Challenges to the utilization of Community-based Health Planning and Services: the views of stakeholders in Yendi Municipality, Ghana

Abstract

Background The Community-based Health Planning and Services (CHPS) is a national health reform programme that provides healthcare at the doorsteps of rural community members, particularly, women and children. It seeks to reduce health inequalities and promote equity of health outcomes. The study explored implementation and utilization challenges of the CHPS programme in the Northern Region of Ghana. Methods This was an observational study that employed qualitative methods to interview key informants covering relevant stakeholders. The study was guided by the systems theory. In all, 30 in-depth interviews were conducted involving 8 community health officers, 8 community volunteers, and 14 women receiving postnatal care in four (4) CHPS zones in the Yendi Municipality. The data were thematically analysed using Atlas.ti.v.7 software and manual coding system. Results The participants reported poor clinical attendance including delays in seeking health care, low antenatal and postnatal care visits. The barriers of the CHPS utilization include lack of transportation, poor road network, cultural beliefs (e.g. taboos of certain foods), proof of women’s faithfulness to their husbands and absence of health workers. Other challenges were poor communication networks during emergencies, and inaccessibility of ambulance service. In seeking health care, insured members of the national health insurance scheme (NHIS) still pay for services that are covered by the NHIS. We found that the CHPS compounds lack the capacity to sterilize some of their equipment, lack of incentives for Community Health Officers and Community Health Volunteers and inadequate infrastructures such as potable water and electricity. The study also observed poor coordination of interventions, inadequate equipment and poor community engagement as setbacks to the progress of the CHPS policy. Conclusions Clinical attendance, timing and number of antenatal and postnatal care visits, remain major concerns for the CHPS programme in the study setting. The CHPS barriers include transportation, poor road network, cost of referrals, cultural beliefs, inadequate equipment, lack of incentives and poor community engagement. There is an urgent need to address these challenges to improve the utilization of CHPS compounds and to contribute to achieving the sustainable development goals.

Improving maternal and child nutrition services in Community based Health Planning and Services zones in the Jirapa municipality of northern Ghana- Challenges and strategies: The perspective of community health officers

“…The role of community engagement by CHOs to ensure effective health services delivery at the community level cannot be overemphasized. Previous studies [21,24] have highlighted how the lack of effective community engagement was identi ed as a major challenge to service delivery in CHPS zones which is consistent with the ndings in this study.…”

“…A major challenge to the provision of maternal and child nutrition services in the Jirapa municipality were the lack of nancial support, motivation or incentives for the CHWs. The nding in this study is consistent with that of other studies that looked at challenges facing CHOs and CHWs under the CHPS concept in Ghana [21,24,25]. Currently Ghana does not remunerate its CHWs contrary to recommendations by the WHO and existing empirical ndings in the literature which suggests that there are better health outcomes at the community level when CHWs are remunerated [26].…”

Quality of maternal healthcare and travel time influence birthing service utilisation in Ghanaian health facilities: a geographical analysis of routine health data

“…In addition, privacy during consultation and labour, cleanliness and well-kept physical surroundings were other factors that determined service satisfaction among women seeking birthing services 23. Although the Community Health Planning and Services (CHPS) initiative aims to achieve universal health coverage in Ghana, there is substandard maternal care in some CHPS facilities 24 25. Thus, women are likely to travel longer to receive care in a health facility perceived as better than the nearest one 26…”

Knowledge and determinants of infection prevention and control compliance among nurses in Yendi municipality, Ghana

“…In relatively rural parts of the world like Yendi, northern Ghana, there is limited data regarding clinical nurses’ knowledge and compliance to IPC guidelines. Also, inadequacy of equipment, lack of incentives and poor human resource has been highlighted by Bassoumah et al [ 15 ] in their recent study to have characterised the Yendi municipality’s health system. Therefore, this study aims to determine the level of knowledge and related factors on IPC compliance among nurses in the Yendi Municipality, northern Ghana.…”