Health 2 Go (H2Go) is a program that provides quality basic health services to rural and other underserved communities using a distributed delivery model operated by local residents trained as community health workers. The program is currently operating in Ghana and making an impact. The H2Go team is looking at expansion into new communities in Ghana. With all the talk of expansion, we wanted to hear from our on-the-ground team in Ghana about what it takes to run the program and some of the challenges it faces as it grows. We connected with Dr. Stephen Manortey, Head of Academic Programs at Ensign Global College and in-country Principal Investigator (PI) for H2Go to learn about the logistics and the bright future the program has.
Interviewer: Tell us about what it entails as the role of an in-country Principal Investigator (PI) for Health 2 Go (H2Go).
Steve Manortey (SM): In that capacity, I help to direct the day-to-day activities of the H2Go Program. The H2Go Program falls in line with what we do as an academic institution at Ensign Global College. All tertiary academic institutions for higher learning in Ghana have three mandates. We teach, we conduct research, and we offer service in the form of consultancy and projects to individuals and communities. We see H2Go as our flagship service component at Ensign Global College. The project is designed to work in collaboration with the Ghana Health Service in promoting health and improving health outcomes for individuals who live in communities that to a large extent do not have any existing health care facilities and services using the Community-Based Health Worker model. Ideally, it is the responsibility of Ghana Health Service to provide these health services to every Ghanaian irrespective of where someone may live. We know resource challenges come up, so there are communities that do not have access to health care facilities. We work with Ghana Health Service to provide services to these hard-to-reach communities, which are completely way off from the normal communities, mainly farming communities. We are providing health care to children under the age of 5 and providing health care promoting activities for pregnant women. In my role, I work with the Project Coordinator, Gideon Acheampong, to manage the activities of the team who are doing all the good stuff for H2Go and bringing health care to the doorsteps of those in our participatory communities in Ghana.
Interviewer: I am sure you get this question often. You mentioned H2Go focuses on providing health care to children under the age of five and expecting mothers, are there any plans on expanding the age range to serve a larger population?
SM: We intermittently evaluate what we are doing in the community through a durbar or in US terms we would say a town hall meeting. During these durbars, we get feedback from the communities which are led by the Community-Based Agents (CBAs) who help run the health care activities in their communities. In that evaluation setting, you hear from the leadership in the community that they would like H2Go to expand the age range for children. Once a child goes past their 6th birthday, they are no longer part of the H2Go program. We wish we had all the resources to take care of more children and even adults. As it stands now, we cannot do that. Currently, we stay focused on what we set our program up to do. It would be good if we had the resources to extend a helping hand to children past their 6th birthday and even to adults. We have men and women who live in these communities who see H2Go taking health care to doorsteps in their community, but they do not have access right now because of the age range. H2Go cannot do it all with our limited resources. We must stay focused on what we set ourselves to do.
In the future, if we have more resources we would love to expand our wings and take care of everyone.
Interviewer: It sounds like the resources needed to expand H2Go to support a larger age range of children and even adults in the current communities are not available at this time. So, you are focusing on the current goal of providing health services to children under the age of five, is that correct?
SM: If we had all the resources we could get, we would want to expand health care delivery to everyone. For now, we are working with a strained resource, we have to stay focused on our goal and do it well. We are in these communities to help improve health outcomes. We want to do what we set out to do and do it well. We hear how impactful the role of H2Go is now. There are testimonies from the mothers in the communities about how powerful the current impact of H2Go is. Mothers have said that without H2Go intervention, then they could have lost their children to ill health, including failing health episodes in the middle of the night. Then they talk about the trained health care workers who live in their community and are able to examine the child and provide some basic treatments or provide a referral to the closest health facility. After a referral takes place, the CBA continues to follow up on the children and mothers.
H2Go is making a very impactful role in these communities. We do wish we had more resources to expand the age range or go to other neighboring communities.
We recently undertook a feasibility study to see if we can expand H2Go into the Yilo Krobo Municipality.
Interviewer: We recently did a feature of H2Go in our Center for Business, Health, and Prosperity newsletter, so we would love to hear your perspective on the biggest accomplishment H2Go has had so far.
SM: The name ‘Health 2 Go’ itself is literally saying we are taking health care to the doorsteps of those that don’t have anything. If we are talking about the impact, I can say confidently over the years we have provided services for children in rural and hard-to-reach communities. We have been tracking them to even understand the referral cases. When I say referral cases, these are severe illnesses that require taking the individual to a higher-level facility outside the community. We have trained individuals who are the eyes of the community and can treat a sick child and if it is beyond their capacity they can link the caregiver to the larger health system. There is nothing more impactful than these few things H2Go is doing.
In my perspective, H2Go is helping improve health conditions in operating rural communities that do not have any existing health infrastructure. Now, through H2Go, there is an individual in their backyard who is trained to treat some minor illnesses and find danger signs. All it takes is to call the CBA and a family can get the help it needs. H2Go is helping in the place where the government resources cannot reach.
Interviewer: You mentioned earlier a potential study for an expansion in the Yilo Krobo Municipality. Can you tell us about the expansion plans and what you are most excited about regarding a potential expansion?
SM: H2Go is operating in two administrative districts in Ghana – Lower Manya Krobo Municipality in the Eastern Region and the Atwima Nwiabiagya North District near Kumasi in the Ashanti Region. We have been working in these areas for close to six years now. We have learned lessons while working in these communities, and think we are in a position to scale up H2Go services to other communities in similar situations. Currently, as we speak, we are looking at the Yilo Krobo District to see which of their communities needs this help. We are also in touch with the Ghana Health Service Directorate in this area to understand which communities in the municipality are in most need of this help. We have been able to review the communities in the district and pinpoint 12 communities that may benefit from the expansion.
What is exciting to me now, from where we started at our demonstration sites is that we have learned lessons, so we now can go to other areas to share health and improve health outcomes for children and expecting mothers in these new areas.
Health is a human right, irrespective of where one lives. We all deserve to be healthy. The excitement for me is to be able to go to another place and help others to live healthily. And now we are going there with improved competencies and improved skills. Now when we go there, we are not learning on the job. We have already gone through that in our demonstration phase. We are extending with skills we have learned from what we have been doing over the years. This is what I am excited about.
I am grateful to help fellow human beings. It brings joy to my heart. It might not be perfect, but we do the best we can.
Interviewer: As H2Go expands, what challenges do you foresee with the expansion?
SM: We are offering these activities in hard-to-reach communities. With the feasibility study, we have established that these places are far off from the urban communities. One challenge will be the mode of transportation to access these communities. If we set ourselves up for success, we will need to be prepared with logistics. These are very rural communities and the roads are hard to navigate. We will need a strong vehicle to go through this rough terrain.
The other part is working with a new set of people, so we will take our time to build their confidence. That is why we offer training. We are going to take our time integrating with the new communities. We have learned this from the demonstration site. These are the areas we will focus on in these new communities.
Interviewer: Personally, what is the most rewarding experience for you as part of the H2Go project and expansion?
SM: My joy is being able to offer health to my fellow neighbors no matter where they live or who they are. There is always a good feeling if you can step in and offer that little help. H2Go might not be covering the whole nation, but little by little we are getting there. We started with two places, and now we are getting ready to go to another area. That is the rewarding part.
We have heard from mothers who could have lost a child or two had it not been for this program. If you hear these testimonies, you know you had a role to help a mother in this area that may not have otherwise gotten the help needed. You feel the fulfilment that you are doing something good.
Interviewer: Do you have anything you want to share that we did not touch during our interview?
SM: We have registered the good work we have been doing. The next thing on my mind is sustainability and how long can we be there. This brings up the issue of capacity building. We are training lay individuals with no medical knowledge and working tools to do work to help their communities. A concern for the future is to get buy-in for the expansion from other institutions and organizations that could provide support to take the model to other areas. We are working on this, and we hope this helps us sustain the program. We want to get the government to buy-in to support the program. Also, we want to get individuals who can in little ways support this program to move forward.
We will do the best we can to achieve this goal. We started from a certain point and we will get to an end. We are looking for people to come over and support this work.
Acknowledgment
A special thank you to Dr. Stephen Manortey for taking time out of his schedule to share his experience and the future of H2Go with our audience. Stay tuned as we continue to highlight the work of H2Go and the team that makes it possible. To learn more about H2Go, visit our website.