“From Experts to Locals Hands” Healthcare services Planning in Sub-Saharan Africa: Insight from the Integrated Community Case Management of Ghana

Abstract

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.