Reciprocal Innovation – Focused-PPC: An integrated postpartum care, education, and support model for women in Ghana2022-05-03T06:35:57-04:00

Focused-PPC: An integrated postpartum care, education, and support model for women in Ghana

Principal Investigator Yenupini (Joyce) Adams, University of Notre Dame
International Collaborator(s) John Stephen Agbenyo, Savana Signatures; Ethel Emefa Ehla, Savana Signatures
Project Type Demonstration Grant
Project Title Focused-PPC: An integrated postpartum care, education, and support model for women in Ghana
Priority Area Infant and maternal Health
The Intervention In many settings in Sub-Saharan Africa, quality postpartum care, education, and support for the mother are often the missing components of postnatal care delivery, which focuses on care of the baby. The lack of standard postpartum care for the mother contributes to maternal deaths. Thus, the purpose of this project is to test and evaluate an innovative postpartum care, education, and support model known as Focused-PPC, in Tamale, Ghana. The proposed project will be the first of its kind to design an integrated and comprehensive group postpartum care delivery model, focused on clinical care of the mother and baby, as well as education and peer support in Ghana. Focused Postpartum Care (Focused-PPC) will be delivered to mothers in 4 health facilities (Choggu, Kanvilli, Kalpohini and Bagabaga health centers) up to one year after delivery. Specifically, women enrolled in Focused-PPC will receive postpartum clinical assessments and education for the first 6 weeks, and will continue to receive education, measures of vital signs, and peer support for 12 months postpartum during child welfare visits. Our model supports the clinical assessments and timeframes recommended by the World Health Organization (WHO) and adopted by Ghana Health Service (GHS). Each group will meet at 1-2 weeks, 6 weeks, and monthly thereafter for up to 1 year postpartum following the Ghana health service postnatal care schedule. Led by trained midwives in the health centers, each group session will consist of postpartum clinical assessments for mother (in addition to baby), education, and support. Postpartum clinical assessments follow the recommended clinical assessments by GHS and WHO and include assessment of vital signs, fundal assessment, vaginal bleeding/discharge, any incisions, breast exam, and baby exam. The content of Focused-PPC education focuses on the unique needs of postpartum women based on time-frame after delivery. This specific content has been developed from evidence-based guidelines, reviewed by several experts, and approved by GHS. Both audio and visual content will be used during Focused-PPC sessions at the health centers. Focused-PPC has the potential to change the postpartum care delivery model in Ghana and other countries in sub-Saharan Africa and beyond. Results from this implementation will be used to further refine and scale up the Focused-PPC model of postpartum care.
Key Facilitators This project is in collaboration with Savana Signatures Organization in Tamale, Ghana. Key partnerships include the Ghana Health Service, both the District/Municipal and Regional levels, and 4 health centers in Sagnarigu Municipal (Choggu Health Center, Bagabaga Health Center, Kanvilli Health Center, Kalpohin Health Center). Focused-PPC sessions will be facilitated by midwives and hired project assistants. Other key personnel include consultants on the project.
Target Population The target population include women in Sagnarigu Municipal, Tamale, who receive pregnancy care from the four health centers. Women recruited are in their third trimester of pregnancy, 18 years and older, and able to speak and understand Dagbani and/or English.
Process to Implementation The intervention is currently being Implemented in Tamale, Ghana. It has not yet been implemented in Indiana. We hope to learn from the Ghana project and apply this intervention to underserved settings in Indiana. Plans are underway to identify potential pilot sites in Indiana. Following identification of pilot sites, Focused-PPC will be adapted to the US context and pilot tested.
Key Stakeholders Stakeholders include pregnant and postpartum mothers, their partners/support persons/family, health facilities, Ministry of Health, and community partners
Scaled or Transferred? We aim to refine and scale up Focused-PPC in Ghana and other SSA contexts. We aim to scale to Indiana and other US contexts
Type of Research Randomized Controlled Trial: This is a parallel designed study with balanced randomization (1:1) conducted in 4 health centers in Tamale, Ghana. Differences in outcome measures between the intervention and control groups will be assessed. We also plan to evaluate the acceptability and satisfaction of Focused-PPC. Focus groups will be conducted with the midwives who implemented Focused-PPC, and with each group of participants in Focused-PPC intervention.
Published Materials Study protocol manuscript in process
Year Funded 2021

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