Impact of community health interventions on maternal and child health indicators in the upper east region of Ghana

Abstract

Background This paper reports on results of a health system strengthening implementation research initiative conducted the Upper East Region of northern Ghana. Transformative interventions to accelerate and strengthen the health delivery were implemented that included empowering community leaders and members to actively participate in health delivery, strengthening the referral systems through the provision of community transport systems, providing basic medical equipment to community clinics, and improving the skills of critical health staff through training. Methods A mixed method design was used to evaluate the impact of the interventions. A quantitative evaluation employed a flexible research design to test the effects of various component activities of the project. To assess impact, a pre-versus–post randomized cluster survey design was used. Qualitative research was conducted with focus group data and individual in depth interviews to gauge the views of various stakeholders associated with the implementation process. Results After intervention, significant improvements in key maternal and child health indicators such as antenatal and postnatal care coverage were observed and increases in the proportion of deliveries occurring in health facilities and assisted by skilled health personnel relative to pre-intervention conditions. There was also increased uptake of oral rehydration salts (ORS) for treatment of childhood diarrhoea, as well as marked reductions in the incidence of upper respiratory infections (URI). Conclusions A pre-and post-evaluation of impact suggests that the programme had a strong positive impact on the functioning of primary health care. Findings are consistent with the proposition that the coverage and content of the Ghana Community-based Health Planning and Services programme was improved by program interventions and induced discernable changes in key indicators of health system performance.

The level of wasting and associated factors among children aged 6–59 months in sub-Saharan African countries: multilevel ordinal logistic regression analysis

“…Furthermore, integrating individual and community-level interventions can yield synergistic effects, amplifying the impact on reducing wasting and improving child health outcomes. Community-level interventions complement individual efforts by creating supportive environments that reinforce healthy behaviors and access to resources ( 31 , 32 ). Recognizing the significance of community-level factors, policy changes must prioritize these interventions in health programming and decision-making processes.…”

Evaluation of the RISE II integrated social and behavior change approach in Niger: A contribution analysis

“…The role that the health facility and providers played in sharing health messages, however, proved promising. Previous studies have found leveraging health system interactions [ 34 , 35 ] and integrating demand creation program with supply side interventions can lead to improvements in health outcomes [ 36 , 37 ].…”

Community-Based Health Planning and Services (CHPS) concept and access to healthcare delivery in Sefwi Wiawso Municipal, Ghana

“…It has specifically targeted underserved communities, addressing disparities in access and providing a wide range of services including maternal and child health, family planning, preventive health care such as immunizations, and treatment for common ailments[ 3 , 4 , 8 , 9 ]. CHPS has demonstrated tangible impacts on health outcomes, including reductions in maternal and child mortality rates and improvements in healthcare-seeking behaviors [ 10 , 12 ] Moreover, it has proven to be cost-effective, efficient, scalable, and sustainable, making it a viable model for PHC in Ghana [ 3 , 8 ].…”

“…Despite the successes of the CHPS policy, some barriers mitigating access to health care among the rural populace have been identified [ 12 , 16 ]. Consequently, the CHPS concept is not meeting its expected outcomes due to several factors[ 12 , 15 ].…”

“…Despite the successes of the CHPS policy, some barriers mitigating access to health care among the rural populace have been identified [ 12 , 16 ]. Consequently, the CHPS concept is not meeting its expected outcomes due to several factors[ 12 , 15 ]. These include lack of practical understanding of CHPS implementation by district-level managers; CHPS evolving into static clinic services focused on constructing health posts rather than its community-driven approach; managers often delaying CHPS implementation, waiting for central government resources instead of mobilizing local community resources; no central government budgetary allocation to cover startup costs as anticipated; heavy investment in CHPS staff recruitment and training without accompanied adequate investment in equipment; and poor leadership and supervision hindering effective implementation[ 14 , 17 ].…”