Upper East, a relatively poor and rural region in Ghana’s north, has transformed its provision of maternal and child health care. In 2008, it had one of the lowest levels of basic maternal and child health service coverage in the country – yet by 2014, it had the best coverage of all regions in the country. The proportion of deliveries with a skilled birth attendant in the region was 70%, compared to the national average of 55%.
What happened? And what can be learnt from this example of rapid progress?
During this period, Dr Koku Awoonor-Williams was Regional Health Director for Upper East. He oversaw a range of initiatives to improve the use of disaggregated data in planning and service delivery; to recruit, train and retain significantly more health workers; and to mobilise additional funding from the government and donors. Dr Awoonor-Williams is now the Director of Policy, Planning, Monitoring and Evaluation (PPME) at the headquarters of the Ghana Health Service.
In March, I travelled to Accra, and met with Dr Awoonor-Williams. We discussed the lessons that can be learned from the case of ‘positive deviance’ in Upper East, as well as key challenges in making progress towards universal health coverage in Ghana.
‘Positive deviance’ involves exploring what works, and why. We used this approach as part of our five-year research project, Development Progress, that worked to measure, understand and communicate where and how progress happened.
