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USAID GLOBAL HEALTH || GHONOBS


Over the previous 20 years, important health indices have made significant progress. Between 2007 and 2017, maternal mortality associated to pregnancy declined by 24%, from 451 to 343 deaths per 100,000 live births, while under-five mortality decreased by 37%, from 82 to 52 deaths per 1,000 live births. Malaria prevalence in Ghana's under-five population dropped considerably from 21% in 2016 to 14% in 2019.

Regional gaps still exist, though, as northern Ghana lags behind in key health indicators like under-five malnutrition and severe anemia, greater rates of child death, and lesser access to essential medical care. Many rural populations, especially in the northern regions, continue to face severe issues due to widespread open defecation and limited access to improved water sources. Mothers' and children's health continues to be harmed by low contraceptive prevalence nationwide (married women utilize modern methods of contraception at a rate of 25%) and high fertility rates in the north. HIV prevalence is still high in certain critical demographics, with rates of 4.6% for female sex workers and 18% for men who have sex with men. Although there is a fair amount of access to health care, the level of quality remains low.

The GoG is still dedicated to achieving universal health coverage by 2030, with a focus on primary healthcare, and USAID is still prepared to assist.

RESPONSE TO COVID-19
On March 12, 2020, Ghana reported its first case of COVID-19. A COVID-19 Coordination Unit and Emergency Operations Center (EOC) were set up by President Nana Akufo-Addo to manage the nation's response. Working together to strengthen the following areas, the United States Government (USG) has played a crucial part in helping Ghana's COVID-19 response.

Treatment with oxygen and case management
continuity of additional crucial medical services
giving away COVID-19 vaccinations
operational vaccination deployment
distribution of the COVID-19 vaccine's supply chain
Pharmacovigilance to keep an eye on vaccination side effects
The development and dissemination of messaging for COVID-19 prevention and demand creation for vaccination uptake rely on social and behavioral change.
The USG has provided 28 high-flow, high-pressure oxygen concentrators to healthcare facilities throughout Ghana's 16 regions in addition to four Pressure Swing Adsorption oxygen generating units for the GoG. Additionally, the USG has helped Ghana's national case management team for COVID-19 train doctors in oxygen therapy and COVID-19 critical, severe, moderate, and mild case management utilizing a combination of didactic techniques and clinical rounds. As of April 7, the USG had given 9,605,158 doses of the COVID-19 vaccine to the GoG and was helping Ghana with operations so that it could reach its target of immunizing 20 million people by June 2022.

REPRODUCTIVE, MATERNAL, Neonatal, AND CHILD HEALTH To enhance maternal, newborn, and child health care, USAID collaborates with the Ghana Health Service (GHS). The goal of assistance is to increase the skills of health professionals so they can deliver high-quality Maternal, Newborn, and Child Health (MNCH) services, enabling GHS to:

Increase the ability of midwives to provide better and more standardized infant care, emergency obstetric and newborn care, and care for small and unwell newborns (EmONC).
Deliver a comprehensive technique mix of reversible long-acting contraceptives for family planning.
Through provider outreach and social marketing strategies to new mothers, USAID, working through a local social marketing organization, increased awareness of and use of chlorhexidine gel to prevent neonatal sepsis in 2021. The organization also distributed 209,104 units of the gel to retail establishments across Ghana.

NUTRITION
In order to enhance the nutritional condition of women and children under the age of five, USAID collaborates with the GoG through on-budget support as part of the USG's Global Health and Feed the Future Initiatives. Resilience in Northern Ghana II (RING II), the main initiative, aims to maintain advancements in the provision of services that support the resilience and nutrition of disadvantaged communities in northern Ghana. By empowering residents to contribute to the enhancement of the provision of social sector services, RING II increases government capacity to plan, finance, and provide local services. Additional cross-sectoral initiatives include:

supporting neighborhood programs to treat and stop severe acute malnutrition
enhancing the production and consumption of wholesome meals.
encouraging actions that will enhance early child feeding, anemia treatment, and dietary diversity.
ensuring that people who are vulnerable have access to social services.
According to a USAID study, between 2015 and 2019, the percentage of children in districts in the Northern, Savannah, and North East regions that consume a minimum acceptable diet rose from 10% to 65%.

MALARIA
The United States President's Malaria Initiative (PMI), which aims to scale up effective malaria prevention and treatment strategies, is directed by USAID in collaboration with the Centers for Disease Control and Prevention. In order to increase the GoG's capacity to develop, carry out, and evaluate malaria control interventions that are suited to particular regional and district malaria needs, PMI supports the GoG's National Malaria Control Program. The following high impact interventions are supported by PMI in Ghana:

bednet procurement and distribution
spraying indoor residuals
Seasonal chemoprevention of malaria
Diagnostic and intermittent prenatal care for expectant mothers
malaria treatment using effective medications
PMI assists Ghana's health system by strengthening the supply chain and enhancing the District Health Information Management System to ensure accurate, timely, and comprehensive reporting of malaria data. In Sub-Saharan Africa, Ghana has one of the highest rates of intermittent preventive medication for expectant women (78%), and the nation records more than 80% of malaria laboratory confirmations prior to the administration of malaria treatment. According to routine health information, the number of malaria deaths decreased by 88.5 percent from 2,072 in 2015 to 238 in 2021.

HIV/AIDS

To accomplish the goals specified in Ghana's HIV and AIDS Strategic Plan 2021–2025, the USG's President's Emergency Plan for AIDS Relief (PEPFAR) Initiative works closely with the Ghana AIDS Commission, the Ghana Health Service's National AIDS Control Programme, and civil society organizations. USAID prioritizes:

improving direct service delivery in the Western, Western North, and Ahafo Regions in order to reduce epidemics.
supporting case detection that is efficient and sustainable, treatment start and continuation, viral load lowering, and progress toward the PEPFAR and UNAIDS 95-95-95 targets.
With 73 percent of all prescriptions for antiretrovirals now being written for multiple months, 93 percent of patients have switched to the improved WHO Tenofovir, Lamivudine, and Dolutegravir (TLD) line of treatment, and pre-exposure prophylaxis and HIV self-testing have been piloted thanks in large part to PEPFAR support over the past two years. By the end of 2021, 4,349 HIV-positive individuals had been diagnosed, 4,134 (95 percent) had been linked to treatment, and our technical assistance had contributed to the maintenance of about 29,000 individuals on treatment in the Western, Western North, and Ahafo areas.

STRENGTHENING HEALTH SYSTEMS
In order to improve the overall national health care system and policy environment, USAID assists the Ministry of Health. In order to ensure that high quality care is delivered at all levels of Ghana's health system, USAID invests in long-term supervisory mechanisms. Also, USAID

supports decentralized levels of the sector with health funding, operations research and data for decision-making, leadership enhancement, workforce development in the health field, supply chain transformation, service delivery models, and management systems.
works collaboratively with the private sector to increase access to reasonably priced, life-saving medical supplies, including the Ghana Social Marketing Foundation and Total Family Health Organization.
For the purpose of streamlining the real-time tracking and forecasting of medical supplies and commodities at all levels of the health system, USAID has assisted the GoG in operationalizing the Ghana Integrated Logistics Management Information System in 1,508 sites as of this writing.

societal defense
The Ministry of Gender, Children and Social Protection (MoGCSP) is supported by USAID and UNICEF to strengthen social protection and welfare systems for better health outcomes for marginalized women and children. In order for the MoGCSP to:

Through the GoG's Livelihood Empowerment Against Poverty (LEAP) initiative, cash transfers are being tested with the goal of improving newborn nutrition during the critical first 1,000 days of life, when the effects of malnutrition are particularly severe.
The GoG changed its qualifying requirements in response to the successful trial, expanding the program's reach to pregnant women and infants countrywide. Between 2016 and 2021, a government-to-government agreement with the MoGCSP led to significant changes in Ghana's foster care system that support family-based care rather than institutionalization.
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