Wiru Kenneth, Kumi-Kyereme Akwasi, Mahama Emmanuel N, Amenga-Etego Seeba, Owusu-Agyei Seth
Kintampo Health Research Centre, Ghana Health Service, P.O Box 200, Kintampo, B/A Region, Ghana.
Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
BMC Health Serv Res. 2017 Sep 26;17(1):679. doi: 10.1186/s12913-017-2622-4.
The Community-based Health Planning and Services (CHPS) initiative was introduced to improve coverage and utilization of basic health services for people in remote rural communities whose use of orthodox health services was hitherto limited by distance. To achieve this aim, the scheme has so far been scaled up to several communities nationwide as part of government's agenda to improve the general wellbeing of the populace. The objectives of this study were to examine the extent of patronage of CHPS compounds in the Kintampo North Municipality, factors associated with their use and challenges faced by community members regarding the use of these facilities.
We adopted a descriptive cross-sectional correlational design for this study. We collected data from 171 household heads or their representatives, selected through a multistage sampling technique. The respondents were drawn from five randomly selected communities among those with CHPS compounds and their proportions weighted based on the populations of these communities.
Our analysis revealed that a high proportion (73.7%) of the respondents patronized CHPS compounds for health care. We also found sex and income to predict the use of the facilities though income was less significant after adjusting for sex in a multivariate analysis. Females were about six times more likely than males to patronize CHPS compounds (adjusted OR = 5.98, 95% CI 2.55, 14.0, P = < 0.01). Household heads earning between GH¢ 200.00 and GH¢ 300.00 were about nine times more likely to use the facilities than those who earned below GH¢ 100.00 (adjusted OR = 8.88, 95% CI 1.94, 40.6, P = 0.05). Our findings also showed that shortage of medicines (41.5%), lack of money to pay for services (28.7%) and absenteeism of Community Health Officers (CHOs) (12.3%) were major barriers to the use of the facilities.
Based on the foregoing findings, there is an apparent need to ensure timely replenishment of medicines at the facilities and step up supervision of CHOs in order to sustain patronage of the compounds.
基于社区的健康规划与服务(CHPS)倡议旨在提高偏远农村社区居民基本医疗服务的覆盖范围和利用率,此前这些社区居民因距离远,使用传统医疗服务受限。为实现这一目标,该计划目前已在全国范围内扩大到多个社区,作为政府改善民众总体福祉议程的一部分。本研究的目的是调查金坦波北市CHPS诊所的就诊情况、使用这些诊所的相关因素以及社区成员在使用这些设施时面临的挑战。
本研究采用描述性横断面相关设计。我们通过多阶段抽样技术从171名户主或其代表那里收集数据。受访者来自设有CHPS诊所的社区中随机选取的5个社区,并根据这些社区的人口对其比例进行加权。
我们的分析显示,很大一部分(73.7%)受访者前往CHPS诊所就医。我们还发现性别和收入可预测这些设施的使用情况,不过在多变量分析中对性别进行调整后,收入的影响较小。女性前往CHPS诊所就诊的可能性比男性高约六倍(调整后的比值比=5.98,95%置信区间2.55,14.0,P=<0.01)。收入在200.00加纳塞地至300.00加纳塞地之间的户主使用这些设施的可能性比收入低于100.00加纳塞地的户主高约九倍(调整后的比值比=8.88,95%置信区间1.94,40.6,P=0.05)。我们的研究结果还表明,药品短缺(41.5%)、没钱支付服务费用(28.7%)以及社区卫生官员缺勤(12.3%)是使用这些设施的主要障碍。
基于上述研究结果,显然有必要确保诊所药品的及时补充,并加强对社区卫生官员的监督,以维持对这些诊所的就诊率。