Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #102486

J. Koku Awoonor-Williams, MD, MPH¹, Frank K. Nyonator, MD, MPH², Maya Vaughan-Smith, MPP³, Ellie Feinglass, MPH³, and James Phillips, PhD³. (1) District Director, Nwkanta District Health Administration, Ghana Health Service, P.O. Box 54, Nkwanta, Volta Region, Ghana, 233-20-816-1394, kawoonor@hotmail.com, (2) Director, Policy, Planning, Monitoring and Evaluation Division, Ghana Health Service, Private Mail Bag, Accra, Ghana, (3) Policy Research Division, Population Council, One Dag Hammarskjold Plaza, New York, NY 10017

Ghana has developed a programme of evidence-based health sector reform that is community-led and community-based. In 1998, Nkwanta - one of the country's most deprived and isolated districts - launched Community-based Health Planning and Services (CHPS) to increase access to care, with an emphasis on door-to-door family planning and safe motherhood services. The effect of CHPS exposure on family planning indicators confirms the need for strategies to bridge the gap between evidence-based innovation and national health sector reform. Odds ratios suggest that exposure to CHPS increases the odds of family planning knowledge two fold, and that CHPS not only generates knowledge of family planning (1.83 relative risk ratio for non-users who know a method), but also actual practice once a method is known (relative risk ratio 3.39). In addition, findings indicate that men can be mobilized to participate in family planning and health promotion. However, besides geographical and financial barriers, cultural taboos, engendered fears, and spiritual beliefs still play a significant role in inhibiting access to care. This presentation aims to define and measure geographic, economic, administrative, information, and psychosocial/cultural access in the context of community-based family planning service delivery. Findings are based on in-depth interviews of key stakeholders. This paper complements already documented evidence that CHPS improves family planning and safe motherhood practices by asking the fundamental questions: By what mechanisms does CHPS increase access to family planning and safe motherhood services? Besides geography, what other means of access can be improved for CHPS?

Learning Objectives:

• participants will learn how we define and measure access to family planning and safe motherhood delivery
• participants will understand how the Government of Ghana has used evidence-based policy to increased access to family planning and safe motherhood delivery
• participants will be able to identify what means of access still need to be improved upon in efforts to address unmet need for services

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.