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

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 ch...

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Bibliographic Details
Published in:PloS one 2020-01, Vol.15 (1), p.e0226808-e0226808
Main Authors: Kweku, Margaret, Amu, Hubert, Awolu, Adam, Adjuik, Martin, Ayanore, Martin Amogre, Manu, Emmanuel, Tarkang, Elvis Enowbeyang, Komesuor, Joyce, Asalu, Geoffrey Adebayo, Aku, Fortress Yayra, Kugbey, Nuworza, Anumu, Fidelis, Boateng, Laud Ampomah, Alornyo, Justine Sefakor, Glover, Roland, Letsa, Timothy, Bawah, Ayaga A, Kanlisi, Nicholas S, Awoonor-Williams, John Koku, Phillips, James F, Gyapong, John Owusu
Format: Article
Language:English
Subjects:
Adult
Analysis
Biology and Life Sciences
Charitable foundations
Collaboration
Community
Community Health Planning - organization & administration
Community Health Services - organization & administration
Community involvement
Community participation
Community planning
Content analysis
Emergency management
Emergency preparedness
Female
Focus Groups
Ghana
Health care
Health care reform
Health facilities
Health insurance
Health Personnel - standards
Health Plan Implementation
Health planning
Health Planning - methods
Health services
Health Services Accessibility
Humans
Information management
Learning
Logistics management
Male
Medical personnel
Medical research
Medicine and Health Sciences
Middle Aged
Neonates
Newborn babies
Newborn infants
People and Places
Population
Primary care
Primary health care
Primary Health Care - standards
Public health
Qualitative Research
Resuscitation
Security
Stakeholder Participation
Studies
Young Adult
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Summary: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. 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. 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. 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.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0226808