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Opinions of Tuesday, 24 April 2018

Columnist: Gabriel Frimpong

The Community-Based Health Planning and Service (CHPS) concept in Ghana

Ghana’s progress in improving the health status of its citizenry since independence has been slow and the incidence and prevalence rates of certain common diseases have been alarming.

A major policy of the Ministry of Health since 1997 has been that” most of the disease problems that cause high rates of illnesses and deaths among Ghanaians are preventable or curable if diagnosed promptly by simple basic and primary health care procedures, and also extending coverage of healthcare will require engaging the cooperation and authorization of the people themselves at the various communities.

This subsequently lead to the introduction of the Community-based Health Planning and Service(CHPS) concept in Ghana.

CHPS is a national strategy for implementing community-based service delivery by reorienting and relocating primary health care from subdistrict health centers to convenient community location. It can be defined as the mobilization of community leadership, decision making systems and resources in a defined catchment area (zone), the placement of reoriented frontline health staff (CHO), with logistic support and community volunteer systems to provide services according to the principles of primary health care.

The CHPS program was approved for implementation in 1999 and it relies on community resources for construction labour, service delivery and program oversight. The ministry of health through the Ghana Health Service (GHS) pioneered the implementation of CHPS to replicate the results of the Navrongo Community Health Family Planning (CHFP) ths was introduced in the Kassena-Nakana district in Navrongo which led to a drastic decrease in the infant mortality rate.

The key pilot districts in the beginning of the introduction of the CHPS concept were; the Nkwanta-South in the Volta Region, Birim-North in the Eastern Region and the Abura-Asebu-Kwamankese in the Central Region.

First of all, the key elements of CHPS include; the community which serves as the social capital, household and individuals as the main targets, planning with community aimed at involving community participation and service delivery to the community. Also, the strategic goal of the CHPS concept is improving the health status of the people living in Ghana by facilitating actions and empowerment at the community levels.

To attain this strategic goal, it focuses on; improving the equity in access to basic health services, improve efficiency and responsiveness to clients and also to develop effective intersectoral collaboration.

Again, the CHPS’s policy of implementation was to create CHPS zones utilizing existing government structures by 2015 and the policy sequential milestones for the establishment of the CHPS zones include; preliminary planning, community entry, health compound construction (CHPS compound), procurement of essential equipment, posting nurses and providing them with technical refresher training and the last milestone being volunteer recruitment.

The three broad areas the Community Health Officer (CHO) and the community health team work towards are; promotion and prevention, management of minor or common ailment and their referrals and case detection, mobilization and referrals.

Penultimately, the basic services provided by the various CHPS compounds include; the provision of health education related to prevailing health problems and the methods of preventing and controlling them; promotion of food supply and proper nutrition; provision of adequate supply of safe water and basic sanitation; maternal and child healthcare; including family planning; immunization programs against the major infectious disease; prevention and control of locally endemic diseases;; appropriate management of the minor ailments and injuries; and provision of essential drugs, which all aim at helping ensure improved access to primary health care in these communities. Lastly, to aid the proper functioning of the various CHPS compounds, there is the need for a very strong community participation in the implementation of the CHPS’s policies.

It has been empirically proven that, programs with citizens participation coordinated by community level officials have generally been more successful than those without these participations. Participation, both at the governance and the operational levels is very important in achieving positive health outcomes. Thus, the key component of CHPS is community-based service delivery that focuses on improved partnership with households, community leaders and social groups.

Where there is strong community participation, traditional leaders and community members provide resources, both financial and non-financial incentives, to support implementation of the program. A CHO is expected to work in partnership with the community, households and district assemblies to ensure that, citizens are able to access services and health information as and when they need them whereas the communities are expected to also exert some levels of answerability to health providers.

To conclude, although the Community-based Health Planning Service (CHPS) faces the challenge of implementation of its policy, it has benefited the various communities by bringing effective healthcare to their doorsteps by acceptable means, through their full participation and at a cost that these communities and the country can afford ensuring the reduction in the mortality and morbidity rates among Ghanaians.

This implies that CHPS is an important concept and so every individual must make it his or her aim to help in the advancement of the CHPS’s services by providing it with any source of help he or she has, being it manpower, information and any other thing that is vital for the day to day activities of these CHPS zones.

Gabriel Frimpong
University of Cape Coast
(A level 200 Physician