Factors Constraining the Scale up of the Navrongo Experiment's Fertility Impact in Northern Ghana

Allison Stone, Columbia University
Abigail Krumholz, Columbia University
Maxwell Dalaba, Navrongo Health Research Centre
Philip B. Adongo, Navrongo Health Research Centre

Initial results of the Navrongo Experiment in northern Ghana demonstrated that community-engaged primary health care with a focus on engaging traditional structures and male networks for family planning acceptance could lead to substantial reductions in fertility and childhood mortality. While long-term observation of the project showed that mortality effects were sustained and scaled up, the fertility decline has stalled as the program’s reach has expanded. A qualitative appraisal was conducted to elicit community stakeholder, frontline worker, and management reactions to the service system as it currently operates. Findings attest to the challenges of sustaining a focus on social mobilization when scale up is dependent upon a medicalized system of care. The Navrongo strategy of engaging male networks for family planning acceptance appears to have atrophied entirely Results indicate a need for strategic reform of national programs for scaling up the Navrongo model, refocusing attention on the original social engagement strategy.