Article

The Long-Term Fertility Impact of the Navrongo Project in Northern Ghana

Studies in Family Planning (Impact Factor: 1.28). 08/2012; 43(3). DOI: 10.1111/j.1728-4465.2012.00316.x

ABSTRACT

This study assesses the long-term fertility impact of the Community Health and Family Planning Project of the Navrongo Health Research Centre in Ghana and addresses policy debates concerning the role of family planning programs in rural Africa. Conducted in a remote traditional area on Ghana's northern border, the study tests the hypothesis that convenient family planning service delivery can induce and sustain reproductive change in a societal context that would not be expected to foster demographic transition. By 1999, results indicated that significant fertility decline arose in the early years of the project, associated with the combination of services provided by community nurses and social mobilization activities focused on men. When project strategies were scaled up, social mobilization components were neglected. As a consequence, the long-term impact of scaled-up operations was negligible. Results suggest that initial effects met the need for child spacing without introducing a sustained demographic transition.

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    • "The evolution of the Navrongo pilot intervention into the national-level Community-based Health Planning and Services (CHPS) Initiative in Ghana is often cited as an example of successful evidence-based research to policy and program implementation in the family planning community and as " one of a few attempts in Africa to translate findings from a research initiative consisting of several studies into a national health reform programme " (Nyonator et al. 2005). One of the original objectives pursued through both the Navrongo pilot and later scale-up efforts, was to examine whether providing family planning services and promoting contraceptive use could " induce and sustain reproductive change " (Phillips et al. 2012). The success of the Navrongo pilot in this regard was not replicated at the national level and the impact on fertility decline after CHPS scale up was reported as negligible. "

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    • "While social and economic conditions have remained generally poor, data analyzed from the demographic and health surveillance show that mortality has declined considerably in the district over the past decade (Oduro et al. 2012; Azongo et al. 2012) Figure 1. Similarly, fertility levels have declined over the same period (Phillips et al. 2012; Debpuur et al. 2002; Oduro et al. 2012). For instance, while infant mortality decreased from 129 deaths per 1,000 live births in 1995 to 85 in 2003 representing a 34 percent decrease , under-five mortality declined from about 147 to 83 per 1000 live births, representing a 44 percent decline over the period (Binka et al. 2007). "
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