Second Phase Of CHPS System

NEWS COMMENTARY ON THE SECOND PHASE OF COMMUNITY-BASED HEALTH PLANNING AND SERVICES, CHPS.

The Community-based Health Planning and Services, CHPS system was first piloted in Navorongo in the Kassena Nankana District of the Upper East Region in the late 1990s.  The project is aimed at providing quality health service and making healthcare easily accessible to all, irrespective of one’s geographical location. The CHPS concept has since been extended to other parts of the country particularly the Upper West, following a successful piloting in the Upper East region. The first phase, christened ‘Project for scaling up CHPS,’ which spanned 2006 to 2009 focused primarily on system development in the region. This included supporting the implementation and enhancement of CHPS system by training Community Health Officers, development of materials and building of CHPS monitoring system. 

The second phase, under “Project for improvement of maternal and neonatal health services utilizing CHPS system in the Upper West Region” started in 2011 and is expected to end in September this year. It seeks to consolidate the gains made under the first phase by introducing innovations and exit strategy. Improvement in the coverage of Antenatal Care ANC, Skilled delivery, Postnatal Natal Care PNC, referral and feedback were among the expected outcomes. These were to be achieved through capacity building for midwives, Community Health Officers and Community Health Nurses to promote behavioral change in beneficiary communities. The facilitators were also trained to provide basic emergency obstetric and newborn care. Beneficiary communities were sensitised to put in place measures to facilitate referrals of patients to hospitals and polyclinics. In addition to the technical support by JICA, sixty-four CHPS compounds were to be constructed in the region with Japanese grant while seventy-five would be provided with equipment. After five years of implementation, the project can be said to have achieved its targets. 

Information from the Upper West Regional Health Directorate indicates that institutional maternal mortality ratio declined from 212 per one hundred thousand live births in 2010 to 155 per one hundred thousand live births last year. The figure further declined from 155 to one hundred and five as at June this year. Again neonatal mortality rate declined from eleven-point-two per one thousand live births in 2010 to seven-point-four in 2015. Skilled attendant at birth increased from fifty-three percent in 2011 to eighty-three percent last year. Early seeking of antenatal care within the first twelve weeks of pregnancy also went up from 47 percent in 2010 to 56 percent in 2015. Postnatal care within the first 48 hours of birth increased from thirty-two percent in 2011 to 78 percent. The number of functional CHPS zones went up from 91 in 2011 to 213 this year out of 253 demarcated zones in the region. 

Currently CHPS alone provides healthcare to fifty-one percent of the region’s population. These successes are no mean achievement as they contribute significantly to improving the lives of people of the region. JICA’s support in the areas of technical and finance deserves high commendation. The CHPS concept is laudable and every effort must be made to sustain and improve upon it. One great feature of it is its acceptability by the communities. Members of the communities are largely involved in the planning, construction and running of the facilities. Through the Community Health Action Plan, CHAP, the people themselves decide on their priority areas. Where access to transport is difficult, they levy themselves to pay for cost of transport of referral cases under what they call Emergency Transport System to other health centres or hospitals for further treatment. Some husbands who previously did not bother about the conditions of their wives during pregnancy now accompany them to CHPS compounds for antennal and postnatal care. These and many more have contributed to the significant reduction in the maternal and neonatal deaths. 

Moving forward, there is the need for Ghana Health Service and its development partners particularly JICA to ensure that these monumental gains are not reversed. They must continue to nurture these facilities and those yet to be established.   

BY SUALAH ABDUL-WAHAB A JOURNALIST.