The influence of the Community‐based Health Planning and Services (CHPS) program on community health sustainability in the Upper West Region of Ghana

Abstract

SummaryGhana introduced Community‐based Health Planning and Services (CHPS) to improve primary health care in rural areas. The extension of health care services to rural areas has the potential to increase sustainability of community health. Drawing on the capitals framework, this study aims to understand the contribution of CHPS to the sustainability of community health in the Upper West Region of Ghana—the poorest region in the country. We conducted in‐depth interviews with community members (n = 25), key informant interviews with health officials (n = 8), and focus group discussions (n = 12: made up of six to eight participants per group) in six communities from two districts. Findings show that through their mandate of primary health care provision, CHPS contributed directly to improvement in community health (eg, access to family planning services) and indirectly through strengthening social, human, and economic capital and thereby improving social cohesion, awareness of health care needs, and willingness to take action at the community level. Despite the current contributions of CHPS in improving the sustainability of community health, there are several challenges, based on which we recommend, that government should increase staffing and infrastructure in order to strengthen and maintain the functionality of CHPS.

Access to primary health care among women: the role of Ghana’s community-based health planning and services policy

“…This is because geographical barriers have been widely shown to hinder access to health care, especially for rural dwellers (Gabrysch and Campbell, 2009 ; Ntsua et al , 2012 ; Atuoye et al , 2015 ). Consistent with previous studies, our findings reveal improved access to care with residence in a CHPS zone (Johnson et al , 2015 ; Woods et al , 2018 ). Modelled around the zoning system, residing within the CHPS zone remarkably reduces the geographical distance previously covered to access health care services.…”

“…Moreover, seeking permission and/or financial support to travel to these distant facilities may be more challenging for women, possibly accounting for the variations in access. In overcoming transportation barriers to accessing health care services, Woods et al ( 2018 ) notes the emergence of the community emergency transport systems (CETS) in some CHPS operational communities. CETS are local-level transport arrangements to assist patients to seek care at referral points in a timely manner in the absence of a working ambulance system for rural communities.…”

“…Yet, there is limited understanding of the contribution of CHPS to PHC access in the country. Most studies on health care access in the context of CHPS have centred on the general population, and the few specific to women focus on maternal health care services (Atuoye et al , 2015 ; Shamsu-Deen, 2015 ; Woods et al , 2018 ). This study examines the contribution of CHPS to PHC services access among women in the Upper West Region (UWR) of Ghana by hypothesising that women in CHPS zones (mostly rural areas) are more likely to access the needed health care than their counterparts in non-CHPS zones.…”

“…Financial accessibility, on the other hand, involves consumers’ ability and willingness to pay for services rendered them, and this is often measured using wealth. In response to financial barriers to health care service use, CHOs in collaboration with CHVs are required to embark on initiatives such as community emergency transport services which will help reduce the financial burden of accessing health care and improve people’s uptake of health care service (Woods et al , 2018 ). This is particularly pertinent to the context of the UWR, which is characterised by high poverty rates (Ghana Statistical Service, Ghana Health Service and ICF International, 2015 ).…”

Improving Access and Utilization of Maternal Healthcare Services through Focused Antenatal Care in Rural Ghana: A Qualitative Study

“…This ensures that women, confirmed to be pregnant, utilize ANC services early and are able to make the minimum of four visits recommended by the WHO. This confirms the assertions that community level structures if identified and harnessed appropriately can be useful tools in improving maternal health in rural areas [33][34][35].…”