Community-Based Health Planning and Services Plus programme in Ghana: A qualitative study with stakeholders in two Systems Learning Districts on improving the implementation of primary health care

English version

Autoři: Margaret Kweku ^aff001; Hubert Amu ^aff001; Adam Awolu ^aff001; Martin Adjuik ^aff001; Martin Amogre Ayanore ^aff001; Emmanuel Manu ^aff001; Elvis Enowbeyang Tarkang ^aff001; Joyce Komesuor ^aff001; Geoffrey Adebayo Asalu ^aff001; Fortress Yayra Aku ^aff001; Nuworza Kugbey ^aff001; Fidelis Anumu ^aff002; Laud Ampomah Boateng ^aff003; Justine Sefakor Alornyo ^aff003; Roland Glover ^aff003; Timothy Letsa ^aff003; Ayaga A. Bawah ^aff004; Nicholas S. Kanlisi ^aff005; John Koku Awoonor-Williams ^aff006; James F. Phillips ^aff005; John Owusu Gyapong ^aff002
Působiště autorů: School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana ^aff001; Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana ^aff002; Volta Regional Health Directorate, Ghana Health Service, Ho, Ghana ^aff003; Regional Institute of Population Studies, University of Ghana, Legon, Accra, Ghana ^aff004; Mailman School of Public Health, Columbia University, New York, New York, United States of America ^aff005; Policy Planning Monitoring and Evaluation Division, Ghana Health Service, Accra, Ghana ^aff006
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0226808

Souhrn

Background

In 1999, Ghana introduced the Community-Based Health Planning and Services (CHPS) as the key primary health care strategy. In this study, we explored the challenges, capacity development priorities, and stakeholder perspectives on improving the CHPS concept as it has been fraught with a myriad of challenges since its inception. Our study is the outcome of the national programme for strengthening the implementation of CHPS Initiative in Ghana (CHPS+) introduced in 2017.

Methods

This exploratory research was a qualitative study conducted in two Systems Learning Districts (SLDs) of CHPS+ in the Volta Region of Ghana from March to May, 2018. Four focus group discussions and two general discussions were conducted among 60 CHPS+ stakeholders made up of health workers and community members. Data analyses were conducted using conceptual content analysis. Statements of the participants were presented as quotes to substantiate the views expressed.

Results

Negative attitude, high attrition, inadequacy and unavailability of health professionals at post when needed were challenges associated with the health professionals. Late referrals, lack of proper community entry and engagement, non-availability of essential logistics, distance of CHPS compounds from communities, and inadequate funding were challenges associated with the health system. Lack of community ownership of the CHPS programme, lack of security at CHPS compounds, and late reporting of cases by the community members were also realised as challenges emanating from the community members. Priority areas for capacity development of health workers identified included logistics management, community entry and engagement, emergency delivery, managing referrals at the CHPS level, and resuscitation of newborns.

Conclusion

Health-worker, community, and health systems-based challenges inhibit the implementation of CHPS in Ghana. Capacity development of health professionals and continuous community engagement are avenues that can improve implementation of the programme.

Klíčová slova:

Neonates – Resuscitation – Nurses – Public and occupational health – Health services administration and management – Ghana – Communication in health care – Health systems strengthening

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