Community-based health care is for people of all ages who need health care assistance at home. Community care services include home support, nursing, physiotherapy and other rehabilitation services. The declaration of Alma-Alta on Primary Health Care (PHC) in 1978 ordered nations to make health care accessible, affordable, and situated in the cultural setting of the people.
Following this declaration, nations have employed various strategies to meet the goals of this declaration. CHPS began as a Community Health and Family Planning (CHFP) project based on lessons learnt from Bangladesh (Phillips, 1988). The project was launched in Navrongo as an operations research in 1994 piloted in three sub-districts.
The Navrongo experiment tested means of addressing inequities in the health system through mobilization of both health sector and community resources. As a step to make health care accessible to Ghanaians, in 2005, the Government of Ghana in collaboration with the Ministry of Health and the Ghana Health Services adopted the Community-Based Health Planning and Services (CHPS) as a national policy for the provision of primary health care services. This policy was aimed at reducing obstacles in physical and geographical access to health care delivery to deprived districts and communities in Ghana. Thus, The Ghana Health Services (GHS) programme of work adopted this model of delivering Primary Health Care (PHC) services as it has the potential of extending health services to poorly served communities in Ghana.
The implementation of CHPS at the local level requires the cooperation of the health sector and communities as it involves systematic planning and negotiation with all stakeholders; local authority, political establishment and the community members through community mobilization and effective participation. In this system of health care delivery, the health sector provides additional training on preventive health care services in areas such as immunizations, family planning, supervising delivery, antenatal/postnatal care, treatment of minor ailments and health education to community health nurses after which they are relocated to the community to provide door-to-door
In addition, the communities in consultation with the health sector select community volunteers to support the work of the Community Health Officers (CHOs) in the area of community mobilization and participation, recording vital community statistics and maintaining other essential activities . As a strategy to improve health services
delivery, some donor agencies and collaborators, provide assistance to
regions to initiate and implement the CHPS strategy.
The Population Council through a USAID grant has been in the forefront of implementing CHPS in mainly in the southern sector of Ghana. In Western and Central regions where this study was conducted, Focus Regions and Marie Stopes International have been actively assisting the regions in the implementation of CHPS.
The CHPS system for organisational change and reform has encountered constraints that are resource related. However, CHPS has developed mechanisms to solve major problems if these resource constraints are resolved. The primary goal of the proposed awards programme is to accelerate the pace of CHPS implementation throughout the nation to a level that is commensurate with the pace of the CHPS planning process.
In March 2016, the President of Ghana, His Excellency John Dramani Mahama launched the revised National CHPS Policy to help accelerate CHPS implementation in Ghana.
The GHS has adopted a model for community-based service delivery known as the Community-based Health Planning and Services (CHPS) Initiative. CHPS is an integral part of the current Ghana Health Service Five Year Programme of Work and represents the health sector component of the national poverty alleviation programme. By 2002, the
CHPS programme was providing doorstep health care in all regions of Ghana through a programme that is supported by Government of Ghana and community resources. In all, 95 of the 110 District Health Management Teams (DHMT) have launched the planning phase of the CHPS programme; of these, 20 districts have implemented most of the components of the CHPS programme in at least one pilot zone.
The general principles of community based health planning and services;
– Community participation, empowerment, ownership, gender considerations and voluntarism.
–Focus on community health needs to determine the package of CHPS services – Task shifting to achieve universal access
-Communities as social and human capital for health system development and delivery – Health services delivered using systems approach.
– Community health worker as a leader and community mobilizer.
DR. KINGSLEY PREKO
DR. A.T DERRICK
PHYSICIAN ASSISTANT STUDENT,
UNIVERSITY OF CAPE COAST.
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