Systems for Health project


We support maternal and child health.

Implemented by a consortium led by University Research Co. LLC and including Plan International USA, the USAID-funded Systems for Health (S4H) project worked to improve maternal and child health in Ghana from 2014-2019.

When the Systems for Health project began in 2014, one in every 24 Ghanaian children was dying before reaching age 1. Meanwhile, one in every 17 children did not survive to see their fifth birthday. S4H worked to expand access and quality of health care services, including at the primary care level, where contributors to infant and child mortality can be addressed at both the community and the health facility.

What are we doing?

The Systems for Health (S4H) project sought to sustainably support improved health-service delivery by strengthening vital systems in Ghana to ensure access and quality while mobilizing communities to maximize coverage and accountability in the health system. 

One of the project’s key strategies was to help improve the functionality of Ghana’s primary health care system — the Community-based Health Planning and Services (CHPS) — in the 483 zones of the project’s coverage area. The project supported planning, capacity building and comprehensive support to health facilities and communities. 

To measure progress, S4H looked at zones that completed 13 steps of the CHPS process. The steps represent the actions that are needed for CHPS to be fully functional, and they include community entry, staff deployment and training, and physical infrastructure requirements, among others. At the beginning of the project, just 7% of participating CHPS zones had completed 13 steps. By the end, 49% of zones had reached this level of implementation. Over the life of the project, this enabled CHPS zones to provide additional primary care services. In the project’s fifth year, the zones provided 500,000 more services as compared to the second year of the project.

In early 2018, the Ghana Health Service added the community scorecard to the CHPS, offering a way for community members to evaluate their services and increase accountability to improve their quality. By facilitating its application in all 483 project-supported CHPS zones, S4H helped to solidify community ownership of CHPS and fill the remaining gap between supply and demand in order to sustainably increase the use of community-based services.


stats and facts

steps to creating fully functional community-based health planning and services.
target regions supported by the project.
target regions achieved all 13 steps needed for fully functional health services.
Community meetings
Community meetings

Project staff met with members of Community Health Management Committees as part of the project.

Community scorecard results: Waiting area
Community scorecard results: Waiting area

Using the community scorecard approach implemented by the Systems for Health project, one community identified the need for a covered waiting area outside of the local health post and began construction.

Community scorecard results: Water system
Community scorecard results: Water system

Another community used the scorecard process to identify the need for a mechanized water system to serve the health facility and the community. The Community Health Management Committee was able raise funds and build a sustainable system with a borehole, electric pump, water tank and tubing to the health facility and surrounding community.

Our projects in the region

More about the

Systems for Health project

Maternal & Child Health

Learn more about Plan’s Maternal & Child Health work.
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African Child

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Ghana country page

Learn more about Plan’s work in Ghana.
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