In Ghana, accessing healthcare in remote, underserved regions remains a significant challenge. These communities face diverse and complex barriers that hinder their ability to afford quality healthcare. Health 2 Go (H2Go), an innovative program launched in 2016, seeks to address this disparity and provide basic healthcare services to children under the age of 5 in rural and underserved communities across Ghana.

Health 2 Go: Bridging the Healthcare Gap

H2Go operates as a program that tackles healthcare shortfalls in underserved communities through a distributed delivery model. It relies on local residents who are trained as community health workers (known as Community Based Agents or CBAs in H2Go) to serve as frontline advocates, bringing healthcare right where it’s needed the most. Currently, H2Go serves a population of over 20,000 people across two diverse regions in Ghana. The program’s approach involves educating communities about health and healthy habits, treating basic illnesses in infants and young children, and connecting residents who have more complex health issues to the appropriate medical facilities.

The Role of Community Based Agents (CBAs) in Ghana

The Ghanaian government introduced the Community-based Health Planning and Services (CHPS) policy in 1999 to make healthcare more accessible in rural areas and empower local communities to take charge of their health.

Ghana has extended the CHPS initiative as the population has changed and the economy has fluctuated. To tackle these issues, a number of healthcare strategies were launched under the CHPS framework, including the national Community Health Worker Cadre initiative in 2014. This CHW Cadre aimed to provide preventive health services as well as danger sign surveillance at the household level. The program ran into a shortage of funding and common challenges that other community health programs have encountered.

Below is a comparison of some of the typical challenges from community health worker programs around the world and Health 2 Go solutions to those challenges.

Common Challenges

  • Insufficient training

  • Inconsistent access to equipment, medicines, and supplies

  • Limited supervision structure

  • Disengaged communities

  • Disconnected from formal health system

  • Poor emphasis on prevention

  • Ineffective consumer branding

Health 2 Go Solutions

  • Ongoing high-quality training

  • Consistent provision of durable equipment, medicines, and supplies

  • Regular supportive supervision

  • Continual community engagement

  • Clear integration into formal health system

  • Prevention, health promotion, and early treatment emphasized

  • Effective consumer branding

Integrating H2Go CBAs into Ghana’s Community-Based Health System

The H2Go model aligns well with the CHPS framework, making it a seamless addition to Ghana’s community-based health system. The program identifies individuals from the respective communities to serve as CBAs. H2Go works with community leadership on the nomination and selection of these CBAs. The CBAs are then recruited, trained, equipped, and compensated to provide preventive and basic treatment services to community members.

Being residents of the communities they serve, the CBAs are familiar with the local dialects and cultural norms, enabling more effective communication and interaction with community members. They act as a bridge between the formal healthcare system and the community, collaborating with Community Health Officers (CHOs) assigned to CHPS compounds. When higher-level care is required, the CBAs refer patients to health centers in the sub-districts, districts, region, and tertiary levels, ensuring a comprehensive healthcare approach.

The H2Go model reinforces the concept of community participation and empowerment, encouraging collaboration between the formal system and community members. By involving the community in the health planning and implementation process, the CBAs foster a sense of ownership of local health issues, contributing to the development of sustainable strategies for improving community health.

The Impact of H2Go CBAs

Over the past six years, H2Go has already demonstrated a significant impact in the regions it serves. Approximately 2,400 children under age 5 in rural, remote, and underserved communities in Ghana have gained access to basic healthcare through the program. The CBAs have played a pivotal role in increasing community health literacy, reducing demand on health facilities, and addressing health disparity issues.

*data is current as of May 31, 2023

Looking Ahead

With the success of H2Go’s pilot and demonstration programs, the program is ready to scale and bring healthcare access to more communities. Integrating CBAs into Ghana’s community-based health system creates a sustainable and efficient approach to address healthcare gaps in underserved regions. As the program moves towards national implementation in Ghana, it also paves the way for potential adaptation and expansion to similar countries in West Africa.

By empowering local communities and leveraging the expertise of CBAs, the H2Go model demonstrates the potential to improve health outcomes, enhance community prosperity, and bridge the healthcare gap in underserved regions of West Africa. Through programs like H2Go, we can foster meaningful change, ensuring that no community is left behind in the journey toward universal health coverage and prosperity for all.

We are now actively working to partner with priority stakeholders, such as the Ministry of Health and Ghana Health Service, to sustainably scale H2Go to the country level. Watch for updates on the new and exciting challenge for H2Go!

Further Reading:

Health 2 Go: An Interview with Ghana Director Dr. Stephen Manortey
Health 2 Go: Rising to the Challenge of Bringing Healthcare to Underserved Communities in West Africa