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

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bougangue Bassoumah ◽  
Andani Mohammed Adam ◽  
Martin Nyaaba Adokiya
Keyword(s):  
Health Care ◽  
Community Engagement ◽  
Community Health ◽  
National Health ◽  
Postnatal Care ◽  
Road Network ◽  
Health Planning ◽  
Cultural Beliefs ◽  
Community Based ◽  
Antenatal And Postnatal Care

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.

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

2021 ◽  
Author(s):  
Bougangue Bassoumah ◽  
Mohammed Adam Andani ◽  
Martin Nyaaba Adokiya
Keyword(s):  
Communication Networks ◽  
Postnatal Care ◽  
Health Workers ◽  
Health Planning ◽  
Cultural Beliefs ◽  
Northern Region ◽  
Coding System ◽  
Community Based ◽  
The Sustainable Development ◽  
Antenatal And Postnatal Care

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 challenges of the CHPS utilization following reports by the Ghana Statistical Service of poor clinic attendance and high maternal and child morbidities and mortalities in the Northern Region of Ghana. Methods This observational study 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. 2 Results The study found poor clinical attendance in the form of delays in seeking health care, low antenatal and postnatal care visits, barriers affecting the utilization of the CHPS compounds to include lack of transportation and poor road network, cultural beliefs such as taboos of certain foods and proof for women's faithfulness to their husbands as challenges of health facility utilization. Besides, the absence of health workers at the CHPS compounds such as the CHOs, poor communication networks during emergencies when the ambulance service becomes inaccessible and lack of capacity by CHPS compound to sterilize some equipment. Furthermore, lack of incentives and adequate infrastructures like potable water and electricity, poor coordination of healthcare interventions and practices, lack of specialists and equipment as well as poor community engagement are major setbacks to the progress of the CHPS policy. Conclusions On clinical attendance, timing and number of antenatal and postnatal care visits, remain major concerns for the CHPS programme in the study setting. The barriers accounting for the low utilization of CHPS compounds are cost of referrals and cultural beliefs. 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.

scholarly journals Community utilisation and satisfaction with the community-based health planning and services initiative in Ghana: a comparative study in two system learning districts of the CHPS+ project

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Margaret Kweku ◽  
Hubert Amu ◽  
Martin Adjuik ◽  
Fortress Yayra Aku ◽  
Emmanuel Manu ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Care Delivery ◽  
Health Planning ◽  
Service Utilisation ◽  
Community Based ◽  
Primary Health

Abstract Background To strengthen the implementation of the Community-based Health Planning and Services (CHPS) programme which is Ghana’s key primary health care delivery strategy, the CHPS+ Project was initiated in 2017. We examined community utilisation and satisfaction with CHPS services in two System Learning Districts (SLDs) of the project. Methods This community-based descriptive study was conducted in the Nkwanta South Municipality and Central Tongu District of Ghana. Data were collected from 1008 adults and analysed using frequency, percentage, chi-square, and logistic regression models. Results While the level of utilisation of CHPS services was 65.2%, satisfaction was 46.1%. Utilisation was 76.7% in Nkwanta South and 53.8% in Central Tongu. Satisfaction was also 55.2% in Nkwanta South and 37.1% in Central Tongu. Community members in Nkwanta South were more likely to utilise (AOR = 3.17, 95%CI = 3.98–9.76) and be satisfied (AOR = 2.77, 95%CI = 1.56–4.90) with CHPS services than those in Central Tongu. Females were more likely to utilise (AOR = 1.75, 95%CI = 1.27–2.39) but less likely to be satisfied [AOR = 0.47, 95%CI = 0.25–0.90] with CHPS services than males. Even though subscription to the National Health Insurance Scheme (NHIS) was just 46.3%, NHIS subscribers were more likely to utilise (AOR = 1.51, 95%CI = 1.22–2.03) and be satisfied (AOR = 1.45, 95%CI = 0.53–1.68) with CHPS services than non-subscribers. Conclusion Ghana may not be able to achieve the goal of universal health coverage (UHC) by the year 2030 if current levels of utilisation and satisfaction with CHPS services persist. To accelerate progress towards the achievement of UHC with CHPS as the vehicle through which primary health care is delivered, there should be increased public education by the Ghana Health Service (GHS) on the CHPS concept to increase utilisation. Service quality should also be improved by the GHS and other stakeholders in Ghana’s health industry to increase satisfaction with CHPS services. The GHS and the National Health Insurance Authority (NHIA) should also institute innovative strategies to increase subscription to the NHIS since it has implications for CHPS service utilisation and satisfaction.

scholarly journals Community-based health care:a different approach to health outcomes

1995 ◽  
Vol 18 (4) ◽  
pp. 2 ◽  
Author(s):  
Rae Walker ◽  
Sally Mitchell
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Community Health ◽  
Health Care System ◽  
Healthcare Providers ◽  
Health Sector ◽  
Community Health Care ◽  
Fundamental Change ◽  
Community Based ◽  
Policy Makers

Health sector organisations are undergoing a period of fundamental change. Oneset of changes is about increasing the capacity of the system to provide integratedclient care. This paper discusses the practices that community health care workershave used to approach some basic issues of service integration. Although thediscussion is about practices in community health, the issues are important for healthcare providers, managers and policy-makers throughout the health care system.

scholarly journals Antenatal and Postnatal Care Practices among Indigenous People in Bangladesh: A Case Study in Dinajpur

2020 ◽  
pp. 38-56
Author(s):  
Sumaia Aktar ◽  
U. K. Majumder ◽  
Md. Salauddin Khan
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Health Center ◽  
Indigenous People ◽  
Postnatal Care ◽  
Access To Health Care ◽  
Care Service ◽  
Indigenous Communities ◽  
Access To Health ◽  
Antenatal And Postnatal Care

Antenatal (ANC) and postnatal care (PNC) contact have long been considered a critical component of the continuum of care for a pregnant mother along with the newborn child. The study aims to determine the influential factors related to the practice of antenatal and postnatal care amongst indigenous mothers of newborns and identifier associated with the ANC and PNC contacts for women in indigenous communities. This study was carried out purposefully selected six upazilas of Dinajpur district where most of the indigenous people live and respondents were 223 married women having at least one under-five children. Results found that the respondents had very poor knowledge about their maternal status and literacy. During the pregnancy period, 39.5% and 6.7% mothers had one and two-time miscarriage respectively. Only 43.9% indigenous pregnant mothers appointed to the health center during pregnancy, 27.8% appointed within three months, 13% went at the last stages of pregnancy and 10.3% felt no need to go there. In 69.1% cases delivery occurred at home by inexpert birth attendance. About 10.3% of deliveries, the placenta was removed manually during delivery. About 33% mothers and their husbands (34%) were found illiterate. The likelihood of mothers who received either antenatal care or postnatal care depended on husband’s education level. It was significantly lower for illiterate (OR=0. 247, 95% CI = 0.063-0.969) husband’s compared to a secondary and above level of educated husbands. Distant health service center (More than 2 km from home) was the lower chances (OR=0. 384, 95% CI = 0.152-0.970) for mothers being access to health care service centers compared to low distant centers (≤ 2 km from home). Also, the age of the mother (30+) was another factor that influenced the mothers for taking the service from hospitals or health centers during pregnancy. This study concludes that about one-third of the respondents of the community has access to health care services, which can be one of the most important factors in their poor health. Counseling and proper education can influence people to take antenatal care and visits to the health center to take postnatal care service further.

scholarly journals From “Academic Projectitis” to Partnership: Community Perspectives for Authentic Community Engagement in Health Professional Education

2018 ◽  
Vol 4 (1) ◽  
pp. 79-96 ◽  
Author(s):  
Cathy Kline ◽  
Wafa Asadian ◽  
William Godolphin ◽  
Scott Graham ◽  
Cheryl Hewitt ◽  
...  
Keyword(s):  
Health Care ◽  
Service Learning ◽  
Health Professional ◽  
Community Engagement ◽  
Professional Education ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Common Interest ◽  
Health Professional Education ◽  
Community Based

Health professional education (HPE) has taken a problem-based approach to community service-learning with good intentions to sensitize future health care professionals to community needs and serve the underserved. However, a growing emphasis on social responsibility and accountability has educators rethinking community engagement. Many institutions now seek to improve community participation in educational programs. Likewise, many Canadians are enthusiastic about their health care system and patients, who are “experts by lived experience,” value opportunities to “give back” and improve health care by taking an active role in the education of health professionals. We describe a community-based participatory action research project to develop a mechanism for community engagement in HPE at the University of British Columbia (UBC). In-depth interviews and a community dialogue with leaders from 18 community-based organizations working with vulnerable populations revealed the shared common interest of the community and university in the education of health professionals. Patients and community organizations have a range of expertise that can help to prepare health practitioners to work in partnership with patients, communities, and other professionals. Recommendations are presented to enhance the inclusion of community expertise in HPE by changing the way the community and university engage with each other.

Promotoras Voice Their Challenges in Fulfilling Their Role as Community Health Workers

2020 ◽  
pp. 152483992092118
Author(s):  
Pamela Orpinas ◽  
Rebecca A. Matthew ◽  
Luis R. Alvarez-Hernandez ◽  
Alejandra Calva ◽  
J. Maria Bermúdez
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Participatory Research ◽  
English Language ◽  
Health Workers ◽  
Cultural Beliefs ◽  
Community Based Participatory Research ◽  
Well Being ◽  
Emotional Impact ◽  
Community Based

Promotoras de salud (Spanish for female community health workers) are integral to efforts to enhance the health and well-being of Latinx individuals, families, and communities. The purpose of this study was to describe the challenges that promotoras face and the proposed solutions from the perspective of the promotoras themselves. Five promotoras who worked for a year as volunteers in a community-based participatory research study, Lazos Hispanos, participated in two group interviews. Eight challenges emerged—balancing their new work with their family commitments, handling their perceived imbalance of power with men, managing the emotional impact of hearing participants’ problems, facing and handling the barriers imposed by having limited English language skills, feeling discouraged by the perception of ethnocentric beliefs and discrimination from some providers, feeling disheartened by the cultural beliefs of some Latinx participants, handling the lack of transportation for themselves and for the participants, and managing the burden of data collection for the research aspect of the program. The explanation of these challenges and the practical solutions they proposed are embedded in their intersecting identities. The solutions are a valuable addition to the practice of health promotion and community-based participatory research, particularly within Latinx communities.

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

2019 ◽  
Vol 20 ◽  
Author(s):  
Joseph Asumah Braimah ◽  
Yujiro Sano ◽  
Kilian Nasung Atuoye ◽  
Isaac Luginaah
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Access To Health Care ◽  
Health Planning ◽  
Household Wealth ◽  
Considerable Proportion ◽  
Wealth Status ◽  
Community Based ◽  
Primary Health ◽  
Access To Health

AbstractBackground:Ghana in 1999 adopted the Community-based Health Planning and Service (CHPS) policy to enhance access to primary health care (PHC) service. After two decades of implementation, there remains a considerable proportion of the country’s population, especially women who lack access to basic health care services.Aim:The aim of this paper is to understand the contribution of Ghana’s CHPS policy to women’s access to PHC services in the Upper West Region (UWR) of Ghana.Methods:A logistic regression technique was employed to analyse cross-sectional data collected among women (805) from the UWR.Findings:We found that women who resided in CHPS zones (OR = 1.612;P ≤0.01) were more likely to have access to health care compared with their counterparts who resided in non-CHPS zones. Also, rural-urban residence, distance to health facility, household wealth status and marital status predicted access to health care among women in the region. Our findings underscore the need to expand the CHPS policy to cover many areas in the country, especially rural communities and other deprived localities in urban settings.

St Joseph's Community Health Centre model of community-based interdisciplinary health care team education

2007 ◽  
Vol 3 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Mary-Lou Horst ◽  
Irene Turpie ◽  
Nelson Wendy ◽  
Cole Beverley ◽  
Sammon Sheila ◽  
...  
Keyword(s):  
Health Care ◽  
Community Health ◽  
Health Centre ◽  
Health Care Team ◽  
Care Team ◽  
Community Health Centre ◽  
Community Based ◽  
Interdisciplinary Health Care

Towards quality primary health care: the dilemma of Community-Based Health Planning and Services (CHPS) in health service provision in Ghana

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Barnabas Addi ◽  
Benjamin Doe ◽  
Eric Oduro-Ofori
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Planning ◽  
Health Care Facilities ◽  
Health Needs ◽  
Community Based ◽  
Content Type ◽  
Primary Health ◽  
Care Facilities ◽  
Primary Health Care Facilities

PurposeOver the past two decades, Community-Based Health Planning and Services (CHPS) has been a pragmatic strategy towards universal Primary Health Care (PHC) in Ghana. However, the ability and capacity of these facilities to deliver quality primary health care remain an illusion as they are still crumbling in myriad challenges. These challenges are translated to the poor-quality services provision and low community utilization of CHPS facilities. The study presents a comparative analysis of three communities in the Kassena-Nankana East Municipality, Ghana.Design/methodology/approachUsing a mixed-method research design, the study gathered and analysed data from 110 households, three community health officers (CHOs) and three community leaders using semi-structured questionnaires and interview guides.FindingsThe findings indicated that the facilities do not have the requisite inputs such as drugs and supplies, logistics, appropriate health personnel, good infrastructure, funding support necessary to deliver quality and appropriate healthcare services that meet the health needs of the communities. For the CHPS to realize their full potentials as PHC facilities, it is required that the needed inputs such as logistics, drugs and appropriate staff are in place to facilitate the activities of CHOs.Research limitations/implicationsDue to the limited number of participants and selection of the study communities, the results may generalization. Also, the researchers acknowledged the inability to interview the district level health officials and the Kassena-Nankana Municipal Assembly during the field visits. This could have provided in-depth knowledge on the findings of this research as well as the validation of the results from the communities' perspective. Several attempts were made to contact and interview district-level authorities which proven futile due to the unavailability of targeted respondents. This resulted in limiting the studies at the community level. However, this limitation does not disprove the findings of this study.Practical implicationsThe article implications for planning primary health care strategies include a keen assessment of community health needs and institutional management of primary health care facilities, equip PHC facilities with adequate resources such as drugs and appropriate staffing to provide the health needs of the communities.Originality/valueThe paper fulfils the gap in the literature by providing empirical data on how the challenges of primary health care facilities affected the provision of high quality service and how this can affect community’s use of the facilities.

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