The Community-Based Health Planning and Services (CHPS) Initiative should be re-structured to adequately cater for the health care needs of the entire community, Dr Erasmus Agongo, a Director of the Ghana Health Services (GHS), has said.
Dr Agongo, who is in charge of Policy Planning and Evaluation, said since the CHPS initiative is a national programme seeking to reorient and relocate primary health care from sub-district health centres to convenient community locations, there was the need to review the whole programme for it to become the main module of healthcare providers for deprived communities in the country.
Speaking at a stakeholders’ workshop meant to review CHPS in Accra, Dr Agongo said countries like Ethiopia and Kenya have come to Ghana to study CHPS to enable them address their health care needs and that Ghana needs to strengthen the initiative to enable it to make a meaningful impact in healthcare delivery.
He said the local government system through the district assembly framework should be tasked to support the initiative by committing more towards the CHPS initiative to ensure a successful implementation of the plan within the communities.
Dr Agongo also urged all health personnel, especially doctors to embrace the CHPS system to ensure that all citizens who could not gain access to health care in big centres were attended to within the communities. The Centre for Health and Social Services (CHeSS) in collaboration with Star Ghana held the review workshop which was also used to discuss the findings of a baseline study undertaken by CHeSS on the CHPS Initiative in four regions of Ghana.
The study was carried out in July this year on the CHPS initiative in the Eastern, Greater Accra,Volta and Upper East Regions.
CHPS was launched in Ghana by the late Presidents John Evans Atta Mills to serve as a public health interventions initiative.
The CHPS process relies upon community resources for construction labour, service delivery, and programme oversight. As such, it is a national strategy for the mobilization of grass-roots action and leadership in health and family planning.
Dr Sam Adjei, Chief Executive Officer of CHeSS, said the workshop was hosted to discuss the activities of CHPS and ways to ensure a universal coverage in maternal and child health needs, especially in rural communities.
He said health care in many communities had for some years been faced with difficulties with access, which was also wrought with social, cultural and physical barriers giving rise to the GHS in finding various ways in addressing such gaps.
He said CHeSS sought to review the CHPS and seek possible ways to bridge the gaps as well as to streamline the CHPS Policy to enable operators and supervisors to better understand the initiative.
Dr Alex Korshie Nazzer, Chief Executive Officer of Health and Wellness Consult, who presented the findings of the study, explained that ‘CHPS is an essential health care initiative based on practical, scientifically sound and socially acceptable methods and technology; made universally accessible to individuals and families in the community through their full participation; and at a cost that the community could afford to maintain in the spirit of self-determination.
CHPS therefore focuses on the health of the people by placing people’s health in their own hands, he said.
Dr Nazzer said CHPS involves six general implementation activities that change primary health care services from a sub-district clinic-based operation to a comprehensive community-based programme.
The completion of these six CHPS milestones involving planning, community entry, community health compound construction, community health officer, essential equipment and volunteers, heralds in a functional CHPS ready to provide a comprehensive primary health care service with strong health system strengthening at the community level.
He said a completed CHPS zone was where all the implementation steps had been completed, culminating in the placement of a resident nurse in the community who was supported by organized community volunteers.
Dr Nazzer said evidence from the study suggests that the definition and understanding of CHPS was not consistent to many as most of the CHPS programmes were focused on building compounds for curative services with little outreach services to the detriment of preventive and promotive programmes.
He said some factors needed to ensure the smooth implementation of CHPS include the provision of accommodation in the community for Community Health Officers (CHOs) residence, financial support for outreach activities, pre-service training, support with logistics and other resources from the district assembly and the availability of transport for house to house delivery.
Others factors were learning from peers in the field, as well as on-the-job training and community support for the initiative.
Dr Nazzer said factors hindering the success of CHPS in the implementing communities include: poor or lack of accommodation in the community, lack of transportation for house to house visits, heavy work load, lack of motivation, incentives or compensation for officers in deprived areas and the inadequate or no finances for outreach work.
He said some officials also faced the difficulty of not knowing what to do in critical situations in the community while non-caring community members also hinder the success of the CHPS system.
Dr Nazzer said besides some CHPS centres needing fridges to keep drugs and vaccines, CHOs also needed in-service training to enhance their knowledge and skills on the job.
He said in addition to some officers complaining of their borehole pumps, many of which needs replacement, some centres also needed to be relocated as they were initially built near public toilet facilities which creates inconvenience to the CHOs.
Some, Dr Nazzer said, lacked logistics and machines for testing blood pressure and blood sugar levels of pregnant women while others had no quality forms of transportation for outreach services.
He said some centres also lacked electricity and reliable power sources and as such, they send their vaccines for storage in other towns and retrieve them to the Center before embarking on house to house visits.
Dr Nazzer said the findings also revealed that the relationship between CHPS compounds and their respective sub-districts was sometimes hostile and unprofessional and this does not allow for collaboration for effective service delivery.