Implementation of the Community-based Health Planning and Services (CHPS) in rural and urban Ghana: a history and systematic review of what works, for whom and why.
Implementation of the Community-based Health Planning and Services (CHPS) in rural and urban Ghana: a history and systematic review of what works, for whom and why.
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DOI：
10.3389/fpubh.2023.1105495
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发表时间：
2023
影响因子：
5.2
通讯作者：
Agyepong, Irene
中科院分区：
文献类型：
--
作者：
Elsey, Helen;Abboah-Offei, Mary;Vidyasagaran, Aishwarya Lakshmi;Anaseba, Dominic;Wallace, Lauren;Nwameme, Adanna;Gyasi, Akosua;Ayim, Andrews;Ansah-Ofei, Adelaide;Amedzro, Nina;Dovlo, Delanyo;Agongo, Erasmus;Awoonor-Williams, Koku;Agyepong, Irene
关键词：
尽管全球重新强调加强初级卫生保健，但整个撒哈拉以南非洲地区的卫生保健部门仍然资源不足。20多年来，以社区为基础的卫生规划和服务（CHPS）一直是加纳初级保健系统的基础，它结合了以社区为基础的卫生护士、志愿者和社区参与，提供普遍获得基本治疗护理、健康促进和预防的服务。本次评审旨在了解CHPS规划的影响和实施经验教训。我们根据PRISMA指南使用基于结果的收敛设计进行了混合方法审查，其中定量和定性研究结果分别合成，然后在最终合成中汇集在一起。Embase、Medline、PsycINFO、Scopus和Web of Science使用预定义的搜索词进行搜索。我们纳入了所有设计的初步研究，并使用RE-AIM框架来组织和展示研究结果，以了解CHPS计划的不同影响和实施经验教训。在检索到的N = 117篇全文研究中，N = 58篇符合纳入标准，其中定量研究N = 28篇，定性研究N = 27篇，混合研究N = 3篇。研究的地理分布突出了分布的不均衡，大多数是在上东区进行的。卫生保健服务规划建立在大量证据的基础上，已被发现在降低5岁以下儿童死亡率，特别是对最贫穷和受教育程度最低的儿童，增加计划生育的使用和接受程度以及降低生育率方面是有效的。除了卫生设施外，还有卫生保健服务区，使熟练助产士护理的几率增加了56%。影响有效实施的因素包括信任、社区参与以及通过薪酬、职业发展、培训和尊重激励社区护士。在偏远的农村和城市环境中，执行工作遇到了特别的挑战。CHPS的明确规范与有利的国家政策环境相结合，有助于扩大规模。要成功实施和今后扩大卫生保健服务，就必须加强卫生筹资战略，审查提供服务的情况，以防备和应对大流行病、非传染性疾病的流行，并适应不断变化的社区情况，特别是城市化。https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214006，标识符：CRD42020214006。
Despite renewed emphasis on strengthening primary health care globally, the sector remains under-resourced across sub–Saharan Africa. Community-based Health Planning and Services (CHPS) has been the foundation of Ghana's primary care system for over two decades using a combination of community-based health nurses, volunteers and community engagement to deliver universal access to basic curative care, health promotion and prevention. This review aimed to understand the impacts and implementation lessons of the CHPS programme. We conducted a mixed-methods review in line with PRISMA guidance using a results-based convergent design where quantitative and qualitative findings are synthesized separately, then brought together in a final synthesis. Embase, Medline, PsycINFO, Scopus, and Web of Science were searched using pre-defined search terms. We included all primary studies of any design and used the RE-AIM framework to organize and present the findings to understand the different impacts and implementation lessons of the CHPS programme. N = 58 out of n = 117 full text studies retrieved met the inclusion criteria, of which n = 28 were quantitative, n = 27 were qualitative studies and n = 3 were mixed methods. The geographical spread of studies highlighted uneven distribution, with the majority conducted in the Upper East Region. The CHPS programme is built on a significant body of evidence and has been found effective in reducing under-5 mortality, particularly for the poorest and least educated, increasing use and acceptance of family planning and reduction in fertility. The presence of a CHPS zone in addition to a health facility resulted in increased odds of skilled birth attendant care by 56%. Factors influencing effective implementation included trust, community engagement and motivation of community nurses through salaries, career progression, training and respect. Particular challenges to implementation were found in remote rural and urban contexts. The clear specification of CHPS combined with a conducive national policy environment has aided scale-up. Strengthened health financing strategies, review of service provision to prepare and respond to pandemics, prevalence of non-communicable diseases and adaptation to changing community contexts, particularly urbanization, are required for successful delivery and future scale-up of CHPS. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214006, identifier: CRD42020214006.
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影响因子：
2.9
作者：
Bixby H;Bennett JE;Bawah AA;Arku RE;Annim SK;Anum JD;Mintah SE;Schmidt AM;Agyei-Asabere C;Robinson BE;Cavanaugh A;Agyei-Mensah S;Owusu G;Ezzati M;Baumgartner J
通讯作者：
Baumgartner J
影响因子：
2.8
作者：
Awoonor-Williams JK;Bawah AA;Nyonator FK;Asuru R;Oduro A;Ofosu A;Phillips JF
通讯作者：
Phillips JF
影响因子：
5.4
作者：
Atinga, Roger A.;Agyepong, Irene Akua;Esena, Reuben K.
通讯作者：
Esena, Reuben K.
影响因子：
2.1
作者：
Awoonor-Williams, JK;Feinglass, ES;Jones, TC
通讯作者：
Jones, TC
影响因子：
2.8
作者：
Nwameme AU;Tabong PT;Adongo PB
通讯作者：
Adongo PB