Browsing by Author "Wright, K."
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Item Community-Based Health Planning and Services (CHPS) as a Gateway to Reducing Maternal and Child Mortality in Rural Ghana - A Community-level Analysis(2017-11-09) Wright, K.Institutional maternal mortality in Ghana has decreased between 1990 and 2010, by a narrow margin of 216 to 164 deaths per 100,000 live births. Continued focused intervention is essential to accelerate the rate of decline. Contributing factors of this trajectory have been attributed to sustainability of quality access to care and infrastructure, workforce availability, and leadership stability. Strengthening of community-based primary health services such as, Community-Based Health Planning and Services (CHPS) aims to reduce mortality by removing financial barriers and improving quality access to care. While quantitative data is essential, studies often overlook the community level impact of health systems. Transcripts from qualitative group discussions within 8 communities- functional and non-functional CHPS zones- in the Northern and Volta regions of Ghana (2017), were analyzed to critically assess communities’ experiences with community health services and their vital role in improving health outcomes, and reducing maternal and child mortality in the region.Item Preparing ethical review systems for emergencies: next steps(BMC Medical Ethics, 2023) Wright, K.; Aagaard, N.; Atuire, C.; et al.Ethical review systems need to build on their experiences of COVID-19 research to enhance their preparedness for future pandemics. Recommendations from representatives from over twenty countries include: improving relationships across the research ecosystem; demonstrating willingness to reform and adapt systems and processes; and making the case robustly for better resourcing.Item A qualitative appraisal of stakeholders’ perspectives of a community-based primary health care program in rural Ghana(BMC Health Services Research, 2019-09-18) Kushitor, M.K.; Biney, A.A.; Wright, K.; Phillips, J.F.; Awoonor-Williams, J.K.; Bawah, A.A.Background: The Ghana Community-based Health Planning and Services (CHPS) initiative is a national strategy for improving access to primary health care services for underserved communities. Following a successful trial in the North Eastern part of the country, CHPS was adopted as Ghana’s flagship programme for achieving the Universal Health Coverage. Recent empirical evidence suggests, however, that scale-up of CHPS has not necessarily replicated the successes of the pilot study. This study examines the community’s perspective of the performance of CHPS and how the scale up could potentially align with the original experimental study. Method: Applying a qualitative research methodology, this study analysed transcripts from 20 focus group discussions (FGDs) in four functional CHPS zones in separate districts of the Northern and Volta Regions of Ghana to understand the community’s assessment of CHPS. The study employed the thematic analysis to explore the content of the CHPS service provision, delivery and how community members feel about the service. In addition, ordinary least regression model was applied in interpreting 126 scores consigned to CHPS by the study respondents. Results: Two broad areas of consensus were observed: general favourable and general unfavourable thematic areas. Favourable themes were informed by approval, appreciation, hard work and recognition of excellent services. The unfavourable thematic area was informed by rudeness, extortion, inappropriate and unprofessional behaviour, lack of basic equipment and disappointments. The findings show that mothers of children under the age of five, adolescent girls without children, and community leaders generally expressed favourable perceptions of CHPS while fathers of children under the age of five and adolescent boys without children had unfavourable expressions about the CHPS program. A narrow focus on maternal and child health explains the demographic divide on the perception of CHPS. The study revealed wide disparities in actual CHPS deliverables and community expectations. Conclusions: A communication gap between health care providers and community members explains the high and unrealistic expectations of CHPS. Efforts to improve program acceptability and impact should address the need for more general outreach to social networks and men rather than a sole focus on facility-based maternal and child health care.