Adolescent mental, sexual and reproductive health and wellbeing policy, program and primary care implementation priorities in West Africa
Lead Research Organisation:
Ghana College of Physicians and Surgeons
Department Name: Faculty of Public Health
Abstract
Adolescence is a period marked by rapid physical, cognitive, social, emotional and sexual development. Globally, leading causes of death among adolescents include road injury, HIV, suicide, lower respiratory infections and interpersonal violence. The most common causes of years lost to disability (YLD) include unipolar depressive disorders, iron deficiency anemia, asthma, back and neck pain, anxiety disorders, and in older male adolescents, alcohol use disorders. There are gender and regional differences in the causes of morbidity and mortality in adolescents including in the African region which has the highest rates of disability-adjusted life years lost among adolescents. Globally adolescent pregnancy and childbirth is declining alongside increases in school participation, demand for contraception and age at first marriage. However, in parts of West Africa, rates remain unacceptably high, given the medical and social risks and complications of early pregnancy and childbirth. Therefore, apart from mental health; sexual and reproductive health is a priority concern for adolescent health and wellbeing interventions in West Africa. We aim to generate evidence to inform country and sub-regional level policy advocacy, priority setting, implementation (and de-implementation) for improved adolescent mental, sexual and reproductive health and wellbeing in West Africa. Our principal research question is: "what and why are adolescent wellbeing policy and program priorities in countries in West Africa, what mental, sexual and reproductive health services are available at primary health care level (sub-district /health centers and community) for adolescent health and wellbeing; are they proven effective, what and why are the mechanisms by which these services are funded and how efficiently are available resources used to deliver these services". In the context of these question our research objectives are to: (1) Map and analyze country and sub-regional actors and their ideas, ideology, interests and power, priorities and institutional environment /contexts and decision making in relation to adolescent health and wellbeing policies and programs in West Africa; which policies and priorities are moved into implementation (or not) and why. (2) Analyze sub-district and community level decision making processes of prioritizing which services to deliver and finding and allocating available resources at primary care level to provide adolescents health and wellbeing services (3) Synthesize the existing evidence on the proven effectiveness (or otherwise) of policy priorities and programs related to mental, sexual and reproductive adolescent health and wellbeing being implemented and generate evidence to support implementation and de-implementation (4) Describe the amounts of resources allocated to the various components of primary care mental, sexual and reproductive service provision for adolescent health and wellbeing at sub-district and primary health centers. (5) Assess the effectiveness, and technical efficiencies of available primary health centers in providing adolescents' mental, sexual and reproductive health services. (6) Analyze the factors that explain the technical efficiencies observed in primary health centers in providing Adolescents mental, sexual and reproductive health services. Our study design is a multi-country case study in three selected countries: Ghana (Anglophone) and Niger and Burkina Faso (Francophone). Data collection and analysis will involve qualitative and quantitative methods across a mix of public health disciplines relevant to the questions we are asking; specifically policy analysis, health economics, sociology and anthropology. Our findings will help to inform recommendations as to how primary care mental, sexual and reproductive health services can be configured to better respond to the needs of adolescents' in West Africa.
Technical Summary
The principal research question of this study is: "what and why are adolescent wellbeing policy and program priorities in countries in West Africa, what mental, sexual and reproductive health services are available at primary health care level for adolescent health and wellbeing; are they proven effective, what and why are the mechanisms by which these services are funded and how efficiently are available resources used to deliver these services". The study design is a multi-country case study in West Africa with the case is defined as: "Country level adolescent mental, sexual and reproductive health and wellbeing policy and implementation priorities, financing, technical and allocative efficiency of primary health care service provision". The three countries purposively selected for this study to reflect the anglophone francophone language divide in the sub-region as well as stable and more fragile contexts are Niger, Burkina Faso and Ghana. Specific groups to be studied will be adolescents (in and out of school) and their families and communities, national and sub-national level policy makers and frontline health workers. Within each country one region and two rural and two urban districts within the region will be selected for the sub-national level study. In each district four sub-district level primary care facilities will be randomly selected along with their surrounding communities. The conceptual framework of the study draws on several policy analysis and econometric frameworks including Leichter's scheme for analyzing context and the political economy framework of 4 I's (interests, institutions, ideas and ideology). Methods of data collection and analysis include desk review, key informant interviews, focus group discussions, participant and non participant observation, conversations, resource mapping, revenue and expenditure records analysis and Data Envelopment Analysis (DEA) or Stochastic frontier analysis (SFA).
Planned Impact
Who might benefit from this research?
Major potential beneficiaries of this research are adolescents, researchers, country and sub-regional level decision makers in the Economic Community of West African States (ECOWAS), frontline health workers, primary care facilities and their managers, families and communities of adolescents, civil society organizations (CSO) and media interested /involved in adolescent mental, sexual and reproductive health promotion and support.
How might they benefit from this research?
1) Adolescents
a) Improved engagement of adolescents in decision making concerning primary care mental, sexual and reproductive health services targeted at improving their health and wellbeing.
b) Improved quality and responsiveness of adolescent primary care mental, sexual and reproductive health services and related improved access and use of these services by adolescents who need them
c) Improved awareness among adolescents leading to their behavior/practice change for better health and wellbeing
2) Researchers
a) Deepened understanding in cross disciplinary research for adolescent health and wellbeing across multiple relevant disciplines such health economics, primary care, health systems and health policy research and analysis.
b) Strengthened capacity to generate evidence to inform advocacy, policy, planning and implementation for adolescent mental, sexual and reproductive health and wellbeing
c) Strengthened South-South research capacity and research networks of individuals embedded in institutions embedded in countries in West Africa
d) Strengthened North-South research networks and collaborative research capacity between individuals embedded in institutions in West Africa, UK and Canada
3) Country and sub-regional Level Decision Makers
a) Improved access to research evidence to inform policy and planning decisions and implementation support for adolescent mental, sexual and reproductive health and wellbeing.
b) Improved use of research evidence to inform adolescent mental, sexual and reproductive health and wellbeing policy and program decision making and implementation and or de-implementation for primary care (including priority setting and resource allocation).
4) Frontline health workers, primary care facilities and their managers
a) Improved prioritization and resource allocation for adolescent primary care mental, sexual and reproductive health services
b) Effective program planning
c) Improved quality, effectiveness and adolescent responsive primary care service design
d) Improved engagement of adolescents in decision making concerning their health and wellbeing.
5) Families and Communities of adolescents
a) Better understanding of adolescent mental, sexual and reproductive health and needs and effects on adolescent health and wellbeing
b) Application of the understanding to provide better support for improved adolescent health and wellbeing at the household and community level
6) Civil Society Organizations (CSO) and Media
a) Improved awareness of adolescent health and well being priorities in the West African sub-region
b) Improved use of evidence to inform adolescent mental, sexual and reproductive health and wellbeing policy and program decision making and implementation and or de-implementation advocacy and information provision.
Major potential beneficiaries of this research are adolescents, researchers, country and sub-regional level decision makers in the Economic Community of West African States (ECOWAS), frontline health workers, primary care facilities and their managers, families and communities of adolescents, civil society organizations (CSO) and media interested /involved in adolescent mental, sexual and reproductive health promotion and support.
How might they benefit from this research?
1) Adolescents
a) Improved engagement of adolescents in decision making concerning primary care mental, sexual and reproductive health services targeted at improving their health and wellbeing.
b) Improved quality and responsiveness of adolescent primary care mental, sexual and reproductive health services and related improved access and use of these services by adolescents who need them
c) Improved awareness among adolescents leading to their behavior/practice change for better health and wellbeing
2) Researchers
a) Deepened understanding in cross disciplinary research for adolescent health and wellbeing across multiple relevant disciplines such health economics, primary care, health systems and health policy research and analysis.
b) Strengthened capacity to generate evidence to inform advocacy, policy, planning and implementation for adolescent mental, sexual and reproductive health and wellbeing
c) Strengthened South-South research capacity and research networks of individuals embedded in institutions embedded in countries in West Africa
d) Strengthened North-South research networks and collaborative research capacity between individuals embedded in institutions in West Africa, UK and Canada
3) Country and sub-regional Level Decision Makers
a) Improved access to research evidence to inform policy and planning decisions and implementation support for adolescent mental, sexual and reproductive health and wellbeing.
b) Improved use of research evidence to inform adolescent mental, sexual and reproductive health and wellbeing policy and program decision making and implementation and or de-implementation for primary care (including priority setting and resource allocation).
4) Frontline health workers, primary care facilities and their managers
a) Improved prioritization and resource allocation for adolescent primary care mental, sexual and reproductive health services
b) Effective program planning
c) Improved quality, effectiveness and adolescent responsive primary care service design
d) Improved engagement of adolescents in decision making concerning their health and wellbeing.
5) Families and Communities of adolescents
a) Better understanding of adolescent mental, sexual and reproductive health and needs and effects on adolescent health and wellbeing
b) Application of the understanding to provide better support for improved adolescent health and wellbeing at the household and community level
6) Civil Society Organizations (CSO) and Media
a) Improved awareness of adolescent health and well being priorities in the West African sub-region
b) Improved use of evidence to inform adolescent mental, sexual and reproductive health and wellbeing policy and program decision making and implementation and or de-implementation advocacy and information provision.
Publications
Ibrahim N
(2022)
Profile of health facilities and determinants of the family planning services supply to unmarried adolescents in Burkina Faso, Ghana, and Niger.
in Ghana medical journal
Agblevor E
(2023)
"We have nice policies but": implementation gaps in the Ghana adolescent health service policy and strategy (2016-2020)
in Frontiers in Public Health
Amenah MA
(2024)
Adolescent mental health services in West Africa: a comparative analysis of Burkina Faso, Ghana, and Niger.
in Child and adolescent psychiatry and mental health
Agyepong I
(2024)
Interventions for adolescent mental, sexual and reproductive health in West Africa: A scoping review
in Public Health in Practice
| Description | Provision of advice and input to West Africa Health Organization Maternal Newborn Child and Adolescent Health Strategy document |
| Geographic Reach | Africa |
| Policy Influence Type | Participation in a guidance/advisory committee |
| URL | https://www.wahooas.org/web-ooas/en/actualites/cote-divoire/regional-workshop-maternal-and-child-hea... |
| Description | Gender-transformative approaches to address unmet adolescent mental, sexual, and reproductive health needs in Ghana, Niger, and Burkina Faso |
| Amount | $997,200 (CAD) |
| Funding ID | 109808 |
| Organisation | International Development Research Centre |
| Sector | Public |
| Country | Canada |
| Start | 12/2021 |
| End | 08/2025 |
| Description | Sharing of Data, co-production, pilot testing of intervention, research uptake activities, and publications (under peer review) in relation to interventions to improve health systems responsiveness to mental health of adolescents who end up pregnant and /or as mothers with Grant Reference MR/T023481/2: Improving health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam |
| Organisation | London School of Hygiene and Tropical Medicine (LSHTM) |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | The RESPONSE project (PI-Tolib Mirzoev and Grant Reference MR/T023481/2: Improving health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam) and the AdoWA-REP project (PI- Irene Agyepong and Grant reference MR/T040203/1: Adolescent mental, sexual and reproductive health and wellbeing policy, program and primary care implementation priorities in West Africa) are both funded by the UK Medical Research Council (MRC) and the Foreign Commonwealth and Development Office (FCDO) under the MRC/FCDO Concordat agreement, together with the Department of Health and Social Care (DHSC). The baseline findings from the adolescent health research in Ghana and from the responsiveness to maternal mental health research in Ghana showed important synergies and potential efficiency gains in a joined approach to interventions co-production for maternal mental health. Mental health was neglected in primary health care priorities for both adolescents and for pregnant and postpartum women. Some maternal health clients in the RESPONSE baseline studies in Ghana were adolescents' 15 to 19 years. They were the age group with the highest mental health assessment scores on the Depression Anxiety and Stress Scale (DASS). The research teams therefore agreed to collaborate in the co-production, implementation and feasibility assessment /formative evaluation of an intervention to improve health system responsiveness to maternal mental health for antenatal and post-natal women including adolescent maternal health clients in Ghana. The adolescent health research focused especially on making sure the intervention was responsive to the issues of adolescent mothers and raising awareness and creating synergies between relevant adolescent health policies and programs in the study setting and maternal and mental health programs in co-creation, piloting and process evaluation of the intervention The collaboration was also extended to the West Africa Health Organization forum in Abuja on Maternal, Newborn, Child and Adolescent health |
| Collaborator Contribution | By agreement the the RESPONSE project (PI-Tolib Mirzoev and Grant Reference MR/T023481/2: Improving health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam) and the AdoWA-REP project (PI- Irene Agyepong and Grant reference MR/T040203/1: Adolescent mental, sexual and reproductive health and wellbeing policy, program and primary care implementation priorities in West Africa) shared data, meetings and activities in all areas where synergies clearly promoted the shared desired outcomes of research and research uptake to inform adolescent mental, sexual and reproductive health improvement. The collaboration commenced 2024 when the analysis of the context analysis findings from both projects, the issues arising and the initial outputs of co-production forums clearly showed the issues synergies. It was made easier by the fact that the PI in each case is the co-PI on the other project and as the research evolved the need to work together became clear from seeing the shared data and outputs |
| Impact | Shared West African dissemination and policy dialogue in Abuja Nigeria in May 2024. Joint co-produced intervention that has been piloted with the engagement of health system policy makers and implementers in Ghana. Joint publication has been prepared and submitted to a peer reviewed journal (BMC Pregnancy and Child Birth) on the process evaluation of the co-created interventions. It is currently undergoing peer review so not available as an output that can be reported |
| Start Year | 2023 |
| Title | Integrating mental health into primary health care for adolescent and adult mothers as a collaborative effort with the RESONSE project |
| Description | The intervention components aimed to increase responsiveness to MMH for adult (age 20 and above years) and adolescent (age 10 to 19 years) clients in Ghana by using knowledge to empower frontline providers and managers as well as program beneficiaries, strengthening inter-relationships and breaking down the siloed approaches to maternal, adolescent and mental health programs at primary care and supporting frontline health workers and managers at primary care to provide synergized person centered rather than siloed program centered services. Capacity strengthening focused on capacities of frontline PHC providers to implement the intervention. Joint meetings and capacity building approaches were also established across maternal health, mental health and adolescent health at national, regional, district and primary care facility levels to enable effective communication between staff at different levels and across different service programs. The capacity building to support implementation of the intervention involved several components. It began with an initial full day district level orientation and training of intervention leads with representation from all six intervention PHC clinics. This was followed by facility level orientation and training of all PHC staff organised by the District Health Management Team (DHMT) in each district with support from the MHA and relevant Ghana Health Service (GHS) national and regional level program coordinators and members of the research team. The focus of the capacity building was on the intervention processes, understanding MMH and common mental health conditions, providing basic psychosocial support to maintain mental health and the 20-item Self -Reporting Questionnaire (SRQ- 20) mental health screening tool, identified as being relevant through an earlier review.21 Mental health workers (MHW) at district level comprise community psychiatric nurses who are diploma and graduate level professional nurses with mental health training and community mental health officers who are mental health auxiliaries. They work together and in the rest of this paper we will refer to them as mental health workers (MHW). They are trained by the MHA and the mental health department of the Institutional Care Division of the Ghana Health Service the GHS using the WHO mental health Gap Action Program (mhGAP) intervention manual for use in non specialised settings. They formed the first line of evaluation and management of clients seen by the midwifes and requiring further evaluation because of high SRQ- 20 scores. Clients were only referred to higher level specialists if the MHW could not manage the case. The beneficiaries of the intervention were adolescent (10 to 19 years) and adult women (20 years and above) attending the intervention primary care clinic for antenatal, immediate delivery, post abortion or miscarriage, or post-natal clinic and infant and child welfare clinics or seen by midwives and community health nurses during community home visits who had not been previously screened at a clinic visit. Based on feedback and discussions during the intervention co-production; male partners and in the case of adolescents without a partner, any guardians accompanying women to the clinic or present with the maternal health client during the home visit, were also counselled on MMH and given the chance to be screened if they wanted to. The rationale provided for requesting the option to include guardians and spouses during the co-production forums was that situations such as pregnancy, miscarriage and still birth can be stressful for both partners. The mental health challenges faced by partners or guardians can contribute to mental health stress experienced by maternal clients. Within the clinic, or at home visits midwives, community health officers and nurses, and national service personnel providing frontline care to maternal health clients administered the SRQ-20 questionnaire under the guidance and supervision of the Head of the maternal health team. All FHW were literate in English the tool was in English. It was translated into the most common local languages with the help of frontline staff during training since not all clients are fluent in English. The SRQ-20 questionnaire was designed with KoboCollect23, an open source android app for collecting survey data so that it could be administered via mobile phones and tablets with informed consent. KoboCollect allows for use in areas where internet connectivity is poor or challenging and data entered is synched when internet connectivity is restored or available. The SRQ-20 final score was automatically calculated by the app and could be seen by the nurse and shared with the client. For the purposes of research monitoring and evaluation the data was also accessible to research team members EA, LG and WS. A paper option was provided for staff in case the web-based app was not working. This had the disadvantage that the nurse had the extra work of transferring it to the online data base at the end of the day and was not much used. Where screening scores were considered normal (6 or less) FHW reassured the client and reinforced the education they had been trained to provide on mental health and wellbeing. Clients were advised to come back to the clinic if at any time they felt anxious, worried, depressed and needed support. Where the score was higher than 6 the FHW provided more extended counselling and referred clients to the nearest district based MHW. The MHWs further evaluated using the WHO Mental Health Gap Action Program (mhGAP) guidelines. Depending on the severity and tentative diagnosis the MHW managed in the district or referred to the psychiatry team from Pantang Hospital under the MHA for review during the periodic specialist mental health outreach visits to the PHC facilities that was part of the intervention. The only Clinical Psychologist available for both districts was stationed in DSO and referral was determined by the psychiatry team after their assessment. Where the case was considered an emergency, such as involving a danger of self-harm an arrangement was in place to request an ambulance and hospital referral. The co-production and pilot testing of this intervention has been a joint effort with the project: Improving health systems responsiveness to neglected needs of vulnerable groups in Ghana and Vietnam: Grant # MR/T023481/2" (RESPONSE) following the observation that in terms of mental health, adolescent mothers were one of the most vulnerable sub-groups. |
| Type | Health and Social Care Services |
| Current Stage Of Development | Initial development |
| Year Development Stage Completed | 2024 |
| Development Status | Actively seeking support |
| Impact | We engaged the adolescent and maternal health programs of Ghana Health Service at national, regional and district level and the Mental health authority in the development and pilot test of this intervention are partners in the development and pilot test of the intervention. They are keen to evaluate impact and approaches to scale up. |
| URL | https://www.youtube.com/watch?v=jeQurHktv4w |
| Description | Online Policy dialogue on AMH and the intersection with ASRH: A neglected dimension of adolescent PHC in West Africa |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Background Date: 28th Feb 2024. Time: 2:00 to 4:00pm UT /GMT. Organizer: West Africa Health Organization and AdoWA project Meeting chair: Prof. Issiaka Sombie, Public Health Directorate, WAHO. Aim To present some of the initial findings of the AdoWA research and the policy and program implications and stimulate discussion with policy makers, researchers, practicioners, the general public, civil society organizations, advocates and funders of adolescent health programs and interventions at the level of the Economic Community of West African States (ECOWAS) Target audience and participation The target audience for the webinar were: Ministry of health Policy makers, Global level policy makers, Technical advisors, Funders, Frontline health workers, Civil Society organizations, Adolescent groups and representatives and the general public / Any other interested stakeholders. The webinar was advertised via social media, on websites, through email and through networks. Two hundred and fifty three (253) individuals registered to participate in the seminar of whom 155 were able to effectively participate. They were from the 15 countries and institutions within the 15 West African countries that make up the Economic Community of West African States (ECOWAS). Simultaneous interpretation in English, French and Portuguese, the 3 official languages used in the ECOWAS was provided. |
| Year(s) Of Engagement Activity | 2024 |
| Description | Policy and Information briefs on preliminary results disseminated via website and link made available to online policy dialogue participants and in local stakeholder forums and engagement |
| Form Of Engagement Activity | Engagement focused website, blog or social media channel |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | We have prepared policy and information briefs of preliminary results that have been used in stakeholder validation forums, dissemination meetings and also posted online on our research website. https://www.wahpscon.org |
| Year(s) Of Engagement Activity | 2023,2024 |
| URL | https://www.wahpscon.org |
| Description | Regional Workshop on Maternal and Child Health in the ECOWAS region |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Policymakers/politicians |
| Results and Impact | The research PI (Irene Agyepong) at the invitation of the West African Health Organization (WAHO) participated in a meeting from June 18 to 20, 2024 at the Capitol Hotel in Abidjan, Côte d'Ivoire. The main objective of this workshop was to monitor progress in maternal, newborn, child, and adolescent health (MNCAH) and validate the regional strategy for accelerated reduction of maternal, newborn, and child mortality (MMNI) in the ECOWAS region by 2030. The workshop was organized by ,a team from the West African Health Organization (WAHO), led by Dr. Yves Mongbo, in collaboration with the USAID Regional Health Office. WAHO requested the program PI (Irene Agyepong) to make a presentation in the context of this meeting on the research and relevant findings to contribute to informing MNCAH in the West Africa sub-region and the finalization of the strategy. The presentation was made and the findings and their relevance to the validation and revision of the sub-regional strategy discussed. The discussions and presentations were inputs into the work of the team revising the strategy. Participants included delegates from all the 12 ECOWAS countries, representing the ministries of health and MNCAH programs as well as and technical and financial partners such as WHO and UNFPA. The final revisions of the strategy are still ongoing and it is yet to be made publically available. WAHO has undertaken to notify the PI as soon as the revised strategy is finalised and becomes publicly available. |
| Year(s) Of Engagement Activity | 2024 |
| URL | https://www.wahooas.org/web-ooas/en/actualites/cote-divoire/regional-workshop-maternal-and-child-hea... |
| Description | West Africa Research Dissemination and Policy Dialogue meeting on Adolescent and Maternal Health on sidelines of ECOWAS Health Ministers meeting in Abuja, Nigeria 13&14 May 2024 |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Policymakers/politicians |
| Results and Impact | The objectives were: (1) Share results from ongoing research and interventions on adolescent mental, sexual and reproductive health, and health systems responsiveness to maternal mental health in West Africa. (2) Engage with key stakeholders and reflect on implications for policy and program development, and implementation, for improving adolescent mental, sexual, and reproductive health and maternal mental health. (3) Collectively reflect with policy actors on needs and demands for future research. (4) Reflect on the strengths and limitations of coproduction approaches from the two consortia about establishing and sustaining research policy partnerships. The meeting organizers were the West African Health Organization (WAHO), in the context of the Assembly of Economic Community of West African States (ECOWAS) Health Ministers meeting held from 13 to 17 May at the ECOWAS Commission, Abuja. In collaboration with research partners: Ghana College of Physicians and Surgeons (GCPS) and Ghana Health Service, Research and Development Division, Dodowa Health Research Centre (DHRC); KNUST, ISSER, IASP Burkina Faso, LASDEL Niger, UdeM Canada, LSHTM & UoL UK, HUSPH Vietnam, UoM Australia (AdoWA and RESPONSE research teams). The primary audience were MOH National and sub-national level Policy makers, West Africa Health Organization (WAHO) Director General (DG) and technical officers, Communication to the DG WAHO and ECOWAS ministers of health forum via a meeting communique There were 53 participants from seven countries in West Africa namely: Ghana, Burkina Faso, Niger, Cote d'Ivoire, Nigeria, Senegal and Guinea. They were from national and sub-national levels representing decision makers, implementers, CSO, Journalists, frontline health workers, representatives of adolescents and researchers. Most participants were from ministries of health in their countries. There was one journalist from Senegal and Civil Society Organization participation from Ghana and Burkina Faso. There were relatively more participants from Ghana because of the three collaborating research teams (AdoWA-REP, AdoWA-GTR, RESPONSE) as well as the national level decision makers, frontline health workers and managers involved in the pilot and formative evaluation of the joint RESPONSE & AdoWA-REP intervention in two districts in Ghana. The co-production and participatory action research approach taken to the piloting and formative evaluation of the intervention in Ghana, meant that most of the presentations of experiences and lessons was led by participants from the health system or done jointly by the research team and participants from the health system. A communique was jointly developed by participants at the end of the meeting and submitted through the Director of Public Health in WAHO to the DG WAHO to inform policy discussions and strategy development in West Africa on maternal and adolescent health. Following the meeting, Prof. Irene Agyepong was invited by WAHO to present a summary of the key issues and participate in their three sub-regional meeting to review the draft and help to finalize the development of their next five year maternal, newborn, child and adolescent health (MNCAH) strategy for West Africa from 18 - 20 June 2024 in Abidjan Cote d'Ivoire. The need to include and integrate mental health into adolescent sexual and reproductive health as well as maternal mental health were agreed to be included in the revisions of the strategy along with the other recommended priorities for Maternal, Newborn, Child and Adolescent health improvement in the ECOWAS sub-region. |
| Year(s) Of Engagement Activity | 2024 |
| URL | https://www.wahpscon.org/2024/07/23/final-report-adowa-response-dissemination-in-abuja-may-2024/ |