Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana's Community-based Health Planning and Services (CHPS).
Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana's Community-based Health Planning and Services (CHPS).
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DOI：
10.1186/1478-4505-12-16
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发表时间：
2014-04-01
影响因子：
4
通讯作者：
Binka FN
中科院分区：
文献类型：
--
作者：
Adongo PB;Phillips JF;Aikins M;Arhin DA;Schmitt M;Nwameme AU;Tabong PT;Binka FN
城市人口的快速增长引起了全球的关注，因为它伴随着一些新的健康挑战。居住在非正规住区的城市贫民更容易受到这些健康挑战的影响。缺乏正规的政府公共卫生设施来提供医疗保健也是城市贫民居住社区的普遍现象。为了帮助改善这种情况，加纳城市引入了创新的城市初级卫生系统，该系统基于农村社区卫生规划和服务（CHPS）系统开发的里程碑模型。本文概述了在解决这些城市健康问题时采用的创新经验，包括汲取建设性经验教训的过程，这些经验教训为设计和实施可持续社区健康规划和服务（CHPS）模式的讨论提供信息，以应对加纳南部的城市健康挑战。这项研究是在城市 CHPS 计划为期六个月的试点期间进行的，在两个选定的区域作为设计的干预和控制臂。日常数据的收集基于最初为对照社区农村 CHPS 模型制定的里程碑，而在干预社区，对农村里程碑进行了一些修改。实施活动的结果表明，由于城市环境中独特的组织结构和流行病学特征，许多来自农村热电联产实验的最佳实践无法移植到贫困的城市住区。例如，在区域内建设社区卫生院和住宅设施是农村 CHPS 战略的核心组成部分，但事实证明不适合城市部门。启动夜间和周末家访计划，更好地安置城镇居民，扩大覆盖范围。城市居民疾病负担的广泛性也需要 CHO 具备更广泛的专业知识和培训。获得改善的城市卫生服务仍然是一个挑战。然而，当前基于农村经验和实验设计的初级卫生模式实施政策指南需要仔细审查和修改，以满足城市环境的需要。
Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban residents also requires a broader expertise and training of the CHOs. Access to improved urban health services remains a challenge. However, current policy guidelines for the implementation of a primary health model based on rural experiences and experimental design requires careful review and modifications to meet the needs of the urban settings.
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影响因子：
7.4
作者：
Källander K;Tibenderana JK;Akpogheneta OJ;Strachan DL;Hill Z;ten Asbroek AH;Conteh L;Kirkwood BR;Meek SR
通讯作者：
Meek SR
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
DOI：
10.2471/blt.06.030064
发表时间：
2006-12-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Phillips, James F;Bawah, Ayaga A;Binka, Fred N
通讯作者：
Binka, Fred N
影响因子：
3.2
作者：
Nyonator, FK;Awoonor-Williams, JK;Miller, RA
通讯作者：
Miller, RA
影响因子：
6.3
作者：
Oliver, A;Mossialos, E
通讯作者：
Mossialos, E