COMMUNITY INVOLVEMENT IN HEALTH DELIVERY SYSTEM: AN EXAMINATION OF COMMUNITY BASED HEALTH PLANNING AND SERVICES STRATEGY IN THE WEST MAMPRUSI DISTRICT OF NORTHERN GHANA.

Abstract

The Declaration of Alma-Ata in 1978 sought the commitment of Member States of the World Health Organization to the target of health for all by the year 2000 (WHO, 1979). To achieve this vision a strategy of Primary Health Care, was adopted which intended to change the practice of health care and health development. The strategy was designed to bring better health care to millions of people who lacked even basic access to such facilities. Over the years therefore the Ministry of Health and the Ghana Health Service have sought to improve access of people, living in Ghana, to health services through various policy initiatives that include decentralization of health services to the district levels; the establishment of district health management teams and the introduction of sub district concepts. Unfortunately these initiatives have not achieved the objectives of bringing health care to all communities especially in the rural areas. This thesis was concerned with health delivery system, but at the same time examined the use of Community- Based Health Planning and Services (CHPS) as a strategy to promoting health equity, both in terms of increasing access to essential care and improving health outcomes in the West Mamprusi District. Analysis of the strategy was restricted to that adopted by the Ghana Health Service in accordance with the Ghana Poverty Reduction Strategy. The process employed largely both the qualitative and quantitative methods, and field surveys to collect data in order to assess how the individual households, traditional authorities, and health providers function together in the health delivery system. It was designed to find out the knowledge and understanding of the strategy, to evaluate the effectiveness in the implementation process, and develop modules for its evaluation. Emphasis was laid on how culture and spirituality are incorporated in management , strategies for community participation in health delivery system from groups that co-exist within the community to ensure equity, assess and quality health care at the rural areas in the District. The research found out that the Government has sought to improve the rural poor through the participation of people by adopting the CHPS program as a process of strategic planning and implementation of Primary Health Care activities within a community. However, there still remain some problems militating against the concept: including lack of commitment, logistics and different interpretations amongst others. This therefore calls for the need to sustain the process by advocating for the commitment of all health care providers; ensuring their involvement; training and motivation of Community Health Officers (CHO); the commitment of the MOH and District Assemblies to the provision of the required logistics and infrastructure to support operations and maintenance of the CHPS process.