The Ghana Community-Based Health Planning and Services initiative: barriers to smooth implementation in the new Juaben Municipality

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The study was aimed at identifying the barriers to the smooth implementation of CHPS. A Ghana Health Service (GHS) initiative meant to improve geographical access of health services in the rural communities in Ghana. The objective of the study includes examining the proximity of health facilities, the level of implementing the guidelines, sensitization of health staff on CHPS, outcome of established CHPS centres and the way forward to scaling up of CHPS in the New Juaben Municipality. A descriptive study with a cross sectional design, a total of two hundred (200) staff/management was interviewed with questionnaire. In addition, a checklist was designed to review two CHPS centres in Oyoko/Jumapo and Medical Village/Old Estate sub-districts. The findings showed that an average of 91% of the population and 72% of communities live within 3 km radius of a health facility. There was resemblance of some level of implementation of all the guidelines/milestones/procedures, however, the construction of staff accommodation, purchase of essential equipments and logistics are key milestones that hinder the smooth implementation of CHPS in the New Juaben Municipality. The average Sensitization of health staff on CHPS was 81% with the Hospital having 51% as against 97% from the Municipal Health Directorate (MHD). Outcome of CHPS on records review indicated that the CHPS centers provides public health services like EPI, ANCICWC etc and clinical services by giving ambulatory services to the communities with unimpressive documentation on referrals. Suggestions given by health workers and the communities on the way forward includes personnel training and motivation, provision of basic logistics, skills in community mobilization and the provision of standard referral form. Appropriate recommendations have been made for the MHMT, the Municipal Assembly and other stakeholders in the Municipality to help improve upon the establishment of CHPS compounds.
A thesis submitted to the Board of Postgraduate Studies, Kwame Nkrumah University of Science and Technology, Kumasi in fulfilment of the requirements for the degree of Master of Science in Health Services Planning and Management, 2005