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 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.

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.

Antenatal and postnatal care practices among mothers in rural Bangladesh: A community based cross-sectional study

Midwifery ◽  
2017 ◽  
Vol 52 ◽  
pp. 42-48 ◽  
Author(s):  
Md Shahjahan ◽  
Hasina Akhter Chowdhury ◽  
Ahmed Y. Al-Hadhrami ◽  
Golam Dostogir Harun
Keyword(s):  
Postnatal Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Rural Bangladesh ◽  
Care Practices ◽  
Antenatal And Postnatal Care

scholarly journals Community-based health care

2019 ◽  
pp. 3-20
Author(s):  
Ted Lankester
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Health Workers ◽  
National Level ◽  
Community Based ◽  
The Sustainable Development ◽  
Root Cause ◽  
Development Goals ◽  
The Many

This chapter sets the background and context for the rest of the book. It talks about the history and progress of community-based health care (CBHC), and the many emerging challenges we now face. These challenges include a lack of trained health workers, poor planning and capacity at the national level, and weak or non-existent health systems. It tackles the question of how CBHC can help meet these challenges. It describes the special features of CHBC, and explains how CBHC is an integral part of well-functioning health systems, including primary health care. In the context of the Sustainable Development Goals (SDGs), it shows how CBHC can tackle poverty, a root cause of ill health. The chapter discusses how we can focus on strengthening and scaling up existing programmes, aim for long-term development, and identify some ‘quick wins’.

The Woman-Centeredness of Various Dutch Maternity Service Providers During Antenatal and Postnatal Care

2019 ◽  
Vol 9 (2) ◽  
pp. 92-101 ◽  
Author(s):  
Yvonne Fontein-Kuipers ◽  
Elise van Beeck ◽  
Liesbeth Kammeraat ◽  
Fleur Rutten
Keyword(s):  
Maternity Care ◽  
Postnatal Care ◽  
Service Providers ◽  
Self Report ◽  
Care Providers ◽  
Validity And Reliability ◽  
Community Based ◽  
Cross Sectional ◽  
Centered Care ◽  
Antenatal And Postnatal Care

AIMSTo examine the woman-centeredness of maternity care providers from the woman's perspective. To investigate the validity and reliability of the Client Centered Care Questionnaire among a childbearing population.DESIGNA cross-sectional study.METHODSThe self-report Client Centered Care Questionnaire was administered to evaluate women's one-on-one antenatal and postnatal care appointments with various Dutch care providers: community and hospital-based midwives, General Practitioners, (registrar) obstetricians, sonographers, and maternity care nurses.RESULTSEight-hundred and fifteen completed questionnaires were received. Exploratory and confirmatory factor analyses provided support for a two-factor model, with an acceptable model fit. Woman-centeredness of all maternity care providers showed scores above baseline for the neutral value. Welch ANOVA showed a statistical significant effect of the type of maternity care practitioner in providing woman-centered care during antenatal and postnatal visits (F(5.8) = 7.79). The Bonferroni post hoc test showed that women assigned significantly higher woman-centered care scores to community-based midwives compared with hospital-based midwives (p .011) and compared with registrars/obstetricians (p < .001).CONCLUSIONAlthough overall scores of perceived woman-centeredness indicated a good to excellent performance of woman-centered care, with significantly higher scores for community-based midwives, it cannot be assumed that current woman-centered care completely meets the needs of Dutch childbearing women. The Client Centered Care Questionnaire (CCCQ) is an adequate instrument to measure woman-centered care in antenatal and postnatal maternity services. Further research regarding measuring woman-centered care is needed.

scholarly journals Can public sector community health workers deliver a nurturing care intervention in South Africa? The Amagugu Asakhula feasibility study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sonja Klingberg ◽  
Esther M. F. van Sluijs ◽  
Stephanie T. Jong ◽  
Catherine E. Draper
Keyword(s):  
South Africa ◽  
Health Care ◽  
Public Sector ◽  
Health Workers ◽  
Care Facility ◽  
Health Care Facility ◽  
Preschool Age ◽  
Primary Health Care Facility ◽  
Community Based ◽  
Primary Health

Abstract Background Nurturing care interventions have the potential to promote health and development in early childhood. Amagugu Asakhula was designed to promote developmentally important dietary and movement behaviours among children of preschool age (3–5 years) in South Africa. An initial formative study in Cape Town found the intervention to be feasible and acceptable when delivered by community health workers (CHWs) linked to a community-based organisation. This study evaluated the delivery of the Amagugu Asakhula intervention by CHWs linked to a public sector primary health care facility in Soweto, as this mode of delivery could have more potential for sustainability and scalability. Methods A qualitative design was utilised to assess feasibility, acceptability, adoption, appropriateness, implementation, fidelity and context. CHWs (n = 14) delivered the intervention to caregivers (n = 23) of preschool-age children in Soweto over 6 weeks. Following the completion of the intervention, focus group discussions were held with CHWs and caregivers. Further data were obtained through observations, study records and key informant interviews (n = 5). Data were analysed using deductive thematic analysis guided by a process evaluation framework. Results The delivery of the Amagugu Asakhula intervention through CHWs linked to a primary health care facility in Soweto was not found to be feasible due to contextual challenges such as late payment of salaries influencing CHW performance and willingness to deliver the intervention. CHWs expressed dissatisfaction with their general working conditions and were thus reluctant to take on new tasks. Despite barriers to successful delivery, the intervention was well received by both CHWs and caregivers and was considered a good fit with the CHWs’ scope of work. Conclusions Based on these findings, delivery of the Amagugu Asakhula intervention is not recommended through public sector CHWs in South Africa. This feasibility study informs the optimisation of implementation and supports further testing of the intervention’s effectiveness when delivered by CHWs linked to community-based organisations. The present study further demonstrates how implementation challenges can be identified through qualitative feasibility studies and subsequently addressed prior to large-scale trials, avoiding the wasting of research and resources.

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