School of Public Health - International Health
Ghana - Maternal and Child Survival Program
In Ghana, Jhpiego is implementing USAIDâ€™s flagship Maternal and Child Survival Program. Ghana is in its third year of the program with the goal to better prepare the midwifery and nursing workforce with knowledge and skills to effectively provide HIV, malaria, nutrition, family planning and maternal, newborn and child health services, as well as to improve the national and regional capacity to implement a harmonized Community-based Health Planning and Services (CHPS) model which provides high quality services. Specific activities include strengthening pre-service education by training tutors, equipping skills labs, developing mobile learning modules among others and advocating for the development of early childhood development skills and positive parenting.
Global Health PI/Mentor: Rachel Favero
My time in Ghana certainly did not go as expected, but it was a rich learning opportunity and in the end, a joyful and formative experience.
The initial focus of my work for Jhpiego-Ghana was a research study which sat under the USAID Maternal and Child Survival Program umbrella. The study was looking to adapt Ghana’s Community-Based Health Planning & Services delivery model to urban environments. The first few weeks were a crash course in field research - developing data collection tools, hiring data collectors, and preparing for our teams to travel. We were all set to begin data collector training and pilot testing when the news came crashing in that, due to funding uncertainty, our project would be delayed and perhaps cancelled altogether. This was a major disappointment. Several months in we were very invested in the project. We also knew the research was a high priority for Ghana Health Services and the Ministry of Health and had real policy implications. GHS had signed on as co-investigators on the study and had taken great pains to coordinate with their colleagues at the regional, district, and sub-district level on our behalf.
As disappointing as it was to learn that our project would not go forward, it was also a lesson in the realities of the field. As with many global health programs, being dependent on external funding (and in this case the shifting winds of a new U.S. administration) means accepting a certain level of unpredictability. It requires making tough choices about where to cut back in your budget. For me, it required being adaptable and finding other ways to add value to the organization. I like to think I did so. I found myself leading team sessions to develop intervention impact models (they really work!) and building out M&E plans for other programs. It was office work and not the field experience I’d planned, but it was real work, and it felt good to take what I’d learned in the classroom and apply it.
The experience pushed me, too, to see that part of my role as a public health professional is to be an advocate, to communicate the value of public health to policymakers. As I move forward in my career, I know that lobbying for fiscal space at the global and national level will be important, as well as considering ways to improve the sustainability of health financing. I hope the experience made me more cognizant and empathetic to the challenges implementers face too. Deciding how to prioritize limited funds is an unenviable task and even small delays at the top can cause major setbacks on the ground. These are things I’ll make pains to remember.
Above all else, what I’ll remember is the Jhpiego-Ghana team. My colleagues were warm, knowledgeable, and fiercely committed to their work. I leaned on them heavily for their insights into Ghana and the health system, and I would behoove any future students to do the same. I would have been decidedly lost without their guidance on how to navigate a new context, and my time would have been less joyous.
Timing is a strange and aggravating thing, but this story ends with good news. Just as I landed back in Seattle, WA after 3 months in Ghana I received a message from my colleague that funding had come through and the project would resume the following spring. Yes!!