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加纳上西部基于社区的卫生规划和服务(CHPS)项目对社区卫生可持续性的影响。

The influence of the Community-based Health Planning and Services (CHPS) program on community health sustainability in the Upper West Region of Ghana.

机构信息

Department of Geography, University of Western Ontario, London, Ontario, Canada.

Department of Social, Political and Historical Studies, University for Development Studies, Wa Campus, Wa, Ghana.

出版信息

Int J Health Plann Manage. 2019 Jan;34(1):e802-e816. doi: 10.1002/hpm.2694. Epub 2018 Nov 15.

Abstract

Ghana introduced Community-based Health Planning and Services (CHPS) to improve primary health care in rural areas. The extension of health care services to rural areas has the potential to increase sustainability of community health. Drawing on the capitals framework, this study aims to understand the contribution of CHPS to the sustainability of community health in the Upper West Region of Ghana-the poorest region in the country. We conducted in-depth interviews with community members (n = 25), key informant interviews with health officials (n = 8), and focus group discussions (n = 12: made up of six to eight participants per group) in six communities from two districts. Findings show that through their mandate of primary health care provision, CHPS contributed directly to improvement in community health (eg, access to family planning services) and indirectly through strengthening social, human, and economic capital and thereby improving social cohesion, awareness of health care needs, and willingness to take action at the community level. Despite the current contributions of CHPS in improving the sustainability of community health, there are several challenges, based on which we recommend, that government should increase staffing and infrastructure in order to strengthen and maintain the functionality of CHPS.

摘要

加纳引入了基于社区的卫生规划和服务(CHPS),以改善农村地区的初级卫生保健。将医疗保健服务扩展到农村地区有潜力提高社区卫生的可持续性。本研究借鉴资本框架,旨在了解 CHPS 对加纳上西部地区(该国最贫穷的地区)社区卫生可持续性的贡献。我们对来自两个区的六个社区的社区成员(n=25)进行了深入访谈,对卫生官员(n=8)进行了重点人员访谈,并进行了焦点小组讨论(n=12:每个小组由六到八名参与者组成)。调查结果表明,通过提供初级卫生保健的任务,CHPS 直接有助于改善社区健康(例如,获得计划生育服务),并通过加强社会、人力和经济资本间接地改善了社会凝聚力、对医疗保健需求的认识以及在社区层面采取行动的意愿。尽管 CHPS 在提高社区卫生可持续性方面做出了贡献,但仍存在一些挑战,为此我们建议政府增加人员配备和基础设施,以加强和维持 CHPS 的功能。

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