Community Health Workers In The Primary Health Care (Phc) Programme In Rural Ghana. A Study At Nkoranza

ABSTRACT The search for a m or^ equitable health care delivery system to cover the majority o f the people, more especially the Vulnerable groups (women and children) has led many developing countries including Ghana to adopt the Primary Health Care (PHC) programme. Primary Health Care as envisaged, is to make health care available, accessible and affordable to the underprivileged an also to enable the people and the system is to serve to participate in its planning and implementation. Community Health Workers (CHWs) have been identified as the corner-stone o f such a programme. Ghana has thus found it appropriate to use such community-trained health care providers. Using a sample of 32 CHWS, some leaders o f the communities o f the 32 CHWs and some health personnel in the h Nkoranza area in the Brong-Ahafo Region o f Ghana, an attempt has been made to examine factors affecting the performance o f CHWs in the implementation o f the CHW programme in rural Ghana (chapter 1). The thesis as demonstrated in cCapter Two, has shown that the programme took o ff w ith the participation o f the communities concerned, the government o f Ghana (through the Ministry o f Health) and the various non-governmental organisations UNICEF, WHO, World Vision International and Catholic Secretariat. The research has however revealed that the institutionalization of the programme has not recorded much success (as shown in chapters 4,5 and 6). The state of affairs in the organization of community clinics is attributed to among other things, the lack of community education on the programme and improper planning and development of the necessary support systems. These factors which are interrelated and interconnected have damped the enthusiasm of the community members and most o f the trained CHWs, The end result is that, about 80% of the CHWs have abandoned the programme.While some measures such as the organization of fund raising activities and the training o f community leaders in management skills could be adopted locally to deal with the problems o f remuneration, supervision and drug supplies, more comprehensive measures will be needed at the national