1.0 Introduction - The COVID 19 pandemic is more than a health crisis. It is also a socio-economic crisis affecting most countries across the world. The hardest hit being vulnerable, marginalised and socially excluded groups in countries across the world. Over 34 million confirmed cases have been recorded with a little more than 1 million deaths. The World Health Organisation (WHO) requested for all countries to put in place measures to curb the spread of the pandemic.
In Ghana, the first COVID 19 case was confirmed on March 13, 2020. The country has since recorded over 46,000 cases and 303 deaths as of 29th September 2020. As a response to the pandemic, the government instituted several policy measures, education and relief programmes to curb the spread and mitigate the negative impact on the socio-economic lives of the citizens.
To complement the efforts of government, STAR Ghana Foundation developed the COVID 19 Response Project (CRP). The CRP aimed at supporting coordinated civil society actions around COVID-19 prevention, management and mitigation. The overall objective of the project was to increase the effectiveness of inclusive actions by state and non-state actors towards the elimination of the COVID-19 pandemic. Specifically, the CRP sought to:
The foundation employed its 3C strategy (convening, catalysing and coordinating) and partnered with relevant actors CSOs, traditional authorities, faith-based organisations and leaders, the media and state agencies to build a multi-stakeholder collaboration on COVID-19 response in Ghana to mitigate the impact of the pandemic on vulnerable and marginalised groups and the general citizenry as a whole.
This learning brief is based on the findings from the CRP phase 1 review. Given how rapidly the pandemic is evolving, this brief presents key outcomes of the project. It also highlights lessons learnt in coordinating CSOs response and programming in crises situations.
2.0 What were the Key outcomes of the CRP project?
The key outcomes achieved are discussed according to the four specific objectives of the project.
Objective 1: To increase and improve on citizens’ access to accurate, timely, inclusive and relevant information on COVID-19 and response actions
The CRP partners led by Media Foundation for West Africa (MFWA) developed a system to fact-check COVID-19 information, combating fake news, misinformation and disinformation to vulnerable and marginalised groups. The fact-checked information were published on https://www.fact-checkghana.com/ and further disseminated to citizens by CRP partners in local languages across the country. Radio discussions and drama were also used to educate citizens. The project reached out to over 8 million vulnerable, marginalised and socially excluded groups. This increased their knowledge on COVID-19 pandemic using information, education and communication (IEC) materials developed in various local Ghanaian languages across the country. CHAG worked with other partners – Ghana Federation of Disability Organisations (GFDOs); CARITAS, PenPlusByte – to develop these IEC materials using inclusive and targeted approach to address the specific needs of various marginalised and vulnerable groups.
Obj 2: To support communities, NGOs and other citizens’ groups develop and implement initiatives at local and national levels for supporting vulnerable groups and the implementation of national and local response plans
The CRP partners took diverse initiatives to achieve this specific objective. A major outcome was the coordination support provided to the already established CSO COVID 19 Response Fund by the CSOs platform on Sustainable Development Goals (SDGs). The fund mobilized resources from individuals, civil society organisations, private sector organisations at both national and sub-national levels and supported procurement of medical essentials, food items and accurate IEC materials to vulnerable groups and institutions. Other CRP partners including CARITAS, GFDO and FIDA implemented interventions that directly supported vulnerable, excluded groups to have access PPEs and IEC materials. CHAG engaged the government and coordinated the distribution of COVID-19 medical supplies and PPEs to over 326 health facilities across Ghana and trained health workers on effective COVID-19 prevention and control.
Obj 3: Increase the transparency, responsiveness and accountability of government and its relevant agencies to citizens around the development and implementation of COVID-19 response plans, including the utilisation of resources
The review identified three main outcomes that contributed towards attainment of this objective. The CSOs Platform on SDGs conducted a survey to collate empirical evidence and also enable citizens assess the government’s national response to COVID 19. The citizens’ survey tracked government’s expenditure by virtually collecting data across the country. The findings were disseminated to representatives of government ministries and agencies. CHAG also successfully advocated for the transparent state allocation of COVID-19 medical supplies to healthcare providers. This led to 18% increase in allocation of PPEs and other medical supplies to CHAG members. The Ministry of Health adopted CHAG’s resource utilisation monitoring tool to monitor health facilities across the country.
The foundation in partnership with CSOs, faith based organisations and private sector associations established the CSO COVID-19 Coordinated Platform to engaged with state actors and authorities to ensure transparency and accountability on resource utilisation, allocation and monitoring.
Obj. 4 To harvest, document and share learning around COVID-19 responses
Due to the rapidly changing context in which the CRP was being implemented, the project partners developed different approaches to harvest, document and share major learnings that emerged from their project. WASCI developed a COVID-19 information repository and a learning guide that harvested lessons by CSOs across the country and disseminated through a monthly newsletter (SITREP). The MFWA created a fact-check website https://www.fact-checkghana.com/ that publishes verified and accurate information and uses radio drama, discussions; podcast and network partners to disseminate it to wider public. Pebplusbytes also created online platforms that documented and shared relevant and accurate information to citizens.
Box 1: Case study [Impact Story]: combating sub-standard alcohol-based sanitizers in the market and development of a COVID-19 resource utilization monitoring tool
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The Christian Health Association of Ghana (CHAG) is a network of health facilities and health training institutions owned by 33 different Christian church denominations in Ghana. CHAG focuses on providing healthcare to the most vulnerable and marginalised groups across Ghana, particularly in the most remote areas.
CHAG is a grant partner that implemented the STAR Ghana Foundation COVID-19 Response Programme. CHAG’s intervention focused on three broad intervention areas: development and distribution of IEC materials, coordinate support to health workers to prevent spread of COVID-19; and engage government on national response programme using evidence.
Combating sale of sub-standard alcohol-based sanitizers in the market As part of CRP project activities, CHAG healthcare workers were trained in Infection Prevention and Control (IPC) on COVID-19. Participants including health managers, were taught how to test the true concentration of alcohol-based sanitizers and chlorine solutions they buy from the market. It was highlighted during the training that the reason the health facilities and individuals continue to spread infections is that they may not be using the right concentration of alcohol or chlorine. Participants were then taught how to test and determine the right concentrations of the various products they get from the market.
Through the knowledge gained during the training, some of the facilities have tested selected alcohol-based hand sanitizers in the market and found that the alcohol content is less than standard. The sub-standard sanitizers were reported to Food and Drugs Authority (FDA) for necessary sanctions. CHAG continuous engagement of households on COVID-19, engaging in public education and national level advocacy to ensure vulnerable and marginalized groups are protected.
Monitoring of utilization of COVID-19 medical supplies to hospitals CHAG engaged the Ministry of Health and Ghana Health Service and advocated for equity distribution of PPEs, medical supplies and support services to vulnerable health workers, particularly in remote and urban poor communities to mitigate the spread of COVID-19 in Ghana. This led the GHS to allocate 18% - 20% of COVID-19 PPEs and medical supplies to CHAG member hospitals in rural, urban and peri-urban areas across the country. The Executive Director of CHAG has been appointed to the technical and monitoring committee on COVID-19 established by Ministry of Health to supervise resource supply and utilization in hospitals across the country. The COVID-19 resource monitoring tool developed by CHAG has been adopted by the Ministry of Health to track the allocation and utilization of the resources sent to agencies and health facilities across the country. The first level of monitoring has been done by a team of experts using the CHAG monitoring tool. |
3.0 Are the Project Result sustainable?
To effectively discuss the extent to which the net benefits of the CRP projects are likely to continue after the project; three factors were analysed: (i) External coherence and alignment with national COVID-19 response program; (ii) Internal coherence of and networking among CRP project partners; and (iii) Institutional capacity of the CRP partners to sustain the project results overtime.
- External coherence and alignment with national COVID-19 response program is a positive sign of sustainability: The CSO-CRP intervention is consistent with current covid-19 priorities of government of Ghana. The national covid-19 response program broadly aims at implementing interventions to mitigate the negative impact of the pandemic on the economy and society as a whole. The CRP partners are working closely with various government ministries and institutions implementing the National COVID-19 Response programmes. As a result of the CRP project, the Ministry of Health and Ghana Health Services now work closely with CHAG to ensure that PPEs and medical suppliers are fairly distributed to healthcare service provides across that country. The GHS had further adapted a COVID-19 resource utilization monitoring tool developed by CHAG to monitor the use of PPEs supplied to both private and public hospitals. Another effective example of alignment is how the MFWA’s intervention on combating fake news by setting up systems to fact-check COVID-19 related information and website https://www.fact-checkghana.com/ to disseminate accurate information to citizens is well aligned with the efforts of ministries of information and communications in fighting the spread of misinformation and disinformation to the public during the pandemic. At the sub-national levels, the CRP projects are well aligned with and complements response programmes by various decentralised agencies including NCCE, MMDAs, among others.
- Internal coherence and existence of strong network among CRP project partners: Internally, there exist a strong synergy and interlinkages between projects implemented by the CRP partners. This is evident in the vertical and horizontal networks and partnership mixes established by the CRP partners that guided implementation and coordination of the various project. The internal coherence and functional network among the partners is a positive indicator for sustainability of project outcomes as it reduces duplication, expands reach and deepens depth of impact. Partners post the CRP period are likely to continue to share information and implement activities to support vulnerable and marginalised groups in a coordinated manner using the CRP networks.
- Institutional capacity of the CRP partners to sustain the project results overtime: All eight partners that implemented the CRP project have adequate capacity to continue to sustain the results of the CRP interventions. The projects were based on their areas of speciality and targeted vulnerable groups they work with. For instance, the GFDOs work mainly with persons with disabilities; FIDA works mainly to support women and girls to have access to justice; CARITAS works with inter-faith networks; MFWA works to disseminate accurate information to vulnerable citizens in local languages, etc. A potential limitation to institutional sustainability could be the inability of CRP partners to retain project officers to continue project activities due to funding challenges.
4.0 What did we learn from implementing a crisis response programme?
The CRP was implemented in a rapid changing context with much complexities due to the uncertain nature of COVID-19. Based on the findings from documentary review and direct engagements with CRP partners, the team distilled key lessons learnt during the project period.
- Emergency crises require targeted responses adapted to the needs of people affected: The CRP project has demonstrated that targeted response is required during emergency response programming in crises situations. The CSO partners developed Information Education and Communication (IEC) materials and distributed them in accessible formats to targeted vulnerable, marginalised and socially excluded groups according to their needs. Using local languages and community radio platforms are essential in implementing response programs. Health workers must be trained to specifically target and engage vulnerable groups.
- Real-time learning and flexible design structures are required in designing emergency response programmes: There is enough evidence from the CRP to confirm that Social Behavioural Change Programmes in uncertain context of crisis need flexible design structures to adapt to real-time changes. The CRP grant partners were allowed to operate flexible project structures which enabled them to ‘learn’ and ‘adapt’ to the changing context within which the projects were being implemented. This is a clear confirmation that context matters in effective adaptation and learning in crisis response programmes. Central to the learning process is a conscious effort to document and build an evidence-based learning-agenda to guide project implementation. WACSI built an information repository to document and share knowledge with partners, MFWA developed a dedicated website for sharing ‘verified’ information to citizens while GFDO developed IEC materials in various forms and formats to support members to learn and share knowledge.
- Vertical and horizontal networks and collaborations are critical for wider outreach and effective results in emergency response programming: This is evident from how CRP partners managed to reach an estimated 8,922,813 million Ghanaians directly and indirectly through establishment of networks at national and sub-national levels. The CSO-CRP strategic partnership mix facilitated by STAR Ghana Foundation built institutional partnership mix around each objective of the project and expanded their spheres of influence to wider vulnerable and marginalized groups. These networks and partnerships cut across organisations from public, private, CSOs and media houses. The partnership mix played three critical roles: ensuring adequate reach to targeted vulnerable groups/beneficiaries; leveraging on comparative strength/capabilities of each partner; and building interlinkages with relevant government ministries, agencies and institutions. For instance, the collaborative approach deployed by MFWA, CRP Partners (particularly CARITAS, WASCI, GFDO, Penplusbytes) and the media to curb the spread of fake news and societal misinformation and disinformation. CHAG also partnered the Ministry of Health to develop a COVID-19 resource monitoring tool to help monitor the allocation and utilisation of PPEs and medical supplies
- Structured approach is required to combat spread of fake news, misinformation and disinformation to vulnerable groups during crisis. A major general outcome observed from the review of all eight projects under the CRP is a conscious structured approach to combat the spread of misinformation and disinformation through fake news to gullible citizens and vulnerable groups across the country.
- A blended approach is required not a rapid shift to the use of virtual platforms: Online and virtual platforms are the ‘new normal’ in disseminating information but care must be taken not to widen the inequality gap in access to accurate information in the process. Adequate training and support are needed for some vulnerable groups and organisations to learn the ethics and use of these platforms. A general assumption should not be made that all CSOs have the basic infrastructure to support the use of virtual platforms to actively engage their targeted beneficiaries.
- There is an opportunity for growth in private philanthropy and local fund raising to complement government efforts in Ghana. The SDG platform under the CRP phase 1 established a CSO COVID-19 Response Fund. CSOs and private individuals positively responded and voluntarily donated to the fund. Though fund raised about 60% of its targeted amount within period, the positive response it received is an indication that there is a possibility of local fund raising and resource mobilization to support crises response programs to reach out to vulnerable and marginalised groups.
5.0 Conclusion
The CRP project has been designed to ensure adequate strategies are employed by both state and non-state actors to address issues of inequality, exclusion and safeguarding among vulnerable groups as they work towards elimination of COVID 19 pandemic.
Within the first phase of the project, several lessons (as discussed above) were learnt from design through to implementation, learning and documenting of project outcomes. The lessons learnt must serve as a guide in designing CRP phase II and post-COVID recovery programmes.
