@article{448628,
      recid = {448628},
      author = {Couttolenc, Bernard.},
      title = {Decentralization and governance in the Ghana health sector  [electronic resource] /},
      publisher = {International Bank for Reconstruction and Development/The  World Bank,},
      address = {Washington, D.C. :},
      pages = {1 online resource (xvii, 102 p.) :},
      year = {2012},
      abstract = {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 strong regulatory and  policy framework for health, regulatory conflicts and  duplications accumulated by several waves of regulations,  weak capacity to coordinate and manage a devolved health  system, fragmented management systems regarding staff  management, procurement and budgeting and financing.  Political instability and the resulting lack of continuity  and consistency in the process during most of the period  have also prevented the process to take root, and have  contributed to the current fragmentation in the health  system. International comparisons indicate that Ghana shows  a narrow effective decision space with respect to most  health functions and sub-functions when compared with  several other developing countries. However, taking  advantage of the structures and features that have been put  in place, strengthening the policy framework, ensuring  effective coordination, and addressing the weaknesses  highlighted above, could make decentralization of the  health system more effective and consistent with GOG  general policy. This study analyzes the strengths and  weaknesses of the decentralization of the Ghanaian health  system and presents a few recommendations and strategies  for strengthening the process. It is relevant and timely as  the GOG seeks to strengthen and deepen decentralization of  the health system; it is also useful for other middle- and  low-income countries which are pursuing some form of  decentralization of their health system to improve its  efficiency and effectiveness.},
      url = {http://library.usi.edu/record/448628},
}