Community-Based Health Planning and Services Plus programme in Ghana: A qualitative study with stakeholders in two Systems Learning Districts on improving the implementation of primary health care
Date
2020-01-08
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Abstract
In 1999, Ghana introduced the Community-Based Health Planning and Services (CHPS) as
the key primary health care strategy. In this study, we explored the challenges, capacity
development priorities, and stakeholder perspectives on improving the CHPS concept as it
has been fraught with a myriad of challenges since its inception. Our study is the outcome of
the national programme for strengthening the implementation of CHPS Initiative in Ghana
(CHPS+) introduced in 2017.
Methods
This exploratory research was a qualitative study conducted in two Systems Learning Districts
(SLDs) of CHPS+ in the Volta Region of Ghana from March to May, 2018. Four focus
group discussions and two general discussions were conducted among 60 CHPS+ stakeholders
made up of health workers and community members. Data analyses were conducted
using conceptual content analysis. Statements of the participants were presented as
quotes to substantiate the views expressed.
Results
Negative attitude, high attrition, inadequacy and unavailability of health professionals at
post when needed were challenges associated with the health professionals. Late referrals lack of proper community entry and engagement, non-availability of essential logistics, distance
of CHPS compounds from communities, and inadequate funding were challenges
associated with the health system. Lack of community ownership of the CHPS programme,
lack of security at CHPS compounds, and late reporting of cases by the community members
were also realised as challenges emanating from the community members. Priority
areas for capacity development of health workers identified included logistics management,
community entry and engagement, emergency delivery, managing referrals at the CHPS
level, and resuscitation of newborns.
Conclusion
Health-worker, community, and health systems-based challenges inhibit the implementation
of CHPS in Ghana. Capacity development of health professionals and continuous community
engagement are avenues that can improve implementation of the programme
Description
Research Article
Keywords
Centres for Disease Control and Prevention; CHPS, Systems Learning Districts (SLDs), Ghana, health professionals