CHPS and the Journey to Universal Health Coverage: Closing the Gap in Access and Equity

In Ghana, where rural communities often face long distances to the nearest clinic, the idea of “health for all” can seem out of reach. Yet, for over two decades, the Community-Based Health Planning and Services (CHPS) strategy has been the country’s boldest response to this challenge, a deliberate effort to take healthcare to the doorstep of every Ghanaian, especially the most underserved.

The CHPS model works by assigning trained Community Health Officers (CHOs) to live and work in designated zones, supported by volunteers and guided by Community Health Management Committees. CHOs provide a wide range of essential services, from antenatal and postnatal care to child immunizations, treatment of common illnesses, family planning, health education, and disease prevention. This approach eliminates the need for long and costly travel to health facilities, particularly in deprived and remote areas. In fully functional CHPS zones, communities have reported improved maternal and child health outcomes, reduced child mortality, increased contraceptive use, and greater uptake of preventive health services. Beyond service delivery, CHPS fosters trust in the healthcare system by involving communities directly in health planning and decision-making, making care both accessible and culturally responsive.

However, despite these achievements, CHPS has not yet realised its full potential. Out of the over 5,400 CHPS zones demarcated nationwide, only a fraction is fully functional. Many compounds remain incomplete, lacking essential infrastructure such as electricity, water, medical equipment, and residential facilities for CHOs. The absence of these basic amenities and logistics can limit service availability and reduce the willingness of health workers to accept postings in remote areas. Volunteer participation, a core pillar of the model, is also inconsistent due to inadequate training, irregular supervision, and the absence of sustainable incentives. In some areas, Community Health Management Committees are inactive, weakening the programme’s community-driven character.

Financing is another major constraint. Funding sources for CHPS facilities and operations are fragmented, with different development partners, local governments, and NGOs supporting various components in an uncoordinated way. This results in uneven standards, maintenance challenges, and recurring gaps in essential supplies. Additionally, while CHPS has proven effective in rural settings, its adaptation to urban and peri-urban areas has been slow and inconsistent, leaving behind pockets of underserved populations even within cities.

To strengthen CHPS, Ghana needs to approach it as a long-term investment rather than a project. Infrastructure must be standardised and completed so that every CHPS compound is equipped, functional, and maintained. CHOs should be provided with decent accommodation, adequate tools, and clear career progression to attract and retain skilled personnel in hard-to-reach areas. Volunteers, whose role is critical in mobilising communities and supporting outreach, should receive regular training, supervision, and recognition to sustain their motivation. Community ownership should be revitalised by ensuring active, well-trained Health Management Committees are engaged in planning, monitoring, and mobilising local support for services.

Sustainable financing will be key. Harmonising contributions from the government, the National Health Insurance Scheme, development partners, and local stakeholders can create a more stable funding base. This should be backed by a clear national roadmap for scaling CHPS to underserved areas, including tailored strategies for urban settings. Stronger coordination between the Ministry of Health, the Ghana Health Service, and local authorities will also be essential to ensure consistent quality of care across all CHPS zones.

CHPS is more than a delivery mechanism, it is a social contract that promises every Ghanaian, regardless of where they live the right to accessible, quality healthcare. Its successes in improving maternal and child health, promoting preventive care, and building community trust are proof of its value. Yet, without renewed political commitment, adequate funding, and stronger operational support, its impact will remain uneven. If fully supported and expanded, CHPS could become the cornerstone of Ghana’s Universal Health Coverage agenda, ensuring that no one is left behind in the journey toward equitable healthcare.