Prioritizing Safe Water Access in Healthcare Facilities
Summary
The Northern Region of Ghana faces severe water scarcity, affecting communities and healthcare centers. The Aid for Development Foundation (AFORD) partnered with SEND GHANA to implement the People for Health (P4H) project, aiming to improve water, sanitation, and hygiene (WASH) conditions.
Through advocacy training and lobbying efforts, AFORD successfully secured safe water access for a healthcare facility in Tamale, resulting in increased usage and supervised deliveries, reducing maternal and perinatal mortality. However, challenges persist, including inadequate financing for the WASH sector and delays in fund disbursement, highlighting the need for sustained advocacy efforts at both local and central government levels.
The Northern Region of Ghana is known for being extremely dry. For approximately half the year, there is no rainfall, wherein rivers, streams, and dams dry up, which makes it challenging for communities that rely on surface water resources to meet their demand. Due to the lack of access to safe water in communities, including limited or nonexistent access to piped water, many individuals will walk long distances in search of water and the quality of water they do find is often poor. Healthcare centres, in particular, feel the impacts of the limited access, as they require a safe and accessible water supply to provide quality care (CDC, 2022). Without appropriate water, sanitation and hygiene (WASH) infrastructure and services, patients, healthcare workers, and communities are at increased risk of disease (CDC, 2022).
Intervention
Aid for Development Foundation (AFORD) is a local non-governmental organization operating in the northern region of Ghana, headquartered in Tamale. AFORD was founded in 1996 and its first operations were focused on providing relief to victims of the 1994 civil war in northern Ghana, however, it has since expanded to assist in the general development of communities affected by the conflict (Water Action Hub, n.d.). The organization is dedicated to supporting communities and vulnerable groups, specifically women and children, to improve their standard of living.
Given AFORD'ss experience in citizen engagement and monitoring, in August 2016 the organization entered into a partnership with SEND GHANA via Memorandum of Understanding to implement the People for Health (P4H) project. Overall, the P4H project aims to strengthen organizational and institutional capabilities of government and civil society actors for mutual accountability in WASH policy formulation and implementation through cost-effective and evidence-based solutions. 20 districts across four regions (Greater Accra, Eastern, Northern, and Volta) were targeted for the P4H project.
In February 2018, the P4H project provided advocacy training to Water, Sanitation and Hygiene committees (WATSANs) and Community Health Management Committees (CHMCs) in Yong (a suburb of Tamale Metropolitan), with funding provided by USAID and SEND GHANA. The WATSAN is a community-based management team of water and sanitation facilities aiming to improve WASH service delivery and is composed of seven members. The CHMC is a community-based management team of health facilities, acting as an intermediary between healthcare providers and the community and is composed of nine members . These committees were established in 2012, but were dormant until the implementation of the P4H project. The P4H project represented an opportunity for AFORD to effectively lobby government officials as part of its commitment to support community development.
The advocacy training through the P4H project supported capacity-building to lobby government officials on WASH issues, in addition to education, health, women's empowerment, and social protection, focused on the small farming village outside of Tamale that is home to approximately 3400 people. Applying the skills acquired through the P4H training, WATSAN members sent a letter to the Chief Executive Officer of the Tamale Metropolitan Assembly with the aim to highlight ongoing water challenges, specifically the lack of access to safe water at the community healthcare facility, and the considerable impacts on healthcare delivery. Several follow-ups were sent by WATSAN members and, in July 2019, the Ghana Water Company extended service to the healthcare facility. This followed the posting of a midwife at the healthcare facility in May 2019, the first since the establishment of the facility in 2015. Prior to this, community residents who were pregnant would have to travel to a neighbouring village for medical attention due to the lack of safe water to support deliveries.
Challenges
While the P4H project has had considerable, measurable impacts on the community due to the provision of safe water at the local healthcare facility, two key challenges have been identified. First, there is an overall inadequacy in the financing of the WASH sector from all levels of government. Second, there have been delays in the release of funds from the central government for WASH activity implementation, which impedes lobbying efforts due to the increased time to achieve results. For these reasons, there needs to be continuous efforts to lobby local authorities and the central government as to the importance of sufficient and timely funding for the WASH sector.
Outcomes
While AFORD has been involved in WASH, education, health, women's empowerment, and social protection for over 20 years, the P4H project represented a significant step in building capacity to ensure lasting solutions to challenges that hinder effective community development. Since 2019, more women have been using the healthcare facility to seek medical attention. Since the midwife joined the facility in May 2019, over 125 supervised deliveries were performed over her first two years. Since then, there were 80 supervised deliveries in 2022, 32 supervised deliveries in 2023, and 9 deliveries in January/February 2024. Due to the presence of a trained healthcare professional during deliveries, the number of home births has decreased, which supports a reduction in maternal and perinatal mortality and morbidity and promotes effective postnatal care.
Since the initial lobbying push, and with the enhanced capacity of WATSANs following the P4H training, committee members are continuously working to address water issues across communities. There has been an incremental increase in funding allocations from various levels of government, however, funding for the WASH sector remains largely donor-funded.
References
Prioritizing Safe Water Access in Healthcare Facilities
Summary
The Northern Region of Ghana faces severe water scarcity, affecting communities and healthcare centers. The Aid for Development Foundation (AFORD) partnered with SEND GHANA to implement the People for Health (P4H) project, aiming to improve water, sanitation, and hygiene (WASH) conditions.
Through advocacy training and lobbying efforts, AFORD successfully secured safe water access for a healthcare facility in Tamale, resulting in increased usage and supervised deliveries, reducing maternal and perinatal mortality. However, challenges persist, including inadequate financing for the WASH sector and delays in fund disbursement, highlighting the need for sustained advocacy efforts at both local and central government levels.
The Northern Region of Ghana is known for being extremely dry. For approximately half the year, there is no rainfall, wherein rivers, streams, and dams dry up, which makes it challenging for communities that rely on surface water resources to meet their demand. Due to the lack of access to safe water in communities, including limited or nonexistent access to piped water, many individuals will walk long distances in search of water and the quality of water they do find is often poor. Healthcare centres, in particular, feel the impacts of the limited access, as they require a safe and accessible water supply to provide quality care (CDC, 2022). Without appropriate water, sanitation and hygiene (WASH) infrastructure and services, patients, healthcare workers, and communities are at increased risk of disease (CDC, 2022).
Issue
Intervention
Aid for Development Foundation (AFORD) is a local non-governmental organization operating in the northern region of Ghana, headquartered in Tamale. AFORD was founded in 1996 and its first operations were focused on providing relief to victims of the 1994 civil war in northern Ghana, however, it has since expanded to assist in the general development of communities affected by the conflict (Water Action Hub, n.d.). The organization is dedicated to supporting communities and vulnerable groups, specifically women and children, to improve their standard of living.
Given AFORD'ss experience in citizen engagement and monitoring, in August 2016 the organization entered into a partnership with SEND GHANA via Memorandum of Understanding to implement the People for Health (P4H) project. Overall, the P4H project aims to strengthen organizational and institutional capabilities of government and civil society actors for mutual accountability in WASH policy formulation and implementation through cost-effective and evidence-based solutions. 20 districts across four regions (Greater Accra, Eastern, Northern, and Volta) were targeted for the P4H project.
In February 2018, the P4H project provided advocacy training to Water, Sanitation and Hygiene committees (WATSANs) and Community Health Management Committees (CHMCs) in Yong (a suburb of Tamale Metropolitan), with funding provided by USAID and SEND GHANA. The WATSAN is a community-based management team of water and sanitation facilities aiming to improve WASH service delivery and is composed of seven members. The CHMC is a community-based management team of health facilities, acting as an intermediary between healthcare providers and the community and is composed of nine members . These committees were established in 2012, but were dormant until the implementation of the P4H project. The P4H project represented an opportunity for AFORD to effectively lobby government officials as part of its commitment to support community development.
The advocacy training through the P4H project supported capacity-building to lobby government officials on WASH issues, in addition to education, health, women's empowerment, and social protection, focused on the small farming village outside of Tamale that is home to approximately 3400 people. Applying the skills acquired through the P4H training, WATSAN members sent a letter to the Chief Executive Officer of the Tamale Metropolitan Assembly with the aim to highlight ongoing water challenges, specifically the lack of access to safe water at the community healthcare facility, and the considerable impacts on healthcare delivery. Several follow-ups were sent by WATSAN members and, in July 2019, the Ghana Water Company extended service to the healthcare facility. This followed the posting of a midwife at the healthcare facility in May 2019, the first since the establishment of the facility in 2015. Prior to this, community residents who were pregnant would have to travel to a neighbouring village for medical attention due to the lack of safe water to support deliveries.
Challenges
While the P4H project has had considerable, measurable impacts on the community due to the provision of safe water at the local healthcare facility, two key challenges have been identified. First, there is an overall inadequacy in the financing of the WASH sector from all levels of government. Second, there have been delays in the release of funds from the central government for WASH activity implementation, which impedes lobbying efforts due to the increased time to achieve results. For these reasons, there needs to be continuous efforts to lobby local authorities and the central government as to the importance of sufficient and timely funding for the WASH sector.
Outcomes
While AFORD has been involved in WASH, education, health, women's empowerment, and social protection for over 20 years, the P4H project represented a significant step in building capacity to ensure lasting solutions to challenges that hinder effective community development. Since 2019, more women have been using the healthcare facility to seek medical attention. Since the midwife joined the facility in May 2019, over 125 supervised deliveries were performed over her first two years. Since then, there were 80 supervised deliveries in 2022, 32 supervised deliveries in 2023, and 9 deliveries in January/February 2024. Due to the presence of a trained healthcare professional during deliveries, the number of home births has decreased, which supports a reduction in maternal and perinatal mortality and morbidity and promotes effective postnatal care.
Since the initial lobbying push, and with the enhanced capacity of WATSANs following the P4H training, committee members are continuously working to address water issues across communities. There has been an incremental increase in funding allocations from various levels of government, however, funding for the WASH sector remains largely donor-funded.
Issues |
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Water Scarcity and Access |
Solutions |
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Governance & Accountability |
References
Aid for Development Foundation (AFORD) . Water Action Hub. (n.d.). https://wateractionhub.org/organizations/1038/d/aid-for-development-foundation-aford/
Centers for Disease Control and Prevention. (2022, December 13). Water, sanitation, and hygiene (WASH) in healthcare facilities . Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/healthywater/global/healthcare-facilities/overview.html