Save Mothers and Children in Ghana
The Republic of Ghana (hereinafter as “Ghana”) faces the Gulf of Guinea in West Africa. Its area is about two-thirds of that of Japan. With a population of some 31 million, the country is known as the second largest cocoa producer in the world. For Japan, Ghana accounts for 80 percent of its cocoa imports and many Japanese companies produce chocolate and other goods using cocoa beans from Ghana.
In an initiative that connects the African country with Japan, three leading Japanese corporations from different industries, including NEC, are launching a co-creation project aimed at improving maternal and child health and nutrition, in partnership with the World Food Programme (WFP).
Ghana has a typical primary-product dependent economy with gold and oil topping its list of export items along with cocoa beans. Since the start of commercial oil production in 2010, it has remarkably developed with its economic growth rate jumping to 15 percent the next year. In 2019, the World Bank ranked Ghana among the middle-income countries. At the same time, about half of its workforce is employed in the agriculture sector, and the country’s economic strength is susceptible to international market prices and weather conditions.
Although the poverty situation has been improving in recent years, the rich-poor gap between Ghana’s urban and rural regions still remains evident. As management of people’s health is considered a major challenge in the process of national economic growth, there are a host of issues in the area of nutrition: notably malnutrition, deficiencies of vitamins, minerals and other micronutrients, and overweight/obesity.
Of all, the health condition of mothers and children stands out as a cause for major concern.
Malnutrition is not only a leading factor in stunning the growth of unborn babies and suckling infants, but is also feared to cause anemia, which increases the risk of severe malaria. In particular, stunted growth in the first 1,000 days of life from pregnancy to two years of age is said to be irreversible later. In Ghana, malaria is one of the infectious diseases that account for 30.5 percent of death causes, and is the most common reason for hospital visitation. It is feared to raise the risk of a poor prognosis for mothers and newborn babies resulting in maternal anemia and death, miscarriage, stillbirth, low-birth-weight delivery and the death of newborn babies and suckling infants.
Against this backdrop, an issue has emerged concerning insufficient management of health and nutrition since pregnancy due to lack of health knowledge on the part of mothers. For example, there are mothers who believe that highly nutritious foods are too expensive for them to purchase. There are also cases in which uneven levels of health knowledge among health center staff make it difficult to provide proper medical consultation and guidance.
To find solutions with an integrated approach to these challenges surrounding malnutrition, anemia and malaria, a co-creation project has started involving three Japanese parties from different industries: The Ajinomoto Foundation, Sysmex Corporation (“Sysmex”) and NEC Corporation (“NEC”). They strive to improve mother-child health and nutrition in Ghana.
It all started at TICAD7
In August 2019, the 7th Tokyo International Conference on African Development (TICAD7) was held in Yokohama, Japan, and adopted the Yokohama Declaration 2019, which pledged assistance focused on people--in such areas as development of industrial human resources and education for women in African countries. TICAD is an international conference themed on Africa’s development and has been held since 1993 under the lead of the Japanese government and co-sponsored by the United Nations (UN), the United Nations Development Programme (UNDP), the World Bank and the African Union Commission (AUC).
On that occasion, Japan and Ghana concluded a memorandum of collaboration for expanding ”universal health coverage (UHC)” and implementing the “Africa Health and Wellbeing Initiative (AfHWIN)”, as proposed by the declaration. The three-way co-creation project has been developed as a specific undertaking under this plan, with the aims of strengthening public-private and private-private partnershipsin both countries, and improving maternal and child health and nutrition in Ghana.
This project is in sync with the UN-advocated Sustainable Development Goals (SDGs); it aims to achieve Goal 2 (zero hunger) and Goal 3 (good health and well-being for all) while pursuing Goal 17 (partnerships for the goals).
Universal health coverage means “all people can receive health services, ranging from health promotion to medical prevention, treatment and rehabilitation, at an affordable cost.” The achievement of UHC is also part of the SDGs.
The co-creation project has added the element of nutrition to the UHC concept to uphold “Universal ‘Nutrition’ Health Coverage.” To realize this ideal, it targets at contributing to the creation of an environment in which pregnant women, mothers and children have access to as much high-quality nutrition and health services as possible. In this process, it will utilize innovative Japan-originated ICT (information and communications technology) and clinical testing technologies.
The three parties are set to strive for the objective through the division of roles as follows:
【The Ajinomoto Foundation】
- Cooperation with the WFP and management of the entire project
- Improving health and nutrition guidance capacity through training for staff in health centers in collaboration with the Ghana Health Service.
- Construction of a supply chain for nutritional supplement KOKO Plus® around health centers
- Providing experiences and networks gained in Ghana in the past dozen of years as a platform
- Promoting the improvement of test quality and access through the introduction of malaria diagnostic medical devices
- Educational activities for medical professionals (clinical laboratory technicians and clinicians) leading to the early detection and treatment of anemia, malnutrition, and malaria through human resources development, academic symposium, etc.
- Collaboration withthe GHS and the National Malaria Control Program.
- Application development for support of health checkups and nutrition instructions
- Promoting behavior change among mothers and children through the use of newly developed applications that help to deliver health checkup information, nutrition instructions, and recommendations for KOKO Plus® ingestion and/or additional testing at hospitals in which Sysmex clinical testing devices are installed
- Providing tablets and ICT training for staff at health centers
- Government of Ghana
- Government of Japan
- The Ajinomoto Foundation/KOKO Plus Foundation
- Sysmex Corporation/Sysmex West and Central Africa Ltd.
- NEC Corporation
- World Food Programme
What are applications that promote “behavior change” among mothers and children?
In Ghana, a rich-poor gap between the urban and rural regions due to rapid economic growth is having a great impact on the sphere of education. In particular, a gap in the nutritional condition of mothers and children has been evident due to lack of knowledge about nutrition on the part of mothers in the rural region. At the same time, the level of quality of guidance by staff at health centers to improve nutrition/anemia has varied. Moreover, there has been a challenge to create a mechanism of continual follow-up care that could promote behavior change.
To solve this challenge, NEC has taken it upon itself to develop mobile applications, provide tablets to health center staff and train them. The objective is to enable health center staff to notify mothers of their health checkup results in a simple way as well as recommend them to purchase KOKO Plus® as a nutritional supplement to improve their nutritional condition, and to undergo examinations at hospitals equipped with Sysmex clinical testing devices. This process is aimed at promoting behavior change among mothers and children and improving their health and nutrition in a more effective way.
Specifically, it is envisaged that:
- Health center staff will graphically show mothers their health checkup results, using tablets equipped with NEC applications, and explain in a simple way how different their conditions are from what they should be.
- Cases of malnutrition and severe anemia as well as cases, who fail to receive health checkups according to schedules, will be identified and listed to ensure them more solid follow-up care.
- Health center staff will be able to display on tablets the details of optimal assessment they provide on the basis of health checkup results as well as the results of hearings on dietary patterns, iron intakes and other habits.
If data are uploaded to the cloud, it will enable public administrators to accurately track the situation from day to day and formulate policies on the basis of actual conditions through digital transformation of health checkup data.
In a similar initiative, NEC has achieved a track record in tackling diabetes in India.
Diabetic patients are rapidly increasing worldwide and forecast to reach about 630 million by 2045. The increase rate is particularly high in India where the number of patients is expected to hit a world high of about 134 million by 2045.
To counter this problem, NEC and the state government of Bihar, India, jointly conducted a proof-of-concept experiment from February to March 2020.
Specifically, state government health workers provided home-visit health checkup services to 5,000 state residents, using mobile apps. During the visits, they measured the height, weight waist circumference and other parts of the body, as well as asked and advised the residents about their lifestyle habits. The findings were registered in the apps. The residents were encouraged to sign up for further rounds of checkups after a certain interval of time. In addition, they were provided with follow-up care such as measurement of blood pressure and blood sugar, if they so desired.
Drawing on such experience, NEC has been participating in this Ghana project after it made much effort in starting up what was designed as a co-creation initiative involving three parties from completely different industries. The project is directly linked to health and has attracted a great number of participants from across countries. It has been extraordinarily cumbersome and difficult to coordinate among different organizations, departments, professional technicians and local health officials. It is indeed an epoch-making, significant initiative in a sense that it requires differences of principles and various kinds of barriers to be overcome.
This project, launched after overcoming the initial struggle and barriers, has prompted expectations among people including Ghanaian government officials.
“A success or failure of the PPP (public-private partnership) in helping achieve UHC (universal health coverage) will sow the seeds of the field in the ability to combine the lessons of the past with the creativity of the future. I believe the public and private sectors in the country have shown by our own action that we are willing to collaborate with Japanese healthcare companies,” said Dr. Patrick Kuma-Aboagye, Director General of the Ghana Health Service.
“I believe that the Ghana-Japan PPP story will create a successful model that can be scaled up in the rest of Africa.”
A more promising future for the project
The partners are considering expanding the project all across Ghana and to neighboring countries in the future. They also envisage a broader possibility that AI-aided analysis and prediction, based on individual health checkup data of mothers and children, may lead the project to establish more precise health management practices that may contribute to health policy decisions by the Government of Ghana.
The partners are due to promote their initiative worldwide by presenting it as a project example at the 8th Tokyo International Conference on African Development (TICAD8) to be held in Tunisia in August.
These activities are certain to support private-sector endeavors in the area of maternal and child health in Africa.
The project aims to build a mechanism that contributes to promoting the health of mothers and children and, eventually, promoting sustainable and stable economic growth in Ghana. NEC’s challenge is continuing on.
“There are things that can be done only through ICT and things that can be done only through co-creation with partners. By combining them each other, l will aim to ‘create a world that leaves no one behind’ and challenge myself in solving global issues.”