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Abstract：
BACKGROUND: In spite of the successes of the community-based health planning and services (CHPS) policy since its inception in the mid-1990s in Ghana, data pertaining to the implementation and use of CHPS facilities in Sefwi Wiawso Municipal is scant. We assessed access to healthcare delivery and factors influencing the use of CHPS in Sefwi Wiawso Municipal.
METHODS: An analytical community-based cross-sectional study was conducted in the Sefwi Wiawo Municipal from September to October 2020. Respondents for the study were recruited through multi-stage sampling. Information was collected on their socio-demographic characteristics, knowledge and use of CHPS facilities through interviews using a structured pre-tested questionnaire. Factors influencing the use of CHPS facilities were assessed using univariable and multivariable logistic regression to generate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). P ≤ 0.05 was considered statistically significant.
RESULTS: A total of 483 respondents were recruited for the study. The mean age of the respondents was 43.0 ± 16.3 years, and over 70% were females or married/cohabiting with their partners. Most respondents (88.2%) knew about the CHPS concept and more than half (53.4%) accessed healthcare in the CHPS facilities. Most respondents rated the quality of health services (> 65%) and staff attitude (77.2%) very positively. Significant factors influencing the use of the CHPS facilities were; knowledge of the CHPS concept (AOR 6.57, 95% CI 1.57-27.43; p = 0.01), longer waiting time for a vehicle to the facility, and shorter waiting time at the facility before being provided with care. People who waited for 30-60 min (AOR 2.76, 95% CI 1.08-7.07; p = 0.01) or over an hour (AOR 10.91, 95% CI 3.71-32.06; p = 0.01) before getting a vehicle to the facility, while patients who waited for less than 30 min (AOR 5.74, 95% CI 1.28-25.67; p = 0.03) or 30-60 min (AOR 2.60, 95% CI 0.57-11.78; p = 0.03) at the CHPS facility before receiving care were more likely to access care at the CHPS facilities.
CONCLUSIONS: Knowledge, and use of healthcare services at the CHPS facilities were high in this population. Interventions aimed at reducing waiting time at the CHPS facilities could greatly increase use of healthcare services at these facilities.
METHODS: An analytical community-based cross-sectional study was conducted in the Sefwi Wiawo Municipal from September to October 2020. Respondents for the study were recruited through multi-stage sampling. Information was collected on their socio-demographic characteristics, knowledge and use of CHPS facilities through interviews using a structured pre-tested questionnaire. Factors influencing the use of CHPS facilities were assessed using univariable and multivariable logistic regression to generate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). P ≤ 0.05 was considered statistically significant.
RESULTS: A total of 483 respondents were recruited for the study. The mean age of the respondents was 43.0 ± 16.3 years, and over 70% were females or married/cohabiting with their partners. Most respondents (88.2%) knew about the CHPS concept and more than half (53.4%) accessed healthcare in the CHPS facilities. Most respondents rated the quality of health services (> 65%) and staff attitude (77.2%) very positively. Significant factors influencing the use of the CHPS facilities were; knowledge of the CHPS concept (AOR 6.57, 95% CI 1.57-27.43; p = 0.01), longer waiting time for a vehicle to the facility, and shorter waiting time at the facility before being provided with care. People who waited for 30-60 min (AOR 2.76, 95% CI 1.08-7.07; p = 0.01) or over an hour (AOR 10.91, 95% CI 3.71-32.06; p = 0.01) before getting a vehicle to the facility, while patients who waited for less than 30 min (AOR 5.74, 95% CI 1.28-25.67; p = 0.03) or 30-60 min (AOR 2.60, 95% CI 0.57-11.78; p = 0.03) at the CHPS facility before receiving care were more likely to access care at the CHPS facilities.
CONCLUSIONS: Knowledge, and use of healthcare services at the CHPS facilities were high in this population. Interventions aimed at reducing waiting time at the CHPS facilities could greatly increase use of healthcare services at these facilities.
摘要：
背景：尽管基于社区的健康规划和服务（CHPS）政策自1990年代中期在加纳成立以来取得了成功，有关SefwiWiawso市政CHPS设施的实施和使用的数据很少。我们评估了SefwiWiawso市的医疗保健服务和影响CHPS使用的因素。
方法：于2020年9月至10月在SefwiWiawo市进行了一项基于社区的分析性横断面研究。该研究的受访者是通过多阶段抽样招募的。收集了有关其社会人口特征的信息，通过使用结构化的预测试问卷进行访谈，了解和使用CHPS设施。使用单变量和多变量逻辑回归评估影响CHPS设施使用的因素，以产生具有95％置信区间（CI）的粗比值比和调整后的比值比（OR）。P≤0.05被认为具有统计学意义。
结果：共招募了483名调查对象。被调查者平均年龄为43.0±16.3岁,超过70%是女性或与伴侣结婚/同居。大多数受访者（88.2％）了解CHPS概念，超过一半（53.4％）在CHPS设施中获得医疗保健。大多数受访者对卫生服务质量（>65％）和工作人员态度（77.2％）的评价非常积极。影响CHPS设施使用的重要因素是：了解CHPS概念（AOR6.57，95％CI1.57-27.43；p=0.01），车辆到达设施的等待时间更长，以及在提供护理之前在设施的等待时间更短。等待30-60分钟（AOR2.76，95％CI1.08-7.07;p=0.01）或超过一小时（AOR10.91，95％CI3.71-32.06;p=0.01）的人，而在接受护理前在CHPS机构等待少于30分钟(AOR5.74,95%CI1.28-25.67;p=0.03)或30-60分钟(AOR2.60,95%CI0.57-11.78;p=0.03)的患者更有可能在CHPS机构获得护理。
结论：知识，在该人群中，CHPS设施的医疗保健服务使用率很高。旨在减少CHPS设施等待时间的干预措施可以大大增加这些设施对医疗保健服务的使用。
方法：于2020年9月至10月在SefwiWiawo市进行了一项基于社区的分析性横断面研究。该研究的受访者是通过多阶段抽样招募的。收集了有关其社会人口特征的信息，通过使用结构化的预测试问卷进行访谈，了解和使用CHPS设施。使用单变量和多变量逻辑回归评估影响CHPS设施使用的因素，以产生具有95％置信区间（CI）的粗比值比和调整后的比值比（OR）。P≤0.05被认为具有统计学意义。
结果：共招募了483名调查对象。被调查者平均年龄为43.0±16.3岁,超过70%是女性或与伴侣结婚/同居。大多数受访者（88.2％）了解CHPS概念，超过一半（53.4％）在CHPS设施中获得医疗保健。大多数受访者对卫生服务质量（>65％）和工作人员态度（77.2％）的评价非常积极。影响CHPS设施使用的重要因素是：了解CHPS概念（AOR6.57，95％CI1.57-27.43；p=0.01），车辆到达设施的等待时间更长，以及在提供护理之前在设施的等待时间更短。等待30-60分钟（AOR2.76，95％CI1.08-7.07;p=0.01）或超过一小时（AOR10.91，95％CI3.71-32.06;p=0.01）的人，而在接受护理前在CHPS机构等待少于30分钟(AOR5.74,95%CI1.28-25.67;p=0.03)或30-60分钟(AOR2.60,95%CI0.57-11.78;p=0.03)的患者更有可能在CHPS机构获得护理。
结论：知识，在该人群中，CHPS设施的医疗保健服务使用率很高。旨在减少CHPS设施等待时间的干预措施可以大大增加这些设施对医疗保健服务的使用。
