FACILITATIVE SUPERVISION IMPLEMENTATION IN GHANA: AN EXPLORATION OF ADHERENCE AND CONTRIBUTION TO PRIMARY HEALTHCARE DELIVERY IN THE UPPER WEST REGION

Abstract

Given growing concerns about the quality of health care delivery in many developing countries, this thesis explores whether the introduction of Facilitative Supervision (FS) has delivered on its objective of improving the quality of primary health care. Access to basic quality health care is an important healthcare objective of the Ghana Health Service (GHS) and Sustainable Development Goals (SDGs), and in spite of the relevance of FS in this effort, its impact on the quality and uptake of primary health care is seldom explored. Drawing on the implementation of FS in primary health facilities in a municipality and districts in the Upper West region of Ghana, a qualitative approach was employed in the collection and analysis of data. Specifically, semistructured interviews were conducted with 46 participants. Observation and document review were also employed to generate data to triangulate the results obtained through interviews. The results revealed logistical and technical challenges in the implementation of FS in some health facilities studied. These notwithstanding, adherence to FS as observed in most of the facilities studied has contributed to improvements in staff performance. There is also an increase uptake in primary healthcare services which is reflected in increases in OPD visits, maternal and child healthcare services in all of the facilities studied. In order to improve the regularity of FS for improve quality of primary health care delivery in the region, health planners and implementers ought to pay serious attention to the challenges of limited logistics and inadequate human resources ushered in by constrained funding. This would require innovation in the mobilization, distribution and effective monitoring of the use of health resources at the primary level.