Background
Although community participation remains an essential component globally in healthcare service planning, evidence of how rural communities participate in the planning of rural-based healthcare programs has less been explored in Sub-Saharan Africa.
Objective
We explored communities’ participation in health care planning in hard-to-reach communities, within the context of Integrated Community Case Management (iCCM), a community-based health program implemented in Ghana.
Methods
Qualitative data were collected from eleven (11) hard-to-reach communities through Focus Group Discussions (FGDs), Key Informant Interviews (KIIs) as well as district-level studies (Nadowli-Kaleo, and WA East districts of Ghana). The Rifkin’s spider-gram, framework, for measuring and evaluating community participation in healthcare planning was adapted for the study.
The results
The study found that community participation was superficially conducted by the CHOs. A holistic community needs assessment to create awareness, foster a common understanding of health situations, collaboration, acceptance and ownership of the program were indiscernible. Rather, it took the form of an event, expert-led-definition, devoid of coherence to build locals understanding to gain their support as beneficiaries of the program. Consequently, some of the key requirements of the program, such as resource mobilization by rural residents, Community-based monitoring of the program and the act of leadership towards sustainability of the program were not explicitly found in the beneficiaries’ communities.
Conclusion and recommendation
The study concludes that there is a need to expand the concept of community involvement in iCCM to facilitate communities’ contribution to their healthcare. Also, a transdisciplinary approach is required for engineering and scaling up community-based health programs, empowering VHCs, CBHVs and CHAs to realize success.
Background: Although community participation remains a global reckon in services planning, evidence on how rural communities participate in health service delivery has less been explored in Sub-Saharan Africa. Objective: We explored communities’ participation in health care planning in hard-to-reach communities, within the context of Integrated Community Case Management (ICCM), of Ghana. Methods: Qualitative data were collected from eleven (11) hard-to-reach communities through Focus Group Discussions (FGDs), Key Informant Interviews (KIIs) as well as district level studies (Nadowli-Kaleo, and WA districts of Ghana). The Rifkin’s spider-gram, framework, of inputs, process and outcome indicators was adapted for the study. The results: Community participation was superficially conducted by the CHOs. A holistic community needs assessment to create awareness, foster common understanding of health situations, collaboration, acceptance and ownership of the program was indiscernible. Rather, it took the form of an event, expert-led-definition, devoid of coherence to calve locals understanding to support the program. Consequently, evidence of resource mobilization, monitoring and system of leaderships towards sustainability of the program were not explicitly found. Conclusion and recommendation: The study concludes that there is the need to expand the concept of community involvement in ICCM to facilitate communities’ contribution to their healthcare. Also, a transdisciplinary approach is required for engineering and scaling up community-based health programs, empowering VHCs, CBHVs and CHAs to realize success.
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