Effects of the community-based health planning and services on anemia and acute malnutrition amongst under-fives in Ghana: A comparative study

Authors

  • Mark Bigool Department of Management, School of Business, University of Cape Coast, Cape Coast https://orcid.org/0000-0003-2596-0131
  • Nicodemus Osei Owusu Department of Management, School of Business, University of Cape Coast, Cape Coast https://orcid.org/0000-0002-2028-0308
  • Angela Anastasia Frimpong Department of Management, School of Business, University of Cape Coast, Cape Coast

DOI:

https://doi.org/10.4081/jphia.2023.2169

Keywords:

JICA CHPS, Anemia, Acute malnutrition, Difference-in-difference, Ghana

Abstract

Background: Ghana implemented a community-based health planning and services (CHPS) in 2000 with the aim of bringing health services to the doorsteps of the deprived in the communities. Japan International Cooperation Agency (JICA) supported the implementation of the project with a distinct approach in the Upper West region, employing supportive supervision.

Objective: To investigate the impact of the JICA CHPS model on anemia and acute malnutrition prevalence amongst children less than five years of age.

Methods: This is a quasi-experimental study design that com-pares the upper west region with the two other regions of the North implementing the traditional model of CHPS. We used the Ghana demographic and health survey dataset for 2003 as the baseline and 2014 as the follow-up year and employed the difference-in-dif-ference approach. We find a reduction in the likelihood of anemia and acute malnutrition prevalence among children less than five years by 17 and 8 percentage points respectively. We find the proj-ect to be cost-effective, at a cost of $7 per each anemia prevalence averted.

Conclusions: The results indicate that the JICA model of CHPS is cost-effective in the reduction of anemia and acute mal-nutrition prevalence compared to the traditional model. We recom-mend a nationwide expansion of the JICA model to enhance the reduction of anemia and acute malnutrition in Ghana

Download data is not yet available.

References

Haas JD, Brownlie T. Iron Deficiency and Reduced Work Capacity: A Critical Review of the Research to Determine a Causal Relationship. The Journal of Nutrition. 2001 Feb 1;131(2):676S-690S. DOI: https://doi.org/10.1093/jn/131.2.676S

McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B. Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993–2005. PHN. 2009 Apr;12(04):444. DOI: https://doi.org/10.1017/S1368980008002401

Ghana Statistical Service, Ghana Health Service, ICF Macro. Ghana Maternal Health Survey 2014. Accra, Ghana: Ghana Statistical Service; 2014.

Ghana Health Service. Ghana Health Service 2019 Annual Report. Ghana Health Service; 2019.

Chong A, Cohen I, Field E, Nakasone E, Torero M. Iron Deficiency and Schooling Attainment in Peru. American Economic Journal: Applied Economics. 2016 Oct;8(4):222–55. DOI: https://doi.org/10.1257/app.20140494

Ampiah K. The Discourse of Japanese Development Assistance and the Scaling-up of Community-based Health Planning and Services (CHPS) in Ghana. 2017;42.

Friis H, Mwaniki D, Omondi B, Muniu E, Thiong’o F, Ouma J, et al. Effects on haemoglobin of multi-micronutrient supple-mentation and multi-helminth chemotherapy: a randomized, controlled trial in Kenyan school children. Eur J Clin Nutr. 2003 Apr;57(4):573–9. DOI: https://doi.org/10.1038/sj.ejcn.1601568

Fitzsimons E, Malde B, Mesnard A, Vera-Hernández M. Nutrition, information and household behavior: Experimental evidence from Malawi. Journal of Development Economics. 2016 Sep;122:113–26. DOI: https://doi.org/10.1016/j.jdeveco.2016.05.002

Nyonator FK, Awoonor-Williams JK, Phillips JF, Jones TC, Miller RA. The Ghana Community-based Health Planning and Services Initiative for scaling up service delivery innovation. Health Policy and Planning. 2005 Jan 1;20(1):25–34. DOI: https://doi.org/10.1093/heapol/czi003

Ministry of Health M. National Community-Based Health Plaining and Services Policy (CHPS). 2016.

Aikins M, Laar A, Nonvignon J, Sackey S, Ikeda T, Woode G, et al. Evaluation of facilitative supervision visits in primary health care service delivery in Northern Ghana. BMC Health Serv Res. 2013 Dec;13(1):358. DOI: https://doi.org/10.1186/1472-6963-13-358

Green TJ, Karakochuk CD, McLean J, Janmohamed A. Improved Sanitation Facilities are Associated with Higher Body Mass Index and Higher Hemoglobin Concentration Among Rural Cambodian Women in the First Trimester of Pregnancy. The American Journal of Tropical Medicine and Hygiene. 2016 Nov 2;95(5):1211–5. DOI: https://doi.org/10.4269/ajtmh.16-0278

Coffey D, Geruso M, Spears D. Sanitation, Disease Externalities and Anaemia: Evidence From Nepal. The Economic Journal. 2018 Jun 1;128(611):1395–432. DOI: https://doi.org/10.1111/ecoj.12491

WHO, UNICEF, editors. Progress on sanitation and drinking-water. Geneva: World Health Organization; 2010. 55 p.

Woods B, Revill P, Sculpher M, Claxton K. Country-Level Cost-Effectiveness Thresholds: Initial Estimates and the Need for Further Research. Value in Health. 2016 Dec;19(8):929–35. DOI: https://doi.org/10.1016/j.jval.2016.02.017

Berry J, Mehta S, Mukherjee P, Ruebeck H, Shastry GK. Implementation and effects of India’s national school-based iron supplementation program. Journal of Development Economics. 2020 May;144:102428. DOI: https://doi.org/10.1016/j.jdeveco.2019.102428

Vir S. Community based maternal and child health nutrition project, Uttar Pradesh: An innovative strategy focusing on “at risk” families. Indian J Community Med. 2013;38(4):234. DOI: https://doi.org/10.4103/0970-0218.120159

Downloads

Published

07-02-2023

How to Cite

Bigool, M., Osei Owusu , N., & Frimpong, A. A. (2023). Effects of the community-based health planning and services on anemia and acute malnutrition amongst under-fives in Ghana: A comparative study. Journal of Public Health in Africa, 14(1). https://doi.org/10.4081/jphia.2023.2169

Issue

Section

Original Articles