Peer-reviewed article
How ready are health managers to use effective coverage indicators to monitor and evaluate maternal and child health programmes? A qualitative study in rural Ghana
Ferguson Saapiire, Charlotte Tawiah, Francis Agbokey, Kenneth Ayuurebobi Ae-Ngibise, Wisdom Kudzo Axame et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This qualitative study asked district and subdistrict health managers in Kintampo North and Kintampo South, Ghana, how ready they are to use 'effective coverage' to monitor maternal and child health services. Effective coverage is an indicator of service use that also takes service quality into account. Managers took part in a 3-month pilot with workshops, hands-on training and planning sessions, and were interviewed before and after it. Afterwards they said they understood the indicator, felt confident computing it from routine data, and were willing to use it in routine monitoring. They also described technical and logistical challenges and said the national health information system does not hold enough data.
Key points
- After the learning sessions, participants reported understanding the components of effective coverage and how to compute and apply it using routine district data.
- Participants reported confidence in computing and interpreting the indicator.
- In follow-up interviews, participants were willing to integrate the indicator into routine monitoring processes.
- Participants identified technical and logistical challenges.
- Limited routine data in the national health information management system was described as a major barrier to implementation.
Limitations
The study draws on interviews with a purposively selected group of managers in two rural districts, so the findings reflect self-reported perceptions and may not apply elsewhere. It does not measure whether the indicator was actually adopted or whether maternal and child health outcomes improved.
Abstract
OBJECTIVE: To explore the readiness of health managers to integrate effective coverage into routine monitoring of maternal and child health (MCH) services in two rural districts of Ghana. METHODS: An exploratory qualitative study was conducted among purposively selected district and subdistrict health managers in Kintampo North and Kintampo South, Ghana. Two rounds of in-depth interviews explored participants' perceptions and implementation considerations regarding the use of effective coverage. Between the two rounds, participants took part in a 3-month pilot implementation phase. This phase included workshops, hands-on training and planning sessions. During this period, participants were trained to compute and interpret effective coverage using routine data and to explore its application to MCH monitoring and evaluation. Data were analysed thematically in NVivo V.17 using Braun and Clarke's six-phase approach. RESULTS: Following the learning sessions, participants reported an understanding of the components of effective coverage and how to compute and apply the indicator using routine district data. They also reported confidence in computing and interpreting the indicator. In the follow-up interviews, participants expressed willingness to integrate the indicator into routine monitoring processes. However, they identified technical and logistical challenges and inadequate data in the current national health information management system. CONCLUSION: Health managers in rural Ghana expressed willingness to integrate effective coverage into the routine monitoring and evaluation of MCH programmes. However, limited availability of routine data within the national health information management system remains a major barrier to implementation.