PROJECT
Scaling Up the Community-based Health Planning and Services Initiative in Nkwanta District

Ghana’s Nkwanta District, spanning 90 miles from north to south, is the poorest and most remote in the Volta Region. Access to education is limited, and a significant portion of the population is illiterate. The population has no access to pipe-borne water and instead depends primarily on drinking water from boreholes and hand-dug wells. In the context of profound isolation, impoverishment, and a doctor-to-patient ratio of 1:115,000, the district is characterized by a high prevalence of communicable and water-borne disease, high infant and child mortality, poor maternal health, and high fertility. Both family planning and childhood immunization coverage in Nkwanta have been persistently low, and approximately 25 percent of all children under five years of age suffer from severe malnutrition.

In responding to these complex challenges, Nkwanta has pioneered the implementation of a national program based on the Navrongo Community Health and Family Planning Project. As the first district in Ghana to replicate the Navrongo project, Nkwanta has been a leader in establishing a formal program of scaling up what is known as the Community-based Health Planning and Services (CHPS) Initiative. Results of this effort are already impressive, confirming the validity of the operational model developed in Navrongo and establishing the feasibility and sustainability of implementing the initiative with existing district resources. With this evidence, the government of Ghana is now promoting CHPS as its primary strategy for realizing universal access to health care. As the health component of the National Poverty Reduction Strategy, CHPS aims to strengthen community ownership and promotion of health education and services. Launched in 1998, the program currently operates at varying levels in 106 of Ghana’s 110 districts.

With funding and technical support from the Population Council, the Ghana Health Service established the Nkwanta Health Development Centre (NHDC) in 2001 to focus research, training, and action on improving access to rural health services. The NHDC is organized into units that support the scaling-up of CHPS through public health outreach and community mobilization, research and evaluation, and dissemination and counterpart training. The NHDC works in close collaboration with District Health Administration-managed clinical services that are provided in hospital, sub-district, and community locations.

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Population Council researchers

Ayorinde A. Ajayi, James F. Phillips, Adams Kasanga, Robert A. Miller, Barry Ravitch, Maya N. Vaughan-Smith

Non-Council collaborators

Frank Nyonator (Director, Policy, Planning, Monitoring and Evaluation Division, Ghana Health Service)

J. Koku Awoonor-Williams (Director, Nkwanta Health Development Centre)

Donor

US Agency for International Development

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Related Projects

• Community-based Health Planning and Services Initiative

• ExCHANGE: Expanding Community Healthcare Accessibility Network

• Ghana Essential Medicines Initiative (GEMI)

• Navrongo Community Health and Family Planning Project

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