The Fertility Impact of the Navrongo Project

James F. Phillips, Population Council
Elizabeth F. Jackson, Population Council
Ayaga A. Bawah, Navrongo Health Research Centre
Cornelius Y. Debpuur, Navrongo Health Research Centre

The Navrongo Community Health and Family Planning Project is an experimental study launched in rural northern Ghana in 1996 to test the hypothesis that reproductive change can be induced and sustained by community health and family planning services in a setting with high fertility and mortality and significant socio-economic barriers to reproductive change. This paper reports results from analyses of demographic surveillance data comparing fertility regimes of women exposed and unexposed to treatment conditions. Where nurses provide outreach services in conjunction with village mobilization activities, project impact is significant, pronounced, and sustained with a fertility reduction of nearly 20 percent. Results support the hypothesis that service delivery approaches can introduce reproductive change. However, achieving this impact is conditional upon launching a comprehensive family planning and health service approach incorporating strategies for community mobilization, male involvement, and continuous outreach addressing a range of social and health activities. Policy implications are discussed.