The role of community-based surveillance in health outcomes measurement.

Unlabelled: Summary
Setting: Community Health Planning and Service (CHPS) strategy was started in Ashanti Region in 2001. It aimed to improve geographic access to comprehensive health care. The Region used community-based surveillance (CBS) as an entry point.
Objectives: were to obtain baseline data and define the magnitude and extent of specific health outcomes.
Design: Districts were divided into health zones and health workers (HWs) assigned. CBS Volunteers were identified, trained to register households, births, deaths, diseases and vaccinations. The Regional level tracked the implementation process and HEALTH OUTCOMES which were evaluated after a year.
Results: Two hundred and eighty-two (282) zones were created, 1-8 per sub-district with populations 1,029-43,998 and communities 1-29. 86.2% zones had HWs assigned, 40.6% resident. Most HWs (89.3%) were community health nurses. 65.7% zones had health institutions, 20.6% chemical shops and 83.7% basic drugs. 2,325 (91%) communities had registers and 2,278 CBS volunteers. Twenty-six thousand, three hundred and sixty (26,360) births were registered (CBR 10.2/1000pop), deaths 5,694 (CDR 2.6/1000pop), Under-one deaths 967 (IMR 36.4/1000Lbs), child deaths 229 (CMR 8.3/1000Lbs), under-5 deaths 1,196 (U5MR 47.1/1000Lbs) and maternal deaths 76 (MMR 288.3/100,000Lbs). Reported diseases included AFP 18, Neonatal tetanus 38, Buruli Ulcer 80 and Guinea worm 34. The challenges were in data management and use.
Conclusions: We conclude that health institutional data may only represent the ear of the hippopotamus and complimented by CBS, health outcomes can be well defined in the CHPS concept and thus contribute immensely to community action with stakeholders.