Seeking New Understanding of Primarycare Policy Constraints: A Qualitative Assessment of Health Workers and Community Perspectives on the Role of Communication in the Implementation of Ghana‘s National Community Health Policy

Ghana has been implementing the Community-based Health Planning and Service (CHPS) initiative as a national health policy for over twenty years. The CHPS program is designed for delivering Primary Health Care services to under-served population who mostly reside in economically poor and hard to reach locations. Over the years studies looking at various aspects of the operation of the policy have found that community members and other stakeholders lack proper understanding of the program. This study analyzed qualitative data collected in two districts in Northern and Volta Regions of Ghana to assess health workers and community members’ perspectives on the role of communication in the implementation of the CHPS policy. The study utilized Airhihenbuwa (1989) PEN-3 cultural model as the framework to evaluate the cultural relevancy of communicating and delivering the program. The study found that CHPS is framed around the relationship and expectations domain of the PEN-3 model and that communication plays a significant role in CHPS implementation as core activities for initiating decisions, planning and delivery of health services involve communication processes including community engagement and participation and dissemination of best practices. The study makes key contribution to the PEN-3 cultural model for evaluating community based health interventions. For advancing policy and program development it recommends the strengthening of communication processes in CHPS scale up for sustainability and effective implementation of the policy

Supporting the utilization of community-based primary health care implementation research in Ghana

From Crossref journal articles via Jisc Publications RouterItem not available in this repository.Ever since the 1990s, implementation research in Ghana has guided the development of policies and practices that are essential to establishing community-based primary health care. In response to evidence emerging from this research, the Community-based Health Planning and Services (CHPS) policy was promulgated in 1999 to scale-up results. However, during the first decade of CHPS operation, national monitoring showed that its pace of coverage expansion was unacceptably slow. In 2010, the Ghana Health Service launched a five-year plausibility trial of CHPS reform for testing ways to accelerate scale-up. This initiative, known as the Ghana Essential Health Intervention Program (GEHIP), included a knowledge management component for establishing congruence of knowledge generation and flow with the operational system that GEHIP evidence was intended to reform. Four Upper East Region districts served as trial areas while seven districts were comparison areas. Interventions tested means of developing the upward flow of information based on perspectives of district managers, sub-district supervisors, and community-level workers. GEHIP also endeavored to improve procedures for the downward flow and utilization of policy guidelines. Field exchanges were convened for providing national, regional, and district leaders with opportunities for participatory learning about GEHIP implementation innovations. This systems approach facilitated the process of augmenting the communication of evidence with practical field experience. Scientific rigor associated with the production of evidence was thereby integrated into management decision-making processes in ways that institutionalized learning at all levels. The GEHIP knowledge management system functioned as a prototype for guiding the planning of a national knowledge management strategy. A follow-up project transferred its mechanisms from the Upper East Regional Health Administration to the Policy Planning Monitoring and Evaluation Division of the Ghana Health Service in Accra.Funder: Doris Duke Charitable Foundation; FundRef: 10.13039/100000862; Grant(s): 201610737pubpub