Decentralization And Governance In The Ghana Health Sector

In recent years, many countries, both developed and developing, have engaged in a process of decentralization of health service delivery and/or other functions of the health system. In most cases, decentralization has been adopted to improve accountability to local population, efficiency in service provision, equity in access and resource distribution, or to increase resource mobilization. Ghana has a long history of local government, going back to pre-independence times of the nineteenth century. By 1859 Municipal Councils were established in the major coastal towns of the then Gold Coast. Native Authorities, Councils and Courts were also established to administer law and order under the indirect authority of the colonial government; the limitations of this system was repeatedly put forward in the 1930s and 1940s, and reforms were introduced in 1951 by the Local Government Ordinance (Ahwoi 2010). The government has embarked in a decentralization policy since independence, which was strengthened and amplified by the local government act of 1993 and other legislations. At the present the Government of Ghana (GOG) is committed to strengthen the implementation of decentralization and for that purpose revise and strengthen the policy and regulatory framework governing decentralization. In spite of this long history and successive waves of decentralization reforms, effective decentralization in the country still faces considerable challenges, especially in large social sectors involving large structures. The public health sector is one that has not fully embraced the decentralization model adopted by the GOG, decentralization by devolution to the districts, for a number of reasons that will be discussed in this report. Some functions and responsibilities have been decentralized, but others remain centralized or simply deconcentrated.

Ghana's government has embarked on a decentralization process since the 1980s, but devolution of the health system faces important challenges and weaknesses. Ghana has made significant progress, and several building blocks for a devolved health system have been put in place. However, important weaknesses remain regarding several of the key requirements to successful decentralization. Ghana has along the years put in place several important building blocks for a truly decentralized health system. But these efforts have been hampered, and their effectiveness diminished, by the absence of a stron.

Drawing on field-based data and experiences from the practice of democratic decentralization and local governance over the last three decades in Ghana, this book examines whether and how democratic decentralization and local governance reforms in developing countries have produced the anticipated development outcomes. In seventeen related contributions, the authors present four relevant focal themes, including conceptual and historical trajectories of decentralization and local governance; institutional choice, democratic representation, and poverty reduction; local governance, resource capacity, and service delivery; and non-state actors, local governance and sustainable development. The book blends perspectives of scholars, practitioners, and policy-makers to provide a holistic analysis of linkages between decentralization, local governance, and sustainable development efforts, presenting a novel and useful guide for science, policy, and practice of bottom-up governance and development. It provides relevant lessons and experiences for scholars, policy-makers, and development practitioners in Africa in particular and developing countries in general.

"... briefly discusses some of the debates in Ghana's health sector: decentralization and governance, private sector partnership, strengthening health systems, and health financing. It brings together several elements of health system development and challenges and links it to health financing and delivery performance. The volume reviews the situation among human resources for health and pharmaceuticals. The private sector is growing and attention is required on its development. The volume benefits from health service delivery assessments in the public and private sectors, and finds large variations in distribution and weak incentives to improve productivity and performance. It also reviews the demand side financing reform, its coverage of the population and its effect on service use and the financial sustainability of the National Health Insurance Scheme ..."--Publisher's website.

Exploring the capacity and impact of decentralization within European health care systems, this book examines both the theoretical underpinnings as well as practical experience with decentralization.

Ghana's government has embarked on a decentralization process since the 1980s, but the intended devolution of the health system faces important challenges and shortfalls. This study analyzes the strengths and weaknesses of the decentralization of the Ghanaian health system.

Looking at Canada, Brazil, Germany, Mexico, Nigeria, Pakistan, South Africa and Switzerland, Federalism and Decentralization in Health Care examines the overall organization of the health system.

Polemic Paper from the year 2016 in the subject Business economics - Economic Policy, , language: English, abstract: This paper explores the definition of New Public Management (NPM), introduces its application in developing countries, and uses specific examples pertaining to health sector reform to demonstrate the effectiveness of NPM. The essay first introduces different concepts of NPM from different scholars, then discusses the implementations of NPM in developing countries, using as case-studies the health sector reforms of Ghana, Zambia and China. Furthermore, the essay shows the influence of NPM and illustrates the improvements of health services in the aforementioned countries. Finally, this report concludes the findings, showcasing NPM as a useful paradigm to reform health sector in developing countries.

This volume analyzes Ghana s National Health Insurance Scheme and highlights the range of policy options needed to assure its financially sustainable transition to universal coverage.