interviewees would like to see an in-country PRIME office established in Ghana. This would both facilitate the management of activities and provide an opportunity for more timely interventions.