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Book Cover
Author Couttolenc, Bernard.

Title Decentralization and governance in the Ghana health sector / Bernard F. Couttolenc
Published Washington : World Bank Publications, 2012
Online access available from:
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Description 1 online resource (xvii, 102 pages) : illustrations
Series World Bank study
World Bank studies.
Contents Foreword; Acknowledgments; About the Author; Acronyms and Abbreviations; Executive Summary; 1. Introduction; Objectives; The Ghana Health System; Tables; Table 1.1: Distribution of facilities by type and ownership; Table 1.2: Facility number and density by region; Figures; Figure 1.1: Levels and institutions in the Ghana health system; Table 1.3: Mean size of hospitals by type, 2008; Table 1.4: Mean size of other facilities and administrative units by type, 2008; Main Issues in the Health System; 2. Literature Review on Decentralization; Conceptual Framework
4. Rapid Assessment of Local Capacity and ChallengesApproach and Methods; Size and Organization of District Health Systems; Table 4.1: Structure and number of questions in the instrument; Figure 4.1: Participants in the workshop; Governance and Accountability of DHAs; Table 4.2: Mean density of public health infrastructure per district; Figure 4.2: Administrative lines of authority; Figure 4.3: Lines of accountability; Figure 4.4: Role of the committee; Structure and Staff; Figure 4.5: Contracting arrangements with other public entities; Planning and Budgeting
Experience in Developing CountriesFigure 2.1: Relation between scope, depth, and types of decentralization; Lessons Learned; Table 2.1: Mapping the decision space: Ghana, Philippines, Uganda, and Zambia; Table 2.2: Main advantages and disadvantages of the modalities of decentralization; Table 2.3: Expected impacts and risks in decentralization; 3. Regulatory and Policy Framework on Decentralization in Ghana; General Legal Regulatory Framework; Current Legislation and Policies for Decentralization in Health; Table 3.1: Mapping out the decision space for Ghana districts regarding health
Figure 4.14: Supervision and interaction with sub-district health servicesFigure 4.15: Awareness of role and responsibilities under decentralization; Figure 4.16: Expected main responsibilities under decentralization; Figure 4.17: Perceptions about transfer of DHAs to DA authority (percentage of agreement); Figure 4.18: Perceptions about transfer of facilities to DAs: Health Centers (percentage of agreement); Figure 4.19: Perceptions about transfer of facilities to DAs: Hospitals (percent of agreement); Figure 4.20: Perceptions on the feasibility of decentralization
Figure 4.6: Administrative units present at RHAs and DHAsFigure 4.7: Health Office involvement in integrated planning; Finance and Expenditure; Figure 4.8: Responsibility for budget execution; Figure 4.9: Contracting arrangements with other public entities; Human Resources; Figure 4.10: Authority for determining staff numbers and composition; Procurement; Figure 4.11: Authority for hiring staff; Health Care Management; Figure 4.12: Responsibility for drugs procurement; Knowledge and Perceptions of Decentralization; Figure 4.13: Supervision of and interaction with District Hospitals
Summary 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 stron
Notes Figure 4.21: Expectations on positive impact of decentralization on health system performance
Title from PDF title page (viewed September 10, 2012)
Bibliography Includes bibliographical references
Subject Health planning -- Law and legislation -- Ghana.
Health planning -- Ghana.
Health services administration -- Ghana.
Health Policy.
Regional Health Planning -- economics.
Regional Health Planning -- organization & administration.
Form Electronic book
LC no. 2012023399
ISBN 0821395904 (electronic bk.)
9780821395905 (electronic bk.)