In Ghana, most health care is provided by the government and largely administered by the Ministry of Health and Ghana Health Service. The healthcare system has five levels of providers: health posts which are first level primary care for rural areas, health centers and clinics, district hospitals, regional hospitals and tertiary hospitals.
Ghana has a Universal Health Care system, National Health Insurance Scheme (NHIS), and until the establishment of the National Health Insurance Scheme, many people died because they did not have money to pay for their health care needs when they were taken ill. The system of health which operated was known as the “Cash and Carry” system. Under this system, the health need of an individual was only attended to after initial payment for the service was made. Even in cases when patients had been brought into the hospital on emergencies, it was required that money was paid at every point of service delivery. When the country returned to democratic rule in 1992, its health care sector started seeing improvements in terms of:
- Service delivery
- Human resource improvement
- Public education about health condition
Even with these initiatives in place, many still could not access health care services because of the cash and carry system.
According to the World Health Organization (WHO), the most common diseases in Ghana include those endemic to sub-Saharan African countries, particularly: cholera, typhoid, pulmonary tuberculosis, anthrax, pertussis, tetanus, chicken pox, yellow fever, measles, infectious hepatitis, trachoma, malaria, HIV and schistosomiasis. Though not as common, other regularly treated diseases include dracunculiasis, dysentery, river blindness or onchocerciasis, several kinds of pneumonia, dehydration, veneral diseases, and poliomyelitis.
Herbal Treatment: Herbalism (also herbal medicine or phytotherapy) is the study of botany and use of plants intended for medicinal purposes or for supplementing a diet. Plants have been the basis for medical treatments through much of human history, and such traditional medicine is still widely practiced today. Modern medicine recognizes herbalism as a form of alternative medicine and pseudoscience, as the practice of herbalism is not strictly based on evidence gathered using the scientific method. Modern medicine makes use of many plant-derived compounds as the basis for evidence-based pharmaceutical drugs. Although phytotherapy may apply modern standards of effectiveness testing to herbs and medicines derived from natural sources, few high-quality clinical trials and standards for purity or dosage exist. The scope of herbal medicine is sometimes extended to include fungal and bee products, as well as minerals, shells and certain animal parts.
Volunteers who are interested to acquire herbal treatment knowledge would be entreated. However, he/she would be taught on how to give first aid at the Agricultural Farms and/or herbal facilities when someone gets injured. This is by the use of the herbs at the farms. Each herb has its own cure to a specific disease whereas others may serve to cure more than just one disease. Herbalist would be provided to lecture and guide volunteers through all the processes involved in using herbs as first aid at the farms. This would help volunteers to learn the African way of giving first aid at the farms.
Health Education: this is strongly vital in the lives of children. Though this improvement in children’s health has also been witnessed in Ghana, it has been slow and unevenly distributed across the country. We educate marginalized communities on maternal health and communicable diseases such as HIV/AIDS, malaria, hepatitis A and B, measles, tuberculosis, sexually transmitted diseases and rabies among others. However, the influence of maternal education on child health in Ghana is largely unknown and as a result, child health policies in Ghana have ignored maternal education.
A set of items presented to YLF children by a volunteer from Germany to be used during their leisure time. the item presented was two set of computers, footballs and printers for office used. the children of the foundation show worth appreciation to the donor and wished him a prosperity in all his life. one of the child voice out with deeply passion of thanks given. she said, only God can bless him for such a gift presented to them, she assured the volunteer that, they will take good care of it and use it meaningfully.
STAKEHOLDERS MEETING ON GAVI HSS PROJECT
On 6th may, 2015. HERO-Network in collaboration with Young and Lonely Foundation, ICARE, Ghana Health Service held a stakeholders meeting which was sponsored by Gavi. The whole project is called Gavi HSS project which is implemented to ensure that every child is immunised against the 12 killer diseases. Research as shown that, Gomoa East is among the 7 District in Ghana who has recorded lower coverage of immunisation. Out of 100 % coverage, only 61% of the children under five has been immunised against the 12 child killer disease. It has become necessary for the entire key stakeholder (Ghana health service, volunteers, chiefs and elders, NGOs, etc) in Gomoa East District to deliberate on how they will reach every community and target every child for immunization by 2020.
The meeting commence with an open prayer form Rev. Oduro which was followed by introduction of all participant from the various organisation. Thus the CEO of Young and Lonely Foundation, CEO of HERO- Network, District Health Director, District Coordinating Director, Disease Control Officer, Nananuom from all the various communities in the Gomoa East District, Ghana Education Service, Golden Star FM, Adom FM, Obrepong FM, Daily Graphic ( media) and all other participant from the various organisation and communities in the Gomoa East District.
Mr. Benjamin Buabeng, the project coordinator for HERO- Network gave the main purpose for the gathering. He said, the gathering is about how we can reach every community and target every child for immunization 2020. He stress that, Gomoa East District is one of the most under- coverage of the immunisation program that goes on in the country there by making the children under five year suffer certain diseases when it attacks them. Subsequently, we have all come together to find out the reason why the immunisation is under coverage and how it can be improved in the subsequent years to come.
The chief for Gomoa Aboso as the chairman for the occasion said, he is much thankful to everyone for been present for such an occasion and he is highly honoured to chair the meeting. He persuades each and everyone to put up his or her maximum best to make the meeting a successful one of course. He added that, when everybody is able to contribute his or her best of ideas to the meeting, at the end of the day we all can make a great input as to how by 2020 we can reach every community and target every child for immunization.
Mr. Bright Amissah the CEO for HERO- Network said, Ghana is not the only country who receive immunisation agent certain diseases. He stress that about 221 countries also receive immunisation worldwide. The total number of people who receive immunization in Gomoa East District is 61% of the total population in the District. Gomoa East District is one of the under coverage district, so far as immunisation is concern in Ghana. He explains that the immunisation is all about
children under five about the 12 killer diseases. This is a disease which have cure and the cure is immunising children under five to prevent them from getting attack from such disease in the future. He said some of their research and their funding show that, some parents prevent their children from immunising against the 12 killer diseases due to certain preventions and beliefs and which all the stakeholder should come on board to help to clarify certain misconception and beliefs so that every child can be immunise against the 12 child killer disease. Base on this finding and research, HERO- Network, and Young and Lonely Foundation has come together to help sensitizes the communities on the importance of immunisation and why it is necessary for every child to be immunised. They have also trained 18 volunteers in all the ten communities who will help to assist the health workers. He said they are currently working in ten communities and he hope they can extent their coverage areas of work.
The District Health Director for Gomoa East said, immunisation is a share responsibility for everyone thus ranging from parent to all stakeholders in the district. He explain that, If the unit committees, Assembly leaders, the chief and his elders, community volunteers and the health care personal plays their role well, soon than later every child will be immunise against such diseases. He added that, it will be very advisable if all the pregnant women and children under five in the various communities are register in the volunteers’ handbook and the nurse book, so that it can serve as a reference or a check book to identify those who did not attend for the immunisations. He said the community health workers should also communicate with the chief and his elder thus given them a feedback on the work done for the day, which will help them to know if every child was present to receive the treatment. He added that, during Sundays and Fridays a desk can be mounted in front of the churches or the mosque for the children to be immunised after the church or the mosque services. He stress that, desk should also be mounted at the market centre during the market day, when such measure are been put in place, it will be very easy to immunise a lot of children which will help for the percentage or the coverage area increase and this can be achieved through commitment and hardworking by all stakeholders .
The District coordinator said, the district will do all this best and avail the resource needed for the immunisation to cover a wider range of children. He believes together we can help each and every child to get immunised against this deadly disease and he is hope by the year 2020 the coverage will be 100% in the Gomoa East district. He entreated all participant to put up their maximum effort and they district will also do all what they can in their power to see to it that every child get the vaccinated.
The District Disease Control Officer gave a brief presentation about the immunisation and some of the disease they immunised children under five are BCG, Hepatitis B, Polio, DTP, Rubella, Rotavirus, Measles, HIB etc. He said, it is very important to immunised since Ghana has not reported any polio case since 20o8, tetanus eliminated has be eliminated in Ghana since 2011, no death from measles since 2003. He said, immunisation serves the lives of millions of children every year by preventing serious illnesses. He said, since immunisation is free and available at the health facilities everybody should take part to avoid any illness. He said they are numerous of challenges they face which also contribute to under coverage, some of which are transportation, migration, not reaching the target population etc.
- The community volunteers who help in mobilizing the mother or the children under five should be given incentives to boost them to work hard. The chief should set a policy which will make it possible for every child under five to be immunised
- Much education should go on in the communities to ensure better understand and reasons why children under five should be immunised
- The volunteers should do well to go to every home to register pregnant woman and children under five which will sever as a guard to check who children who were not immunised and they can easily be identify.
- They should always announce by using the community address system to ensure that all children under five a present to be immunised.
The chairman for the occasion once again said a big thanks to the entire participant for their input and cooperation. He said, all that which has been said can only work if we are committed and very body is ready to play his role as a stakeholder. He added to it that, the life of the children depends on our effort, due to that we all should do our best for the coverage to increase by 2020 so far as immunisation against 12 killer diseases is concern.
YOUNG AND LONELY FOUNDATION (YLF): REPORT ON GLOBAL ALLIANCE FOR VACCINES AND IMMUNISATION (GAVI HSS) PROJECT IN THE GOMOA EAST DISTRICT, CENTRAL REGION- FUNDED BY GAVI (The Vaccines Alliance)
Child immunization and vaccination health education is one of the surest ways of eradicating child mortality in our communities and the country at large. Over the years, various social interventions and education were carried out by Young and Lonely Foundation (YLF) and Ghana Coalition of NGOs in Health (GCHN) to sensitize people on immunization. This among other things led to the coverage of sixty eight percent even though it is below the national target of ninety percent ( Ghana health service report, 2014 Gomoa East). The nature of the problem demands that more collaborative efforts are brought to the fore so that a lasting solution can be provided to child mortality underpinned by lack of immunization. The advent of the GAVI HISS project could not have come at a better time than this as it will help create more awareness on immunization hence the need for parents and stakeholders to treat immunization with all seriousness.
GAVI HSS Project seeks to create demand for immunization in selected districts and communities across the country. In the Gomoa East District, GAVI HSS Project has been implemented in ten (10) communities by three NGOs namely: Young and Lonely Foundation (YLF), ICARE and HERO-Network. YLF has implemented the project in two communities in the District namely Pomadzi and Asebu. The implementation of the project in these two communities in the Gomoa East District will be the focus of this report.
OPENING DIALOGUE WITH STAKEHOLDLERS
As part of the pre-implementing activities, the staff of HERO Network and other two supporting NGOs –Young and Lonely Foundation and ICARE who are the implementers for the GAVI HSS Project in the Gomoa East District organized a meeting with the District Health Management Team (DHMT) and the District Assembly on 18th March, 2015. The meeting was attended by the district director of health, disease control officer, executive directors of implementing NGOs with supporting staff, District Coordinating Director and other supporting staff of DHMT and the District Assembly.
The purposes of the meeting were to introducing the Project to the stakeholders and seek their support. At the meeting, the DHMT and the district assembly applauded the NGOs for the initiative and have promised their total support for effective and successful implementation of the project.
The meeting also created the platform where the NGOs, DHMT, and the District Assembly discussed strategies for the effective implementation of the project in the communities. Before the meeting came to a close, ten (10) communities in the District where immunization education was low were selected for the project. Finally, the stakeholders discussed some health challenges such as lack of health facilities, lack of commitment on the part of community volunteers malaria, cholera………. And possible solutions to nip the health challenges in the bud were suggested
INTRODUCTION OF THE PROJECT IN THE COMMUNITIES
On 17th and 18th March, 2015, Young and Lonely Foundation (YLF) introduced the GAVI HSS Project in the Gomoa Pomadze and Gomoa
Asebu communities. The first point of contact was the chiefs, elders and opinion leaders of the communities. This was done in collaboration with health personnel in the District.
After the introduction of the project, the chief, opinion, leaders pledged their unflinching support towards the project. They also urged the organization to adequately motivate volunteers and health personnel so that they can be well energized to carry out a regular education and interaction with community members The executive director of YLF assured the community leaders that the organization will motivate health workers and volunteers alike to perform their duties well.
Having successfully introduced the project to the communities through the community leadership, the organization proceeded to select Community Based Health Volunteers (CBHV) for the GAVI HSS project.
Volunteers and Community Health Nurses Training on GAVI HSS Project
In order to build the capacities and deepen the understanding of the key players in the GAVI HSS Project in the Gomoa East District, a one day workshop was organized to train volunteers and community health nurses .The training was organized by HERO-Network which is the focal NGO of the GAVI HSS Project in the Gomoa East District. The workshop came off on 25th March, 2015 at Hatampa Hotel, Aborso, Agona Swedru
The training brought together stakeholders in the GAVI HSS Project including the District Director for Health Services to discuss important health concerns in the district. Among issues discussed are importance of child immunization, immunization schedule, role of volunteers in health delivery, how to complete M&E tools and challenges in child immunization services.
The district health director in his speech advised the volunteers and the nurses to see their work as a calling to support their communities and the nation as whole. The training was facilitated by the district disease control officer, and supported by executive director of HERO-Network who doubles as the GAVI HSS Project coordinator and a senior nurse from Buduata Health Centre.
After the presentations time was allowed for questions, suggestions, contributions and answers. The occasion was also used to correct certain misconceptions people have on child immunization. For example people believe that when a child has a boil should not be immunized, secondly, the children are stubborn because of the immunization, when they are taking herbal medicine
The training was attended by the district health director, executive’s directors of all implementing NGOs, disease control officer and his deputy, all other supporting staff from GHS,HERO-Network, community health nurses and volunteers. All participants pledged to fully offer their support so that the project can be implemented successfully.
The following are the outcomes of the workshop:
- Eighteen (18) community based health volunteers trained on the GAVI HSS Project
- Twelve(12) community health nurses and other health staff trained on the GAVI HSS Project
- Challenges in child immunization services delivery discussed
Follow Up Visits to Assess Community Response
The outcomes of the follow up can be seen below:
- Community response to the project assessed by project staff effectively.
- Community Health Based Volunteers (CHBV) given technical support in their communities to carry out their duties very well.
Community Health Durbar at Gomoa Pomadze (Main Activity 5)
As part of the activities outlined in the implementation plan, health education durbar was organized by Young and Lonely Foundation to educate people on immunization issues. The focus of the durbar were the importance of immunization, and immunization schedules. The activity was organized in collaboration with HERO-Network and Ghana Health Service (GHS) staff who have been very supportive since the inception of the project.
At the durbar a health person took the community immunization and the need for communities to attach seriousness to the immunization programme. After the education, a forum was opened for community members to ask questions, and contribute towards the programme. From the interactions, we gather that community members were not given enough prior information before CWC activities. In response to this concern, the GHS staff promised revealed that they are collaborating effectively with volunteers through the GAVI project and this collaboration will help them to get in touch with whatever is happening in the communities as well a give prior notice on CWC activities on time.
The programme was attended by chiefs, elders and community members of Gomoa Pomadze and Asebu, Deputy District Disease Control Officer, Community Health Nurses from Okyereko Health Centre, staff of YLF and HERO –Network. The chiefs and elders expressed much interest in the programme and appealed to YLF and GHS to continuously organize such programmes to sensitize people on health issues.
The following are the outcomes of the durbar:
- Over 250 community members educated on importance of immunization
- Over 250 community members educated on immunization schedule
- Misconceptions about child immunization such as a child cannot take immunization when the child has boils were all cleared by the disease control officer
- The volunteers at Asebu have resigned and need to be replaced with new set of volunteers
- Lack of a health facility at Asebu and Pomadzi so people go to other district such as Winneba to have immunisation
- Inadequate training for the volunteers to equip them with the skills to carry out their duties well
- Inadequate motivation for volunteers
- The District Assembly should liaise with the Ghana Health Service to put up a heath facility Asebu and Pomadzi and its environs
- The community leadership should be engaged so that they can select dedicated volunteers to carry out the education, mobilisation and registration on immunisation.
- The volunteers should be motivated enough to carry out their duties well
- There should be a regular training for the volunteers so that they can improve upon their performance on the job.
Child immunisation is one of the ways of eradicating childhood killer diseases among children. This is the reason why education on immunisation has been carried in Pomadzi and Asebu communities to prevent killer diseases from wiping out our children. The education has gone down well and most of the community members including the community leadership are happy about the project and are looking forwarding to receiving more education and immunisation on regular basis so that childhood killer diseases would become a thing of the past.
WORLD IMMUNIZATION DAY (the role of the stakeholder)
Young and Lonely Foundation (YLF) and Ghana Coalition of NGOs in Health (GCHN) part take in the world immunization day. The immunization day was held at Kolabu hospital as one of the biggest hospital in the country. The backbone of the immunization worldwide is an organisation called GAVI. GAVI HSS Project seeks to create demand for immunization in selected districts and communities across the country. In the Gomoa East District, GAVI HSS Project has been implemented in ten (10) communities by three NGOs namely: Young and Lonely Foundation (YLF), ICARE and HERO-Network. YLF has implemented the project in two communities in the District namely Pomadzi and Asebu. The implementation of the project in these two communities in the Gomoa East District will be the focus of this report. Basically, the world immunisation day was celebrated to bring all implementer partner and all the stakeholders together to talk about the successes and the challenges facing the immunisation project in the country and to suggest a solution to the problems uncounted.
The purposes of the meeting were to introducing the Project to the stakeholders and seek their support. At the meeting, the DHMT and the all other stakeholders applauded the NGOs for the initiative and have promised their total support for effective and successful implementation of the project.
The meeting also created the platform where the NGOs, DHMT, and the stakeholder discussed strategies for the effective implementation of the project in the communities and the country at large. Before the meeting came to a close, ten (10) Districts where immunization education was low were selected for the project. Finally, the stakeholders discussed some health challenges such as lack of health facilities, lack of commitment on the part of community volunteers’ malaria, cholera and possible solutions to nip the health
challenges in the bud were suggested
Mr. Gilbert K. Germain, the executive director for YLF said, Child immunization and vaccination health education is one of the surest ways of eradicating child mortality in our communities and the country at large. Over the years, various social interventions and education were carried out by Young and Lonely Foundation in their catchment areas of sensitization (Gomoa East district). This among other things led to the coverage of sixty eight percent even though it is below the national target of ninety percent (Ghana health service report, 2014 Gomoa East). The nature of the problem demands that more collaborative efforts are brought to the fore so that a lasting solution can be provided to child mortality underpinned by lack of immunization. The advent of the GAVI HISS project could not have come at a better time than this as it will help create more awareness on immunization hence the need for parents and stakeholders to treat immunization with all seriousness.
The meeting was successfully with a lot of progress even though there were some challenges. The entire participant agreed to put up their best and promised to implement the strategies discussed to chalk more progress in the subsequent years to come.