The Community-based Health Planning and Services (CHPS) programme, has been hailed as a brilliant strategy to bring health services to the door steps of communities and rightly so.

However, its expansion and adoption can be enhanced if the District Assemblies are made directly responsible, because health delivery at the community level is more of a developmental issue rather than a mere health concern.

And for healthcare to be a central part of development, then the district assemblies should be made to have oversight responsibility for planning, budgeting, delivery and supervision of the CHPS strategy.

The ideal of the CHPS strategy was to relocate nurses to communities where they would work at CHPS zones to promote health services, which include educating the community on basic health issues, treatment of malaria, acute respiratory infections, diarrhoeal and other childhood illnesses.

The Community Health Officers (CHOs) were also to provide family planning services and immunization at the home level, as well as serving mainly as agents of referral services for serious conditions.

The CHOs needs to work hand in hand with agriculture extension officers, environmental health officers, community development officers, education, information and gender officers among others, in a decentralized manner.

 The District assemblies involvement is being piloted in the Kwabeng and Birim districts in the Eastern Region and Ho Municipality, capital of the Volta Region, by the Centre for Health and Social Services (CHESS) with support from STAR- Ghana, a multi-donor pooled agency.

In an Interview with Ghana News Agency in Accra, Dr Korshie Nazzar, Principal Investigator for the pilot programme and a Director at CHESS, said this follows extensive research conducted in these areas to review the implementation of CHPS around the country since its implementation 10 years ago.

He said some of the key findings of the research indicate that the district assemblies are showing less commitment to the programme, whilst the CHPS zones are also being converted into clinics, because the National Health Insurance Scheme reimburses them only for clinical or facility treatment.

The district assemblies are also declining interest in the CHPS zones, he said.

Recently, government had sought to revitalise the CHPS strategy to achieve its objective of providing a “close to client” service to communities.

In line with the measures to revitalise the CHPS, President John Dramani Mahama directed District Chief Executives (DCEs) to take direct control of the programme and ensure that the CHPS is implemented.

The financing required to support the programme would come from the 10 per cent cut in salaries of top government appointees.

The CHPS is a follow up to a research project that was carried out in the Kasena Nakena District in the Upper East region from 1994-1998.

The research, referred to as the Navrongo Experiment, tested out four different strategies on how to deliver services to rural communities in an effective, efficient and affordable manner.

The key recommendation was that, to achieve the best health outcome, nurses must be relocated to the communities to ensure that they communicate and mobilise the people to identify their health needs and plan with them to solve their problems.

This concept was then scaled up nationwide with varying successes across the country.

The key constraint identified includes limited capacity to mobilise, accommodation and lack of logistics, such as transport.

After 10 years, the CHESS recommended to the District Assemblies to take responsibility of the concept, as being piloted in the three assemblies, and explore how best the DCEs, District Coordinating Officers and the Ghana Health Service District Directors can work together with the assemblies to move the programme forward.

The CHPS strategy requires community members to discuss their health service needs with CHOs, who have been relocated to their communities and who stay with them and plan these services with them.

They were to move from house to house and attend to the health needs of individual as well as the community, and provide health education, family planning services and also attend to minor ailments they may come across and refer serious cases to the health centre.

The time has come for the authorities to involve the district assemblies to ensure grassroots participation of the CHPS if Ghana is to achieve its ambitious aims and objectives spelt out in the Millennium Development Goals. A stitch in time saves nine.




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