Ghana s demographic profile is changing, and demographic,
epidemiological, and nutrition transitions are well underway.
However, several of Ghana s health outcome performances, especially
in terms of child health and maternal health, are worse than the
levels found in other comparable lower middle income and health
spending countries. The volume is timely, given the stage of the
Ghana's development. It 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. There is
fragmentation in financing of public health, and inefficiency in
health spending, and there is need to improve spending in areas
that provide a higher value for money. Data overall has been a
constraint, however, the study benefits from various household
level surveys to disaggregate the analysis by income quintiles. It
also reviews the household s vulnerability to health shocks and
their financial protection against illness costs. There is inequity
in health access, health service use, and health outcomes. The
Northern regions have poorer results. Finally, the volume
highlights the range of policy options needed to improve health
system performance and health outcomes. At this stage of the
country s development, and taking the agenda for reform to the next
level, the Government of Ghana could embark on significant reforms
in the areas of (a) decentralization and governance, (b) health
service delivery, (c) public health, and (d) health financing.
Further it should set up a holistic and accountable health reform
process as it transitions to universal coverage along with its
concomitant service delivery, public health, and governance
reforms."
General
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