|Upper West Regional Director Dr Alexis Nang-Beifubah.|
WA, Ghana, 2013 - WHEN Dr Alexis Nang-Beifubah arrived in the Upper West Region in 2008, the region had the highest rate of under-five deaths in the country.
A UNICEF-supported household survey in 2006 had found that one out of every five babies born in the region died before their fifth birthday.
The new regional director of Ghana Health Service had his work cut out for him.
Five years later, it is a different story. By 2011, the same household survey found that under-five mortality had reduced to one in nine children.
Dr Alexis, who in January left Upper West Region to take up a regional director position in the Ashanti Region, can depart proudly.
Upper West region is one of the least populated in Ghana – its 700,000 people living in the top most corner of the country, bordered by Cote d’Ivoire and Burkina Faso. Nearly 85% of people live in rural areas, making it a challenge to provide health services.
“We have never ever had adequate numbers of qualified health personnel,” Dr. Alexis said.
What they did have was the ability to mobilise thousands of health volunteers, who were trained to diagnose and treat common childhood illnesses. Two health volunteers (called community based agents) were chosen by each community in the Upper West Region – totaling 2,500 volunteers. Mothers of sick children would go to these volunteers for basic treatment.
“The orthodox approach was that when you got sick you went to the health centre,” Dr Alexis said. “But these volunteers became the first point of call who could carry out initial treatment to reduce complications (prescribing malaria medications, treating diarrhea with zinc and oral rehydration salts, and diagnosing ARI).”
“They support the mothers to act as first physicians.”
The region also trained extra health staff, called Community Health Officers, stationed at Community Health Planning Services. This brought health services closer to remote rural communities. There are currently 166 CHPS in the region.
Community Health Officers can treat malaria and other common illnesses, deliver babies in an emergency, provide immunisations, and do basic suturing.
Dr Alexis is quick to acknowledge the support of UNICEF – who funded a package of nutrition and health programs in the region which were proven to have the greatest impact of reducing child deaths. The package was called High Impact Rapid Delivery.
Interventions include: immunization, vitamin A supplementation, exclusive breastfeeding, complementary feeding, use of insecticide-treated bed nets, treatment of malaria using antimalarial drugs, management of diarrhoea using oral rehydration therapy, intermittent preventive treatment of malaria during pregnancy, and prevention of mother-to-child transmission of HIV. All these interventions are implemented at the community level.
“UNICEF is like a Volkswagen car. It drives from behind – the engine is at the back. They put us in the driver’s seat.”