In the years before CHPS, access to government services was hampered by the large distances that women needed to travel to get care – the dusty, bumpy roads they had to ride for hours by motorbike to get to the nearest hospital. As she conducts her household chores, bathing her children and sweeping the house, she explains the history of her own relationship with health services.Įarlier in life, Ms Amenyo was trained as a Traditional Birth Attendant by her mother, an occupation handed down through the generations. Like many of the members of her small community in the Volta Region of Ghana, Ms Elizabeth Amenyo farms cassava for a living. Unpaid and yet unstinting, they labour year-on-year to help their communities thrive.
They act as an interface between the community and the Ghana Health Service, communicating about health campaigns and events and supporting the health service to understand the needs of the people. They use checklists and guides to structure their interactions as they go door to door checking on the health of their neighbours – particularly pregnant women and babies. They are active in seeking out community members who are ill or otherwise in need, often travelling long distances to call on their clients.Ĭommunity members have been trained to assist the nurses as Community Health Volunteers. Their job is to act as the frontline of the health system, supporting immunization, family planning and maternal and child health more generally. Specially trained nurses known as Community Health Officers are posted to the rural areas - living in the heart of the community - so that they are available in the case of emergencies.
Instead of placing all their investment in hospitals, Ghana has taken health to the heart of the village. In addition to logistical challenges, there are also local cultural beliefs preventing women from seeking care, even during childbirth. While international standards suggest that the ideal ratio is one doctor per 1,000 people, in Ghana in 2017 there was only one doctor per 8,098 people, and most of these doctors lived in cities and towns. Access to electricity, mobile-cellular coverage and clean water are a challenge in rural areas. Many people live long distances from the nearest health centre. In rural areas, CHPS is often the first point of contact with government health services.Īs in many other low- and middle-income countries, Ghana experiences a great number of impediments to improving health and well-being for its citizens.
But how did it come into being, and what has Ghana done differently that has made it so successful?Ĭommunity-based Health Planning and Services – more commonly referred to by its acronym, CHPS (pronounced ‘chips’) – is well known by health systems experts across the world. It’s a community-centred approach that has transformed maternal and child health in the most inaccessible parts of the country. For over 20 years, Ghana’s CHPS programme has been the focus of the country’s primary health care strategy.
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