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What does the Population Council do?
- The Population Council is an international, not-for-profit,
nongovernmental organization that conducts biomedical, social
science, and public health research on global issues, including
HIV and AIDS; poverty, gender, and youth; and reproductive health.
- Founded in 1952 and headquartered in New York, the Population
Council employs more than 500 people, has offices in Africa,
Asia, and the Americas, and conducts research in more than 60
countries.
The Population Council in Ghana
- The Council has been working in sub-Saharan Africa (SSA) since the 1960s. The organization has offices in Johannesburg
and nine other SSA cities, with plans for one future office on
the continent. During the past decade, the Council has worked on
projects in 25 African countries.
- Current Population Council efforts in Ghana are primarily
focused on scaling up the Community-based Health Planning and
Services (CHPS) Initiative nationwide. Earlier studies that have informed this initiative
were extensive and included research related to antenatal care, child
health, childhood immunization, community-based distribution
programs, contraceptive use trends and practices, malaria, and
teaching maternal care skills to providers.
- The Population Council provided technical assistance to the
Ghana Health Service on the CHPS pilot project in Navrongo in
northern Ghana beginning with its inception in 1993. The program
was then implemented in Nkwanta (an impoverished section of the
Upper Volta region in the eastern part of the country),
demonstrating that the CHPS model could be effectively implemented
in other areas of the country. Based on these initial successes, the
Ministry of Health adopted CHPS as the model for improving access to
high-quality primary-care services in resource-poor communities
nationwide.
- The Council’s Ghanaian collaborators have included the Health
Research Unit of the Ministry of Health, the Ghana Health Service,
AfriKids, the American College of Nurse/Midwives, the Centre for
Development of People, the Christian Health Association of Ghana (CHAG),
EngenderHealth, Ghana Social Marketing Foundation, Noguchi Memorial
Institute for Medical Research, Planned Parenthood Association of
Ghana, and World Vision.
What is the Community-based Health Planning and
Services (CHPS) Initiative?
- Beginning in 1997, the Ghana Health Service launched sector-wide
health reforms aimed at improving access, equity, efficiency,
quality, and sustainability of health and family planning services
throughout Ghana. CHPS has become a core component of this reform
package.
- CHPS helps train health care workers from existing,
underutilized district facilities and deploys them into rural
communities. Community members are actively engaged in the
implementation and maintenance of service-delivery systems.
- CHPS institutes an organizational change process that relies on
community resources for program oversight, service delivery, and
construction labor.
- CHPS mobilizes grassroots action and leadership for improved health provision.
- CHPS is an effort to carry out the vision of “placing a nurse
in every hamlet in Ghana” and part of a general system for
developing "close-to-client" care.
- CHPS engages the community by holding meetings and educational
talks, called durbars, regarding common health problems that need to
be addressed. Local leaders and volunteers are provided with the
means to construct and maintain a local village clinic, known as the
community health compound, where a nurse resides and provides
outpatient clinical services.
- The grassroots participatory CHPS method includes the formation of a
committee to organize communal health action and communication,
fostering local ownership of the health development process.
- In addition to preventive care and community education,
certified nurses specifically trained in community-based health
care provide home treatment for malaria, acute respiratory
infections, diarrhea, and other childhood diseases, as well as safe
motherhood, family planning, and comprehensive immunization services,
as part of CHPS.
- After the completion of their additional training and posting to
the community level, nurses are promoted to Community Health Officer
(CHO). Local health volunteers are recruited to assist the CHO in
her daily activities and to support the social mobilization aspects
of the program, particularly activities that involve the engagement
of both traditional male and female leaders.
- The CHOs travel from compound to compound on motorbikes provided
by the Ghana Health Service.
- The CHOs carry walkie-talkies and communicate with the doctor in
the one hospital in the region and with other CHOs.
Who has access to CHPS?
- Nearly all of the 110 districts in Ghana have initiated the
process of rolling out CHPS.
- The plan is for every Ghanaian to have access to the services of
a CHO by 2015.
- As part of the ExCHANGE Africa program, health teams from
Burkina Faso, Ethiopia, and Sierra Leone have visited Ghana to study CHPS
implementation for possible replication in their own countries.
What is the
- The Ghana Essential Medicines Initiative is a partnership
between the Government of Ghana, American pharmaceutical companies,
and impoverished rural communities. By using existing expertise,
products, and connections, this public–private endeavor will build on
the successes already achieved by CHPS in reducing mortality and
morbidity.
- GEMI's objective is to inform national policy recommendations
for providing underserved populations with access to reproductive
and child health care. It is intended to provide free essential
drugs—as well as maternal and child health education for mothers—in
a financially sustainable program.
- With the implementation of GEMI, CHPS nurses and community health
compounds in the experimental communities will have access to vital
drugs listed on the World Health Organization’s Essential Medicines
List.
- Researchers will assess the cost and effectiveness of rolling
out this program in 18 CHPS zones over three years to determine the
value of expanding this program throughout Ghana. Before-and-after
results in the zones will also be monitored for comparison.
- On 27 April 2007 the GEMI pilot project was launched in Nkwanta at a durbar, a traditional meeting convened by chiefs and elders to build
community consensus about matters of common interest, such as the
launching of activities requiring collective action. Durbars have a
formal role in traditional governance.
- At durbars, speechmaking and
open discussion build consensus, while pageantry, dancing, and drumming
provide a means of celebrating progress in development and
problem-solving. Social order, politics, development, and marketing are
typical themes of durbars, which end the process of community dialogue
and signal the beginning of community action.
- CHPS revolves around
durbars convened to launch activities, monitor progress, and gauge
community reaction to services.
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