Enhancing family planning services in northern Ghana: a landscape assessment to develop strategic interventions using an academic partnership approach
Through an academic partnership utilizing the EPIS framework and an adapted SEED landscape assessment, stakeholders identified key priorities—including staff training, service integration, and youth-centered care—to strategically enhance family planning services at Tamale Teaching Hospital in northern Ghana.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of a preprint that has not been peer-reviewed. It is not medical advice. Do not make health decisions based on this content. Read full disclaimer
Imagine Northern Ghana as a vast, bustling city that has been left behind while the southern part of the country has built skyscrapers and highways. In this northern city, many families are struggling, and women and girls face extra hurdles, especially when it comes to planning their families. They often have unplanned pregnancies or unsafe abortions, which can be dangerous for their health.
To fix this, a team of "medical architects" from three different universities (two in Ghana and one in New York) decided to work together. They didn't just bring blueprints from the outside; they wanted to understand the local terrain first. They used a special map-making tool called the EPIS framework, which is like a four-step recipe for building a better house: Explore the land, Prepare the materials, Build the house, and Maintain it so it lasts.
The "Landscape Assessment" (Exploring the Land)
Before they could build anything, they needed to know exactly what was broken in the current clinic at Tamale Teaching Hospital (TTH), which is the main hospital for the whole region. They used a survey tool called SEED (which stands for Supply, Enabling Environment, and Demand). Think of this survey as a "health check-up" for the clinic's family planning services.
They asked the doctors, nurses, and midwives working there: "What's working? What's missing? What makes your job hard?"
What They Found (The Cracks in the Foundation)
The survey results revealed three main problems, like three cracks in the foundation of a house:
The Training Gap (The "Outdated Toolbelt"):
The staff were hardworking and skilled, but they felt their toolkits were outdated. They said, "We learn on the job, but we rarely get fresh training." Specifically, they needed more practice on how to talk to young people (adolescents) in a friendly, non-judgmental way, and they needed more training on how to perform certain procedures like sterilization. One doctor noted that when training happens, the northern region often gets forgotten, like being left off the guest list.The "Silo" Problem (Services That Don't Talk):
Right now, the clinic offers many services, but they are often in separate rooms that don't talk to each other. For example, a woman might come in for a pregnancy check-up but not get offered family planning, or she might need cancer screening but have to go to a different building. The staff wanted to "knock down the walls" and combine services—like offering cervical cancer screening right where women are getting family planning advice.The "Closed Door" for Some (Access Barriers):
The clinic felt like a fortress that was hard to enter for certain groups. The survey showed that single men and teenagers felt the least welcome. Sometimes, they were told they needed permission from a parent or a spouse to get help, even though the law didn't strictly require it. The clinic also lacked private spaces where a teenager could talk to a doctor without being overheard.
The Plan (Preparing the Blueprint)
After gathering all this feedback, the team didn't just write a report and leave. They sat down with the hospital leaders to decide what to fix first. They picked three "priority repairs" to tackle in the next 6 to 12 months:
- Fix the Toolbelt: Organize specific training sessions for the staff, focusing on how to be "youth-friendly" and how to handle difficult conversations.
- Combine the Rooms: Start offering cervical cancer screening right alongside family planning services so women get everything they need in one visit.
- Open the Doors for Teens: Train staff specifically on how to counsel adolescents and create a private, welcoming space for them.
The Big Picture
This paper is essentially a story about how a team of partners decided to stop guessing what a community needs and started asking them directly. By using a structured approach (the EPIS framework) and listening to the local staff, they created a clear roadmap. They aren't just building a clinic; they are building a system that is fair, accessible, and ready to last, ensuring that women and families in Northern Ghana get the care they deserve.
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