Enhancing Community Participation in Health Service Delivery: A Case Study of Community-Based Health Planning and Services (CHPS) Nadowli District in the Upper West Region

Abstract

One major problem facing health service delivery in Ghana with particular reference to the implementation of the new health policy, the Community-Based Health Planning and Services (CHPS), is poor community participation. This is due to the seemingly inadequate understanding of the CHPS concept and participatory methodologies by Community Health Officers (CHOs) who are the frontline staff of the Ghana Health Service (GHS) in the implementation of the CHPS program. This study examined the knowledge of CHOs in the CHPS concept and the approaches in facilitating community engagement processes as some of the factors influencing the level of community participation in CHPS.

The study was conducted in 10 selected CHPS zones in the Nadowli district of the Upper West Region of Ghana. Three set of survey questionnaires were employed bearing in mind the objectives of the study. One set of questionnaire was administered to a sample of 18 Health staff that included CHOs and Sub district In-charges. The other questionnaires were administered to 56 CHVs/CHCs and 28 selected community opinion leaders in sampled CHPS communities.

The findings present a situation of mixed understanding of the CHPS concept and methodology by CHOs and their immediate supervisors (SDHTs) who are the vanguard in the implementation of the CHPS program .The study observed a generally low level of community involvement at the various stages of the CHPS implementation processes. This is partly attributable to the inadequate knowledge of CHOs in the CHPS concept and skills in facilitating community engagement processes. The paper further argues that heterogeneity of the CHPS communities does not pose an obstacle to participation with effective community entry and facilitation of working together processes. It concludes that to enhance community participation in CHPS, practical innovative strategies of improving CHOs’ understanding of the CHPS concept, community dynamics and skills in facilitating participatory methodologies must be re-visited.

Keywords: Community, empowerment, enhancement, facilitation, heterogeneity, participation,