“Were you satisfied with the services you received?”

I’ve spent a lot of time during my internship within the walls of the Pathfinder’s country office in Accra. Although it is less glamorous than visiting the sites overseeing project activities, much important work (program-related and otherwise) is done behind the scenes in Ghana as well as HQ and our other country offices throughout the world. Finance, monitoring and evaluation, fundraising, communications and various administrative functions are all important facets of Pathfinder’s work; each one is a meaningful part of the daily program work and contributes to the final impact of the organization.

One particular example of such work behind the scenes in Ghana deserves, at least I think, an out-front mention. As part of an effort to improve monitoring and evaluation of the Youth Friendly Postabortion Care (YF PAC) project, the Ghana office is using the collection of mobile phone numbers to facilitate confidential exit interviews. In many projects exit interviews are conducted, most times immediately after the patient receives care, to measure service quality. These interviews feed a broader monitoring and evaluation effort and provide those implementing the project with patients’ views of the services rendered. However, due to the fact that PAC can be traumatic both physically and emotionally for the client, it doesn’t make sense, nor would it be appropriate, to conduct exit interviews directly following the procedure. The collection of mobile phone numbers provides an innovative solution to this problem. Moreover, through interviews conducted via mobile phones, the confidentiality of the patient is maintained, which would not be the case for home visits.

I have learned a lot from watching Getrude, the Assistant Program Officer, conduct these interviews and admire the care and concern she shows for the clients throughout her questioning. Getrude conducts the interviews in a mix of English and the local language, easing into the local language as the interview becomes more conversational and less formal. The prepared questions, dealing with pain management, interaction with the service providers and quality of family planning counseling, work to create an understanding of the services from the clients’ view; a composite of the answers informs the project in a way that site visits and record keeping alone cannot. In addition to this primary purpose, the interviews are used to check-in on the client to make sure she is well after the procedure and receiving any follow-up care that she needs. In a few of the interviews, the young women did not receive a family planning method because of various reasons, even though they were interested in receiving a method. Getrude informally counseled them on their options and encouraged them to return to the family planning clinic, giving detailed instructions as to where it was located and who would be there to help them—even going so far as to call the service provider at the family planning clinic to notify her of when the women would be coming. This kind of personalized follow-up is invaluable to the women to whom Getrude speaks and, although the impact is minor in terms of overall numbers, will make a difference in the individual lives of these young women.

The YF PAC project is a one-year privately funded initiative taking place in eight countries throughout Africa and it is truly innovative in its focus on PAC, a topic largely ignored by aid projects in the developing world, as well as its focus on the special needs of adolescent clients. Its mark on the community is not measured solely by the impact of the services rendered in that short year, but also on the lessons learned and progress made throughout that year. The YF PAC program in Ghana has not been without challenges, but these challenges, if examined, can lead to successes in future programs—either for Pathfinder or another NGO—and ultimately could contribute more to the health of the community than an initial success of a more standard project. Pathfinder anticipates replicating this innovative project throughout Ghana and other African countries, so the impact of this detailed and creative monitoring (although behind the scenes!) will be felt for years to come.

(This photo shows the PI staff in Accra as well as the PI staff based in the North who happened to be in Accra for a meeting.)