CHPS INNOVATORS DISTRICT REVIEW MEETING

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Conrad Harris
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1 CHPS INNOVATORS DISTRICT REVIEW MEETING BAWKU WEST DISTRICT 20 TH JANUARY 2005 BY: MS EVELYN ADDA

2 ORDER OF PRESENTATION Background Information The CHPs Initiative in Bawku West Impact of CHPs Bawku West CHPS Innovators Award Project Status of Project Implementation Constraints/Challenges Strategies to Overcome Challenges

3 BACKGROUND INFOMRATION

4 Total District population WIFA Expected Pregnancy 2021 Children No. of communities 114 CBS volunteers 228 TBAs 170

5 HEALTH FACILITIES District Hospital 1 Zebilla Hospital Health centres: 3 Binaba Anglican Health Centre 1 Zongoire Health Centre 1 Sapelliga Health Centre 1 Clinics 5 Public Clinics 2 (TILLI, WIDNABA) Private Clinics 3 (YELWOKO,FAITH, GOSSIP)

6 THE CHPS INITIATIVE IN BAWKU WEST In January 1999, there was a conference of Senior Health Managers in Bolgatanga. During the conference, staff from the Navrongo Health Research Centre (NHRC) made a presentation on the Community-based Health Planning and Service (CHPS) process.

7 Shortly after that, members of the Bawku West District Assembly, the District Health Management Team (DHMT) and sub-district management teams (SDHMT) were provided with a detailed briefing on the CHPS process. These two events generated a lot of discussion from which resulted a decision to adopt the CHPS process in the Bawku West District. A plan was drawn up for the implementation of the CHPS process.

8 Stakeholders agreed that the pilot zone for CHPS should be remote area with a relatively high population, an exisiting structure that could be renovated into a CHO compound, active community leaders and a network of community health workers who could be trained as volunteers. Tanga was a chosen for this purpose.

9 A community Health Nurse (CHN) was sent to the HNRC to be trained as a Community Health Officer (CHO). A community durbar was held in June 1999 to introduce the CHO, explain the project and clarify the roles of the different actors in the project (i.e, the CHO, the community, the DHMT, the District Assembly and the SDHMT). The community members showed keen interest and readiness to support the CHO and volunteers to the best of their ability.

10 The CHO was placed in the community after her residential accommodation was rehabilitated by the DHMT. Motorbikes and bicycles were provided by the Upper East Region Health Administration (UERHA). Gas lamps, a tape recorder, raincoat, furniture, stationery, drugs, etc etc, were provided by the DHMT from the Financial Encumbrance (FE) fund. Shortly afterwards, the CHO left for additional schooling and the programme lapsed until she was replaced in 2001.

11 In 2001, three additional CHN were recruited and trained at the NHRC. One CHN was to be deployed to Tanga to reactivate CHPS services, and the others were to be assigned to two new CHPS zones Googo and Teshie. All 15 steps in the CHPS implementation process were completed in the zones. This led to a districtwide CHPS coverage of 26 percent. Bawku West remains one of a few districts in Ghana where all steps have been completed in more than one zone. Two additional zones Tilli (Tarikom) and Zongoire-Natinga.

12 begin to be established in 2002, when CHOs were trained to operate them. These zones will have completed all CHPS steps and fully operational by the end of April thus, by the onset of this project, five zones will be functioning in the district.

13 District CHPs Coverage plan 15 zones Completed CHC 6 Completed CHPs zones 3 - Tanga - Teshie - Googo

14 Partially Completed Zones Zongoire Natinga at Zongoire subdistrict - Tarikom at Tiil/Widnaba subdistrict, though completed all steps yet without compounds for CHOs and again. - Both CHOs left for midwifery training in October February 2004 two CHOs left on transfer to Bolgatanga district. - New CHOs have been trained in December 2004 for replacement at these zones.

15 Salpiiga CHPs Zone started Training of CHO, - community information CHO introduction durbar organized - CHO compound completed since May 2004, - No motor for CHO. Was using Sapelliga motor for compound registration which was collected at gun point from her on May 2004.

16 IMPACT OF CHPS Reproductive/Child Health YEAR ANC Supervised (TBA) PNC Family Planning Acceptors G. Monitoring BCG Penta OPV3 Measles Yellow fever

17 Patients seen and treated by CHO Year Malaria Diarrhoea Referral 18 47

18 BAWKU WEST CHPS INNOVATORS AWARD PROJECT Project Title - Developing and Disseminating a strategy of CHPs expansion with communities leading communities

19 During the proposed project period, Bawku West will develop and implement its approach to building sustained community involvement in CHPs. The Communities leading communties strategy involves orienting new CHPs communities to programme through active participation in community durbars, during which the purpose and achievements of CHPs are explained by community leaders already immersed in the CHPs process.

20 The new communities become aware of the benefits of the programme and the individual community s responsibilities and launching and maintaining the programme.

21 Status of Project Implementation We received our fund late in November 2004 instead of April Micro planning meeting was held on the 23th November for 20 participant from DHMT, SDHMT Leaders, New Community Health Nurses from propose zones for project and old CHOs who shared their experiences.

22 TRAINING OF NEW CHOs Three community Health Nurses from Yarigu, Kansoogo and Timondi zones were trained on the CHPs concept on 13 th to 24 th December Field experience from 4 th 14 th January 2005.

23 Durbar at Tanga Communities leading communities durbar was held at Tanga on the 14 th January Chiefs, opinion leaders from Yarigu, Kansongo, Timondi were invited to attend. Community members from Tanga testified how the CHPs concept has helped them. i.e. - CHO help in times of emergencies, referrals, - No more travelling long distance to received health services - Immunization Reduction in measles and CSM cases. - Provision of Family Planning services.

24 YARIGU - Community information durbar held - CHO Trained - CHO introduction durbar schedule on 25 th January CHO compound completed by District Assembly (HIPEC Funds)

25 TIMONDI - CHO Trained - Community information/cho introduction durbar organized - CHO compound completed by District Assembly (HIPEC funds)

26 The district - level evaluation survey preparation of questionnaires for survey in February Three staff visited Juabeosu Bia to participate in the Training of their supervisors and interviewers and to also learn from them.

27 CONSTRAINTS/CHALLENGES - Inadequate motor bikes - Stealing of motor bikes - Clients who call on CHO for services complain of meeting her absences when she changes on cluster - Report formats for collecting information and reporting - Transfer of CHOs out of the district - Inadequate drug supply.

28 STRATEGIES TO OVERCOME CHALLENGES - Bawku West District Assembly sponsor 8 CHN at Navrongo Day CHNTs - Plans to trains all CHN in the district on CHPs - Plans to place 2 CHOs in a zone when their number increases. - Meeting was held with District Assembly/Chiefs and Opinion Leaders on the security of CHOs and motor bikes. i.e. motorbikes to be packed at chiefs palace after days work.

29 THANK YOU

ORIENTED PRIMARY HEALTH CARE(JB-COPHC)

JUABESO-BIA BIA DISTRICT HEALTH DIRECTORATE JUABESO-BIA BIA COMMUNITY-ORIENTED ORIENTED PRIMARY HEALTH CARE(JB-COPHC) COPHC) PRESENTED BY DR. JACK GALLEY DDHS/Med Supt NHRC 20th January, 2005 TALKING MENU