Electronic Thesis and Dissertation Repository


Master of Arts




Dr. Isaac Luginaah


The Community-based Health Planning and Services (CHPS) policy was implemented in 1999 to improve access to Primary Health Care (PHC) services in Ghana, particularly in rural and remote areas as part of global efforts to achieve universal health coverage. Despite this initiative, health care access in the Upper West Region (UWR) remains poor with wide gender disparities. Yet, little is known about the impact of CHPS on women’s access to health care services in the UWR of Ghana. This study therefore examines the role of CHPS on women’s access to health care services in the region. Data were obtained from a cross-sectional survey of women (n=805) in seven selected districts using a multi-stage sampling method and analysed using a logistic regression technique. Study findings reveal that women resident in CHPS zones (OR=1.612, p≤ 0.01) were more likely to have access to basic health care services compared to their counterparts in non-CHPS zones. Similarly, women who resided in CHPS zones (OR=2.806, p≤ 0.01) were more likely to report being able to make independent decisions to utilize health facility-based deliveries compared to their non-CHPS resident counterparts. Additionally, women’s geographical location (rural-urban residence and distance to health facility) as well as their socio-economic and demographic status were found to be associated with their access to health care services. These findings suggest that CHPS policy seems to have positive impacts on health care access among women in its operational areas, which are mostly rural. Based on the findings, the study recommends improvement in the number of services and quality of care delivered at CHPS compounds while ensuring community ownership for its sustainability. It is further recommended that the CHPS policy be expanded to cover more rural communities in the region. The current electoral area based zoning system should be re-conceptualized, and a multi-criteria approach used in siting CHPS to ensure optimization of health care services and coverage.