Catalyzing the scale‐up of community‐based primary healthcare in a rural impoverished region of northern Ghana

John Koku Awoonor‐Williams · James F. Phillips · Ayaga Agula Bawah

41 citations0/0 files storedThe International Journal of Health Planning and Management

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Healthcare Systems and Reforms Global Health Workforce Issues Health Policy Implementation Science

Abstract

Ghana's Community-based Health Planning and Services (CHPS) initiative develops accessible healthcare with participatory community support, using strategies developed and tested by a project of the Navrongo Health Research Centre. In 1996, the project was expanded to a district-wide four-celled trial. In response to evidence that strategies could reduce fertility and childhood mortality, a replication project was launched to develop methods for scale-up. Based on experience gained, CHPS scale-up was launched in 2000. Although CHPS now reaches all of Ghana's districts, the pace of scale-up within districts has been slow. In response, the Ministry of Health conducted a review of factors that constrain CHPS scale-up and problems that detract from its original evidence-based design. To resolve problems that were identified, a project was launched in 2010 to test means of accelerating CHPS scale-up and expand its range of care. Known as the Ghana Essential Health Interventions Program (GEHIP), the project provided catalytic revenue to four treatment district managers for 3 years, in conjunction with implementation of strategies for comprehensive leadership development and community partnership. Monitoring systems were developed to gauge CHPS coverage time trends in all nine study districts. GEHIP successfully accelerated CHPS implementation, producing 100% of its targeted community coverage within 5 years of implementation. Coverage in comparison districts also improved. However, the rate of coverage and per cent of the population reached by CHPS in comparison districts was only half that of GEHIP districts. GEHIP success in completing CHPS coverage represents the initial stage of a national program for strengthening community health systems in Ghana. Copyright © 2015 John Wiley & Sons, Ltd.

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1963Diffusion of Innovations 2005The Ghana Community-based Health Planning and Services Initiative for scaling up service delivery innovation 2003Scaling Up Community-Driven Development: Theoretical Underpinnings and Program Design Implications

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2021Positioning the National Health Insurance for financial sustainability and Universal Health Coverage in Ghana: A qualitative study among key stakeholders 2023Financing and provision of healthcare for two billion people in low-income nations: Is the cooperative healthcare model a solution?2019Cost of implementing a community-based primary health care strengthening program: The case of the Ghana Essential Health Interventions Program in northern Ghana 2017Utilization of community-based health planning and services compounds in the Kintampo North Municipality: a cross-sectional descriptive correlational study 2019Scaling down to scale-up: a strategy for accelerating Community-based Health Service Coverage in Ghana

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