Towards Malaria elimination: The Contribution of Community-based Health Planning and Services (CHPS) in access to malaria interventions in Ghana

Background: Despite Ghana's renewed efforts to transition from malaria control to elimination, the Community-based Health Planning and Services (CHPS), the cornerstone to the country's primary healthcare system, and a key platform for delivering malaria elimination interventions remains significantly under-resourced and insufficiently studied. This study aims to assess the operational challenges confronting CHPS and to identify opportunities for strengthening its role in accelerating malaria elimination efforts. Methods: A descriptive analysis was conducted using secondary data from Ghana’s District Health Information Management System 2 (DHIMS2) and the CHPS database system for the Volta Region. Results: There was a total of 462 CHPS zones in the region, covering an estimated 72.8% of the population, of which 75.1% are currently functional. Among 728 healthcare workers deployed to functional CHPS, only 7.1% are trained Community Health Officers (CHOs). Only 15.5% of functional CHPS were equipped with the full complement of basic medical equipment while 10.2% has none. 59.5% CHPS lack staff accommodation, 68.4% were without motorbikes, and only 56.6% and 49.9% have access to potable water and toilet facilities respectively. Notwithstanding, over the five-year period (2019–2023), CHPS contributed significantly to primary health care delivery, accounting for the highest number of home visits (n = 93,082) and outreach services (n = 22,278). Improved CHPS functionality corresponded with improvements in malaria indicators: IPTp coverage increased from 10.4% to 18.5%; the gap between the 4th + antenatal care visit and IPTp-3 uptake narrowed from 30% to 7.8%; management of uncomplicated malaria improved from 24.4% to 34.8%; ITN distribution rose from 5.2% to 12.4%; and with CHPS accounting for approximately 50% of malaria vaccine coverage among children. Conclusions: Despite persistent resource constraints, CHPS has demonstrated significant contributions to malaria intervention coverage and primary health care service delivery. Strengthening CHPS infrastructure and workforce capacity offers a viable strategy for accelerating and sustaining malaria elimination efforts in Ghana.