Communities get involved in health outcomes 

At the heart of delivering quality health care is the critical question of meeting the needs of clients visiting health facilities and ensuring that their expectations are managed to their satisfaction.   What people want and how they perceive heath delivery services within local communities is taking centre stage as health authorities are bent on pursuing people-centred health care though the Ghana Community Scorecard (CSC) project. The CSC is being institutionalized through partnerships at the community level to ensure a two-way affair in primary health care and to strengthen the country’s health systems. As a community-led governance tool, the CSC is being used jointly by health facilities, local government structures and communities to promote accountability and responsiveness to community needs. Specifically, it provides a mechanism for stakeholders to monitor the quality of services and respond to community needs. It also strengthens the accountability of primary health care facilities and community health officers by capturing community members’ perceptions of how they experience health care delivery within their Community-based Health Planning and Services (CHPS) zone. Additionally, it enables community members to score their health facility on nine quality-of-care indicators and then act to resolve identified problems using local knowledge and resources. This gives the Ghana Health Service (GHS) and other stakeholders evidence on where support should be targeted. According to Dr. Samuel K. Boakye-Boateng Director of Policy, Planning, Monitoring and Evaluation Division  of the GHS, what people think must matter when they are accessing health care.  “What do the people we serve think about the services we provide? Routine information systems tell us how many clients attended, how many children were immunized and how many women received antenatal care. Those measures are essential,”. “Alongside them, we must also understand whether clients felt respected, whether waiting times were reasonable, whether medicines and diagnostic services were available, and whether facilities were accessible, clean and safe, he said. He was speaking during a media engagement virtual meeting on the CSC project with journalists from across the country including health officials and partners from civil society organizations. The meeting was jointly organized by the African Media and Malaria Research Network (AMMREN) and the GHS. It forms part of the strategies to provide visibility for the scaling up and institutionalization of the CSC project. In 2018, the Ministry of Health through the GHS and in collaboration with the African Leaders Malaria Alliance (ALMA) developed the Ghana Community Scorecard. The tool empowers communities to play an active role in improving the quality of health services delivered in their own localities. In 2022, the GHS and its partner civil society organizations were awarded a grant under the French Government’s 5% Initiative, through Expertise France. The grant is to help in scaling up and institutionalizing the CSC nationwide. Dr. Boakye-Boateng said the CSC provides a structured way for “communities and health service providers to assess service experiences, discuss what is working and what is not, understand the reasons behind the findings and agree on practical actions for improvement.” “Responsibilities are assigned and progress is reviewed. In essence, the scorecard creates a pathway from community experience, to evidence, to action,” he explained. “The community scorecard is about giving communities a voice, ensuring that voice is heard, and turning it into action that improves the quality and responsiveness of healthcare,” he added. Overview of the CSC Ms.Aseye Kpodotsi, Community Scorecard Project Focal Person at the GHS, in an overview on the CSC initiative, explained that the CSC strengthens accountability and gives communities a structured voice in how their health services are planned, delivered and improved. Adding that it improves service quality, identify gaps in care, medicines, infrastructure and outreach, and track improvement including building trust and partnership. According to her, the CSC creates routine respectful dialogue between communities, community health management committees and the health facility teams. It also informs decisions with data, feed community perspectives into the health system and the national performance reviews. She also spoke about the nine indicators for scoring health facilities and translating scoring into action. “The CSC turns community experience into structured, comparable data on nine dimensions of service quality. Its strength lies in the process: honest scoring without staff present, followed by respectful dialogue at the interface meeting.” Ms. Kpodotsi, said these meetings end in a community health action plans, so scoring always leads to concrete, jointly owned improvement actions. The results, she explained flows into the health system to the scorecard web platform, linking community voices directly to the national performance management.  She touched on how the scoring works when community members meet to score the health facility based on the nine indicators and also mentioned some challenges of the implementation of the CSC processes. These challenges include inconsistent reporting by facilities from quarter to quarter, action plans not entered in the action tracker so they do not match facilities that reported scores. Other challenges, she said are community fatigue with scoring every quarter, incomplete scoring, some facilities left unscored and  no routine analysis to identify  the best and least performing zones. Ms. Kpodotsi mentioned some recommendations to deal with the challenges and they include following up on non-scoring facilities every quarter, confirming all nine indicators are scored before data entry and crossing reporting facilities against action tracker.  Dr. Charity Binka, Executive Secretary of AMMREN, said strengthening community participation and accountability in health service delivery requires not only effective systems, but also information, communication and sustained public engagement. “For this process to have a lasting impact, the lessons emerging from communities must be communicated widely, and the voices of citizens must be heard beyond the immediate project locations.” The virtual meeting, she noted provides an opportunity to bring together the GHS, media practitioners and key partners to share experiences, reflect on progress, and deepen the understanding of the CSC approach. Work the CSC works The CSC is embedded within the Community-based Health Planning and Services (CHPS) strategy, which forms the foundation of Ghana’s primary health care system. Primary health care extends from the district level down to the community level, where services are delivered through CHPS structures. Under the CHPS concept, community health nurses, volunteers and community mobilization are used to bring basic curative, promotive and preventive health services closer to the people. Services are delivered from a CHPS compound, which serves both as a local service delivery point and as accommodation for community health workers. Each quarter, the community health management committee in every participating CHPS zone convenes a scoring session. During the session, community members vote on nine core quality-of-care indicators relating to the services provided in their community. The results are then used to develop community health action plans which mobilize the community and other stakeholders to address the gaps identified. The nine quality-of-care indicators are caring, respectful and compassionate care, waiting time for service provision and availability of medicines, diagnostic services and supplies. Others are availability, accessibility and quality of health services and infrastructure, cleanliness and safety of the facility, leadership and management of the facility. The rest are home visits conducted by health staff, home visits conducted by community health volunteers and assessment of National Health Insurance Authority services. In hospital settings, separate scoring and action planning sessions are held with key populations, including people living with HIV and tuberculosis who receive care at hospitals within their communities. To support this, the project has developed standalone scorecards for HIV and TB. By Eunice Menka The post Communities get involved in health outcomes  appeared first on Ghana Business News.