From abandoned warehouse to life-saving facility, Pakro, Ghana

Preliminary studies: Focus group discussions in Akwapim South District, Ghana, highlighted a lack of accessible health facilities as an important factor contributing to maternal deaths. Interventions: In 1991, a health center was established by renovating an abandoned warehouse. The center was equipped with beds, a refrigerator, a safe water supply, drugs and supplies. With the posting of a community health nurse from the Ministry of Health (MOH), it began functioning as a maternal and child health/family planning clinic. A senior nurse-midwife was posted in 1992 and obstetric services were offered. Starting in 1994, community interventions focused on reducing the delay in seeking care. Results: An average of nine women with major obstetric complications were seen each 12-month period between 1992 and 1995. Many minor complications and non-obstetric ailments were also treated. Costs: The material costs of establishing the health center amounted to US $12,550: 47% came from the community, 43% came from non-governmental organizations (NGOs), 7% from PMM and 3% from MOH. The costs of staff salaries were paid by obstetric services. If emergency obstetric services are available, women will use them, even before the launching of community information and education campaigns.