Urban CHPS


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Urban CHPS

  1. 1. The Urban Health Intervention UGSPH Status Report on GEHIP for Ga East District Philip Adongo, PhD
  2. 2. Preparation for Urban CHPS CHPS Programme Milestones Questions that we addressed: • Are the rural milestones relevant to the urban environment? • How are urban CHPS service operations different from rural operations? The milestones are: 1) Community engaged planning (Community Health Committee, zoning, mapping, etc) 2) Community entry (liaison with traditional and opinion leaders). Developing participatory implementation. 3) Community Health Compound development (construction, renovation, or rental) 4) Essential equipment procurement. 5) Nurse orientation to community work and posting to Community Health Compounds 6) Volunteer identification, recruitment, training and deployment
  3. 3. Community Entry Strategy assessment for Urban CHPS Formative Research: 1. Focus Group Discussions (FGDs) 2. In-depth interviews with stakeholders and opinion leaders To seek views on – Health seeking behavior for child and maternal health – Health decision making at local level – Community conceptualization of Urban CHPS – Potential models of CHPS
  4. 4. Milestone #1: CHPS Planning Urban versus Rural Model • Urban CHPS – Large populations (20,000-40,000) – Zoning is required and it is important exercise – Difficult to mobilize community to contribute – Nurses may need to concentrate on promotion activities • Rural CHPS – Small population (3000- 5000) – Zoning is easier – Easy to mobilize community to contribute – Curative aspects very important
  5. 5. Milestone #1: Zoning of Ga East into CHPS areas All four Ga East sub-districts were “zoned” for CHPS including…. –Dome – Danfar – Madina – Abokobi
  6. 6. Milestone #1: Selection of start up CHPS zones in Ga East Zones Area covered Estimated total population Estimated no. of chn 0-59m Estimated no. of household One Rabit, Auntie Mary, Ohenho etc. 23,282 4,191 1,219 Two Dome market, Dome Park, Grushie Town etc. 41,169 7412 966 Three CSC, GYM, Atomic, Atomic Ayigbe Town etc. 18,894 3400 729
  7. 7. Milestone #2: Urban Community Entry Sensitization meetings with the SPH, Region and Districts • Discussions with regional health administration • The forum to has been created where GEHIP has been presented to the – School of Public, University of Ghana – All MHMTS, DHMTs – GA East – The Assemblies-Discussions with planning officers of Ga East (intervention area) and Ga West (comparison area)
  8. 8. Milestone #3 Procurement of work space or clinic • Municipal Assembly providing storage space for equipment, but construction of a “Community Health Compound” may present a challenge • Partnership with private health providers to provide space • Municipal Assembly to providing space for the GEHIP field office in Ga East.
  9. 9. Milestone #4: Essential equipment Health workers needs small Vehicles to conduct their activity
  10. 10. Milestone #5 The Training of CHOs • TOT training completed in Mid September: • Training of CHOs started in October, 2010 – GEHIP is supporting the training of CHOs
  11. 11. Milestone #5: CHO deployment The way forward for urban CHOs… • A non-residential service • Collaborate with private health institutions • We will learn from experience on in-service training for urban CHO. – Innovation in communication (ways to replace durbars) – May have to make modifications during our “Phase 2” implementation process
  12. 12. Milestone #6 Volunteers – Volunteer identification, recruitment, training and deployment
  13. 13. Milestone Rural CHPS Urban CHPS 1) Community - based Planning Situation analysis, initial outreach to chiefs, “zoning” of catchment areas. Block and neighborhood identification, clarification of geographic responsibility 2) Community entry • Building understanding with chiefs, elders, & opinion leaders. • Developing Community Health • Organizing CHC action • Developing durbars for health communication • Focus on identifying social networks (corresponding to ethnicity of settlers). • Outreach to formal authorities & politicians 3) Essential equipment Motorbikes & bicycles + clinical equipment for IMCI, EPI, FP/RH Low cost 3 or 4 wheel vehicles + clinical equipment for IMCI, EPI, FP/RH 4) Facility development Community volunteer construction of CHC or renovation of existing facility Arranging donation of secure space or renovation of donated space. No CHC 5) Nurse community engagement training & posting Training in community entry, liaison, and sustaining community participation Training in health education in the urban context 6) Volunteer identification, training, & deployment Community organizational focused Basic medicinal products distribution (Major role in health promotion: bednet promotion, condoms, ORS, etc.) Service focused volunteers with no curative services. (Limited role)