Decentralization and Governance in the Ghana Health Sector.
Title:
Decentralization and Governance in the Ghana Health Sector.
Author:
Couttolenc, Bernard F.
ISBN:
9780821395905
Personal Author:
Physical Description:
1 online resource (133 pages)
Series:
World Bank Studies
Contents:
Title Page -- Copyright -- Contents -- Foreword -- Acknowledgments -- About the Author -- Acronyms and Abbreviations -- Executive Summary -- 1. Introduction -- Objectives -- The Ghana Health System -- Main Issues in the Health System -- 2. Literature Review on Decentralization -- Conceptual Framework -- Experience in Developing Countries -- Lessons Learned -- 3. Regulatory and Policy Framework on Decentralization in Ghana -- General Legal Regulatory Framework -- Current Legislation and Policies for Decentralization in Health -- 4. Rapid Assessment of Local Capacity and Challenges -- Approach and Methods -- Size and Organization of District Health Systems -- Governance and Accountability of DHAs -- Structure and Staff -- Planning and Budgeting -- Finance and Expenditure -- Human Resources -- Procurement -- Health Care Management -- Knowledge and Perceptions of Decentralization -- Conclusion -- 5. Analysis of Regional Resource Allocation -- Data Sources and Issues -- Some Evidence on Fiscal Decentralization in Health -- The Financing of District Health in Ghana -- Resource Allocation Patterns -- Regional Variation in Health Expenditure per Capita -- Summary of Findings from the Resource Allocation Analysis -- 6. Main Challenges and Policy Options -- Capacity Strengthening -- Coordination Mechanism -- Policy Framework -- Integrated Planning and Budgeting -- Strengthening of DAs' Structure and Capacity -- Management at the Facility Level -- Financing Framework for Decentralization -- Procurement Process -- Human Resources Management -- Information and M&E Systems -- Legal Framework -- Appendix A: Main Legislation and Policy Documents Regarding Decentralization and Local Government in Ghana -- References -- Back Cover.
Abstract:
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 strong regulatory and policy framework for health, regulatory conflicts and duplications accumulated by several waves of regulations, weak capacity to coordinate and manage a devolved health system, fragmented management systems regarding staff management, procurement and budgeting and financing. Political instability and the resulting lack of continuity and consistency in the process during most of the period have also prevented the process to take root, and have contributed to the current fragmentation in the health system. International comparisons indicate that Ghana shows a narrow effective decision space with respect to most health functions and sub-functions when compared with several other developing countries. However, taking advantage of the structures and features that have been put in place, strengthening the policy framework, ensuring effective coordination, and addressing the weaknesses highlighted above, could make decentralization of the health system more effective and consistent with GOG general policy.This study analyzes the strengths and weaknesses of the decentralization of the Ghanaian health system and presents a few recommendations and strategies for strengthening the process. It is relevant and timely as the GOG seeks to strengthen and
deepen decentralization of the health system; it is also useful for other middle- and low-income countries which are pursuing some form of decentralization of their health system to improve its efficiency and effectiveness.
Local Note:
Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, 2017. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries.
Genre:
Electronic Access:
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