Ghana: community case management

Overview

  • Previously called Home Based Care (HBC)
  • Community-based services provided through Community Health Planning & Services (CHPS) system
    • Community Health Officers (CHOs) work with community volunteers and structures to increase access to integrated package of health services

■ Rectal artesunate implemented as pre-referral intervention for severe malaria

  • iCCM has leveraged the CHPS system
    • Village Development Committee (VDC): provides oversight/accountability for health programmes
    • CHOs linked closely with VDCs and other community-based organizations (CBOs)

■ CBOs engage in social mobilization, awareness raising and sensitization on environmental sanitation

  • NMCP collaborates with Reproductive and Child Health Programme (RCHP), district health teams and others to implement iCCM

Roll-out:

  • Phased approach starting from most deprived communities in 3 northern regions, progressively scaling up to other districts over time.
  • iCCM prioritized activities (2015-2017)
  • Development, procurement and deployment of tools and enablers, training supervision, communication and transportation of community health workers

Community-based Health Planning and Services

  • There are currently 5,981 Community-based Health Planning and Services (CHPS) zones and 4,034 functioning CHPS zones with a CHPS compound or a community health nurse affiliated to a health clinic that provides community-based health services.
  • CHPS compounds (minimally, a two-room facility with equipment for basic curative and preventive care) provide access to nurses and midwives in communities of at least 6,000 people
  • 2016: Government of Ghana (GOG) completed construction of CHPS compounds in 1,809 of 4,034 CHPS zones.
  • Japan International Cooperation Agency has built 60+ new CHPS compounds, with a target of 80 by the end 2017
  • A typical district with a population of 100,000 people has one district hospital, 5 health centers and 10-15 CHPS compounds.

Challenges

  • Health worker capacity to carry out core functions
  • Accountability and monitoring of community-based initiatives