Community and Health Workers Perceptions on a Feasibility of Establishing a Facility For NCD Control in the Manya Krobo Traditional Area

Abstract

Introduction The burden of non-communicable diseases is increasing in sub-Saharan Africa and in areas where HIV/AIDS has traditionally been high, the availability of antiretroviral drugs is leading to a chronicization of the disease, and this is adding to disease burden in a uniquely-demanding way. The Manya Krobo Traditional Area in the Eastern Region of Ghana is suffering this double burden. Method This was a qualitative study conducted among purposively-selected community members, opinion leaders and health workers. Data was collected through in-depth interviews and focus group discussions. Areas of inquiry included level of community and health system support, mode of financing, expected range of services, considerations for the sitting of the facility and the model of management of the facility. Interviews were tape-recorded, transcribed, and coded under the areas of inquiry, with concurrent identification of emergent themes. MAXQDA version 12 was used in the analysis. Results Twenty IDIs and six FGDs were conducted. There was strong expression of interest in the establishment of the facility with enthusiasm being greatest among community members. Health workers were however less enthusiastic. They raised issues about alternative use of the available resources, including the upgrading of existing facilities. Generally there was preference for a comprehensive health facility that although specializing in NCD prevention and care could manage other health conditions. There were strong sentiments in favor of the incorporation of alternative medicine and faith-based approaches. Community members were skeptical about the quality of a government-ran facility. Health workers however saw this as a means to sustainability. Preference was for a facility whose operation will be managed by a faith-based organization. Majority of participants wanted the facility to operate a flexible mode of payment for services. Although there was acknowledgement that the Upper Manya Krobo area lacked health facility, the participant’s preference of the site of the facility often appeared to be influenced by current residence. Conclusion Enthusiasm for the establishment of the facility is high but this should be weighed carefully as it is underpinned by conditions may be difficult to negotiate. The study has highlighted the differences in perceptions between community members, opinion leaders and health workers about the establishment and operation of the health facility. Concerns are raised about sustainability.