CHPS INITIATIVE: CHALLENGES AND OPPORTUNITIES TO IMPROVING RURAL ACCESS TO HEALTH SERVICE DELIVERY IN THE LAWRA DISTRICT

Abstract

Adequate coverage and efficiency of public health services are high priorities for sustainable growth and development. In manycountries, public healthcare continues to fall short of demand, and remains unevenly distributed among the population. Some 70 per cent of the Ghanaian population resides in communities that are over five (5) kilometers from the nearest health facility, where childhood mortality is 40 per cent higher than in communities located within five (5) kilometers of health facilities. Also, there is a great disparity in health status between urban and rural areas. This disparity is caused by poor geographical access and service delivery barriers. Results from an experiment of the Navrongo Health Research Centre demonstrated that childhood mortality and fertility can be reduced in impoverished rural communities through improved outreach and community mobilization. This finding, first disseminated as a preliminary finding in 1998, led to a Government of Ghana national program for developing primary health care on the Navrongo service model. Known as the Community-based Health Planning and Services (CHPS) initiative. The Community-Based Health Planning and Services (CHPS) initiative, which is a participatory processof a sector-wide health system change and development, aims to provide accessible primary health care to all communities of Ghana, through the promotion of health interventions and actions designed to make people healthy and stay healthy; and to bridge the inequality gap between urban and rural communities. Some opportunities for the successful implementation of the CHPS initiative depend largely on the support it enjoys from government through the introduction of the National Health Insurance Scheme (NHIS) as well as the participatory nature of the initiative. Some of the challenges that the initiative encounter include human resource constraints which are further complicated by the issue of brain drain and the concerns about clinical staffs not staying in the community, resource constrain as well as poor feeder road network. In order to improve upon access to quality health care services, the health sector will have to deepen efforts and emphasis on the three broad policy objectives of bridging the equity gap in access to quality health and nutritional services; ensuring sustainable financing arrangements that protect the poor; and enhancing efficiency and coverage in service delivery.