223139 Scaling Up Field-Trial Success to National Policy Initiative in Ghana: Reviewing a Decade of the Community-based Health Planning and Services Program

Tuesday, November 9, 2010 : 1:15 PM - 1:30 PM

John Koku Awoonor-Williams, MD, MPH, MPP , Director of Regional Health Services, Upper East Region of Ghana, The Ghana Health Service, Bolgatanga, Upper East Region, Ghana
Colin Baynes , Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City, NY
In the 1990s the Ghana Ministry of Health assessed the relative effectiveness of workforce strategies to reduce fertility and maternal and child mortality levels. When this demonstrated the success of combining programs that relocate primary healthcare nurses to villages and mobilizes community-volunteerism, this approach, Community-based Health Planning and Services (CHPS), became the national policy. CHPS relocates nurses to village ‘CHPS Zones'; engages traditional institutions in service-delivery, and builds capacity to implement CHPS at management and community levels. It produces replicable service-delivery capabilities and mechanisms to filter down use of findings and implementation locally. CHPS has been scaled up to 10 percent of Ghanaian households, but in Ghana's poorest region, the Upper East, CHPS coverage is 50 percent, placing CHPS-districts on target to achieve MDGs 4 and 5. This presentation explains why CHPS has succeeded in the Upper East and proffers a framework for effective policy development and scaling-up. CHPS responds to cultural and workforce-related constraints to health programming with evidence-based planning and community integration. This presentation describes the research that has driven CHPS from pilot to program expansion and discusses how advocacy has grown consensus for CHPS and capabilities to scale it up, catalyzing community-based planning, clinical service and management that improves governance, resource development and volunteerism. It outlines future CHPS goals and the research and action agenda required for realizing them. CHPS has brought impoverished villages to the forefront of health development in Ghana, showing how policy initiatives create scalable mechanisms to increase health equity and achieve population-level impact.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Public health administration or related administration
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Demonstrate how to use operations research to drive health policy development, replication and scaling up in Ghana; explain mechanisms employed to expand policy implementation throughout the health system; assess the efforts and outcomes of ten years of Community-based Health Planning and Services in Ghana and discuss the way forward.

Keywords: International MCH, Community-Based Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Please view the following biographical statement which summarizes my qualifications: Dr. John Koku Awoonor-Williams is the Regional Director for Health Services in the Upper East Region, Ghana, Executive Director of the Nkwanta Health Development Research Center and National Coordinator for the Community-based Health Planning and Services initiative, Ghana’s national family planning and maternal-child health policy. Previously, from 1995-2006 he was the District Director for Health Services in Nkwanta District, Volta Region of Ghana. In these capacities, Dr. Awoonor has complemented his clinical, surgical and administrative responsibilities with leading efforts to evaluate and scale up the CHPS initiative and other health service-delivery innovations in the Volta and Upper East Regions. His work has informed national policy decisions concerning human resources and health and the challenge to meet Millennium Development Goals 4 and 5 for child and maternal health in Ghana. Dr. Awoonor has published several articles in leading journals such as Studies in Family Planning and Health Policy and Planning and has been commissioned to consult for DANIDA, Population Council, UNICEF, UNFPA and WHO on topics concerning health workforce orientation and maternal and child survival. For his work he has received awards at national and international levels. He is presently a visiting lecturer at the Heilbrunn Department of Population and Family Health at Columbia University’s Mailman School of Public Health and is the holder of an M.D. from Minsk State Medical Institute, Belarus; MPH from Leeds University, UK; MPA from the Ghana Institute for Management and Public Administration; and Certificates in Reproductive Health Leadership and Research from the Bloomberg School of Public Health, Johns Hopkins University.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.