The Impact of Decentralisation on Sexual and Reproductive Health Services in Ghana

Datos Bibliográficos

ID3972296
AutoresSusannah H Mayhew (0000-0002-2433-3809, University of London, autor de correspondencia)
Año2003
Volumen11
Número21
Páginas74-87
Fecha de publicación2003-01-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaReproductive Health Matters (JOURNAL)
Identificadores de la revistaISSN: 0968-8080 • E-ISSN: 1460-9576
EditorialInforma UK Limited (PUBLISHER • GB)
DOI10.1016/s0968-8080(03)02171-2
PMID12800705
OpenAlexW2085348157
IdiomaEN
Citas recibidas9
Referencias citadas8

This paper analyses the impact of decentralisation on the political organisation, management and provision of sexual and reproductive health services in Ghana. It draws on qualitative research and interviews with key informants from the Ministry of Health, donors, NGOs, regional and district health management teams, local government and community leaders. Within a national reproductive health policy framework, previously disparate family planning, maternal and child health, STI and HIV/AIDS programmes have become more integrated, and donors have pooled or co-ordinated their funding. Some decision-making about resource allocation is meant to happen at district and regional level but in practice, this remains centrally controlled, which may be a necessary safeguard for sexual and reproductive health services. Earmarked donor funds still ensure a regular supply of contraceptives and STI drugs. However, paying for these is problematic at local level. Sexual and reproductive health staff make up a large proportion of primary health care staff, but especially in rural areas they experience poor working conditions, and there is high turnover and vacancies. District and sub-district level links are working well in this new system, but clarity is still needed on how different national sexual and reproductive health bodies relate to each other and to regional and district health authorities. The development of formal mechanisms for priority setting and advocacy at local levels could help to secure benefits for sexual and reproductive health care

Business · Decentralization · Economic growth · Environmental health · Family planning · Health care · Health facility · Health services · Political science · Population · Public health · Reproductive health · Reproductive rights · Sexual and reproductive health and rights · Adolescent Sexual and Reproductive Health · Global Maternal and Child Health · Healthcare Systems and Reforms · Medicine · Nursing · Health Policy