Applied Research and Evaluation GUIDING THE GHANA COMMUNITY-BASED HEALTH PLANNING AND SERVICES APPROACH TO SCALING UP WITH QUALITATIVE SYSTEMS APPRAISAL*

When a Navrongo Health Research Centre experiment demonstrated that community-based health services could reduce child mortality and fertility in impoverished communities, the Government of Ghana launched the Community-based Health Planning and Services (CHPS) Initiative to scale up results. This article reports on a “Qualitative Systems Appraisal ” (QSA) of factors explaining why CHPS is implemented in some districts, but stalled in others. QSA consists of groups representing levels of the service hierarchy (community members, frontline service providers, supervisors, and district managers) to portray systemic reactions to CHPS. Community members ar