Community participation in health service delivery in some peri-urban communities in Manhyia North Sub-Metro, Kumasi, Ghana

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Community Participation (CP) in health is accorded great importance in the face of scarce resources at the disposal of governments the world over. As a result of the large potential benefits attributed to participation, including addressing of community needs through more locally adopted organizational processes and improvement in health outcomes, governments have adopted policies and programmes of community participation as part of their strategy to improve primary health care services as laid down by WHO (1978) in the Alma Ata Declaration. As the main component of primary health care, proponents of community participation envisioned self-motivated individuals and communities working together with the state to design their own health programmes and improve health development. Individuals and families would come to view health not only as a right, but a responsibility. Individuals and communities would therefore be involved in assessment of situation, definition of (health) problems and setting of priorities as well as help in planning health activities and subsequently cooperate when these activities are carried out. Community participation, as a medium for successful primary health care services, is an essential cog in the wheel of ensuring that community programmes and projects are well thought out, executed, monitored, evaluated, maintained, managed and sustained for this generation and posterity. There have been several and varied attempts in Ghana of involving communities in provision of essential health care as early as the late 1970s. But it seems the desired results have been eluding the rural communities. The main objective of this study therefore, was to assess community participation in health care delivery and factors affecting if in the Manhyia North sub-metro, Kurnasi in the Ashanti Region, Ghana. The study covered the non-professional components of primary health care in programmes construction of infrastructure for clinics, toilets and rubbish dumps. Efforts were made to establish findings from the data analysis. The extent of community participation was established or arrived at in the percentage (%) agreement of communities on their communal involvement and participation on consensus building on decisions concerning each community’s project (s). The level of participation (high or low) was arrived at on the basis that there was consultation with the beneficiary community’s part in decisions on (the projects or) health needs which concerned or affected their lives - a very vital principle of the WHO’s (1978) Alma Ata Declaration that considered Community Participation as the “involvement of communities themselves in identifying their own health needs and finding solutions to them. Recommendations made, were considered to improve community involvement and participation in health programmes and projects.
A thesis submitted to the Department of Community Health, School of Medical Sciences in partial fulfilment of the requirements for the degree of Master of Science, 2004