Abstract
ObjectivesGhana’s Community-based Health Planning and Service (CHPS) initiative to design a system for developing community based health care with full participation and support from community members. The CHPS initiative scales up strategies developed and tested by a project of the Navrongo Health Research Centre in northern Ghana. Launched in 1994 as a three village pilot to develop strategies for mobilizing volunteerism, resources, and cultural institutions for supporting community-based primary health care, the project was expanded to a district-wide four celled trial in 1996. When evidence demonstrated that Navrongo strategies reduced childhood mortality, a replication project was launched in Nkwanta district to test and develop methods for scale-up. Using evidence from Nkwanta, national scale-up was launched in 2000 as a program of exchanges for district teams to work with Navrongo and Nkwanta implementers on designing pilot implementation of CHPS elsewhere in Ghana. ResultsThis paper reviews operational determinants of this success and implications of the Upper East Region experience for efforts to develop evidence-based community health services elsewhere in Africa Although CHPS scale-up has been launched in all 170 districts, the Upper East Region remains its lead performing region, despite challenging economic, ecological, and social circumstances for health development.
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