POST 00916E : COMMUNITY HEALTH PLANNING

POST 00916E : COMMUNITY HEALTH PLANNING Follow-up on Posts 00888E, 00893E and 00907E 24 April 2006 ____________________________________ This posting contains two contributions coincidently both from Ghana. The first is from J. Koku Awoonor (mailto:[email protected]) who answers some of the concerns expressed by A.T Seddoh in Post 00893E. He also shares some interesting results of a new impact assessment especially on vaccination. The second is from Francis Abotsi (mailto:[email protected]) who comments on the reminder slip. May I appeal again to members who may know of a recall system in developing countries that has been assessed. ____________________________________ "I have followed the debate generated by the CHPS paper I posted and it makes interesting reading all the arguments being made. I read the argument by Dr. Seddoh. I have also followed the ACSD experiment in the UER that was cited and am fully aware of the results that was disseminated. I have my personal opinion on this and can comment on this later. But coming to CHPS regarding Dr. Seddoh's argument, let me say that the main issue about BCG - perhaps needs more clarification along with an equation. Yes, the method hasn't been used before and therefore lacks precedence. However, it is a commonly used probability and statistics method. It is not as simple as just assuming anyone with a BCG will have received a certain amount of immunizations. Rather it is a four step process.This is calculated using observed sample of children with cards, to estimate joint probabilities. Calculate for children with BCG scar--proportion that have received each vaccination Calculate for children with BCG scar--proportion that have not received each vaccination Calculate for children without BCG scar--proportion that have received each vaccination Calculate for children without BCG scar--proportion that have not received each vaccination These proportions are transformed into estimated joint probabilities given BCG scar status. Then for the children without records, estimated joint probabilities are assigned for each vaccination given their BCG status. I am aware this is an accurate method for calculating joint probabilities. It should be known that this was only used for descriptive statistics and was not used for the regression analysis -in which only children with records were used. Let me also say that CHPS is intended to increase resources within the district and not take away from static health facilities. The community health compounds (CHC) are built as a partnership from district mobilized and community-level mobilized resources. It is not the facility itself that produces results, but the manner in which the nurse provides services - reaching her clients instead of waiting for the clients to come to her. More importantly, since she is an integral part of the community she is more likely to hear of a pregnancy and delivery in an informal or casual way and consequently more births are likely to be immunized, registered and followed-up for continuing immunizations. This is about the effectiveness of community involvement and district-village partnerships..." There are enough evidence taking from the Ghana CHPS Initiative the positive impact front-line health workers (CHOs) are making on health outcomes. We have just concluded our second district-wide CHPS impact assessment and the results are impressive. Just to cite a few of these, we found that • Women in CHPS zones where frontline CHOs are working were 2.2 times more likely to know of at least one method of Family Planning than NOT YET CHPS women (where frontline health workers CHOs are not working), controlling for a number of demographic and wealth indicators (p