The impact of decentralized district partnering on scaling up the community-based reform of the health sector in Ghana

Frank Nyonator, Ghana Health Service
James F. Phillips, Population Council
John K. Awoonor-Williams, Volta Regional Health Administration
Adams Kasanga, The Population Council

Decentralizing health service management has been a priority of health sector reform in Ghana since the mid-1990s. However, meaningful progress on this goal was not achieved until 1999 when Ghana extended decentralization to the community level―launching the Community-based Health Planning and Services (CHPS) Initiative. Guided by research in Kassena-Nankana District by the Navrongo Health Research Centre, CHPS scales up Navrongo approaches to social mobilization for supporting and implementing community health services. Milestones in the scaling-up process involving local planning, on-the-job training, locally financed health facilities development, and volunteer mobilization are achieved by forging partnerships between district health managers, service providers, and communities. Two District Health Management Teams that have completed implementation―Kassena-Nankana and Nkwanta―have demonstrated functioning community-based services to teams from other districts during the 1999 to 2004 period. This paper assesses the impact of the peer training strategy on CHPS implementation in the 108 other districts of Ghana.