The Impact of the Community-Based Health Planning and Services Programme (CHPS) on Skilled Assistance at Birth in Ghana

Philomena E. Nyarko, University of Ghana
Faustina Frempong-Ainguah, University of Ghana
Fiifi Amoako Johnson, University of Southampton
Zoe Matthews, University of Southampton
Peter Gething, University of Southampton
Peter Atkinson, University of Southampton
Francis Nii-Amoo Dodoo, Pennsylvania State University
Jane C. Falkingham, University of Southampton

In 1999, Ghana launched the Community-based Health Planning and Services Programme nationwide with the aim of reducing barriers to geographical access to health care. The programme involves deploying professional health workers to provide community-based health care, including safe motherhood and family planning services in excluded areas. Thirty districts out of 110 had started CHPS implementation activities by end 2000. Twenty-seven months later, 104 districts reported the start of CHPS implementation in a phased startup over many CHPS zones. By March 2003, the initiative had become a national effort. Despite the wealth of survey data originating around 2003, no study has matched up geographical implementation with service use. The Core Welfare Indicators Survey 2003 suggests that geographical barriers remain. Using spatial regression modelling and the programme start time in various geographically defined CHPs zones, this paper assesses the impact of the CHPS programme on skilled birth attendance from 1999 to 2003.