Background. Maternal, Child Health and Nutrition improvement Project is a World Bank-funded project implemented in all then ten regions of Ghana, which aims at improving access and utilization of community-based maternal, child health, and nutrition services in order to accelerate progress. This study is aimed at determining the implementation status of the project in the Eastern region by evaluating the processes involved and identifying implementation barriers from the perspective of implementors. Methods. The study was a cross-sectional in design and employed a quantitative data collection approach in ten Community-based Health Planning and Services (CHPS) centres in five districts in the region. The project coordinators and Community Health Officers were interviewed using a structured questionnaire. The project implementation reports at the facility level were reviewed using a checklist. Tertile statistic was used to describe the status of the project implementation. Result. The finding from this study indicated “complete implementation status” for maternal, child health, and nutrition activities of the project. However, none of the facilities evaluated had satisfactorily implemented all the governance processes and were therefore rated as “partially complete.” The main implementation barriers emerged from the study were related to restrictions placed on the use of project funds and delays in the fund disbursement to CHPS facilities. Conclusion. The evidence gathered from the study showed very good implementation status for community-led maternal and child health service delivery, indicative of a positive response to the guidelines by service providers at the periphery and can have positive impact on the project’s objectives and goals. Governance component of the project, however, revealed inadequate alignment with guidelines which might have been influenced by the lack of knowledge as a result of lack of training for implementers. This therefore calls for in-service training and improved supportive supervision at both administrative and service delivery levels.

中文翻译：

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加纳东部地区孕产妇、儿童健康和营养改善项目 (MCHNP) 的过程评估：选定地区的案例研究

背景。孕产妇、儿童健康和营养改善项目是世界银行资助的项目，在加纳所有十个地区实施，旨在改善社区孕产妇、儿童健康和营养服务的获取和利用，以加快进展。本研究旨在通过评估所涉及的过程并从实施者的角度确定实施障碍，以确定东部地区项目的实施状况。方法. 该研究采用横断面设计，并在该地区五个地区的十个社区健康规划和服务 (CHPS) 中心采用了定量数据收集方法。使用结构化问卷对项目协调员和社区卫生官员进行了采访。使用清单审查了设施级别的项目实施报告。三分位统计量用于描述项目实施的状态。结果. 这项研究的结果表明该项目的孕产妇、儿童健康和营养活动的“完全实施状态”。然而，评估的设施都没有令人满意地实施所有治理流程，因此被评为“部分完成”。研究中出现的主要实施障碍与对项目资金使用的限制以及向 CHPS 设施的资金支付延迟有关。结论. 从研究中收集的证据表明，以社区为主导的妇幼保健服务提供的实施状况非常好，表明外围服务提供者对指南的积极响应，可以对项目的目标和目标产生积极影响。然而，该项目的治理部分显示与指导方针的一致性不足，这可能是由于缺乏对实施者的培训而导致缺乏知识的影响。因此，这需要在行政和服务提供层面进行在职培训和改进支持性监督。