The Health Sector in Ghana

Saleh, Karima

doi:10.1596/978-0-8213-9599-8

Cited by 51 publications

(36 citation statements)

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“…For example, apart from the single tertiary hospital in northern Ghana, the other two northern regional hospitals do not have CT, MRI brain scanning services or a neurologist. This finding reinforces earlier reports of limited access to health care facilities in the northern parts of Ghana and has often resulted in poor health outcomes compared to the other parts of Ghana [ 39 , 71 , 72 ]. To address this, an affirmative action in the form of health policy reforms to address this situation will be in the right direction.…”

Section: Discussionsupporting

confidence: 90%

“…Long-term and community-level care after in-patient care remains largely a family responsibility in the absence of a community level rehabilitative care. This augments earlier reports of limited health policy commitment to address the current disease burden posed by stroke and other non-communicable diseases in Ghana [ 39 , 60 – 63 ]. It also concurs with reports of low prioritization of stroke care in the health policy agendas of most LMIC [ 64 – 67 ].…”

Section: Discussionsupporting

confidence: 72%

“…Ghana has a multi-health care system with the involvement of both public and private health care providers where healthcare delivery is provided by the formal medical healthcare system, faith-based health care system and the services from the ethno-medical system [ 38 ]. Of these, there are tertiary-teaching hospitals, regional hospitals, psychiatric hospitals, district hospitals and subdistrict health centres in the public sector [ 39 ]. However, the district hospitals and sub-district health centres often have limited clinical capacity for stroke care and so were excluded in this study.…”

Section: Methodsmentioning

confidence: 99%

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Towards best practice in acute stroke care in Ghana: a survey of hospital services

Baatiema

Otim

Mnatzaganian

et al. 2017

BMC Health Serv Res

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BackgroundStroke and other non-communicable diseases are important emerging public health concerns in sub-Saharan Africa where stroke-related mortality and morbidity are higher compared to other parts of the world. Despite the availability of evidence-based acute stroke interventions globally, uptake in low-middle income countries (LMIC) such as Ghana is uncertain. This study aimed to identify and evaluate available acute stroke services in Ghana and the extent to which these services align with global best practice.MethodsA multi-site, hospital-based survey was conducted in 11 major referral hospitals (regional and tertiary - teaching hospitals) in Ghana from November 2015 to April 2016. Respondents included neurologists, physician specialists and medical officers (general physicians). A pre-tested, structured questionnaire was used to gather data on available hospital-based acute stroke services in the study sites, using The World Stroke Organisation Global Stroke Services Guideline as a reference for global standards.ResultsAvailability of evidence-based services for acute stroke care in the study hospitals were varied and limited. The results showed one tertiary-teaching hospital had a stroke unit. However, thrombolytic therapy (thrombolysis) using recombinant tissue plasminogen activator for acute ischemic stroke care was not available in any of the study hospitals. Aspirin therapy was administered in all the 11 study hospitals. Although eight study sites reported having a brain computed tomographic (CT) scan, only 7 (63.6%) were functional at the time of the study. Magnetic resonance imaging (MRI scan) services were also limited to only 4 (36.4%) hospitals (only functional in three). Acute stroke care by specialists, especially neurologists, was found in 36.4% (4) of the study hospitals whilst none of the study hospitals had an occupational or a speech pathologist to support in the provision of acute stroke care.ConclusionThis study confirms previous reports of limited and variable provision of evidence based stroke services and the low priority for stroke care in resource poor settings. Health policy initiatives to enhance uptake of evidence-based acute stroke services is required to reduce stroke-related mortality and morbidity in countries such as Ghana.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2061-2) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 72%

Section: Methodsmentioning

confidence: 99%

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Towards best practice in acute stroke care in Ghana: a survey of hospital services

Baatiema

Otim

Mnatzaganian

et al. 2017

BMC Health Serv Res

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“…Public facilities provide roughly half of Ghana’s healthcare services, and are overseen by Ghana Health Services, which functions as the implementation agency of the MOH. Teaching hospitals are excluded from the remit of GHS [47]. This has provided them operational independence, but has also limited their influence in health system priority-setting in at least two ways: firstly, by compromising the inclusion of institutional data in national processes health system monitoring and evaluation, and secondly, by weakening the influence of institutional and program leaders in GHS-led reforms (PRA1-GHA) [48].…”

Section: Resultsmentioning

confidence: 99%

Political priority and pathways to scale-up of childhood cancer care in five nations

et al. 2019

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Background Despite increasing global attention to non-communicable diseases (NCDs) and their incorporation into universal health coverage (UHC), the factors that determine whether and how NCDs are prioritized in national health agendas and integrated into health systems remain poorly understood. Childhood cancer is a leading non-communicable cause of death in children aged 0–14 years worldwide. We investigated the political, social, and economic factors that influence health system priority-setting on childhood cancer care in a range of low- and middle-income countries (LMIC). Methods and findings Based on in-depth qualitative case studies, we analyzed the determinants of priority-setting for childhood cancer care in El Salvador, Guatemala, Ghana, India, and the Philippines using a conceptual framework that considers four principal influences on political prioritization: political contexts, actor power, ideas, and issue characteristics. Data for the analysis derived from in-depth interviews ( n = 68) with key informants involved in or impacted by childhood cancer policies and programs in participating countries, supplemented by published academic literature and available policy documents. Political priority for childhood cancer varies widely across the countries studied and is most influenced by political context and actor power dynamics. Ghana has placed relatively little national priority on childhood cancer, largely due to competing priorities and a lack of cohesion among stakeholders. In both El Salvador and Guatemala, actor power has played a central role in generating national priority for childhood cancer, where well-organized and -resourced civil society organizations have disrupted legacies of fragmented governance and financing to create priority for childhood cancer care. In India, the role of a uniquely empowered private actor was instrumental in creating political priority and establishing sustained channels of financing for childhood cancer care. In the Philippines, the childhood cancer community has capitalized on a window of opportunity to expand access and reduce disparities in childhood cancer care through the political prioritization of UHC and NCDs in current health system reforms. Conclusions The importance of key health system actors in determining the relative political priority for childhood cancer in the countries studied points to actor power as a critical enabler of prioritization in other LMIC. Responsiveness to political contexts–in particular, rhetorical and policy priority placed on NCDs and UHC–will be crucial to efforts to place childhood cancer firmly on national health agendas. National governments must be convinced of the potential for foundational health system strengthening through attention to childhood cancer care, and the presence and capability of networked actors primed to amplify public sector investments and catalyze change on the ground.

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“…Payments for referrals up to the teaching hospitals are covered. However, HIV retroviral drugs, hormone, and organ replacement therapy, heart and brain surgery other than the ones caused accidents, diagnosis, and treatment abroad, dialysis for chronic renal failure and cancers are excluded from the insurance package [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Determinants and the impact of the National Health Insurance on neonatal mortality in Ghana

Lambon‐Quayefio

Owoo

2017

Health Econ Rev

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The national health insurance was established to increase access to health care services and the maternal component was later introduced to improve the health outcomes of both mother and child. The main objectives of this study are to investigate the factors that affect neonatal deaths as well as examine the effect of the Ghana Health Insurance on neonatal deaths in Ghana. Using the most recent round of the Ghana Demographic and Health Survey, the study estimates the probit model with interaction effects to account for the heterogeneity in outcomes. Additionally, the study employs the propensity score matching approach to account for the possible endogeneity in the insurance enrolment decision. Results from the estimations, after controlling for relevant individual and household characteristics suggest that the national health insurance significantly reduces the likelihood of neonatal deaths. Estimates remain consistent even after more robust estimators are employed. Estimates from the interaction between place of residence and health insurance indicate that health insurance beneficiaries who reside in urban areas are at a higher risk of neonatal deaths compared to other women. Access to medical facilities proxied by distance to the nearest health post emerged as an important predictor of neonatal death. The study also suggests significant regional differences in neonatal deaths. We, therefore, conclude that the national health insurance may have the potential to substantially improve the health outcomes of neonates and have policy implications for increasing coverage to more mothers and their neonates, as well as coverage in critical neonatal services and drugs.

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The Health Sector in Ghana

Cited by 51 publications

References 0 publications

Towards best practice in acute stroke care in Ghana: a survey of hospital services

Towards best practice in acute stroke care in Ghana: a survey of hospital services

Political priority and pathways to scale-up of childhood cancer care in five nations

Determinants and the impact of the National Health Insurance on neonatal mortality in Ghana

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