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Project Fives Alive! is funded through a grant provided by

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Project Fives Alive! focuses on improving the implementation of the Ghana Health Service’s already-existing program based on the most cost-effective interventions for maternal and child health, known as High Impact Rapid Delivery (HIRD).  

Specifically, the project staff assists health providers and their managers to improve the coverage, quality, reliability, and patient-centeredness of health services for pregnant women and children under five years of age. This is done through training, coaching, and mentoring clinic, hospital, district, and regional health staff in acquiring and applying quality improvement knowledge and skills to achieve ambitious collaborative goals over a 12- to 18-month period. 


The project’s systems thinking approach promotes strategies to maintain the continuum of care between the health workers and their clients from the point at which pregnancy is detected, through the most vulnerable periods of labor, delivery, and postnatal care all the way up to age five, as well as the continuum of care from home to clinic to hospital.

Project Fives Alive! emphasizes the use of local data and local innovation by the front-line providers who are closest to the processes, thus improving their capacity for data analysis, data-driven decision-making, and local ownership of health outcomes. IHI also works closely with managers and senior leaders of the hospitals, districts, and regions to provide an enabling environment for the frontline providers to succeed in developing, testing, and sustaining successful changes to health services delivery. 

We anticipate that these strategies, if implemented reliably and on a large-scale, will ultimately strengthen the health system beyond the life of the project.


Project Fives Alive! uses two guiding methods: the Model for Improvement and the IHI Breakthrough Series Collaborative methodology.

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The Model for Improvement enables the project staff and the local QI teams with whom they work to set aims; identify process failures; and develop, test, and assess whether changes are leading to improvements in an iterative and continuous manner.

The Improvement Collaborative Network accelerates peer-to-peer learning and improvement on a large scale by using the IHI Breakthrough Series Collaborative methodology. Local QI teams convene at a Learning Session every four to six months to acquire QI knowledge and skills, and to share their QI experiences and learn from their peers’ successes and challenges. During the intervening Activity Periods, teams apply what they have learned, with support from their district managers and the project staff who visit them monthly to assist with development and testing of change ideas, and implementation and sustainability of successful changes.