Sustaining Health Intervention Programmes in Ghana: The Role of ‘the Community’ in Community-Based Health Planning and Services. A Mixed Study

The Community-based Health Planning and Services(CHPS) is an initiative to improve access to quality healthcare and family planning services for rural Ghana. Its management has been decentralized from the sub-district level to the community level. Although several studies have been conducted on the CHPS, little attention has been focused on its management. Therefore, this research sought to examine the management of CHPS by the Community Health Management Committees(CHMC) at the Atwima Ngwabiagya North district, Ashanti Region,Ghana. Descriptive cross-sectional survey was adopted. Mixed method was used. Using systematic and simple random sampling, 384 respondents were assessed. Further, a total of five Focus Group Discussions and eight In-depth interviews were conducted. Stata was used to analyze the quantitative data whilst the qualitative data was analyzed using thematic analysis. Communities had no strategy in place to ensure the acquisition of trained staff but have ever requested for nurses from Ghana Health Service(GHS). Also, the CHPS do not always have the required logistics. About 41% indicated that, community members provide support to the CHPS. Interest of the CHMC in the CHPS is dying out gradually due to the continuous demand for its maintenance by the GHS. Again, 52% of community members were involved in decision making. Decentralization of the management of health services at the community level is not as effective as envisaged; failure can be attributed to both central government and the communities. Suggestions to become more effective include reserving a percentage of the internally generated funds for its management and community sensitization.