Strengthening Community Health Systems in Ghana Introducing the - PowerPoint PPT Presentation

Strengthening Community Health Systems in Ghana Introducing the GhCHW Concept September 4, 2014 Bolga, Ghana Chief Nat Nsarko Local Consultant

Evidence to Policy • Earlier achievements/challenges guided subsequent steps and efforts to address access to quality health care for all in Ghana Pilot Factorial CHPS – Home Experiments Studies -> Grown PHC & Studies -> Compare Strategy Knowledge Options

The Health Worker / Community interphase Within the CHPS Zone Composite Complex 2. CHMCs Ref 14 3. Community Health 1. Mobilized Volunteers Communities 1. Mobilized Communities in a CHPS ¡Zone ¡with ¡… 4. CHPS Compound 2. Active Community Health With CHO Management ¡Committees ¡and ¡… 3. Motivated Community Health Volunteers ¡… 4. ¡… ¡and ¡a ¡CHPS ¡Compound ¡for ¡CHO ¡ residence and treatment of minor ailments

THE CHALLENGE IS SOMETIMES WE ADVOCATE FOR CHPS COMPOUNDS WITHOUT THE ACTIVE INVOLVEMENT OF THE COMMUNITY. SO THIS IS WHAT WE ¡GET……

The Health Worker / Community interphase Within the CHPS Zone Composite Complex Ref 14 1. No Mobilized Communities 4. CHPS Compound in ¡a ¡CHPS ¡Zone ¡with ¡… With lonely CHO 2. No Community Health Management ¡Committees ¡and ¡… 3 . ¡Unreliable ¡Health ¡Volunteers ¡… 4. ¡… ¡But ¡procure ¡CHPS ¡Compound ¡for ¡CHO ¡ residence and treatment of minor ailments

GhCHW CONCEPT! A proposed reward system to appreciate long serving volunteers and encourage others to do same. • The GHCHW strategy is to animate the community health system:-  Mobilize the community to actively own the concept  Establish conscientized CHMCs  Recruit, train and equip long serving trainable volunteers as CHWS  Re-orient CHOs to supervise the CHWs  Re-orient and empower SDHTs to provide supportive supervision  Empower and support DHMTs to consolidate all community based health interventions to ensure efficiency  Empower and Reposition RHMTs to monitor and supervise a robust community health system

Aim of the Consolidation & GHCHW • To maximize cost effectiveness and the potentials of CHWs • Increase health coverage and contribute to achieving MDGs 4, 5 and 6 • To ensure effective involvement of the community in health planning and health service delivery

THE CHW • A CHW is a long serving trainable community health volunteers or a committed unemployed school leaver trained, equipped and deployed to bring basic healthcare services to the doorsteps of rural populations and hard-to-reach areas; • This cadre, with terminal performance -based renewable appointment of three years,will work directly under the CHO and with active CHMCs. • The CHW – must come from the community – Will be present in each community – Will work closely with the CHMCs and other Volunteers

…CHW ¡at ¡a ¡glance

THE CHWS CONCEPT AND STRENGTHENING CHPS ….  recruitment, hiring, training, firing, and management of leave of absence and attrition will be handled by local NGOs ( vendors), in close relationship with the district, sub-district health and community health management teams.  The guidelines and norms for recruitment will be set by the Ministry of Health and Ghana Health Service  Specific CHW number needs will be determined at the regional level.  The Regional Health Team will also be charged with quality assurance of vendor engagement processes in the region.  Sensitization of communities and selection of potential CHWs will be conducted at the district and sub-district level starting from a nomination and endorsement by Community Health Management Committees.  Long serving community volunteers and school leavers living in the respective communities they apply from are earmarked to be considered for a three year terminal-renewable engagement.  These CHWs will extend essential health services to the household level, functioning as a core component of the community-based health services team within the infrastructure and human resources already in place.  Furthermore, the CHW will be used as a platform to strategically consolidate all vertical community health interventions under CHPS

Ref 7 GHANA COMMUNITY HEALTH WORKER CONCEPT INTERPHSAING WITH CHPS

CHWS PROMPTING COLLECTIVE ACTION- From a faint signal at the COMMUNITY-National level DHMT RHMT REGION INFO Merge & SUB-DISTRICT Analyze LEVEL DISTRICT LEVEL Collective understanding CHOs – peer information Event Characterization sharing and collaboration Response initiation Immediate analysis & Real time feedback and Decision making Stronger data support capacity collection with CHWS CHPS-COM CHW / CHMC interphase Proactive education & at community level preparation ROBUST COMMUNITY HEALTH SYSTEM with CHWS

Roll-out Timeline • In total, the national CHW concept will require approximately 25,261 CHWs to cover 100% of the rural population by 2019. • The concept aims to roll-out this cadre gradually, aiming for 20% of the CHWs to be deployed in 2014, 40% by 2015, 60% by 2016. • In 2014, the first 20% of the CHWs (4,735) will be rolled out to approximately 4 CHPS zones per region (40 zones). • In 2015, an additional 5,037 CHWs will be added to approximately 3-4 CHP zones per region. • By 2016, we aim to have 15,157 total CHWs covering 60% of the rural population.

Key Stakeholders at the February Meeting

Consultative Stakeholder Activities • Team Ghana worked with the 1mCHW campaign- EICU New York to develop a detailed road map and drew an action plan, • Team Ghana met and briefed the following stakeholders: – Divisional Directors at the MoH – Divisional Directors at the GHS HQ – Program Managers for GFTAM, UNICEF, WB, WHO – Managers of iCCM to align and integrate iCCM with GhCHW campaign – GHS Regional Directors and Senior Managers

Post February Stakeholder Activities • The Minister of Health and the Director General of the Ghana Health Service are in agreement and have caused the following to be done: – iCCM and TAG to develop a joint TOR to align/streamline all community health interventions in the country – All health interventions at the community level hence forth to be integrated and delivered through a unitary Community Health System under the CHPS – GhCHW campaign now incorporated into the following documents: National HR Policy, POW 2014, MTHSP etc

• The GhCHW is simply a system designed to strengthen our community health system and support the implementation of CHPS. • To consolidate all Community-based Health Interventions • No verticalization , ¡No ¡‘ silosification ’, ¡Rather ¡ Integration from the Start

Open Forum • Comments, Contributions and Discussions