|
Title |
Does the design and implementation of proven
innovations for delivering basic primary health
care services in rural communities fit the urban
setting: the case of Ghana’s Community-based
Health Planning and Services (CHPS) |
Author(s) |
Philip Baba Adongo, James F Phillips, Moses Aikins, et al - Personal Name
|
Subject |
Rural Health |
Publisher |
Bio Med Central Ltd |
Publishing Year |
2014 |
Specific Detail Info |
Background: Rapid urban population growth is of global concern as it is accompanied with several new health
challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges.
Lack of formal government public health facilities for the provision of health care is also a common phenomenon
among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary
health system was introduced in urban Ghana, based on the milestones model developed with the rural
Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative
experiences adapted while addressing these urban health issues, including the process of deriving constructive
lessons needed to inform discourse on the design and implementation of the sustainable Community-Based
Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana.
Methods: This research was conducted during the six-month pilot of the urban CHPS programme in two selected
areas acting as the intervention and control arms of the design. Daily routine data were collected based on
milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention
communities, some modifications were made to the rural milestones.
Results: The findings from the implementation activities revealed that many of the best practices derived from the
rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational
structures and epidemiological characteristics found in the urban context. For example, constructing Community
Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved
inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate
urban residents and increase coverage. The breadth of the disease burden of the urban residents also requires a
broader expertise and training of the CHOs.
Conclusions: Access to improved urban health services remains a challenge. However, current policy guidelines for
the implementation of a primary health model based on rural experiences and experimental design requires careful
review and modifications to meet the needs of the urban settings. |
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