Ghana Health Service: It works

GAVI/2012/Olivier AsselinI accompanied GAVI CEO, Dr Seth Berkley, on a joint country visit with Mr.  Bill Gates to Ghana two weeks ago.  This was Mr Gates first visit with the Ghana Health Service.

We spent our first morning on the field, visiting more specifically the Community-based Health Planning and Services initiative’s compound which is part of the strategy for changing primary health care from a focus on clinical care at district and sub-district levels to a new focus on high quality services at community and doorstep locations.

The Community Health Officers were at an outreach clinic, under a shady tree providing some cover from the hot sun.  They showed us their child registers and Well Baby Clinic cards with records of vaccinations, weight and other relevant child health records. This particular district is also using mobile phone technology to register pregnant women. Regular messages including vaccination appointments are sent in the local language to mothers.

GAVI_2012_Olivier Asselin_GHANA_308The Community Health Officers use this mobile technology to generate a list of expected clients and defaulters for follow up. They also use paper systems of child health cards and registers and logbooks in clinics to track a child’s progress with vaccinations.  Mr Gates saw progress that they have made using the paper system and the culture of data that it supports. For example, the district holds regular monthly meetings to validate data before it is shared with higher levels.

At the end of the day, the health workers were happy with Mr Gates summary of the visit: ‘The system is not perfect but it works’ 

I was reminded of his words in subsequent conversations I had with family and friends the following week. My cousin, a dermatologist, praised the Community Health Officers for the way they keep and use immunisation data. Monthly inter-district review meetings were opportunities to share best practices and validate data on reproductive and child health including immunisation. She wished clinical services were as organised as the preventive services organised by the Community Health Officers.

2011.01.29. PCV Yemen (13)At a subsequent dinner organised by some retired public health colleagues, one of them described how medical students he examined could not remember the last time they saw a case of clinical measles. He spoke eloquently about the dedication of Community Health Officers at peripheral levels of the health care system in bringing services including immunisation to communities.  Countries unhampered by the scourge of vaccine preventable diseases can rise to their full developmental potential, he said. More should be done by the Ghana Health Service and developmental organisations to publicise how we are contributing to national prosperity.

Strong primary health care systems are the bedrock of successful immunisation programmes which contributes to saving lives.


Mercy Ahun
Special Representative,
GAVI Alliance



  1. Ali Butt says

    GAVI has undoubtedly outdone itself in spreading the immunization programs across the globe and especially in the developing world. I think countries really need to synchronize their efforts in improving their PHC to ensure that vaccination programs work in the true sense.

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