Using community-driven solutions to improve maternal and neonatal outcomes in rural northern Ghana: the PREMAND Project

Abstract

Abstract Background Community interventions are often created by researchers, non-profit organisations, or other community outsiders and launched in communities with minimal input from the community members themselves. In addition, these are often blanket interventions, or generic programming offered across varied communities that do not take into account the unique needs of each community. The PREventing Maternal And Neonatal Death (PREMAND) project in rural northern Ghana hypothesised that the root causes of maternal and neonatal deaths and near-misses would vary based on each community's unique geographic, social, and cultural factors, and that interventions to address these issues should be driven by the community members and tailored to their specific needs. Methods PREMAND is a three-phase project beginning with sociocultural audits of near-misses and verbal and social autopsies of deaths of mothers and babies in four districts in Ghana. Semi-structured qualitative interviews about each event are also conducted and transcribed. Data are then mapped to demonstrate where clusters of events are located and to determine which five communities are experiencing the highest numbers of deaths and near-deaths. Lastly, data and maps generated by PREMAND are presented to community leaders and elders through large community meetings. Communities are provided with small seed grants (US$2000) to generate their own solutions based on the data presented and their own experiences as experts on their own communities. Findings The community intervention stage is still underway, but preliminary results indicate that all five identified communities have planned unique interventions, and two of the communities have completed their interventions. One community plumbed water to a local health facility where deliveries occur, and another purchased and retrofitted a motor ambulance for emergency transport. All of the communities have committed to putting forth their own funds so that they can undertake bigger projects than seed money will allow. Interpretation Preliminary results from the community intervention phase demonstrate that, when provided with basic information about the problem and a small amount of resources to develop their own solutions, community members are motivated to enact change, develop unique solutions specific to their own needs, and even contribute their own time and funds to improve their communities. Funding USAID Ghana.