THE CHALLENGES AND PROSPECTS OF COMMUNITY-BASED HEALTH PLANNING AND SERVICES (CHPS) IN THE NADOWLI DISTRICT OF THE UPPER WEST REGION, GHANA

Abstract

Before the emergence of the Community-based Health Planning and Services (CHPS) initiative, about 70% of Ghanaians were in communities without access to health facilities beyond five kilomenters (MOH, 1998). It has also been noted that about 40 percent of childhood mortality in these communities is higher than those that are within five kilometers of health facilities due to geographical barriers to quality health service delivery. The CHPS initiative is a community-based participatory health planning process and aims at ensuring access to health care needs for all Ghanaians at their doorsteps in order to bridge the inequality gap between urban and rural communities. This study seeks to assess the challenges and prospects of the CHPS strategy in the Nadowli District. The study is a descriptive research design and adopted a mix of research approaches to make use of both quantitative and qualitative approaches. The information for the study was drawn from both secondary and primary sources. The study was conducted in three communities; namely Duong, Sampina and Tabiasi. The three communities were carefully selected from the 16 communities with functional CHPS compounds purposively based on their geographical locations, poor road network to their service points, low immunization coverage among others. Purposive sampling method was also employed to select the key informants and experts to obtain the primary data for the study. Multi-stage sampling was used to select the section of the communities within which a random sampling method was used to sample the community members. Out of the 72 accessible respondents that the questionnaires were distributed for administration, The researcher retrieved 64 administered questionnaires representing 88.9%. The issues identified in the questionnaires were analysed through the help of SPSS version 16. Some of the prospects of the CHPS initiative included community commitment and involvement in identifying their own health problems with the government's and NGOs' support, reduction in maternal complications due to early detections and referral of mothers in labour to the nearest health centres or clinic for supervised deliveries. The CHPS initiative is however confronted with some challenges of human and financial resource constraints, poor transport and road network systems, lack of electricity, portable water at the CHPS compounds, logistical, utilities, non-uniformity in CHPS compounds constructions among others. In order to ensure accelerated access to quality health services to all Ghanaians at their doorsteps, there is a need for efforts to be improved in providing OHPS compounds equipped with the requisite equipment/logistics and at least two Community Health Officers (CHOs) to meet the health needs of the rural people. This could be done by ensuring sustainable financial, human resource arrangements and intensive health education for the sustenance of the CHPS initiative implemented in the communities, enhancing community involvement, ownership and commitment in the planning of their health needs .