Citizen participation in the provision of health services in the South Kwahu District

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Healthy person makes a healthy nation. Without good health, a nation’s assets cannot be tapped as manpower development will be retarded. Beside, citizens cannot enjoy life as they want to. The importance of good health cannot be overemphasized. Yet a review of Ghana’s health situation reveals that majority of the people are still plagued with communicable and preventable diseases. The average life spans for males and females are lower than those of countries like Great Britain, Sweden, United States of America, Japan and even some developing countries like China, Cuba and Libya. In fact mortality is alarmingly high and malnutrition is still a problem. Basic sanitation and personal hygiene are not practised by many citizens. Since the emphasis in the past has been on curative medicine characterized by highly qualified doctors, huge buildings and sophisticated equipment usually located in urban areas, very few Ghanaians have access to these health facilities. In the Kwahu district for example, the health facilities — hospitals, health centres arid posts are located in the bigger settlements on the ridge. This situation coupled with the bad net work, have limited access to these facilities - to those living in such settlements. It has been over a decade since the Primary Health Care (PHC) system was officially launched in Ghana and yet communicable and preventable diseases have persisted to date. The objective of the study was to find out the various health services available in the study area and to evaluate citizens’ involvement in health problems identification, mobilization of human, material and financial resources, decision-making, implementation and management of health and health related projects. In order to achieve the study objectives, data were collected from secondary anc. primary sources. The secondary sources included documents from World Health Organization (WHO) publications, records from Ministry of Health, Hospitals, Health Centres and Posts. During the primary data collection, formal and informal interviews were conducted. Household surveys were conducted in selected settlements and in all, about 100 citizens were interviewed. Informaal interviews were held with all traditional birth attendants’ and. traditional healers in the sampled settlements. The study’s major findings are outlined as follows: (a) Physical health facilities are lacking in areas along the lake shore; (b) Traditional Birth Attendants and Traditional Healers play vital roles in the community’s health improvement (c) Child and maternal care, the Medical Field Unit services and the environmental Health services are limited, to the settlements with health facilities which are mostly on the ridge. (d) Citizens’ participation in implementation of projects is high whereas in mobilization and. management, participation is low (e) Citizens are aware of health hazards, nutrition, basic sanitation, breast-feeding and family planning. In the light of the foregoing findings, the major recommendations of the study include the following: (a) Regarding problem identification, a formal channel to enable citizens inform authorities of problems is to be introduced. This special committee should be formed within the CDR organization (b) For effective mobilization and accountability, citizens should be involved in the selection of mobilization committee members (c) To improve citizens’ participation in implementation, especially in raising funds for projects, communal farms, special levies, annual harvests are recommended (d) Citizens should be involved in the selection of members of Health Management Teams. Citizens’ participation in health care services is the only way to ensure that modest gains towards the goal “health for all by the year 2000” would be achieved. To what extent have citizens’ health situations improved as a result of citizen’s participation? This issue needs further investigation.
A thesis submitted to the Board of Postgraduate Studies, Kwame Nkrumah University of Science and Technology, Kumasi, in partial fulfilment of the requirements for the award of the Degree of Master of Science in Development Planning and Management, 1988