Accra, Ghana – A mother waits her turn at the busy Community Based Health and Planning Services (CHPS) center in the village of Assakae, hoping she can get some help for her sick baby. Community Health Officer Mariama Bukari examines the feverish child and diagnoses simple malaria and a chest infection.
Bukari, a nurse, is among more than 150 frontline health workers, managers and community volunteers who have received education and management training through an innovative, Jhpiego-led, public-private initiative to strengthen primary health care services in western Ghana—with a focus on malaria prevention and treatment for women and families. The pioneering STAR (Supportive Technical Assistance for Revitalizing) CHPS project is working toward building the capacity of service providers in 61 health facilities, improving health systems and engaging communities in health outcomes across six coastal districts.
The skills training Bukari received through the STAR CHPS project, she says, “has really helped me to understand better how to assess and diagnose a child with malaria.” The skills and guidelines are practical and easy to incorporate in her work routine, Bukari explains, and now she has more confidence in advising clients on the detection and treatment of malaria.
As envisioned by the Ghana Health Service, a CHPS center is a health care model directed and supported by the community. At least one community health officer lives at each CHPS center, situated within a CHPS compound, and provides basic, primary care at the facility and at schools and homes in three to five surrounding communities.
“Before [the training], I was staying in the (health) compound more,” says Bukari. “Now I do more home visits and spend more time to counsel mothers.” She adds that she is able to advise on a broader range of issues and carry out more skilled work, including immunizing children.
Jhpiego and the Ghana Health Service entered into this unique collaboration in 2011 to strengthen malaria services in the western coastal region. Malaria is the primary cause of death in health institutions in Ghana’s western region and accounts for 39 percent of all outpatient visits, 48 percent of hospital admissions for children under five and 18 percent of deaths in facilities.
The five-year partnership was made possible through the generous support of the Jubilee Joint Venture—a collaboration of Tullow Ghana Limited, Kosmos Ghana HC, Anadarko WCTP Company, Ghana National Petroleum Corporation, Sabre Oil and Gas and the EO Group.
The impact of the first year of STAR CHPS’ efforts in strengthening community-level health services can be seen in the CHPS center at the compound in Assakae, which serves a population of more than 5,000 people. Posters with messages promoting family planning, immunization and the prevention of diseases such as cholera and malaria adorn otherwise bare walls in the simple structure. A thin curtain draped between small consulting rooms offers some privacy for clients at the Assakae facility.
In meeting with a client, Nurse Bukari discusses the use of insecticide-treated bed nets to protect against malaria infection. The woman, a mother, mentions several other malaria prevention techniques she learned about while attending a child welfare clinic.
When Bukari asks what she will do to help prevent malaria in her own household, her client says she will use insecticide spray and make sure stagnant water—a breeding ground for mosquitos—is drained from around her home. Bukari also encourages her to share her knowledge and help to protect other family members.
As the STAR CHPS project enters its second phase, team members will focus on data collection and analysis with the help of GlaxoSmithKline’s PULSE program. The PULSE program offers partner organizations GSK’s skills and expertise to expedite sustainable change in local communities, with the primary aim of tackling health issues and diseases.
GSK professionals will work with Jhpiego’s Monitoring and Evaluation Advisor in Ghana, Richard Okyere Boadu, to collect and analyze data from the Jhpiego-supported community health facilities.
“The new, expanded partnership will ensure that efforts by [Bukari] and other CHPS nurses to improve malaria service delivery will be well documented,” explains Dr. Bill Brieger, Jhpiego’s malaria expert, who is working on the project.
The overall objective of these activities is to understand current health outcomes, local capacity to support rural communities and challenges to public health access and service provision within this area. The longer-term goal is to improve data quality to provide a meaningful measure of service improvement and ultimately demonstrate a decrease in the disease burden within the communities served.