COVID-19 in Ghana-Using the health system framework to describe RISE-mitigation strategies for COVID-19 response and recovery in Ghana

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Navigating global crises like the Coronavirus Disease 2019 (COVID-19) demands strategic and impactful health interventions. Evaluating these interventions is crucial for fortifying health systems at both national and global scales. This article described and appraised projects carried out under the United States Government-funded, Reaching Impact Saturation and Epidemic Control (RISE) initiative during the pandemic in Ghana, offering insights and lessons learned through six health system building blocks. A mixed study design using qualitative and quantitative approaches: comprehensive document review, engagement with project managers and case narratives of data collections were adopted to appraise 10 novel interventions. Projects were selected using a census method, which included all projects that had been completed at the time of appraisal. Following selection, each project was mapped to the six building components using well-defined criteria; sustainable health financing, service provision, health management and leadership, products and logistics, information systems and data integration, and human resource. Overall, significant improvements in service delivery and health system strength were noted. COVID-19 immunization was successfully integrated into routine service delivery, resulting in 93.2% coverage attainment. Data quality audits and saturation analyses result in the institutionalization of standardized reporting and real-time data utilization. Under the Test-2-Treat (T2T) project, access to COVID-19 medications was provided to 79% confirmed cases. Additionally, RISE-supported oxygen interventions (LOX/PSA systems) improved equitable access to medical oxygen, reducing travel distances for peripheral facilities by 12.1% to 69.7% to procure medical oxygen. Capacity-building activities further strengthened service delivery and equipment maintenance, while generating critical lessons for the Ghana Health Service on integrating pandemic response interventions into routine health system functions.

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