The community-based health planning and services (CHPS) and access to health care in the Ashanti Region, Ghana

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Globalization is putting the social cohesion of many countries under stress and health systems as key constituents of the architecture of contemporary societies are clearly not performing as they should. People are increasingly impatient with the inability of health services to deliver at levels of national coverage that meet stated demands and changing needs, and with their failure to provide services in ways that correspond to their expectations. Since Ghana’s Independence, there has been concentration on improving health services delivery at the Hospital and Health Centers by investing in the construction of health facilities, hoping that the presence of these facilities will lead to an increase in uptake of health services. The Health status of Ghanaians has been improving since independence, however, the rate of change has been slow and current health service indicators are still far from desirable. Good health is one of the most important contributors to individual welfare and ability to perform effectively in all aspects of life. The glaring reality of rural dwellers’ is poor access to health facilities and other social amenities. To improve health conditions in Ghana, the Ministry of Health strategic policy adopted by the Ghana Health Service aims at bringing health care to the door step of people, especially those in the rural and deprived areas. To promote access, quality and equitable health care services to all Ghanaians, particularly those in rural and deprived settlements, the Ghana Health Service adopted the Community-based Health Planning and Services CHPS) as a national programme to achieve its objective. It is in the light of this that this study focused on access to health service delivery under the Community Health Planning and Services programme and the role of the programme in improving access to health services to the poor and deprived communities in the Ashanti Region. The objective of the study was to examine the role of CHPS and access to health care delivery. The Simple random and purposive sampling procedure was used and 15% of the districts implementing CHPS was the sample size for the study. The study used both secondary and primary data. The secondary information was sourced from Ministry of Health annual reports, internet, journals, unpublished thesis reports and CHPS policy document. The primary data was collected using questionnaires. It was evident that, the Ashanti Region is endowed with health facilities including a teaching hospital. However, these health facilities are not evenly distributed across the region. The study revealed that communities with CHPS compounds had easy access to health care as frequency of visits to the CHPS facility was averaging four times within a year and communities without CHPS; frequency of visits was just once a year. This was attributed to long distance travels, bad road conditions and high cost of transportation. Also, the introduction of NHIS has taken care of the financial burden in accessing health care. Secondly, the CHPS compounds serve as the first point of call in the structure of the health system but the health personnel requirement at the CHPS compounds were inadequate in terms of numbers and technical expertise. Some of the findings of the study include the following: The CHPS activities is to involve local participation in health decisions making but it was unearth that there was low participation in CHPS’s activities. The CHPS serves as the first point of call in health care delivery at the community level. Human resource is inadequate in terms of technical expertise. Affordability of health care services by the local people is through the use of NHIS cards. The location of CHPS compounds using the Zone systems do not effectively serve all communities under the catchment area. It is recommended that GHS in collaboration with the District Assemblies should train more health professional of the various categories and bond them to service the districts and communities within the region in order to fill the gap of professional inadequacy. Also, the current system where a CHPS compound serve about six communities or based on zones should be looked at again because distance, condition of road and cost of transportation hinder access to health facilities. Therefore more health facilities should be built.
A thesis submitted to the School of Graduate Studies Kwame Nkrumah University of Science and Technology, in partial fulfillment of the requirement for the degree of Master of Science in Development Policy and Planning,