A case/comparison study in the Eastern Region of Ghana on the effects of incorporating selected reproductive health services on family planning services Judith Fullerton, Alfredo Fort and Kulmindar Johal Objective: toassesstheimpactontheprovisionoffamilyplanning(FP)serviceswhenFP providerswere alsotrainedtoprovide additional, selected, reproductivehealthservices. Design: case/comparisonstudy. Participants and settings: twenty-fourFPservicedeliverypointsinwhichtraininginsexually transmittedinfectionpreventionandcontrolservicesorpost-abortioncareserviceshad been initiated (case facilities), were compared to19 control facilitiesinwhich similar providertraininghadnotyetbeentargeted.AllsettingswerelocatedintheEasternRegion of Ghana. Measurements: service statistics for three study years (1996^1998) were reviewed. Structuredinterviewswithproviders, managers andclientsprovidedqualitative data concerningimpact andsatisfaction. Findings: case facilitieswhichhadintegratedthese additionalreproductivehealth (RH) servicesexperiencedconsistentlyhighernumbersofclientsandthetotalnumberofclients receivingFPservicesincreasedovertime.Therewasalsoastatisticallysigni¢cantincrease incontinuingFPclientswithincasefacilities.Incontrast,thenumberofFPclientsserviced inthecomparisonarearemainedbasicallyunchangedovertime. Key conclusions: interviewsconductedwithprovidersandmanagersinbothtypesof settingsindicatedstrongsupportforreceiptoftrainingtoprovidetheseintegratedservices andarequestforadditionaltraininginanevenbroaderarrayofRHandadult/childservices. Clientsalsoperceivedthebene¢tofadditionalRHservicesandperceivedtheseservicesto be of highquality. Implications for practice: expandingtherepertoireofclinicalskillsofFPproviders,enabling thesepractitionerstorenderRHservicesthataugmentbasicFPservices,hasthepotential toincreasethenumberofnewandcontinuingFPclients,andincreasesthesatisfactionof bothprovidersandconsumerswithrespecttotheseservices. & 2003 Elsevier Science Ltd. Allrightsreserved. INTRODUCTION Given its recent population growth of 2.13% per year (Republic of Ghana, 1999), Ghana was estimated to have achieved a population of approximately 20 million people as of the year 2000. However, the government of Ghana has long recognised the high fertility, and maternal and infant mortality levels prevalent in the country. In 1993, the infant mortality rate JudithT.Fullerton Ph.D., CNM,FACNM Consultant, American College of Nurse Midwives Department of Global Outreach, Professor,College of Health Sciences, School of Nursing,University of Texas at El Paso,1101N Campbell Ave.El Paso,TX 79902-0581,USA, Alfredo Fort M.D., Ph.D. Director, Research and Evaluation,The PRIME Project at Intrah/ University of North Carolina at Chapel Hill/ School of Medicine,1700 Airport Road,Chapel Hill, NC 27599-1800,USA Kulmindar Johal M.S., CNMConsultant, American College of Nurse-Midwives, Department of Global Outreach,982 Seapearl Place,V|ctoria, B.C., CanadaV8Y 2X3 (Correspondence to JTF, Tel.: +1915 747 7236, E-mail: jfullert@cts.com) Received15th May 2002 Revised 9th July 2002 Accepted 20th September 2002 Midwifery (2003) 19, 17^26 & 2003 Elsevier Science Ltd. All rights reserved. doi:10.1054/midw.2002.0334