BACKGROUND INFORMATION
Over the past decades Ghana has invested strongly in maternal and reproductive health care to support attainment of its development goals. Several high level initiatives have been launched in the country since 1990 to enhance progress towards MDG5, of which Making Pregnancy Safer Initiative, CARMMA and MDG5 acceleration framework(MAF) are amongst the most notable. Ghana is signatory and staunch supporter to a number of key frameworks that drive the Maternal and Reproductive Health global agenda such as ICPD PoA, MDG and FP2020.
A predictable result of this commitment was a considerable improvement of both the coverage of Maternal and Reproductive Health services and associated health outcomes. The percentage of deliveries occurring in a health facility has increased from 42% in 1988 to 73% in 2014. The percentage of births attended by a skilled provider has increased from 40% to 74% over the same period. 97% of women in Ghana receive antenatal care from a skilled provider.
This percentage has increased steadily from 82% in 1988 to 97% in 2014 (DHS 2014).
Nevertheless, these investments have fallen short of putting the country on track to reach the 75% reduction of the Maternal Mortality Rate (MMR) required by the MDG5. According to the latest estimate by the Maternal Mortality Estimation Inter-agency Group (MMEIG), the MMR in Ghana has fallen from 634 per 100,000 live births in 1990 to 376 per 100,000 live births in 2005 and is currently 319 per 100,000 live births in 2015.
The slow progress has been of great concern to policy/decision makers to the extent that Maternal Mortality was declared a national emergency in July 2008.
Responding to these concerns Ghana’s MDG5 Acceleration Framework (MAF) was developed by the Ministry of Health and Ghana Health Service in collaboration with development partners, particularly the United Nations Country Team and other stakeholders in Ghana in 2010. Its aim is to augment implementation of the Maternal and Child Health programme with the objective of attaining the MDG indicators and targets.
Following that, a costed Operational Plan was developed in 2011 to guide implementation of the MAF. The focus of the MAF and its Operational Plan is primarily on MDG 5 although investments in improving access and quality of Skilled Delivery, EmONC and child spacing will have a strong impact on neonatal and infant mortality as well (MDG4).
The MAF focuses on improving maternal health at the level of both community and health care facilities using evidence-based, feasible and cost-effective interventions in order to achieve accelerated reduction in maternal and newborn deaths. The three key priority interventions identified are improving family planning, skilled delivery and emergency obstetric and newborn care.
The MAF was not aimed at replacing existing policies or programmes. Rather, it is meant to build on and complement existing initiatives to accelerate the country progress towards MDG 5 by 2015.
MAF is being implemented with all resources available for realizing maternal and child health in Ghana including 52 million Euros committed by the EU as well as the assistance provided to strengthen maternal and neonatal health by bilateral and multilateral agencies such as DFID, DANIDA, USAID, UNFPA, UNICEF, WB and others.