Policy Planning Monitoring and Evaluation Division, Ghana Health Service, Private Mail Bag, Accra, Ghana.
Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University.
Health Policy Plan. 2022 Mar 4;37(3):420-427. doi: 10.1093/heapol/czab156.
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 5-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 endeavoured 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.
自 20 世纪 90 年代以来，加纳的实施研究一直指导着政策和实践的制定，这些政策和实践对于建立以社区为基础的初级卫生保健至关重要。针对该研究中出现的证据，1999 年颁布了以社区为基础的卫生规划和服务（CHPS）政策，以扩大成果。然而，在 CHPS 运作的第一个十年中，国家监测表明其覆盖范围扩大的速度令人无法接受地缓慢。2010 年，加纳卫生服务部门启动了为期五年的 CHPS 改革可行性试验，以测试加速扩大规模的方法。这项名为加纳基本卫生干预计划（GEHIP）的倡议包括一个知识管理组件，用于建立知识生成和流动与 GEHIP 证据旨在改革的运营系统之间的一致性。四个上东部地区作为试验区，七个地区作为对照区。干预措施测试了基于地区经理、分区主管和社区一级工作人员的观点发展信息上行流动的方法。GEHIP 还努力改进政策指南的下行流动和利用程序。为国家、地区和地区领导人举行了实地交流会议，为他们提供了参与学习 GEHIP 实施创新的机会。这种系统方法促进了将证据与实际现场经验进行交流的过程。通过这种方式，与证据产生相关的科学严谨性被纳入各级管理决策过程，从而实现了制度化学习。GEHIP 知识管理系统充当了指导国家知识管理战略规划的原型。一个后续项目将其机制从上东部地区卫生管理局转移到阿克拉的加纳卫生服务政策规划监测和评价司。
