PERFORM2Scale in action - Ghana Resource Team member

Solomon Boamah Amponsah is the Regional Health Research Coordinator, for Eastern Region in Ghana. He is also part of the Ghana Resource Team. In this interview he talks about his involvement with PERFORM2Scale and its potential in Ghana.

This is the extended version of an interview first featured in this briefing paper on PERFORM2Scale in Ghana.

How did you get involved with PERFORM2Scale and why are you supportive of the project?
I was appointed by my regional director to coordinate the project in my region; I am the Regional Health Research Officer. I am supportive of PERFORM2Scale because of the design and the sustainable approach of the management strengthening intervention (MSI). That is to say, it builds the capacity of the District Health Management Teams (DHMTs) to improve regional health management. This is in line with my work where we build the capacity of the district teams to perform simple, operational research to see if we can solve some of the challenges in the working environment. That is how come I am supportive of the PERFORM2Scale project.  

How does PERFORM2Scale compare with other management strengthening and workforce development projects in Ghana?
During implementation it is the results that make PERFORM2Scale stand out. The project freely guides and allows intervention districts to use local evidence to solve their own district-specific, workforce challenges. So, that is how I would say PERFORM2Scale is different to other projects I have encountered. The way the project allows the district teams themselves to analyse and get to the root causes of problems, and then by their own discussions to come up with suggestions that would eventually solve their challenges. I think it makes the project stand out.  

What evidence have you seen of the impact of the management strengthening intervention so far?
One of the implementing districts was finding it difficult looking for some specific [yaws] cases in the communities. They had a target to look for cases in the communities, but it was difficult to achieve the targets. So, through PERFORM2Scale we met and through the root cause analysis it came out that even staff who were supposed to look for these [yaws] cases were not familiar with the case definition and what they were looking for. So, a platform was suggested that pictures of such cases should be put on. And from that time, health staff in those communities were able to briefly search for these cases, and within some few months they had a lot of cases, more than their targets. This is clear evidence that gathering people and then helping them to realise their needs and find their own solutions greatly helped. That is clear evidence of what I have seen in PERFORM2Scale, where a simple analysis of root causes of challenges helps people to come out with innovative ways of reaching their targets.

What benefits do you think PERFORM2Scale is or can bring to Ghana’s health system at district level?
I can say that during implementation we meet some challenges and see results, and we also find opportunities. This is the basis of developing concrete recommendations for advocacy, and then capacity strengthening and for improving general health delivery. So, I think PERFORM2Scale is giving the system some ideas as to how we can approach some challenges, especially when it has to do with workforce. I would say that the evidence we are gathering from the MSI implementation could be given to Ghana Health Service to aid the scale-up of the MSI in its wider sense to help the system.    

What would you say to districts considering adopting the PERFORM2Scale methodology?
It is a very simple methodology. The evidence that is gathered by all the districts of the outcome of the implementation of PERFORM2Scale would be a very good way to preach to them the benefits as to why they should consider adopting the methodology. They might be battling with issues that maybe they are finding difficult to address, but when they see that others have been able, through simple means, to generate ideas and then make some headway I think they will buy it. So, I would encourage districts considering adopting the PERFORM2Scale methodology. We used evidence from other districts to sell the idea to the remaining districts. I would advocate that they should consider adopting the PERFORM2Scale methodology to improve and also meeting their targets.    

So, sharing experiences of success within limited resource contexts is very important?
Yes, very important.

PERFORM2Scale needs some resourcing if it is be become sustainable and have maximum impact. What needs to be done to achieve this in Ghana?
What I think can be done is based on the evidence that is being gathered from districts. I think if all of this could be put in a report and then forwarded to policy levels I think it could go a long way in advocating for other resources. I would advocate and recommend PERFORM2Scale based on the evidence we have gathered from the implementation to the appropriate leaders like the Ministry of Health and Ghana Health Service. Looking at the hardcore evidence that has been gathered it can serve as the basis for funding for the sustainability of PERFORM2Scale, looking at how it’s helping districts to achieve their targets and then to find solutions to their own local problems.           

Anything more you want to say about PERFORM2Scale?
One thing I would like to add is that my experience with the whole PERFORM2Scale team has enlightened me, and also boosted my morale in doing more than what I was doing before. Through the emergence of PERFORM2Scale I’ve also learnt a lot, and through the application of some of the methods I am also able to do my work well, as well as being able to improve on what I used to do as a research officer.

So, it doesn’t just have impact at the district level, it has impact at individual and higher levels as well?
Yes, it has impact all around. I also serve as part of the Resource Team and the opportunity given to me to lead meetings during district support visits, in inter-district meetings and then coaching and taking others through root cause analysis has actually broadened my scope of thinking and the learning that I need to add to my working area. So, I think it’s not just the districts that have benefitted but some of us who have also been part of the project have been enlightened in one way or another.     

When I was interviewing a Resource Team member from Malawi he said that it’s opened a channel between district-level and ministry-level managers that didn’t exist before, and that ministry managers are now much more aware of what goes on at district level and the challenges that people face.
I think it’s very right. It’s true because if there is a chance for districts to share their experiences they would buy into it, and then managers who would not have known what was happening in the various districts or communities get to know about the evidence. They prompt attention from the various authorities and they get to know the situations as they are in the various facilities and the districts. It is very true.

How would you summarise PERFORM2Scale?
The project is a results-oriented project that, without any serious financial commitment, allows District Health Management Teams to meet their targets and solve issues that were longstanding. So, PERFORM2Scale has actually come to change the mindset of always waiting for resources before some changes can be made. The programme is results directed. You implement it and see the results as soon as possible.

Thanks for taking part in this interview