LECTURE 1

• Reproductive and Child Health (RCH) encompasses reproductive health, sexual

health, maternal health, and child health. It aims to promote complete physical,

mental and social well-being related to reproductive and child health.

• Components of reproductive health include: safe motherhood, family

planning, prevention/management of unsafe abortion, reproductive tract

infections/STIs/HIV, infertility, reproductive cancers, menopause/

andropause issues, harmful practices, counseling on sexuality and health.

• Components of child health include: neonatal health, under 5 health

(immunization, nutrition, disease prevention/treatment), school health,

adolescent health.

• Rationale for RCH: Women and children are vulnerable groups that make

up a large proportion of the population. Their health is a priority as it

impacts development.

• History: Shift from narrow family planning focus to broader reproductive

health approach after 1994 ICPD conference. Emphasis on continuum of

care across lifecycle.

• Reproductive health spans from birth to old age ("womb to tomb"), with

di erent issues arising at each life stage that require appropriate care.

• Service delivery involves various levels (community to national) and

providers. Focus is on accessible integrated care.

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 • Global initiatives like MDGs and SDGs highlight importance of RCH.

LECTURE 2

The Ministry of Health is responsible for health sector policy formulation,

coordination, monitoring and evaluation. It has oversight of agencies involved in

service delivery, regulation, training, research etc.

• The Ghana Health Service and Teaching Hospitals are major implementers

of health service delivery.

• The health sector aims to achieve a healthy population through accessible,

equitable, quality services. Objectives and strategies are outlined in

documents like the Health Sector Medium Term Development Plan.

• Monitoring and evaluation of health sector performance involves routine

data collection, reporting, and periodic reviews at national and sub-

national levels.

• Health care is nanced through government allocation, national health

insurance, development partners, and private sources like households.

There are e orts to expand nancial access e.g. free maternal care

policies.

• Laws like the abortion law and policies provide guidance on health service

delivery. Other relevant laws cover issues like FGM, domestic violence etc.
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 • Health service delivery involves various levels from community to national,

both public and private sector. There are national and global health targets

like the SDGs that the health sector aims to contribute towards.

• Coordination in the sector involves entities like Inter-Agency Coordinating

Committees and partners like NGOs and development agencies.

LECTURE 3

Indices like maternal mortality ratio, under-5 mortality rate, and contraceptive

prevalence rate are important measures of reproductive and child health status.

• They help track progress towards national and global goals and highlight

areas needing more e ort. Knowing the de nitions, data sources, and

methodology behind indices is important.

• Ghana's latest data shows maternal mortality ratio of 310/100,000 live

births, under-5 mortality of 52/1000 live births, and contraceptive

prevalence around 30%.

• Compared to developed countries, Ghana and other developing countries

generally have poorer RCH indices due to factors like lower access to

care.

• Global initiatives like the MDGs helped focus e ort on improving RCH

indices. Progress was made but targets were not fully met.
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 • The SDGs continue momentum with more ambitious global targets for

2030. Ghana monitors progress on these through its national data.

• Setting service coverage and impact targets and tracking them using

quality data helps improve RCH programme performance and health

outcomes.

LECTURE 5

Here are the key points from your slides:

Family Planning:

• De nition: Ensuring that an individual or couple can have the number of

children they desire at the times they want.

• Goals: Assist couples and individuals of all ages to achieve their

reproductive goals and improve their general reproductive health.

• Objectives: Provide information, education, and counselling to individuals

and couples to enable them to decide freely and responsibly the number

and spacing of their children.

Methods of Family Planning:

• Short term: Condoms (male and female), Spermicides, Oral Contraceptive

pills (Combined & Mini-pill), Injectables (3 monthly Progestin only),

Lactational Amenorrhoea Method (LAM).

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 • Long Term (Reversible): Intra Uterine Device (Cu T or LNG-IUS), Implants,

Natural Family Planning Method.

• Permanent/Irreversible: Tubal Ligation, Vasectomy.

Reproductive Rights:

• The right of couples and individuals to decide freely and responsibly the

number and spacing of their children and to have the information and

means to do so.

• The right to attain the highest standard of sexual and reproductive health.

• The right to make decisions free of discrimination, coercion, and violence.

Policies:

• Adolescents: Information and counselling shall be provided for

adolescents.

• Consent of Partner: For couples, consent of partner for contraceptive use

is not required.

• Mental Disability/Psychiatry: In the case of mental disability or serious

psychiatric disease where the nature of the disease does not allow for

informed choice, contraceptives shall be provided in consultation with all

parties including persons in loco parentis and trained service providers.

Service Delivery Approaches:

• Clinic Based

• Community based

• Outreach services.
Providers and Services by level:

• Community level: CHO, CBD, Trained TBA, Chemical Sellers, Pharmacists.

• Health Centre & Maternity Homes: Medical Assistants, Midwives, Nurses.

• District Hospital: Medical Assistants, Midwives, Nurses, Physicians.

• Regional and Teaching Hospitals: Nurses, Midwives, Physicians,

Specialists (Obstetrician/Gynaecologist).

Key Points on Task-Sharing and Family Planning

1. Task-Sharing: Many countries and programs are changing their policies to

allow more types of providers to o er contraceptive methods. This change,

known as task-sharing, helps to address shortages of providers,

particularly in rural and remote areas, and increases access to safe and

timely care.

2. WHO Recommendations: WHO has developed recommendations on

which types of health workers can safely and e ectively provide speci c

family planning methods. These recommendations are based on evidence

that a wide variety of providers can safely and e ectively provide

contraception.

3. Successful Task-Sharing: Successful task-sharing requires attention to

training and support, supplying the new providers with the method,

supervision, referral for managing any complications, changes to

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 protocols, regulations, and training programs, and salaries or payment that

re ect the providers’ scope of practice.

4. Family Planning Terms & De nitions:

◦ Contraceptive Prevalence Rate: Proportion of women aged

between 15 and 49 who are using a method of contraception.

◦ Contraceptive Method Mix: Proportion of various methods by FP

users/acceptors – an indication of preference.

◦ FP Acceptor Rate: Proportion (%) of Women in fertile age (WIFA)

accepting and using a family planning method over a speci ed

period of time.

◦ Couple Years of Protection (CYP): The estimated protection

provided by contraceptive methods during a one-year period, based

upon the volume of all contraceptives sold or distributed to clients

during that period.

5. Family Planning Bene ts: Family planning improves the quality of life for

women, children, men, family as a whole, nation, and the earth. It serves

as a link to other reproductive health services.

6. Family Planning and Maternal Health: Family planning can prevent

unwanted pregnancies, pregnancy complications, unsafe abortion, and

improve health status of mothers. It is one of the primary interventions for

preventing maternal deaths.

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 7. Family Planning in Ghana: The current rate (2014) of contraceptive use

among married women is 27% with 22% using a modern method. The use

of modern methods is higher among women with more than secondary

level education (34%); married women with 3-4 children (30%) and the

fourth quintile of wealthiest women (29%).

8. Obstacles to Provision and Use of Family Planning Services: These

include lack of understanding of full range of services by policy makers

and national leaders, socio-cultural barriers, religious barriers, low literacy

level, ine ective education about family planning, fears about e ects of

family planning methods, and problems of access.

9. Improving Contraceptive Prevalence Rate in Ghana: This can be

achieved through research into reasons for non-use, research into

traditional methods of fertility control, education on modern contraception

based on research ndings, improving level of female education,

incorporating family planning into school curriculum, providing family

planning service units within 5 – 10 km radius of communities, using non-

medical community workers for education on and provision of selected

services –Task shifting, ensuring availability of commodities and providers,

and IEC/BCC.
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 6

Comprehensive Review Notes on Social Welfare System in Ghana

Introduction to Social Welfare

• Social Welfare: Concept encompasses services designed to aid individuals

and communities in achieving a better life.

• Forms of Social Welfare: Includes public assistance, social insurance,

health and welfare services, etc.

Arguments for Social Welfare

• Pro-Social Welfare: Advocates argue it's essential for societal stability,

equity, and support of the vulnerable.

• Anti-Social Welfare: Critics claim it may encourage dependency, misuse of

resources, and ine ciency.

Ghana's Social Welfare System: Historical Context

• Traditional Systems: Relied on extended family and community networks

for social support.

• Colonial In uence: Introduced formal welfare systems, though limited and

largely bene ting colonial structures.

• Post-Independence Era: E orts to establish a comprehensive welfare

system amidst economic and social challenges.

Modern Social Welfare in Ghana

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 • Government Initiatives: Include programs targeting poverty reduction,

health insurance, and social interventions for the vulnerable.

• Challenges: Funding constraints, systemic ine ciencies, and the erosion

of traditional support systems.

• Community-Based Approaches: Encouraged as a means to enhance the

e ectiveness and sustainability of welfare services.

Future Directions and Recommendations

• Integrating Indigenous Systems: Leveraging traditional structures to

complement formal welfare services.

• Policy and Implementation: Need for robust policies, better resource

allocation, and e ective implementation mechanisms.

• Comprehensive Strategy: Emphasizes a holistic approach, addressing

socio-economic factors and enhancing community participation.

These notes encapsulate the key aspects of Ghana's social welfare system,

highlighting its evolution, current challenges, and potential strategies for

improvement. The emphasis on a balanced approach that integrates both

modern and traditional mechanisms underlines the complexity and necessity of

adapting welfare systems to local contexts.

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 7. Comprehensive Review Notes on Medical Tourism

De nition and Evolution

• Medical Tourism: Traveling across borders to receive medical treatment.

• Historical Context: Originated from ancient healing pilgrimages, evolving

into a global industry.

Growth Factors

• Cost: Signi cant cost di erences between countries.

• Quality and Accessibility: Seeking superior or specialized medical

services.

• Wait Times: Avoiding long wait times in home countries.

Pros and Cons

• Pros: Economic bene ts for destination countries, access to high-quality

care.

• Cons: Ethical concerns, potential impact on local healthcare access.

Impacts and Issues

• Destination Countries: Economic boost but raises concerns about

healthcare equity.

• Source Countries: Loss of revenue, encourages improvements in

domestic healthcare.

Policy and Ethical Considerations

• Regulation: Need for international standards and patient protection.

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 • Ethics: Balancing pro t with healthcare access and equity.

Future Trends

• Technology: Role of telemedicine in expanding access.

• Domestic Medical Tourism: Growth within countries, including Ghana.

Ghana's Role

• Potential Market: Emerging as a destination for medical tourism.

• Challenges and Opportunities: Infrastructure development, international

accreditation.

Comprehensive Review Notes on Agencies/Organizations Assisting the

Needy, Sick, and Handicapped

Governmental Organizations

• Focus on ministries, commissions, departments, agencies, and assemblies.

• Key bodies include the Ministry of Employment & Labour Relations,

Department of Social Welfare, Ministry of Health/Ghana Health Service,

Ministry of Education, Ministry of Agriculture, and Ministry of Local

Government & Rural Development.

• Aim to integrate disadvantaged individuals into mainstream development,

protect rights, provide employable skills, psychosocial support, healthcare,

educational support for children with disabilities, and promote community-

based rehabilitation.

Non-Governmental Organizations (NGOs)

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 • Complement government e orts, targeting speci c groups such as

children, women, the poor, victims of abuse, and the sick.

• Key NGOs: Help Age Ghana, Action on Disability and Development, New

Horizon, Ghana Society for the Blind, Cripples Aid Society, Sight Savers

(UK), and the Christian Health Association of Ghana (CHAG).

• Activities include advocacy, support, resource mobilization, and provision

of speci c services like education, healthcare, and rehabilitation.

International Organizations and NGOs

• Include UN agencies, bilateral and multilateral partnerships, and

international NGOs like the Canadian International Development Agency

(CIDA) and World Vision.

• Focus on promoting good governance, health outcomes, basic education,

private sector development, environmental sustainability, and gender

equality.

• Support various programs and projects aimed at socio-economic

development, healthcare, education, and sanitation.

8. Comprehensive Review Notes on Rehabilitation Services

De nition and Scope

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 • Rehabilitation: Aimed at enabling individuals with disabilities or health

conditions to reach and maintain their optimal physical, sensory,

intellectual, psychological, and social functional levels.

• Scope: Extensive, covering physical, occupational, speech and language

therapy, and psychological counseling.

Objectives

• Restore Function: Focus on restoring lost abilities due to injury or illness.

• Maintain Independence: Help individuals achieve as much independence

as possible.

Types and Forms

• Physical Rehabilitation: Addresses physical impairments.

• Occupational Therapy: Aids in adapting to life changes and improving

functional abilities.

• Speech and Language Therapy: Focuses on communication challenges.

• Psychological Support: Addresses mental and emotional aspects.

Professional Roles

• Multidisciplinary Approach: Involves various professionals including

therapists, counselors, and medical practitioners to provide comprehensive

care.

Cross-Cultural Variations
 • Global Di erences: Recognizes the variation in rehabilitation services and

perceptions across cultures, emphasizing the need for culturally sensitive

approaches.

Comprehensive Review Notes on the Role of Doctors in Social Welfare

Medical and Social Responsibilities

• Doctors' Roles: Extend beyond traditional medical care to include social

welfare contributions, emphasizing preventive care, health promotion, and

community health improvement.

Community Health and Preventive Care

• Community Engagement: Doctors play a key role in identifying and

addressing community health needs, including disease prevention and

health education.

Health Promotion

• Advocacy: Medical professionals are advocates for patient welfare, public

health policies, and health education programs.

Support for Vulnerable Groups

• Social Protection: Doctors contribute to the social protection of vulnerable

populations by ensuring access to healthcare and supporting social welfare

programs.

Policy Development and Advocacy

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 • In uence on Health Policy: Active involvement in health policy

development, aiming to improve healthcare systems and access.

Comprehensive Care

• Holistic Approach: Emphasizes the importance of addressing both the

medical and social needs of patients for e ective care.

Comprehensive Review Notes on Services for the Socially Disadvantaged

Description of Services

• Advocacy and support for the socially disadvantaged.

• Review and integration of e ective service provision.

• Development of preventive and empowerment programs.

Goals

• Safety: Economic security, protection from harm.

• Justice: Fair resource allocation, social justice promotion.

• Dignity: Access to services, self-determination respect.

• Mutual Help: Encourage cooperation and community support.

• Development: Foster a collaborative society for individual, family, and

community well-being.

Principles

• Universality: Services for all without stigma.

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 • Comprehensiveness: Addressing nancial, social, and psychological

needs.

• Community Orientation: Diversi ed community-based services.

• E ciency: High-quality, cost-e cient services.

• Coordination: Victim-centered service networks.

• Partnership: Collaboration across sectors.

• Empowerment: Enhancing welfare rights and problem-solving abilities.

Service Ideals

• Humanity: Respect and empathy for those in need.

• Priority of the Disadvantaged: Focusing services on the most in need.

• Family Orientation: Centering welfare around the family.

• Service Integration: Coordinating resources for comprehensive support.

• Citizen Participation: Involving community input in policymaking.

Speci c Services for Targeted Groups

• Children: Protection services, foster care, adoption, living assistance, child

care, child allowance.

• Youth: Protective services, outreach programs, prevention of juvenile

issues, and employment support.

• Elderly: Day care, in-home care, residential homes, nursing homes,

emergency services.
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 • Disabled: Identi cation, assistance, allowance, educational services,

respite care.

• Women: Protective services, legal and living assistance, advocacy for

rights, supportive services for growth and development.

Functions of the Department of Social Welfare

• Includes adult education, hospital welfare services, adoption, community

care, justice administration, assistance for those with disabilities,

community mobilization, and policy development.

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