A step takes the rural dweller to a health care provider

In Ghana, before the Abura-Asebu-Kwamankese (AAK) district started posting nurses to rural communities in 2000, the district had the highest cases of measles and infant mortality and the lowest immunization coverage in the region. The district then had only five health facilities, including a hospital which served nearly 90,000 people.

Today, most individuals in the district's underserved villages have access to health care. Starting with one community-based health zone that consists of a group of villages with less than 5,000 people and within a 5-kilometer radius, the district has expanded health care services to citizens in eight of its 19 zones.

With support from USAID and the local government, the Ghana Health Service assisted community leaders in each zone to select the most accessible village where the community health officer (CHO) would reside. This became the compound from which the CHO offered health care services to the communities. The CHO promotes preventive health, provides pre- and postnatal care, treats minor cases of diarrhea, malaria, and provides family planning services. Volunteers, who are members of the communities, assist the CHO with follow-up home visits.

USAID supported the training of CHOs and the volunteers to help the various communities address their health needs. USAID also provided motorbikes and bicycles, solar panels, fridges and communications equipment to support the zones.

Now, access to health care in the district has increased, particularly through home visits. Each compound has two CHOs and an equal number of volunteers in every community. Antenatal visits rose from 2,939 in 2000 to 3,788 in 2006. Family planning acceptors increased from 6,822 in 2004 to 12, 292 in 2006 and the figure of people seeking treatment with CHOs doubled from 2,686 in 2004 to 5,444 in 2006. With this improvement, the district was adjudged the best organized health team among the 13 districts in the Central Region in 2003, 2004, and a runner-up in 2005.

"In this rural setting the compound is a key to providing health care to our people. If the rural dweller is to access health care with just a few meters walk, he will do it," Job Acquah-Markin, the district chief executive said.