Annual Programme of Work 2005 - Ministry of Health

Maternal and Reproductive Health Services
Improving maternal health outcomes is a key priority of the 5YPOW. Progress in this
area as measured by Maternal Mortality Ratio (MMR) in the country is however largely
unknown. The 214 per 100 000 live births that is quoted in many document was
estimated in 1994 by the Ghana Statistical Service. Indeed some commentators claim that
the current MMR is probably higher than 1993 level. The MOH and Partners have
therefore started planning for a maternal mortality survey that hopefully will be
implemented in 2005.
The trends in key sector-wide indicators for Maternal and Reproductive Health services
have shown steady and sustained increases since 2002. Coverage of antenatal care is over
90% in all regions. Coverage of supervised delivery, (excluding delivery by TBA),
though rising, is still too low at 44.3%, with marked regional variations. There has also
been a steady increase in family planning coverage. The contraceptive prevalence rate for
modern methods has increased from 13% in 1998 to 19% in 2003. (2003 GDHS)
However, the unmet need for family planning remains the same.
The national RH policy and standards document has been revised to provide new focus
for improving access to quality RH services and for reducing maternal and neonatal
morbidity and mortality towards the Millennium Development Goal for maternal health.
The policy emphasizes preventive and promotive aspects of safe motherhood, improving
access to emergency essential obstetric care and increasing coverage of family planning
services to reduce unmet need for family planning and unwanted pregnancies, and
prevent reproductive tract infections and STIs including HIV/AIDS.
The thrust for 2005 will be to increase access to quality essential obstetric and other
reproductive health services emphasizing family planning services. Exemptions for ANC
and for deliveries in all regions will also be sustained. The indicators for measuring
reproductive health services will be revised to cover important strategic issues such as
essential obstetric care. The CHPS programme will also be re-oriented to provide
delivery services through the provision of midwifery skills to CHOs.
Priority activities would include:
• Develop a National Reproductive Health Strategic Plan
• Sustain the ANC coverage while improving its quality
• Sustain delivery exemption policies and document lessons including the impact of
exemptions on maternal health outcomes
• Revise and pre-test indicators for measuring maternal health
• Conduct a survey on maternal mortality
• Assess the extent to which facilities are designed to respond to Maternal and Child
Health services
• Strengthen health institutions through training of health providers and provision of
existing health institutions in the delivery of package of RH services including
Emergency Obstetric Care
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