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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Frank K. Nyonator, MD, MPH1, Tanya C. Jones, MPA2, Robert A. Miller, DrPH3, and James Phillips, PhD2. (1) Director, Policy Planning Monitoring and Evaluation Division, Ghana Health Service, Ministry of Health, Private Mail Bag, Accra, Ghana, 233-20-6010001, nyonator@africaonline.com.gh, (2) Policy Research Division, Population Council, 1 Dag Hammarskjold Plaza, New York, NY 10017, (3) Senior Associate, International Programs Division, Population Council, 1 Dag Hamarskjold Plaza, New York, NY 10017
A Navrongo Health Research Centre experiment demonstrating that community-based care reduces child mortality and fertility in impoverished rural communities led to a national program aimed at improving access to basic health services, known as the Community-based Health Planning and Services (CHPS) initiative. While 66 of the 110 districts have launched some element of the CHPS program, overall coverage remains low. In order to develop insights about CHPS program problems and solutions, a multi-level, qualitative, systems analysis was pursued by convening 19 focus group discussions (FGDs) with District Management Teams, Clinic nurses, Community-based nurses (CHOs), community leaders, women, and men. FGDs were conducted in three districts representing three different levels of program implementation – nascent, moderate, and advanced. Findings suggest that communities are enthusiastic about the program in operation (or the idea of the program where it is not yet functioning). Where the program is nascent, managers are uncertain about the feasibility of the program given resource constraints. Advanced program communities successfully mobilize traditional social structures to construct nurses’ accommodations, recruit volunteers, and provide support to the resident nurse. Clinic nurses worry about their possible transfer to community-based positions, but often become enthusiastic after residential visits to advanced program areas. Although CHOs face numerous problems, many derive satisfaction from their new responsibilities, and demonstrated program impact. Where CHPS is not fully implemented, workers are confused about the initiative and are anxious about possible program impact on their personal welfare. This suggests a need for confidence building through exchanges with advanced program areas.
Learning Objectives:
Keywords: Community-Based Health Care, International Public Health
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.