Assessment of the Implementation of the Home Visiting Strategy: A Case Study of Maternal and New Born Health Care in the Ga South Municipality of Ghana

Abstract

Background: Home visiting has been the pivot of both the Primary Health Care (PHC) and currently the CHPS concepts in the Ghana Health Service; yet there is little information on how the home visit strategy improves maternal and new born health. This study aimed at assessing the implementation of the home visiting strategy and its effect on maternal and newborn health care in the Ga South Municipality in Ghana. Methods: A cross sectional study employing mixed methods approach was carried out. Four hundred and fifty three women were interviewed using a structured questionnaire. Four methods (desk review, observation, Key Informant Interviews, and two Focus Group Discussions) were used in the qualitative aspect. The quantitative data was analysed in SPSS version 22 using descriptive statistics for the background characteristics. Chi Square test was used to determine the association between ANC 4+ visits, Post natal coverage and the home visit strategy on one hand; and on the other, infection prevention and exclusive breastfeeding and the home visiting strategy. Nvivo version 11 was used to analyse the qualitative study. Triangulation of data from the quantitative and qualitative studies was done resulting in a synthesised and synergized document. Results: About 51% of respondents had not seen home visit service providers in their communities. All the respondents agreed that the heavy workload of the Community Health Officers (CHOs) makes it difficult for them to conduct home visiting. The social network of clients influenced responsiveness to home visiting services. Fifty seven percent of respondents felt socio economic status of clients do influence home visiting services but there was not enough statistical evidence to conclude. Geographical access and availability of social amenities did not statistically influence home visiting services. The home visiting strategy is more beneficial to neonates than to pregnant women Conclusion: There are intervening factors that influence home visiting service delivery. Ensuring the availability and managing the workload of service providers could enhance home visiting services. The social networks of clients are valuable resources home visit service providers need to take advantage of.