Making districts functional for universal health coverage attainment: lessons from Ghana

Frontiers in Public Health

Public Health

Cornelius Debpuur¹  Regina Titi-Ofei²  Hillary Kipruto³  Anthony Ofosu⁴  Dominic Atweam⁴  Bertha Kembabazi⁵  Francis Chisaka Kasolo⁵  Solyana Ngusbrhan Kidane⁵  Humphrey Cyprian Karamagi⁵  Thandekile Ntombikayise Moyo⁵  Sokona Sy⁵ 

[1]Ghana Health Service, Accra, Ghana

[2]The Global Fund to Fight AIDS, TB and Malaria, Switzerland, Geneva

[3]World Health Organization (WHO Zimbabwe), Harare, Zimbabwe

[4]World Health Organization, Accra, Ghana

[5]World Health Organization—Regional Office for Africa, Brazzaville, Democratic Republic of Congo

关键词: functionality;    management;    performance;    health systems;    oversight;    service provision assessment;    assessment;   

DOI  :  10.3389/fpubh.2023.1159362

 received in 2023-02-05, accepted in 2023-04-13,  发布年份 2023

来源: Frontiers

【 摘 要 】

Ensuring the sub national level in the health system can function effectively is central to attainment of health results in countries. However, the current health agenda has not prioritized how districts can deploy their existing resources effectively, to maximize the efficiency equity and effectiveness in their use. Ghana initiated a self-assessment process to understand the functionality of districts to deliver on health results. The assessment was conducted by health managers in 33 districts during August–October 2022 using tools pre-developed by the World Health Organization. Functionality was explored around service provision, oversight, and management capacities, each with defined dimensions and attributes. The objective of the study was to highlight specific functionality improvements needed by districts in terms of investments and access to service delivery in achieving Universal Health Care. The results showed a lack of correlation between functionality and performance as is currently defined in Ghana; a higher functionality of oversight capacity compared to service provision or management capacities; and specifically low functionality for dimensions relating to capacity to make available quality services, responsiveness to beneficiaries and the systems and three structures for health management. The findings highlight the need to shift from quantitative outcome indicator-based performance approaches to measures of total health and wellbeing of beneficiaries. Specific functionality improvements are needed to improve the engagement and answerability to the beneficiaries, investments in access to services, and in building management architecture.

【 授权许可】

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Copyright © 2023 Karamagi, Sy, Kipruto, Kembabazi, Kidane, Moyo, Titi-Ofei, Atweam, Debpuur, Ofosu and Kasolo.