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Community Health and Planning Services (CHPS) in Ghana

CHPS in Ghana
Ghana’s capital city, Accra, is pretty urbanized and health services are readily available. However, the surrounding areas are rural and those services are not accessible. CHPS (Community Health and Planning Services) is a national strategy in Ghana geared towards the delivery of crucial community-based health services to these populations, involving service delivery and health planning with communities. CHPS in Ghana is a step forward to achieving the goal of providing universal primary health care.

How Did CHPS in Ghana Start?

CHPS started in 1994 by deploying nurses to their assigned “CHPS zones,” which are geographical areas of rural Ghana, to provide door-to-door services. Due to its early successes, the project started to grow and scale. The Ghana health services took advantage of the incremental rollout to research which parts of the CHPS model proved most effective; community engagement and participation were the most essential for ensuring primary health care and where these two components did not exist, CHPS did not perform as well.

“The primary focus of CHPS is to bring health services close to communities. CHPS’ aim is to move health services to community locations, develop sustainable volunteerism and community health action, empower women and vulnerable groups and improve health provider, household and community interaction,” according to a research article published in PLOS ONE. On a larger scale, CHPS strives toward the ultimate goal of Universal Health Coverage, providing basic health services to every community.

Challenges

Undoubtedly, throughout the years, CHPS went through challenges and failures. Since CHPS started in research, people have continually monitored the progress and challenges the program runs into. These include transportation, road conditions, poor clinical attendance, cultural beliefs and more.

To go into it, one tool CHPS uses is its compounds, which are buildings that act as service delivery points. Transportation to these depends on various factors, such as access to a motorbike, weather conditions and route options. Many mothers do not have such access and the ones who do often experience challenges with rain or lack of roads in remote settlements.

Cultural beliefs and practices also act as a major challenge. Beliefs around pregnancy and childbirth keep many women from seeking care from CHPS. According to an article published in BMC Health Services Research, one mother reported, “I made two visits to the CHPS compound but when it was time for delivery, I delivered at home. Oh! I used medicines from the health center alongside herbs from my mother-in-law.” One reason for such avoidance is to ensure women do not receive tabooed food. People tend to prefer traditional practitioners for such care.

The CHPS program faces many more challenges and as it continues to scale they aim to solve each of these.

According to the World Health Organization (WHO), “UHC [Universal Health Coverage] means that all individuals and communities receive the health services they need without suffering financial hardship. It includes the full spectrum of essential, quality health services, from health promotion to prevention, treatment, rehabilitation and palliative care across the life course.” The first step to achieving such a goal is providing primary care to all. This is also the first step of CHPS.

CHPS aims to scale its program across Ghana, thereby closing its health coverage gap. Its efforts to achieve Universal Health Coverage face challenges, but are largely successful and continue to grow.

– Rachael So
Photo: Flickr

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5 Facts About Healthcare In Spain

Healthcare in SpainSpain is a beautiful country with exquisite landscapes and a rich culture. This country is known for its delicious, elaborate dishes such as paella. Healthcare is usually not the first thing that comes to mind when typically thinking about Spain but it definitely should be. Spain is world-renowned for its amazing healthcare coverage and for the way the Spanish citizens are usually able to stay healthy throughout their life.

5 Facts About Healthcare in Spain

  1. Spain is the healthiest country in the world. In 2019, the Bloomberg Healthiest Country Index evaluated and ranked over 150 nations based on their life expectancy, environmental factors (ex: access to fresh, clean water) and health risks (ex: obesity). This study gave Spain a grade of 92.75 based on the aforementioned criteria and ranked the Iberian country first out of the listed countries.
  2.  Spain has a free, public healthcare system. Spain’s healthcare system is financed by taxes which means that residents have access to free or very low-cost healthcare, provided they pay for social security. According to HealthManagement.org, 99.7% of the Spanish population takes advantage of the public healthcare system, and only 3% of the population decides to go with the private sector. This is indicative of the Spanish healthcare system’s high quality, as the vast majority of the country decides to be covered by it.
  3. Cancer and circulatory system diseases are among the most common causes of death in Spain. The data found at statistica.com attests that “diseases related to the circulatory system and neoplasms (cancer) ranked as the main causes of death, both with over 100 thousand cases in 2017.” In addition to this, Spaniards also suffer from chronic respiratory diseases such as asthma and COPD (chronic obstructive pulmonary disease).
  4. Mental health is taken very seriously in Spain. Taking care of one’s mental health has become a major topic recently, but Spain has always valued the mental health of its citizens. Spain started to realize the importance of mental health in 2006 and has since worked to assist Spaniards with that issue. Spain offers amenities and services including free prescription drugs and has dedicated a portion of its health budget to mental health. For example, according to the WHO, Spain dedicated 5% of its total healthcare budget (6 million euros) to mental health expenditures in the year 2011.
  5. Child healthcare in Spain is taken equally seriously. Along with Spain’s amazing healthcare coverage for adults, this country also offers equally superb healthcare opportunities to children. According to expatica.com, “the healthcare offered to children in Spain includes prenatal and postnatal care, pediatric care up until age 15 (and standard care from a general practitioner afterwards), free vaccinations until age 14, dental care until age 15, access to 23 different types of speciality practitioners, prolonged benefits for children with physical or mental disabilities and free emergency services”.  Evidently, children are taken care of very well in Spain and have access to many amenities and medical opportunities throughout their entire life.

Spain is a country that is home to beautiful landscapes, exquisite cuisine, wonderful people and an amazing healthcare system! It truly earns its spot as one of the best healthcare systems in the world. Spain is a great place to live if someone is looking for a free healthcare system that fully covers all aspects of the medical field.

– Kate Estevez
Photo: Flickr

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Organizations Improving Healthcare in Somalia

Healthcare in Somalia
Many challenges come with being one of the poorest countries in the world. In Somalia, a country located on the Horn of Africa, garnering a quality healthcare system for everyone is a major struggle. With a population of over 12 million, the people of Somalia have one of the lowest life expectancies in the world. Grappling through years of civil war and natural disasters, it has been difficult to overcome widespread disease, malnutrition and an overall lack of healthcare resources. Thankfully, organizations have noticed the absence of a healthcare system and many efforts are going towards improving healthcare in Somalia.

United Nations Development Program

According to the United Nations Development Program (UNDP), 58% of Somalis are without healthcare. Recognizing this issue, the UNDP set the goal to have complete universal healthcare in Somalia by 2030. Since the COVID-19 global pandemic, the UNDP has realized how destructive a pandemic can be in all facets of life in a developing nation. In addition to the goals for universal healthcare, it aims to set up structures to strengthen resilience to any future disasters. The UNDP created a blueprint proposing a multi-step initiative to improve healthcare and ensure that it does not leave anyone behind. The program would provide basic healthcare consisting of two tiers of costs and services to choose from. However, the core service will involve the implementation of telemedicine. This will be an immense advancement, considering that most Somalis have to walk miles to get to their nearest healthcare facility.

The UNDP has also been addressing HIV/AIDS issues in the country since 2004. It has implemented investment programs totaling $5.4 million between 2005 and 2009. Its work includes creating knowledge and awareness programs, increasing testing for Somalis and lobbying for HIV/AIDS legislation. The impact of the program’s efforts is notable. As of 2019, there were approximately 11,000 children and adults living with HIV in Somalia in comparison to the approximate 22,810 in 2008.

For immediate attention to the fight against COVID-19, the UNDP is supporting an emergency call center that the Somali government runs. The UNDP contributed by offering transport to volunteers, office equipment and staff. Anyone needing advice on COVID-19 or feeling ill can simply call the center and find assistance from volunteers comprising of medical students, doctors and other health professionals. Additionally, if a patient has severe symptoms or is sick with underlying health conditions, an ambulance can transport them to their local hospital. The center helps roughly 8,000 people a day.

The World Health Organization (WHO)

The World Health Organization (WHO) pledged to assist health authorities in Somalia in increasing the number of healthcare workers and stabilizing primary healthcare services in the country. In September 2019, the organization assisted in launching the plans for universal health coverage (UHC) for the time period of 2019-2023. The WHO understands the importance of improving health systems in the country and hopes to develop powerful health systems to prevent future epidemics. Thus, the UHC initiative aims to give all Somali people improved protection from healthcare emergencies.

The WHO has declared maternal health one of its priorities and advocates for maternal health as a human right. About one in 20 women die during labor due to an overall lack of health resources, which gives Somalia one of the highest maternal mortality rates in the world. The WHO is bolstering investments in the issue, mobilizing health resources and strengthing healthcare systems to decrease maternal mortality rates.

UNICEF

UNICEF is also fighting to improve healthcare in Somalia. One focus has been to develop safe motherhood and child healthcare programs. The organization worked with Somali health authorities to provide the Essential Package of Health Services (EPHS). Predictions determine that these packages will aid 4.2 million Somalis. The EPHS structure is an extensive range of free health services that will help establish a medical standard for the country. The goal is to provide essential medicines, supplies and equipment as well as train and expand human resources. The program includes aid for neonatal and reproductive health, child immunizations and treatment of widespread diseases like HIV.

Somalia has one of the highest child mortality rates in the world. Due to the lack of sanitation, medical resources and vaccinations, one in seven children will not make it past age 5. Since 1990, deaths among children under 5 have reduced by half. Deaths have decreased thanks to the vaccine initiative that UNICEF and WHO launched in 2013. The program consisted of 1.3 million doses of an innovative “five-in-one” vaccine for the prevention of the top fatal childhood illnesses along with a parental awareness campaign.

The Integrated Community Case Management (ICCM) that UNICEF and WHO organized has also improved healthcare systems. This community-based approach brings experienced and supervised health professionals to the area to help decrease the common childhood illnesses contributing to the high child mortality rate. The system plans to continue developing a solid staff of health leaders and administrators to manage future health disasters.

Moving Forward

Some organizations are making great progress in improving healthcare in Somalia. Since the efforts to create an overall healthcare infrastructure, the country has seen improvements in how it controls widespread diseases. In 2004, the average life expectancy was 50, but as of 2018, it was 55. Life expectancy should increase as chronic malnutrition, infant mortality rates and the spread of preventable diseases decrease with improved healthcare systems. Thanks to these resolutions, overall health and wellbeing in Somalia should be on the horizon.

– Tara Hudson
Photo: Pixabay

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6 Facts About NTDs in Comoros

NTDs in ComorosNeglected tropical diseases are afflictions that affect the world’s poor. They do not often receive attention from first-world nations. Developed nations typically ignore these diseases, which is why they are classified as neglected. The World Health Organization’s Expanded Special Project on the Elimination of Neglected Tropical Diseases has brought together 14 nations to bring an end to these afflictions once and for all. One of the countries involved in this initiative is Comoros. Many of the 14 nations have requested additional human resources, robust systems and technical capacity in order to increase NTD prevention. Attention, in particular, would go towards the ways in which they can research and combat multiple diseases at the same time as there are many different NTDs in Africa. Keep reading for more on these six facts about NTDs in Comoros.

6 Facts About NTDs in Comoros

  1. The Rift Valley fever virus (RVFV) has been infecting livestock in Comoros since 2009. A study found that livestock had the virus despite showing no physical signs. Mosquitoes that transfer infection from cattle to humans are the main spreaders of this illness. Comoros and other several other African countries also experienced outbreaks in 2007. One victim was a young Comorian boy with encephalitis, a kind of abnormal swelling of the brain caused by the virus.
  2. With the advancement of pharmaceutical technology, the NTD crisis can be solved. Pharmaceutical companies have donated more than $4 billion a year in medicines to help nations recover from NTDs. In the last 10 years, the world saw several hundred million people previously affected by these diseases liberated. More research and advanced medical technology will undoubtedly solve this problem.
  3. Comoros’ population have also been afflicted with an NTD known as elephantiasis, a mosquito-transmitted disease that preys upon the blood circulation system. This disease causes fever and, if left untreated, severe swelling of the lower limbs. Luckily, in the year 2017, treatment of this NTD was at 86 percent coverage from Universal Health Coverage (UHC), meaning the majority of people of Comoros had access to the services they need to treat this disease.
  4. Intestinal worms, another NTD affecting Comoros, are parasitic disease-causing worms that multiply in the host’s intestines. The worms feed on the nutrients provided by whatever the host eats, thereby causing malnutrition in hosts. This disease spreads through human waste and unsanitary living conditions. UHC covered 73 percent of treatment for this disease in 2017.
  5. The proportion of children in Comoros with leprosy in 2011 was around 38 percent. Leprosy is considered an NTD. It causes severe disfiguring of the skin and has been ravaging humankind since ancient times.
  6. Since 2012, 600 million tablets of albendazole or mebendazole drugs to treat NTDs have been available every year to treat young children. Programs in countries where soil-transmitted helminthiasis, or parasitic worms, are endemic have already requested an additional 150 million tablets. These facts are signs of a positive increase in the health coverage of NTDs.

In recent years, NTDs in Comoros have harrowed the population with no end in sight. Since 2017, however, the World Health Organization and pharmaceutical companies have come together to end NTDs in Comoros and other countries once and for all.

– William Mendez
Photo: Flickr

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The $24 Billion Pledge for Universal Health Coverage in Africa

Health in AfricaOn August 26, the World Bank and the Global Fund to Fight AIDs, TB and Malaria (Global Fund) committed to investing $24 billion to accelerate universal health coverage in Africa. The funding aims to achieve universal health coverage in Africa (UHC) by 2030 as part of the Sustainable Development Goals (SDGs).

The announcement of funding was made at the sixth annual Tokyo International Conference for African Development (TICAD-VI). The investment will fund UHC in Africa: A Framework for Action, a plan launched by the World Bank, World Health Organization (WHO), the government of Japan, Japan International Cooperation Agency, Global Fund and the African Development Bank. The framework targets specific areas that will greatly contribute to the achievement of UHC in Africa including financing, service delivery, targeting vulnerable populations, mobilizing critical sectors and political leadership.

Over the next five years, the World Bank plans to contribute $15 billion under the Global Financing Facility, Power of Nutrition, early childhood development, pandemic preparedness, targeting the poor, crisis preparedness and response and leveraging the private sector. The Global Fund has committed an additional $9 billion in funding between 2017 and 2019 to treat and prevent HIV, malaria and TB.

Emphasizing the importance of good health for economic productivity, the President of the World Bank Group, Jim Yong Kim, stated, “African countries can become more competitive in the global economy by making several strategic investments, including investing more in their people, their most prized resource.”

Today, millions of impoverished people cannot afford proper health care and are further entrenched in poverty as a result. The provision of universal health care in Africa would create boundless opportunities for individuals to access health care and work towards prosperity.

Not only does ill-health have devastating effects on an individual basis, but it also drastically affects the economy. Poor health impedes impoverished populations from working and prevents children from attending school. Well-designed universal health care can help alleviate the burdens of poor health, including creating employment opportunities in the healthcare industry.

In 2012, the U.N. called on the international community to substantially increase its funding for health care in developing nations. Marking December 12 as ‘Universal Health Coverage Day’ and turning it into an international movement, the global community increasingly emphasizes the positive outcomes of UHC and the importance of new, innovative ways to reach the most impoverished populations.

Recognizing the importance of achieving UHC, African Heads of State, in conjunction with the World Bank and Global Fund, have vowed a commitment to the push for UHC across the continent. Through international funding, a strategic framework and both regional and global support, UHC in Africa could be an obtainable MDG by 2030.

– Anna O’Toole

Photo: Flickr

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5 Possible Changes to Bring a New Era of Reproductive Health

reproductive_health

Only governments can ensure that Universal Health Coverage (UHC) is achieved within their nations. While it is widely regarded to be making strides with reproductive health services, it is important to take note of the following changes to ensure so that new era of services can emerge:

1. Domestic Financing
The Universal Health Coverage goal allows everyone access to health services regardless of financial hardship. Pursuing this goal often leads to dramatic health financing reforms, but the key is to give rise to national insurance initiatives that allow health budgets to be spent on strategic purchasing of health services, rather than on keeping the doors open at public facilities alone.

2. Cost-effective Service Package
Few services are as cost-effective for both health and economic development as contraception. Thus, contraception must be prioritized for universal access. It would be imperative to place importance on measurable health outcomes, or possibly the Sustainable Development Goals.

3. Making UHC Work in the Low-Level Private Sector
Lower-level private facilities, which are often a lifeline to communities, should not be forgotten in public financing reforms. This will prevent a wider spread of coverage to communities that need the types of services that accompany the lower-level private facilities.

4. Advocating Financing by Doing
In countries that have not taken strides with the UHC, organizations can still contribute to progress through proof-of-concept financial projects like large-scale voucher programs to remove financial barriers. All types of health providers (faith-based, for-profit or public) need to be quality-assured for the services they offer.

5. Disrupting the Status Quo
Youth, women, tech-savvy entrepreneurs, health workers, civil society and the private sector will all be the influencers to drive change within family panning over the next 15 years. It is important to welcome new voices to the debates and meetings of importance. Frankness will be key to change, by dropping euphemisms and vague terms there will less trickery and more discussion of the topics that need to be discussed. Even the term “family planning” was created to avoid the associated taboo of the world’s abortion and contraception.

Investment in the health, education and rights of young people, and the alignment of related policies, is critical as it enables productivity and economic growth and the better spread and knowledge of reproductive health services is key to that.

– Alysha Biemolt

Sources: AllAfrica, Impatient Optimists, World Bank
Photo: myScience.org