Strengthening Systems to Improve Nutrition Service Delivery in Northern Ghana

Ensuring program sustainability is a persistent challenge for public health projects. During project implementation, community health outcomes often improve, but what happens when projects end?

Often projects work through parallel systems to deliver programs to improve health and nutrition, making it hard for local systems to take on and continue these programs when projects end. Through the five-year Resiliency in Northern Ghana (RING) project, USAID is testing a different approach to promoting sustainability by investing in local governments directly.

RING aims to improve the livelihoods and nutritional status of vulnerable households in 17 districts of Ghana’s Northern Region, where rates of childhood stunting and wasting are among the highest in the country. JSI leads RING’s nutrition component, working to improve the quality of nutrition services and nutrition-related practices and to enhance nutrition-sensitive agriculture efforts.

The project is implemented in collaboration with local government bodies, including District Assemblies and the Northern Regional Coordinating Council, which receive direct funds to implement quality nutrition, agriculture, livelihoods, and WASH interventions. This approach builds local governments’ capacity to develop action plans and related budgets, and to implement and closely monitor nutrition and livelihood outcomes, which creates a strong sense of community ownership and builds resilient local systems for effective programming.

Save the Children and Oxfam documented the RING project in the report The Power of Ownership, which examined innovative models to promote government and community ownership. The video complementing the report highlights RING’s innovative funding model, and the impact it has had on local government capacity and accountability.

In The Power of Ownership, a Senior Development Planning Officer at the Northern Regional Coordinating Council described the importance of this funding mechanism: “Direct funding from USAID is important to the extent that it supports our own plans and budget. It is not telling us what to do. It is supporting what we planned to do. And I think that is the most important aspect of it.” Other respondents interviewed during the creation of the report said that “the skills acquired from RING will remain beyond the end of the project,” demonstrating the potential long-term impact of the project to strengthen local government systems.

Government-to-government funded programs like RING provide exciting, innovative alternatives to traditional aid models, and could provide important insights into what works and what does not in building resilient local systems and achieving sustainable results.

Written by Agnes Guyon and Sarah Cunningham