GHSA QUARTERLY REPORT – MCSP PILLAR IV Activities & Results

PREVENTION

 In the last quarter, MCSP completed infection prevention and control (IPC) trainings in 28 additional district health facilities across the five MCSP-supported regions (Ashanti, Brong Ahafo, Eastern, Upper East and Upper West). Thirty-six facilities have received IPC trainings to date. This represents 60% of the targeted number of facilities (56 facilities).  As at the end of June 2017, 8,445 frontline health care workers were trained in IPC. This is 57% of the targeted number of healthcare workers. See graph below with detailed regional information.  Of the number of healthcare workers trained, 6,304 (75%) were clinical staff and 2,141 were non-clinical staff (25%).  Among the clinical staff trained, average post training test scores increased from a baseline of 45% to 70% with 40% of those trained scoring 85% and above.

Number of Staff completing on-going IPC Training in 5 MCSP Regions 13,975 14,000

12,000

10,000 8,445 8,000

6,000

NumberStaff of 4,325 3,833 4,000 3,425 3,200

1,509 1,850 2,000 1,430 1,115 1,175 558 - 89% 44% 45% 60% 47% 60% Ashanti Brong Ahafo Eastern Upper East Upper West 5 MCSP Regions

Region and Percent of Staff Completing IPC Training Target Staff Trained

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Challenges

 The significant challenge faced by the project in the last quarter was the slow implementation of the fix amount awards (FAAs) given to the Regional Health Directorates of the Ghana Health Service (GHS) to carry out the IPC trainings, especially Brong Ahafo, Eastern and Upper East regions. This was due to lack of understanding of the FAA process by key stakeholders as was the case in Brong Ahafo and Eastern regions and competing activities from other donors as was experienced in Upper East region.  To address this challenge, a FAA review meeting was organized on May 16-17, 2017 for all the MCSP-supported regions to discuss the delays, share positive lessons and experiences from other regions and develop new implementation strategies to help complete the project activities on time. Ashanti Region, which had completed more trainings than any other region, shared their implementation strategy and the lessons they have learnt with the other regions.

Lessons Learned, Proposed Course Changes, and Recommendations

 Following the FAA review meeting and review of the project implementation plans by the MCSP and GHS, MCSP is seeking a no cost extension to complete the project activities by December 2017 instead of September 2017. Our latest accruals report, which shows a pipeline of approximately $450,677, is sufficient funding to keep essential staff through the extension period.

ANNEX I: Success Stories  The Institutional Care Division (ICD) of the GHS is responsible for ensuring high quality of clinical care. A focus area for improvement has been IPC practices in health facilities. Over the years, many trainings were held for frontline healthcare workers to improve routine IPC practices in the healthcare facilities; however, continuous monitoring post training to ensure sustainability of practices has been lacking hence healthcare workers IPC practices return to the pre-training levels a short while after the training. To address this challenge and ensure continuous improvement of IPC practices in the healthcare facilities, a facility focused IPC action plan to address the specific needs of every facility was to be developed. Through the IPC trainings at the regional and district health facilities, all the 36 healthcare facilities completing the IPC trainings have developed a comprehensive IPC action plans for their health facilities. Following the trainings, IPC focal persons are appointed in all these facilities to ensure implementation of the action plans. This has helped address the challenge of non-sustainability of IPC practices post trainings and its guaranteeing continuous improvement of IPC practices at the healthcare facilities.

ANNEX I: List of facilities completing IPC trainings 2

ASHANTI REGION TOTAL TRAINED Regional Hospital 382 Hospital 240 Effiduase Hospital 194 Ejisu Hospital 215 Ejura Hospital 152 Kokofu Hospital 123 Konongo Hospital 181 Mampong Hospital 212 Manyhia Hospital 302 Maternal Child Health Hospital 220 New Edubiase Hospital 154 Nkawie Hospital 227 Nkenkaasu Hospital 95 Nyinihini Hospital 120 Obuasi Hospital 176 Suntreso Government Hospital 371 Hospital 301 Tepa Hospital 168 TOTAL FOR REGION 3,833 BRONG Regional Hospital 512 Govt Hospital, 180 Holy Family Hospital, Techiman 185 Municipal Hospital, 109 Municipal Hospital, Sunyani 373 St Elizabeth Hospital, Hwidiem 150 TOTAL FOR REGION 1,509 EASTERN REGION Regional Hospital 579 Atua Hospital 231 Kibi Hospital 173 Suhum Hospital 209 Tetteh Quashie Hospital 238 TOTAL FOR REGION 1,430

UPPER WEST REGION 3 Nadowli District Hospital 210 Nandom District Hospital 224 Tumu District Hospital 124 TOTAL FOR REGION 558 UPPER EAST REGION Regional Hospital Bolgatanga 460 Bongo District Hospital 190 Tongo District Hospital 175 War Memorial Hospital 56 Zebilla District Hospital 234 TOTAL FOR REGION 1,115 TOTAL TRAINED TO-DATE 8,445

ANNEX II: Studies/Surveys Completed by Project  MCSP presented an accepted abstract titled “Competency Based Infection Prevention And Control Training Of Healthcare Workers In Ghana: A Systems Approach” at the 4th International Conference on Prevention & Infection Control (ICPIC 2017) held form the 20th to 23rd June in Geneva, Switzerland.

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