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Adapting the Community-based Health Planning and Services (CHPS) to engage poor urban communities in Ghana: protocol for a participatory action research study

Abboah-Offei, Mary; Gyasi Darkwa, Akosua; Ayim, Andrews; Ansah-Ofei, Adelaide Maria; Dovlo, Delanyo; Awoonor‐Williams, John K; Agongo, Erasmus Emmanuel Akurugu; Agyepong, Irene Akua; Elsey, Helen


Akosua Gyasi Darkwa

Andrews Ayim

Adelaide Maria Ansah-Ofei

Delanyo Dovlo

John K Awoonor‐Williams

Erasmus Emmanuel Akurugu Agongo

Irene Akua Agyepong

Helen Elsey


Introduction: With rapid urbanisation in low-income and middle-income countries, health systems are struggling to meet the needs of their growing populations. Community-based Health Planning and Services (CHPS) in Ghana have been effective in improving maternal and child health in rural areas; however, implementation in urban areas has proven challenging. This study aims to engage key stakeholders in urban communities to understand how the CHPS model can be adapted to reach poor urban communities.

Methods and analysis: A Participatory Action Research (PAR) will be used to develop an urban CHPS model with stakeholders in three selected CHPS zones: (a) Old Fadama (Yam and Onion Market community), (b) Adedenkpo and (c) Adotrom 2, representing three categories of poor urban neighbourhoods in Accra, Ghana. Two phases will be implemented: phase 1 (‘reconnaissance phase) will engage and establish PAR research groups in the selected zones, conduct focus groups and individual interviews with urban residents, households vulnerable to ill-health and CHPS staff and key stakeholders. A desk review of preceding efforts to implement CHPS will be conducted to understand what worked (or not), how and why. Findings from phase 1 will be used to inform and co-create an urban CHPS model in phase 2, where PAR groups will be involved in multiple recurrent stages (cycles) of community-based planning, observation, action and reflection to develop and refine the urban CHPS model. Data will be managed using NVivo software and coded using the domains of community engagement as a framework to understand community assets and potential for engagement.

Journal Article Type Article
Acceptance Date Jul 13, 2021
Online Publication Date Jul 27, 2021
Publication Date 2021-07
Deposit Date Oct 14, 2022
Publicly Available Date Oct 14, 2022
Journal BMJ Open
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 11
Issue 7
Article Number e049564
Public URL


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