Written by Delali Kumapley

“To catalyse leadership for improvements in WNCAW, collaboration and networking of professionals across multiple sectors, engaging media in advocacy and community scorecards assessments can generate additional information to national-level data analysis of issues of concern,”

– Mrs. Martha Gyansa-Lutterodt MOH Ghana on behalf of Hon. Kwaku Agyeman Manu, Minister of Health Ghana. Keynote address at the opening ceremony.

The population of West Africa is estimated at a little over 420,000,000 with a median age of about 18 years with women, new-born, children and adolescents forming more than half of the population. (World Africa Population Live, 2022). This makes it an important demographic that draws the attention of policymakers to put in place proper interventions at both the national and sub-regional levels to improve their health and well-being.

It was therefore towards this purpose that representatives from the Ministries of Health of all 15 countries of the Economic Community of West African States (ECOWAS), representatives of country-level communities of practice formed as part of the Women, Newborn, Child and Adolescent Wellbeing (WNCAW) project from 6 countries in the sub-region (Burkina Faso, Cote D’Ivoire, Ghana, Senegal, Sierra Leone and Niger) and other stakeholders came together to deliberate on ways to improve the health and wellbeing of WNCAW. The two-day dissemination and deliberation workshop under the theme “‘Catalysing Leadership to improve Women, Newborn, Child and Adolescent Wellbeing” was held at the Alisa Hotel on the 9^th and 10^th May 2022. It provided an avenue for knowledge sharing as well as rich discussions on ways in which country teams can accelerate the health and wellbeing of WNCAW.

About the WNCAW Project

The Women, Newborn, Child and Adolescent Wellbeing (WNCAW) project which has been running in the sub-region for three years now, is a collaboration between the West African Health Organisation, the Dodowa Health Research Center of the Research and Development division of the Ghana Health Service, the Alliance for Reproductive Health Rights (ARHR), and Women, Media, Change (WOMEC) and country teams in Burkina Faso, Cote d’Ivoire, Ghana, Senegal, Sierra Leone and Niger with funding support from the International Development Research Centre (IDRC) Canada.

The collaboration has successfully piloted interventions for capacity strengthening, evidence generation, synthesis and communication to activate leadership towards informing approaches for strengthening health systems to improve WNCAW in the sub-region. The interventions that were piloted in the three-year lifespan of the project in the six countries in the sub-region were:

• The formation of country-level communities of practice to advocate and lead change. These communities of practice or groups of people generated evidence and advocated for health policy systems to improve WNCAW.
• Using Community Score Cards for assessments to improve WNCAW at the district, sub-district and community levels.
• Engaging and networking with the media for health policy system and WNCAW reporting and advocacy.
• Building the capacity of researchers, journalists, district managers and frontline providers, CSOs, decision-makers at the central and local government levels and all members of communities of practice teams.

At the opening ceremony of the two days of presentation and deliberation, Mrs. Martha Gyansa-Lutterodt of the Ministry of Health Ghana gave the keynote address on behalf of Ghana’s Minister of Health, Hon. Kwaku Agyeman Manu. On behalf of the Minister of Health, she called on all countries in the sub-region to support each other to strengthen their health systems to improve WNCAW both within and across countries through learning and, information and skills exchange. Prof. Stanley Okolo, the Director-General of the West Africa health organization, Ms. Katie Csaba, the Canadian High commissioner to Ghana and Ms. Vera Karikari, a representative of the Minister of Gender, women affairs and social protection for Ghana were all present at the opening ceremony. They all emphasized the importance of improving the health and wellbeing of women, newborns, children and adolescents in the sub-region.

Some Highlights from the Deliberation

In the technical presentation and deliberation sessions, participants recognized that despite contrasts there were also many similarities across the countries. This included several cross-cutting realities in the ECOWAS sub-region that related to the various challenges encountered in the strengthening of Health Policy and Systems (HPS) to support the improvement of WNCAW. There was much potential for countries to support each other and learn from each other.

Among the issues that were identified as needing to be addressed to strengthen HPS and improve WNCAW were:

1. Resource limitation across human, financial, infrastructure, equipment, tools and supplies. Many good initiatives are unable to thrive because of a lack of funding and other resources.
2. Research Capacity building in Ministries of Health, as well as academic institutions, needs to be oriented toward solving problems within the health system.
3. Using a single-pronged approach that ignores the complexity of the health and other systems within which the problems occur to solve issues like the ‘no bed syndrome’ and high adolescent pregnancy rates etc. does not work. These are systems problems and should be treated as such.
4. The state/central government alone should not be seen as responsible to solve the problems. Other stakeholders including the local government, civil society organisations, communities, non-governmental organisations and the media are all essential partners that must get involved using an all-hands-on-deck approach.
5. Addressing professional health system cultures, values and priorities that drive poor responsiveness during the training of health workers as well as at the service delivery levels are essential. Patient charters must be respected while charters dealing with the rights and responsibilities of frontline workers must be provided and also appreciated.
6. In tackling the issues of WNCAW, social determinants of health such as poverty, cultural norms – some of which may be helpful and others harmful, the status of women and girls, teenage pregnancy, gender violence, negative perceptions and stereotypes of what masculinity means etc. must all be taken into consideration.
7. Capacity strengthening is critical and needs to be embedded in all approaches.
8. Important such as leadership, advocacy, policy change, change leadership and teamwork that have been part of the emphasis in the WNCAW project are valuable and need to be continued

Interventions and Approaches to Strengthen Health Policy Systems and Improve WNCAW

The interventions that have been piloted in six countries in the sub-region are worth following up in the medium to long term in the six countries and in other countries of the sub-region. This must be accompanied by monitoring and evaluation of the impact on WNCAW at multiple levels including the community, sub-district, district, country and sub-regional levels. The above recommendations cannot be implemented without some financing. It will therefore be important to explore approaches to continuing and sustaining these initiatives. Such approaches must as much as possible embed in routine systems rather than treated as projects.

References:

Western Africa population (live). Worldometer. (n.d.). Retrieved May 26, 2022, from https://www.worldometers.info/world-population/western-africa-population/

Women, Newborn, Child and Adolescent Well-being Project. (2022, May 10). Strengthening Context, Health Policy and Systems and Catalysing Leadership to Improve WNCAW in West Africa [Draft Communique]

About Author

Delali Kumapley is the Research Uptake Officer with the Catalyse Project. She is based in Accra, Ghana.