The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

4049.0: Tuesday, November 18, 2003 - 9:10 AM

Abstract #60190

Catalysing Large-scale Organizational Change by Replicating an Experimental Approach to Health System Development in Nkwanta District, Ghana

John K. Awoonor-Williams, MD, MPH1, James Phillips, PhD2, Tanya C. Jones, MPA2, and Frank K. Nyonator, MD, MPH3. (1) District Director, Nwkanta District Health Administration, Ghana Health Service, P.O. Box 54, Nkwanta, Volta Region, Ghana, 233-20-816-1394,, (2) Policy Research Division, Population Council, 1 Dag Hammarskjold Plaza, New York, NY 10017, (3) Director, Policy, Planning, Monitoring and Evaluation Division, Ghana Health Service, Private Mail Bag, Accra, Ghana

There are few examples in the developing world where health care reform and innovation is guided by evidence. This paper presents the experience of Nkwanta District, located in the Volta Region of southeastern Ghana, which has successfully replicated experimental service delivery innovations developed by the Navrongo Health Research Centre in northern Ghana. Using locally available and highly constrained resources, the Nkwanta initiative has demonstrated the feasibility and impact of changing clinic-based primary health care to a system based on the Navrongo experimental model of community based services. Successful replication demonstrated that the Navrongo success story is not a mere artefact of the special resources of a research initiative, but is relevant to rural impoverished districts elsewhere in Ghana. This finding has enhanced the credibility of a national scaling-up programme known as Community-based Health and Planning Services (CHPS) which aims to extend Navrongo-like services to all districts of Ghana. This paper describes the links between Navrongo and Nkwanta, the CHPS process in Nkwanta, and the impact of Nkwanta CHPS operations on health indicators. By demonstrating success, a replication project can generate credibility for and validation of a scaling-up programme.

Learning Objectives:

Keywords: Access to Health Care, Community Health

Related Web page:

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Ghana Health Service
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment

Replication, scale, research, and policy

The 131st Annual Meeting (November 15-19, 2003) of APHA