Dr. Koku Awoonor, Director, Policy Planning Monitoring and Evaluation division-Ghana Health Service
Dr. Koku Awoonor, Director, Policy Planning Monitoring and Evaluation division-Ghana Health Service

The Director, Policy Planning Monitoring and Evaluation (PPME) division of Ghana Health Service, Dr. Koku Awoonor has said although Ghana is on course to achieving Universal Health Coverage (UHC) at the primary level by 2020, suggestions for some modifications in the country’s National Health Insurance Scheme if taken onboard and implemented soon would make a significant contribution to this agenda and long the term future national health goal.

Dr. Awoonor, who was speaking at this year’s first meeting of the CHPS Implementation Working Group (CiWG) in Accra, noted that since the early 1970s, Ghana has always sought to pursue a health care system that focuses on the community with emphasis on removing economic and geographical barriers. This objective he pointed out was established when the country successfully launched the Community-based Health Planning and Services (CHPS) strategy in 2000. The launch of CHPS follows experiment with the principle of primary care at Navrongo Health Research Center in 1992-1994.

As part of the Sustainable Development Goals (SDGs), all Member States of the United Nations have agreed to work towards achievement of UHC by 2030. Under this agenda, governments of Member States are encouraged to adopt innovative strategies that would create and expand access to quality essential health care services including health promotion, prevention, treatment, rehabilitation and palliative care to individuals and communities and at the same time protecting the population from financial hardships.

Ahead of the UN target of 2030 however, the Government of Ghana has set itself a timeline to achieve UHC at the primary level by 2020 through expanding and enhancing CHPS service implementation across the country.

CHPS is a wellness strategy, built on community participation with emphasis on health promotion, health education and minimal curative care. For over a decade, Ghana has rolled out CHPS as a national primary health care program. And although the program has achieved tremendous success contributing to increases in child survival rate and improvement in maternal health among other indicators, current national implementation status of CHPS faces a lot of challenges. Some analysts have predicted that the future of the program could be in jeopardy if creative solutions are not devised. One of the challenges, which poses a major threat to CHPS operations, is resources for funding the chunk of its services – preventive and promotive care.

In his view the resource scourge threatening the future of CHPS emanates from a weakness in the design of the national health financing mechanism. Ghana has a long history of prioritizing preventive care, unfortunately however, the design of the National Health Insurance Scheme did not take cognizance of the structure of the country’s health system to be able to determine the contributions of the various services: for example health promotion, health education, curative care and other costs. Instead, the scheme is essentially and strongly built around curative care with minimal attention to wellness. This situation Dr. Awoonor believes needs re-consideration.

“If we have a National Health Insurance Scheme that loves disease and health institutions only receive financial reimbursement when they treat sick people, but if the same institution provides information and other services that help to prevent the person from falling sick, that health provider cannot recover the cost of the service, then we need to look at it again”. He said for the NHIA to adequately address the financial risk burden contained in the UHC goal it urgently needs to implement suggestions to embrace CHPS and to design a payment scheme for preventive services.

The CHPS Implementation Working Group (CiWG) meeting is a quarterly forum hosted by the PPME division of the GHS with major stakeholders and health partners who have interest or provide support for CHPS implementation. The forum is used to get updates and discuss important initiatives and emerging issues in national CHPS implementation.

Commenting on a National CHPS Costing Tool that has been developed, Dr. Awoonor said it was critical to develop a standardized financial planning tool for CHPS to support CHPS scale up. He added that the absence of such a tool has not only accounted for the challenge in ensuring there is consistency in CHPS development, but it has also affected resource mobilization. The new costing tool would therefore serve as an advocacy tool especially for Regional and District Directors to support CHPS scale up and strengthening.

He also indicated of a nationwide CHPS assessment and verification exercise to drive and reposition implementation and was optimistic that data from the verification would support national planning and also make it easy for further inquiry to be done.

Dr. Awoonor commended JICA for leading the CHPS data-based system development in Upper West Region and the current scale up in the Northern and Upper East Regions.

The Deputy Director General of Ghana Health Service, Dr. Gloria Quansah-Asare hinted that the Ghana Health Service will take advantage of the important data generated from the CHPS verification and the CHPS Costing Tool to support its planning to strengthen health centers and CHPS zones as part of measures to deliver quality, accessible primary health care across the country. She expressed the Health Service gratitude to the World Bank, DFID and other donors and health partners for their continued financial and technical support to the health sector, particularly CHPS.

This edition of the CiWG forum featured three key presentations on national CHPS implementation namely, a draft report on the World Bank/DFID supported CHPS Verification, JICA-led CHPS Data-Based System and the National CHPS Costing Tool. There was also a presentation on the National Re-orientation of CHPS.

The National CHPS verification survey sought to determine the current level of functionality of CHPS zones. Results of the verification would be important in helping to refine the parameters to be used for allocation of resources for zones and service scale up. The survey is being undertaken by the three Health Research Institutions in Ghana namely, Navrongo, Kintampo and Dodowa Health Research Centers.

The CHPS Costing Tool with funding support from USAID MCSP is an offline finanicial planning tool, which could be used to generate and compare costed plans for instance, from compound construction to logistics and drugs supplies. The tool is useful for helping to identify funding gaps and resource mobilization.


Send your news stories to [email protected] and via WhatsApp on +233 234-972-832 


Please enter your comment!
Please enter your name here

This site uses Akismet to reduce spam. Learn how your comment data is processed.