Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana’s Community-based Health Planning and Services (CHPS)

Adongo, Philip Baba; Phillips, James F.; Aikins, Moses; Arhin, Doris; Schmitt, Margaret L.; Nwameme, Adanna; Tabong, Philip Teg‐Nefaah; Binka, Fred

doi:10.1186/1478-4505-12-16

Cited by 40 publications

(57 citation statements)

References 19 publications

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“…In line with this, there has been much emphasis on expanding basic health services in rural areas through the Community-based Health Planning and Services (CHPS) program. The urban-based CHPS has turned out to be much more challenging to implement as the population is more volatile and less well demarcated [ 4 ].…”

Section: Resultsmentioning

confidence: 99%

Inequalities in child immunization coverage in Ghana: evidence from a decomposition analysis

2018

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Childhood vaccination has been promoted as a global intervention aimed at improving child survival and health, through the reduction of vaccine preventable deaths. However, there exist significant inequalities in achieving universal coverage of child vaccination among and within countries. In this paper, we examine rural-urban inequalities in child immunizations in Ghana. Using data from the recent two waves of the Ghana Demographic and Health Survey, we examine the probability that a child between 12 and 59 months receives the required vaccinations and proceed to decompose the sources of inequalities in the probability of full immunization between rural and urban areas. We find significant child-specific, maternal and household characteristics on a child’s immunization status. The results show that children in rural areas are more likely to complete the required vaccinations. The direction and sources of inequalities in child immunizations have changed between the two survey waves. We find a pro-urban advantage in 2008 arising from differences in observed characteristics whilst a pro-rural advantage emerges in 2014 dominated by the differences in coefficients. Health system development and campaign efforts have focused on rural areas. There is a need to also specifically target vulnerable children in urban areas, to maintain focus on women empowerment and pay attention to children from high socio-economic households in less favourable economic times.

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Section: Resultsmentioning

confidence: 99%

Inequalities in child immunization coverage in Ghana: evidence from a decomposition analysis

2018

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“…The framework also provides sets of quality-of-care measures (satisfaction of parents who care for children with disabilities) and quality-of-life indicators (breastfeeding and obesity prevalence) [ 2 ]. Such shared accountability at the local or community level could be useful in facilitating cross-sector innovation and improvement efforts, which are essential if healthcare and other service providers are to join forces in addressing the fundamental causes of adversity and provide systemic kinds of support [ 83 ].…”

Section: Resultsmentioning

confidence: 99%

Social Factors Influencing Child Health in Ghana

et al. 2016

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ObjectivesSocial factors have profound effects on health. Children are especially vulnerable to social influences, particularly in their early years. Adverse social exposures in childhood can lead to chronic disorders later in life. Here, we sought to identify and evaluate the impact of social factors on child health in Ghana. As Ghana is unlikely to achieve the Millennium Development Goals’ target of reducing child mortality by two-thirds between 1990 and 2015, we deemed it necessary to identify social determinants that might have contributed to the non-realisation of this goal.MethodsScienceDirect, PubMed, MEDLINE via EBSCO and Google Scholar were searched for published articles reporting on the influence of social factors on child health in Ghana. After screening the 98 articles identified, 34 of them that met our inclusion criteria were selected for qualitative review.ResultsMajor social factors influencing child health in the country include maternal education, rural-urban disparities (place of residence), family income (wealth/poverty) and high dependency (multiparousity). These factors are associated with child mortality, nutritional status of children, completion of immunisation programmes, health-seeking behaviour and hygiene practices.ConclusionsSeveral social factors influence child health outcomes in Ghana. Developing more effective responses to these social determinants would require sustainable efforts from all stakeholders including the Government, healthcare providers and families. We recommend the development of interventions that would support families through direct social support initiatives aimed at alleviating poverty and inequality, and indirect approaches targeted at eliminating the dependence of poor health outcomes on social factors. Importantly, the expansion of quality free education interventions to improve would-be-mother’s health knowledge is emphasised.

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“…The births recorded in the two surveys cover the period July 1999 to October 2008, which coincide with the launch of the CHPS initiative in 1999. Prior to 2005, CHPS was a rural policy [ 11 , 31 ]. In 2005, the Government of Ghana, the Ghana Ministry of Health and Ghana Health Service adopted CHPS as national policy with the aim of developing urban health systems in marginalised urban communities [ 14 , 31 ].…”

Section: Methodsmentioning

confidence: 99%

“…Prior to 2005, CHPS was a rural policy [ 11 , 31 ]. In 2005, the Government of Ghana, the Ghana Ministry of Health and Ghana Health Service adopted CHPS as national policy with the aim of developing urban health systems in marginalised urban communities [ 14 , 31 ]. However, due to the slow implementation of CHPS in urban areas, only two pilot urban CHPS compounds (in Tema and Glefe, both in the Greater Accra region) supported by the CHPS Technical Assistance Project of the USAID were functional [ 32 ] within the study period.…”

Section: Methodsmentioning

confidence: 99%

Evaluating the Impact of the Community-Based Health Planning and Services Initiative on Uptake of Skilled Birth Care in Ghana

et al. 2015

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BackgroundThe Community-based Health Planning and Services (CHPS) initiative is a major government policy to improve maternal and child health and accelerate progress in the reduction of maternal mortality in Ghana. However, strategic intelligence on the impact of the initiative is lacking, given the persistant problems of patchy geographical access to care for rural women. This study investigates the impact of proximity to CHPS on facilitating uptake of skilled birth care in rural areas.Methods and FindingsData from the 2003 and 2008 Demographic and Health Survey, on 4,349 births from 463 rural communities were linked to georeferenced data on health facilities, CHPS and topographic data on national road-networks. Distance to nearest health facility and CHPS was computed using the closest facility functionality in ArcGIS 10.1. Multilevel logistic regression was used to examine the effect of proximity to health facilities and CHPS on use of skilled care at birth, adjusting for relevant predictors and clustering within communities. The results show that a substantial proportion of births continue to occur in communities more than 8 km from both health facilities and CHPS. Increases in uptake of skilled birth care are more pronounced where both health facilities and CHPS compounds are within 8 km, but not in communities within 8 km of CHPS but lack access to health facilities. Where both health facilities and CHPS are within 8 km, the odds of skilled birth care is 16% higher than where there is only a health facility within 8km.ConclusionWhere CHPS compounds are set up near health facilities, there is improved access to care, demonstrating the facilitatory role of CHPS in stimulating access to better care at birth, in areas where health facilities are accessible.

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Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana’s Community-based Health Planning and Services (CHPS)

Cited by 40 publications

References 19 publications

Inequalities in child immunization coverage in Ghana: evidence from a decomposition analysis

Inequalities in child immunization coverage in Ghana: evidence from a decomposition analysis

Social Factors Influencing Child Health in Ghana

Evaluating the Impact of the Community-Based Health Planning and Services Initiative on Uptake of Skilled Birth Care in Ghana

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