Priority setting for reproductive health at the district level in the context of health sector reforms in Ghana

Birungi, Harriet; Nyarko, Philomena; Askew, Ian; Ajayi, Ayorinde; Addico, Gifty; Addai, Edward; Jehu-Appiah, Caroline

doi:10.31899/rh4.1145

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…Under the sector-wide approach, dialogue between government and international donors shifted up a level: from the planning and management of projects, to the overall policy, institutional, and financial framework within which health care is provided at national level [ 7 ]. The Government of Ghana, represented by the MOH, and international donors jointly agreed to national priorities expressed in the programme of work – which states the policies, strategies, targets, and resource envelope and allocation for the sector [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

The role of policy actors and contextual factors in policy agenda setting and formulation: maternal fee exemption policies in Ghana over four and a half decades

Koduah

Dijk

Agyepong

2015

Health Res Policy Sys

106

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BackgroundDevelopment of health policy is a complex process that does not necessarily follow a particular format and a predictable trajectory. Therefore, agenda setting and selecting of alternatives are critical processes of policy development and can give insights into how and why policies are made. Understanding why some policy issues remain and are maintained whiles others drop off the agenda is an important enquiry. This paper aims to advance understanding of health policy agenda setting and formulation in Ghana, a lower middle-income country, by exploring how and why the maternal (antenatal, delivery and postnatal) fee exemption policy agenda in the health sector has been maintained over the four and half decades since a ‘free antenatal care in government facilities’ policy was first introduced in October 1963.MethodsA mix of historical and contemporary qualitative case studies of nine policy agenda setting and formulation processes was used. Data collection methods involved reviews of archival materials, contemporary records, media content, in-depth interviews, and participant observation. Data was analysed drawing on a combination of policy analysis theories and frameworks.ResultsContextual factors, acting in an interrelating manner, shaped how policy actors acted in a timely manner and closely linked policy content to the intended agenda. Contextual factors that served as bases for the policymaking process were: political ideology, economic crisis, data about health outcomes, historical events, social unrest, change in government, election year, austerity measures, and international agendas. Nkrumah’s socialist ideology first set the agenda for free antenatal service in 1963. This policy trajectory taken in 1963 was not reversed by subsequent policy actors because contextual factors and policy actors created a network of influence to maintain this issue on the agenda. Politicians over the years participated in the process to direct and approve the agenda. Donors increasingly gained agenda access within the Ghanaian health sector as they used financial support as leverage.ConclusionInfluencers of policy agenda setting must recognise that the process is complex and intertwined with a mix of political, evidence-based, finance-based, path-dependent, and donor-driven processes. Therefore, influencers need to pay attention to context and policy actors in any strategy.

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Section: Introductionmentioning

confidence: 99%

The role of policy actors and contextual factors in policy agenda setting and formulation: maternal fee exemption policies in Ghana over four and a half decades

Koduah

Dijk

Agyepong

2015

Health Res Policy Sys

106

View full text Add to dashboard Cite

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“…The study was theoretically based on Walt and Gilson's Policy Triangle (1994) which explain policy from four dimensions/elements namely the content, context, process, and actors and had been used by other scholars as the basis of policy studies (Walt & Gilson, 1994;Buse, 2008;Rajkotia & Frick, 2012;Addai et al, 2006;Colombini et al, 2011) as illustrated in Figure 1 below. The policy triangle explains that to every policy, there is a content (what the policy is all about), the context (conditions necessitating the policy), the process (the implementation structure of the policy), and the actors (the stakeholders of the policy).…”

Section: Theoretical and Conceptual Framework For The Studymentioning

confidence: 99%

Medicine Procurement Framework for Public Hospitals under the Ministry of Health in Ghana: A Case of the Western Region

Domie,

Dodzi

2023

OJBM

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Medicine availability is one of the six fundamental building blocks of any well-functioning health system. In Ghana, the Ministry of Health (MOH) introduced the Medicines Procurement Framework Agreement (MPFA) policy in 2017 as part of strategies to ensure an all-time availability of essential medicines to improve the quality of healthcare delivery. The purpose of this research study is to explore the views and opinions of health professionals on the content, context, process, actors, and sustainability of the Medicines Procurement Framework Agreement of the Ministry of Health, Ghana in the Western Region of Ghana and to identify strategies that will help the key stakeholders to better understand the implementation problems and to address them to ensure the sustainability of the policy. This study utilized the traditional case-study approach to explore the key stakeholders' opinions, views, and experiences on implementing and sustaining the Medicines Procurement Framework Agreement. The main population of the study was healthcare professionals in the public sector. The study sample consisted of twenty-five healthcare professionals from six government health facilities in the Western Region of Ghana. A qualitative methodology including nonprobability sampling (Purposive and convenient), in-depth interviews, and documentary review was the main method of data collection. Data were coded and entered into Nvivo 7 statistical software for content and thematic analysis. Descriptive statistics were employed to analyze demographic data and narrative analysis was used to describe respondents' views, perceptions, and opinions with direct quotations to support the analysis. Technical considerations such as improving equity, efficiency, and, quality of healthcare delivery and minimization of administrative bottlenecks associated with institutional base procurements provided the contexts for the introduction of the MPFA; yet most healthcare professionals are not fully aware of the content

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Priority setting for reproductive health at the district level in the context of health sector reforms in Ghana

Cited by 2 publications

References 7 publications

The role of policy actors and contextual factors in policy agenda setting and formulation: maternal fee exemption policies in Ghana over four and a half decades

The role of policy actors and contextual factors in policy agenda setting and formulation: maternal fee exemption policies in Ghana over four and a half decades

Medicine Procurement Framework for Public Hospitals under the Ministry of Health in Ghana: A Case of the Western Region

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