Ghana has made significant progress in maternal and newborn health, yet major challenges remain. Maternal mortality stands at 263 per 100,000 live births and neonatal mortality at 23 per 1,000 live births — both well above global averages and targets set under the Sustainable Development Goals. These sub-optimal outcomes are partly linked to gaps in adherence to clinical best practice and the operational constraints facing public hospitals, where frontline providers work with limited resources.
To address these challenges, Kybele and the Ghana Health Service (GHS) developed and implemented the Obstetric Triage Implementation Package (OTIP) – a structured system of obstetric triage in hospitals that enables midwives to rapidly assess the condition of pregnant women, prioritise care and ensure that those with the most critical needs receive immediate attention.
A central feature of the programme is the use of midwife ’champions’ within each facility, who lead the implementation of the new protocol: training their peers, encouraging adherence to triage procedures, and helping establish and maintain dedicated triage areas.
This briefing highlights the findings of our evaluation, conducted between 2024 and 2025, which examined how different approaches to selecting champions affect the effectiveness of OTIP. The research team partnered with Ghana Health Service (GHS) and Kybele to embed a large-scale experiment into the national rollout of OTIP across 25 hospitals in Greater Accra, Central and Western Regions.