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Project Fives Alive! is funded through a grant provided by

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Project Fives Alive! in Ghana

Project Fives Alive! began in 2008 and ended in 2015.

A collaboration between IHI and the National Catholic Health Service, the focus of the project was to assist Ghana in achieving Millennium Development Goal 4 (reducing morbidity and mortality in children under five).



PFA_Hand_Logo.JPGIn 2000, all 192 United Nations member states and at least 23 international organizations agreed to work together to achieve eight international development goals by 2015. Millennium Development Goals Four (MDG 4) is focused on reducing infant and child mortality.

Project Fives Alive! unleashes the innovative potential of front-line health workers to develop, test, and implement strategies to overcome systems failures that lead to preventable deaths in children less than five years of age (under-5) in Ghana. In so doing, we aim to accelerate the achievement of the Fourth Millennium Development Goal in Ghana (i.e., reduction in under-5 mortality rate by 66 percent, from 110 per 1,000 live births in 1990 to less than 40 per 1,000 live births by 2015) through the application of quality improvement (QI) methods.


The current mortality rate in children less than five years old is estimated at 74 per 1,000 live births (Source: United Nations Statistics Division, 2011). Of these deaths, 40 percent occur in the first month of life. About half of those deaths occur on the first day of life, while an additional 25 percent occur by the end of the first week. For this reason, Project Fives Alive! focuses on helping health workers to improve the processes of care during pregnancy through the most vulnerable period of labor, delivery, and postnatal care, and finally, care of the older infant and child up to the age of five.

The Institute for Healthcare Improvement (IHI) and the National Catholic Health Service (NCHS) are collaborating with the Ghana Health Service (GHS) to spread the implementation of successful strategies across the country for maximal impact. The project is funded by the Bill & Melinda Gates Foundation.

Project Fives Alive!
5-Year Implementation Plan

National in scope, the program is being implemented in four successive waves over five years, starting on a small scale in the North of Ghana and eventually spreading to all health facilities across the country – to cover an estimated 3.3 million children under the age of five.


​Wave 1 ​Rapid innovation and testing of change ideas on a small scale in four districts/dioceses in Northern Sector of Ghana
​Wave 2 ​Spread simplified package of successful changes to all 38 districts in three regions of the North
Wave 3 ​Spread improvements within NCHS hospital system in the South
​Wave 4 ​Spread improvements to South and remainder of country