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Evaluating the impact of the community-based health planning and services initiative on uptake of skilled birth care in Ghana

Evaluating the impact of the community-based health planning and services initiative on uptake of skilled birth care in Ghana
Evaluating the impact of the community-based health planning and services initiative on uptake of skilled birth care in Ghana
Background: the Community-based Health Planning and Services (CHPS) initiative is a major government policy to improve maternal and child health and accelerate progress in the reduction of maternal mortality in Ghana. However, strategic intelligence on the impact of the initiative is lacking, given the persistent ?problems of patchy geographical access to care for rural women. This study investigates the impact of proximity to CHPS on facilitating uptake of skilled ?birth care in rural areas.

Methods and findings: data from the ?2003 and 2008 Demographic and Health Survey, ? on 4,349 births from 463 rural communities were linked to georeferenced data on health facilities, CHPS and topographic data on national road-networks. Distance to nearest health facility and CHPS was computed using the closest facility functionality in ArcGIS 10.1. Multilevel logistic regression was used to examine the effect of proximity to health facilities and CHPS on use of skilled care at birth, adjusting for relevant predictors and clustering within ?communities.? The results show that a substantial proportion of births continue to occur in communities more than 8 km from both ?health facilities and CHPS. Increases in uptake of skilled birth care are more pronounced where both health ?facilities and CHPS compounds are within 8 km, but not in communities within 8 km of CHPS but lack access to health facilities. Where both health facilities and CHPS are within 8 km, the odds of skilled ?birth care is 16% higher than ?where there is only a health facility within 8km.

Conclusion: where CHPS compounds are set up near health facilities, there is improved access to care, demonstrating the facilitatory role of CHPS in stimulating access to better care at birth, in areas where health facilities are accessible.
1932-6203
1-18
Amoako Johnson, F.
e348fd15-9fe2-472f-a701-2980b8cec4d5
Frempong-Ainguah, F
5a44b2be-4ee7-4f07-b9de-955a0c9bddfc
Matthews, Z.
ebaee878-8cb8-415f-8aa1-3af2c3856f55
Harfoot, A.
88b7248e-c2b4-4980-aa62-834e780c3016
Nyarko, P.
63ce301f-82eb-4ce2-aac7-8849bc864448
Baschieri, A..
8512fd8e-0c0a-4741-acb6-5d05bee0b108
Gething, P.W.
82a5722c-21cc-462c-bdaf-7af4d50a6219
Falkingham, J.
8df36615-1547-4a6d-ad55-aa9496e85519
Atkinson, P.M.
96e96579-56fe-424d-a21c-17b6eed13b0b
Amoako Johnson, F.
e348fd15-9fe2-472f-a701-2980b8cec4d5
Frempong-Ainguah, F
5a44b2be-4ee7-4f07-b9de-955a0c9bddfc
Matthews, Z.
ebaee878-8cb8-415f-8aa1-3af2c3856f55
Harfoot, A.
88b7248e-c2b4-4980-aa62-834e780c3016
Nyarko, P.
63ce301f-82eb-4ce2-aac7-8849bc864448
Baschieri, A..
8512fd8e-0c0a-4741-acb6-5d05bee0b108
Gething, P.W.
82a5722c-21cc-462c-bdaf-7af4d50a6219
Falkingham, J.
8df36615-1547-4a6d-ad55-aa9496e85519
Atkinson, P.M.
96e96579-56fe-424d-a21c-17b6eed13b0b

Amoako Johnson, F., Frempong-Ainguah, F, Matthews, Z., Harfoot, A., Nyarko, P., Baschieri, A.., Gething, P.W., Falkingham, J. and Atkinson, P.M. (2015) Evaluating the impact of the community-based health planning and services initiative on uptake of skilled birth care in Ghana. PLoS ONE, 10 (3), 1-18. (doi:10.1371/journal.pone.0120556).

Record type: Article

Abstract

Background: the Community-based Health Planning and Services (CHPS) initiative is a major government policy to improve maternal and child health and accelerate progress in the reduction of maternal mortality in Ghana. However, strategic intelligence on the impact of the initiative is lacking, given the persistent ?problems of patchy geographical access to care for rural women. This study investigates the impact of proximity to CHPS on facilitating uptake of skilled ?birth care in rural areas.

Methods and findings: data from the ?2003 and 2008 Demographic and Health Survey, ? on 4,349 births from 463 rural communities were linked to georeferenced data on health facilities, CHPS and topographic data on national road-networks. Distance to nearest health facility and CHPS was computed using the closest facility functionality in ArcGIS 10.1. Multilevel logistic regression was used to examine the effect of proximity to health facilities and CHPS on use of skilled care at birth, adjusting for relevant predictors and clustering within ?communities.? The results show that a substantial proportion of births continue to occur in communities more than 8 km from both ?health facilities and CHPS. Increases in uptake of skilled birth care are more pronounced where both health ?facilities and CHPS compounds are within 8 km, but not in communities within 8 km of CHPS but lack access to health facilities. Where both health facilities and CHPS are within 8 km, the odds of skilled ?birth care is 16% higher than ?where there is only a health facility within 8km.

Conclusion: where CHPS compounds are set up near health facilities, there is improved access to care, demonstrating the facilitatory role of CHPS in stimulating access to better care at birth, in areas where health facilities are accessible.

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More information

e-pub ahead of print date: 19 March 2015
Published date: 19 March 2015
Organisations: Social Statistics & Demography

Identifiers

Local EPrints ID: 375304
URI: https://eprints.soton.ac.uk/id/eprint/375304
ISSN: 1932-6203
PURE UUID: c4294751-1d95-4d76-b707-bdd48950e92d
ORCID for J. Falkingham: ORCID iD orcid.org/0000-0002-7135-5875
ORCID for P.M. Atkinson: ORCID iD orcid.org/0000-0002-5489-6880

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Date deposited: 23 Mar 2015 10:20
Last modified: 18 May 2019 00:38

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