The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #63932

Elias K Sory, Dr¹, Tanya C. Jones, MPA², Frank K. Nyonator, MD, MPH³, and James Phillips, PhD². (1) Director, Northern Region Health Administration, Ghana Health Service, Private Mail Bag, Accra, Ghana, 233-20-601-0001, moh-nr@africaonline.com.gh, (2) Policy Research Division, Population Council, 14B Ridge Road, PO Box CT4906, Accra, Ghana, (3) Director, Policy, Planning, Monitoring and Evaluation Division, Ghana Health Service, Private Mail Bag, Accra, Ghana

The Ghana Health Service has embarked upon a program, known as the Community-based Health Planning and Services (CHPS) Initiative, which aims to convert clinic focused primary health care to community-based care nation-wide. As of January 2003, implementation of the CHPS initiative has started in 100 of the 110 districts in Ghana. A Strategic Assessment Method evaluation was fielded in two districts in the Central Region which represent areas where the CHPS program is more advanced than other districts in the region. In total, sixteen focus groups were conducted which involved panels of community members, District Assemblymen, health managers, community based nurses and clinic-based nurses. This paper reviews data derived from these sessions to investigate worker, community and District Assembly reaction to the CHPS initiative in the Central Region of Ghana. Findings suggest that the district assembly, a body of locally elected leaders of the district in Ghana, can be instrumental in catalyzing the advancement of community health services in their locality through financial investment and local leadership. Interviews with these political leaders illustrate the manner in which Assemblyman can be best mobilized, as well as the ways in which failure to marshal the support of these officials can lead to confusion and stagnation in community health service delivery. Problems arise when CHPS is implemented by focusing on particular components, such as community clinics, rather than the CHPS system for grassroots mobilization of community and political support.

Learning Objectives:

• Recognize the importance of local governance and community mobilization for the advancement of community-based service delivery initatives.
• Develop plans for involving decentralized government structures for improvements in health service delivery.
• Assess approaches to grassroots mobilization for community health service delivery in other resource-constrained settings.

Keywords: Community Health Planning, Models for Provision

Related Web page: www.ghana-chps.org

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Ghana Health Service
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.