Stakeholders dialogue on maternal health and CHPs

The issue of maternal health care in Ghana is worrisome. Over the last few years, the government and its development partners have implemented many policy options all geared towards addressing challenges hindering the provision of affordable and quality healthcare in our communities, especially the rural sectors.

The implementation of the Community Health Planning Services (CHPS) is one of government's programmes addressing access, quality and equitable delivery of health services to rural communities. Whereas such a good implementation policy was put into place and has achieved varied degrees of successes, challenges such as poor and inaccessible roads, lack of electricity and inadequate logistical supplies, among others, are persistently hindering the attainment of Millennium Development Goals (MDGs) 4 and 5.

Due to these challenges, SEND-Ghana, a non-governmental organisation (NGO), held a national stakeholders' dialogue to address them. The issue of maternal health care and CHPS was raised when the NGO held the dialogue under the theme 'Halting Needless Death of Women: The Need for Priority Investment in Maternal Healthcare Delivery in Ghana.'

Madam Cecilia Senoo, Executive Director, Hope for Future Generations, who chaired the event, said maternal health was, unfortunately, one of the heaviest tasks that Ghana was faced with. Madam Senoo believed that the allocation of more resources could help make the difference in the country's struggling health sector. Ghana is touted as a nation that is on its way to attain many of the MDGs, having achieved MDG 1 in 2006 and made significant progress in MDGs 2, 3, 6 and 8. But the pace of progress suggests that the country is unlikely to attain the goal of reducing maternal mortality rate by three-quarters by 2015.

She said the study of the sources of funding for six district health facilities for the provision of maternal health services examined issues of public financial management mechanisms as it pertained to budget transparency and credibility. The study also assessed the utilisation of funds for improved maternal health services at the district health facilities.

Mr Siapha Kamara, Chief Executive Officer of SEND-West Africa, said promoting policies of maternal health would impact on healthcare delivery in the country. Mr Kamara said it was imperative for government to work to eliminate disparities in access to basic medical and health services as well as ensure the effectiveness of the CHPS strategy in meeting the health needs of rural dwellers. That, he said, would provide quality primary health care to its clients who depend on the kind of services it was providing and how relevant these services were to client's needs. He added that human resources were also important in service delivery and called for improvement of the situation.

Mr Kamara said even though Ghana was on its way to reducing if not completely eradicating maternal mortality, the data indicated slow progress. In 1990, there were 504 per 100000 live births while in 2008, it was 300 per 100000 live births. In the first half of this year, Accra recorded 60 maternal deaths.

Mr Charles Adjei Acquah, Acting Deputy Director in charge of Policy at the Ghana Health Service (GHS), praised SEND-Ghana for the initiative. He added that government has been addressing maternal health care and community-based planning service related problems to ensure the well-being and safety of pregnant women and the sick. Mr Acquah said government had not reneged on its responsibility to provide quality health care as a signatory to the MDGs and the Abuja Declaration, which enjoin nations, to among other things, reduce maternal mortality and devote 15 per cent of its annual budget to health care.

He, however, stated that the CHPS system hinged on the mobilisation of community leadership to participate in the implementation of the policy through volunteerism and community sensitisation on primary health care in specified catchment areas (known as CHPS zones). Communities provide voluntary support in helping to create a conducive environment for frontline health staff (known as Community Health Officers - CHOs) to deliver improved healthcare. He said the interventions could be enhanced and expanded if the District Assemblies are made directly responsible because health delivery at the community level was more of a developmental issue rather than a mere health concern. And for health care to be a central part of development, then the Assemblies should be made to have oversight responsibility for planning, budgeting, delivery and supervision of the CHPS strategy.

Mr Acquah said the ideal of the CHPS strategy was to relocate nurses to communities where they would work at CHPS zones to promote health services, which include educating the community on basic health issues, treatment of malaria, acute respiratory infections, diarrhoea and childhood illnesses. The CHOs were also to provide family planning services and immunisation at the homes, as well as serve mainly as agents of referral services for serious conditions. The CHOs, he noted, needed to work hand in hand with agriculture extension officers, environmental health officers, community development officers, education, information and gender officers, among others, in a decentralised manner.

The Health Director of Ga West District said Government alone could not fund the health interventions and donor support could not be relied on. Hence, he said, resources had to be pulled from various sources for the goals of programmes to be accomplished. He pointed out that the Assemblies should be reminded of their pledges and responsibilities, and that could be done through lobbying. He encouraged NGOs to support maternal health care.