How ready are health managers to use effective coverage indicators to monitor and evaluate maternal and child health programmes? A qualitative study in rural Ghana

Abstract

Abstract Objective To explore the readiness of health managers to integrate effective coverage into routine monitoring of maternal and child health (MCH) services in two rural districts of Ghana. Methods An exploratory qualitative study was conducted among purposively selected district and subdistrict health managers in Kintampo North and Kintampo South, Ghana. Two rounds of in-depth interviews explored participants’ perceptions and implementation considerations regarding the use of effective coverage. Between the two rounds, participants took part in a 3-month pilot implementation phase. This phase included workshops, hands-on training and planning sessions. During this period, participants were trained to compute and interpret effective coverage using routine data and to explore its application to MCH monitoring and evaluation. Data were analysed thematically in NVivo V.17 using Braun and Clarke’s six-phase approach. Results Following the learning sessions, participants reported an understanding of the components of effective coverage and how to compute and apply the indicator using routine district data. They also reported confidence in computing and interpreting the indicator. In the follow-up interviews, participants expressed willingness to integrate the indicator into routine monitoring processes. However, they identified technical and logistical challenges and inadequate data in the current national health information management system. Conclusion Health managers in rural Ghana expressed willingness to integrate effective coverage into the routine monitoring and evaluation of MCH programmes. However, limited availability of routine data within the national health information management system remains a major barrier to implementation.