Irene Akua Agyepong
Dados Biográficos
| ID | 1727202 |
|---|---|
| NOME | Irene Akua Agyepong |
| PRENOMES | Irene Akua |
| SOBRENOME | Agyepong |
| ASSINATURA | AGYEPONG I A |
| AFILIAÇÕES | University of Ghana |
| ORCID | 0000-0002-0193-5882 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 43 |
| TOTAL DE CITAÇÕES | 127 |
| TOTAL COMO AUTOR | 43 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1992 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 6 |
Current and potential uses of drones in healthcare delivery in sub-Saharan Africa
Primary health care networks and impacts in low- and middle-income countries
Primary healthcare provider networks (PHCPNs) are increasingly recognized as promising strategies to effectively strengthen health systems in low- and middle-income countries (LMICs). However, there is limited information on the influence PHCPNs may have on the process and clinical outcomes of health services. This study sought to answer the questions: what is the extent, range, and nature of research on PHCPNs in LMICs, what are the types of PHC…
Disparities in the access and provision of mental health services as part of primary health care
Mental illness can be as debilitating as physical ailments, yet many mental health patients lack access to quality mental health care in low- and middle-income countries. This study aimed to identify and characterize disparities in access to mental health care, as well as challenges in service provision, in the Ga-South district of Ghana. A qualitative case study design was used, employing purposive and snowball sampling to recruit participants. …
Barriers and facilitators of primary care management of type II diabetes mellitus in the West African sub-region
The prevalence of diabetes is rising rapidly across West Africa, posing a significant public health challenge. Effective diabetes management through accessible and quality primary healthcare is crucial, yet multiple barriers persist. This review aimed to synthesise the available evidence on factors influencing access, utilisation, and quality of diabetes primary care in West Africa. Following Arksey and O’Malley’s framework and PRISMA-ScR guideli…
Conceptualizing maternal mental health in rural Ghana
In low- and middle-income countries, maternal mental health needs remain neglected, and common mental disorders during pregnancy and after birth are routinely associated with hormonal changes. The psycho-social and spiritual components of childbirth are often downplayed. A qualitative study was conducted as part of a wider realist evaluation on health systems responsiveness to examine the interrelationships between pregnant and postnatal women, t…
Institutionalizing linkages between informal healthcare providers and the formal health system in Nigeria
With most households in rapidly urbanizing cities in low- and medium-income countries using private and informal providers for basic healthcare, the need to establish linkages with the formal sector is paramount in the drive for universal health coverage. Successful and effective linkage of informal healthcare providers to the formal health system requires an understanding of prevailing contextual factors and how they can be modulated to support …
Adolescent mental, sexual, and reproductive health in Ghana
One in five adolescents (aged 10–19 years) live in sub-Saharan Africa. Despite the availability of policies targeted at this age group, policy formulation, implementation, and gains in adolescent health continue to be underwhelming. Stakeholders or actors are architects of policy, bringing their ideological values, interests, power, and positions to policy formulation and implementation and thus influencing the policy process. We analysed multile…
Tools for screening maternal mental health conditions in primary care settings in sub-Saharan Africa
Uncovering the determinants of health in deprived urban neighborhoods in Accra, Ghana
Background: Delivering primary care services within the context of rapid urbanization and a changing disease burden is a major challenge in sub-Saharan Africa. Rural models of primary care, including the "Community-based Health Planning and Services" (CHPS) programme in Ghana, have shown improved health outcomes. However, adapting these to the urban context has proved problematic. Differences in the determinants of health found in these settings …
“We have nice policies but…”
Introduction: Although policies for adolescent health exist in Ghana, their implementation is challenging. Availability of services for adolescent sexual and reproductive health and adolescent mental health remains less than desired, with adolescent mental health being particularly neglected despite being an important contributor to poor health outcomes. This study presents an analysis of gaps in the implementation of the Ghana Adolescent Health …
We can't expect much”
Responsiveness centres on understanding peoples' ‘legitimate’ expectations of their health system. • Healthcare-related expectations are shaped at the intersection of social, temporal, and spatial ‘locations’. • Expectations are also shaped by social norms, and market-driven practices and forces in the health system. • There is a need for health system actors to consider the impact of market forces on responsive care provision. • Active citizen p…
Learning from the Covid-19 pandemic for future epidemics and pandemics preparedness and response in Guinea
The outbreak of the novel coronavirus (SARS-CoV-2) in December 2019 prompted a response from health systems of countries across the globe. The first case of COVID-19 in Guinea was notified on 12 March 2020; however, from January 2020 preparations at policy and implementation preparedness levels had already begun. This study aimed to assess the response triggered in Guinea between 27 th January 2020 and 1 st November 2021 and lessons for future pa…
The Role of the Private Sector in the Covid-19 Pandemic
As societies urbanize, their populations have become increasingly dependent on the private sector for essential services. The way the private sector responds to health emergencies such as the COVID-19 pandemic can determine the health and economic wellbeing of urban populations, an effect amplified for poorer communities. Here we present a qualitative document analysis of media reports and policy documents in four low resource settings-Bangladesh…
Powers, engagements and resultant influences over the design and implementation of medicine pricing policies in Ghana
INTRODUCTION: Universal availability and affordability of essential medicines are determined by effective design and implementation of relevant policies, typically involving multiple stakeholders. This paper examined stakeholder engagements, powers and resultant influences over design and implementation of four medicines pricing policies in Ghana: Health Commodity Supply Chain Master Plan, framework contracting for high demand medicines, Value Ad…
Learning is a means to progress and empowerment for health systems
‘It’s far too complicated’
Capacity, committed funding and co-production—institutionalizing implementation research in low- and middle-income countries
Implementation research on sustainable electrification of rural primary care facilities in Ghana and Uganda
Access to energy is essential for resilient health systems; however, strengthening energy infrastructure in rural health facilities remains a challenge. In 2015–19, ‘Powering Healthcare’ deployed solar energy solutions to off-grid rural health facilities in Ghana and Uganda to improve the availability of maternal and child health services. To explore the links between health facility electrification and service availability and use, the World Hea…
Countdown to 2030
Leadership styles in two Ghanaian hospitals in a challenging environment
Hospital managers' power to exercise effective leadership in daily management can affect quality of care directly as well as through effects on frontline workers' motivation. This paper explores the influence of contextual factors on hospital managers' leadership styles and the motivation of frontline workers providing maternal and new born care in two public district hospitals in Ghana. It draws on data from an ethnographic study that involved p…
Strengthening health system leadership for better governance
This editorial provides an overview of the six papers included in this special supplement on health leadership in Africa. Together the papers provide evidence of leadership in public hospital settings and of initiatives to strengthen leadership development. On the one hand, they demonstrate both that current leadership practices often impact negatively on staff motivation and patient care, and that contextual factors underpin poor leadership. On …
Strategic leadership capacity building for Sub-Saharan African health systems and public health governance
Leadership capacity needs development and nurturing at all levels for strong health systems governance and improved outcomes. The Doctor of Public Health (DrPH) is a professional, interdisciplinary terminal degree focused on strategic leadership capacity building. The concept is not new and there are several programmes globally–but none within Africa, despite its urgent need for strong strategic leadership in health. To address this gap, a consor…
Ghana's community-based primary health care
Postings and transfers in the Ghanaian health system
These findings point to tensions between individual and organisational goals. This article contributes to a burgeoning literature on postings and transfers as a distinct dynamic which bridges the interactions between health systems governance and health workforce development. Importantly, this article helps to expand the notion of health systems governance beyond 'good' governance towards understanding governance as a process of negotiation
Temporal trends in childhood mortality in Ghana
BACKGROUND: Following the adoption of the Millennium Development Goal 4 (MDG 4) in Ghana to reduce under-five mortality by two-thirds between 1990 and 2015, efforts were made towards its attainment. However, impacts and challenges of implemented intervention programs have not been examined to inform implementation of Sustainable Development Goal 3.2 (SDG 3.2) that seeks to end preventable deaths of newborns and children aged under-five. Thus, thi…
Equity aspects of the National Health Insurance Scheme in Ghana
Public social policy development and implementation
The public social policy and programme decisions that are made in low-income countries have critical effects on human social and development outcomes. Unfortunately, it would appear that inadequate attention is paid to analysing, understanding and factoring into attempts to reshape or change policy, the complex historical, social, cultural, economic, political, organizational and institutional context; actor interests, experiences, positions and …
Malaria
Household perceptions and their implications for enrolment in the National Health Insurance Scheme in Ghana
OBJECTIVE: This paper identifies, ranks and compares perceptions of insured and uninsured households in Ghana on health care providers (quality of care, service delivery adequacy, staff attitudes), health insurance schemes (price, benefits and convenience) and community attributes (health 'beliefs and attitudes' and peer pressure). In addition, it explores the association of these perceptions with household decisions to voluntarily enroll and rem…
Ghana's community-based primary health care
Reforming Health Service Delivery at District Level in Ghana
Many countries in sub-Saharan Africa face the problem of organizing health service delivery in a manner that provides adequate quality and coverage of health care to their populations against a background of economic recession and limited resources. In response to these challenges, different governments, including that of Ghana, have been considering or are in the process of implementing varying degrees of reform in the health sector. This paper …
Strengthening health system leadership for better governance
This editorial provides an overview of the six papers included in this special supplement on health leadership in Africa. Together the papers provide evidence of leadership in public hospital settings and of initiatives to strengthen leadership development. On the one hand, they demonstrate both that current leadership practices often impact negatively on staff motivation and patient care, and that contextual factors underpin poor leadership. On …
Your health our concern, our health whose concern
Taking a perspective of frontline health workers as internal clients within health systems, this study explored how perceived injustice in policy and organizational matters influence frontline health worker motivation and the consequent effect on workers' attitudes and performance in delivering maternal and neonatal health care in public hospitals. It consisted of an ethnographic study in two public hospitals in Southern Ghana. Participant observ…
When 'solutions of yesterday become problems of today
Implementation of policies (decisions) in the health sector is sometimes defeated by the system's response to the policy itself. This can lead to counter-intuitive, unanticipated, or more modest effects than expected by those who designed the policy. The health sector fits the characteristics of complex adaptive systems (CAS) and complexity is at the heart of this phenomenon. Anticipating both positive and negative effects of policy decisions, un…
The path dependence of district manager decision-space in Ghana
The district health system in Ghana today is characterized by high resource-uncertainty and narrow decision-space. This article builds a theory-driven historical case study to describe the influence of path-dependent administrative, fiscal and political decentralization processes on development of the district health system and district manager decision-space. Methods included a non-exhaustive literature review of democratic governance in Ghana, …
The one with the purse makes policy
Leadership styles in two Ghanaian hospitals in a challenging environment
Hospital managers' power to exercise effective leadership in daily management can affect quality of care directly as well as through effects on frontline workers' motivation. This paper explores the influence of contextual factors on hospital managers' leadership styles and the motivation of frontline workers providing maternal and new born care in two public district hospitals in Ghana. It draws on data from an ethnographic study that involved p…
An evaluation of Health Workers for Change in seven settings
This paper presents the findings of a multi-centre study assessing the impact of Health Workers for Change (HWFC) workshops in seven different primary care sites, based on the common core protocol described in this paper. The paper discusses a common methodology used by the studies, consisting of a triangulation of qualitative and quantitative methods. Such methodologies are inherently complex as they require comparisons across systems, sites and…
We can't expect much”
Responsiveness centres on understanding peoples' ‘legitimate’ expectations of their health system. • Healthcare-related expectations are shaped at the intersection of social, temporal, and spatial ‘locations’. • Expectations are also shaped by social norms, and market-driven practices and forces in the health system. • There is a need for health system actors to consider the impact of market forces on responsive care provision. • Active citizen p…
Strategic leadership capacity building for Sub-Saharan African health systems and public health governance
Leadership capacity needs development and nurturing at all levels for strong health systems governance and improved outcomes. The Doctor of Public Health (DrPH) is a professional, interdisciplinary terminal degree focused on strategic leadership capacity building. The concept is not new and there are several programmes globally–but none within Africa, despite its urgent need for strong strategic leadership in health. To address this gap, a consor…
Sustainability of recurrent expenditure on public social welfare programmes
OBJECTIVE: Sustainability of public social welfare programmes has long been of concern in development circles. An important aspect of sustainability is the ability to sustain the recurrent financial costs of programmes. A free maternal care programme (FMCP) was launched under the Ghana National Health Insurance Scheme (NHIS) in 2008 with a start-up grant from the British Government. This article examines claims expenditure under the programme and…
Strategies to improve adherence to recommended chloroquine treatment regimes
Malaria
Mosquito Avoidance and Bed Net Use in the Greater Accra Region, Ghana
Qualitative research and cross-sectional survey methods were used in a study conducted in rural and urban areas of the Greater Accra Region, Ghana, to explore people's understanding of the cause of malaria and patterns of mosquito avoidance, in particular bed net ownership and use. The study indicated far higher bed net ownership and use in rural than urban areas, which was related partly to perceived affordability and partly to the different con…
Reforming Health Service Delivery at District Level in Ghana
Many countries in sub-Saharan Africa face the problem of organizing health service delivery in a manner that provides adequate quality and coverage of health care to their populations against a background of economic recession and limited resources. In response to these challenges, different governments, including that of Ghana, have been considering or are in the process of implementing varying degrees of reform in the health sector. This paper …
An evaluation of Health Workers for Change in seven settings
This paper presents the findings of a multi-centre study assessing the impact of Health Workers for Change (HWFC) workshops in seven different primary care sites, based on the common core protocol described in this paper. The paper discusses a common methodology used by the studies, consisting of a triangulation of qualitative and quantitative methods. Such methodologies are inherently complex as they require comparisons across systems, sites and…
Strategies to improve adherence to recommended chloroquine treatment regimes
Public social policy development and implementation
The public social policy and programme decisions that are made in low-income countries have critical effects on human social and development outcomes. Unfortunately, it would appear that inadequate attention is paid to analysing, understanding and factoring into attempts to reshape or change policy, the complex historical, social, cultural, economic, political, organizational and institutional context; actor interests, experiences, positions and …
Building the Field of Health Policy and Systems Research
Following the First Global Symposium on Health Systems Research in Montreux in November 2010, PLoS Medicine commissioned three articles on the state-of-the-art in Health Policy and Systems Research (HPSR). Three Policy Forum articles, authored by a diverse group of global health academics, critically examine the current challenges to the field and lay out what is needed to build capacity in HPSR and support local policy development and health sys…
Building the Field of Health Policy and Systems Research
Following the First Global Symposium \non Health Systems Research in \nMontreux in November 2010, PLoS \nMedicine commissioned three articles \non the state-of-the-art in Health \nPolicy and Systems Research (HPSR). \nThree Policy Forum articles, authored \nby a diverse group of global \nhealth academics, critically examine \nthe current challenges to the field \nand lay out what is needed to build \ncapacity in HPSR and support local \npolicy de…
Equity aspects of the National Health Insurance Scheme in Ghana
When 'solutions of yesterday become problems of today
Implementation of policies (decisions) in the health sector is sometimes defeated by the system's response to the policy itself. This can lead to counter-intuitive, unanticipated, or more modest effects than expected by those who designed the policy. The health sector fits the characteristics of complex adaptive systems (CAS) and complexity is at the heart of this phenomenon. Anticipating both positive and negative effects of policy decisions, un…
Household perceptions and their implications for enrolment in the National Health Insurance Scheme in Ghana
OBJECTIVE: This paper identifies, ranks and compares perceptions of insured and uninsured households in Ghana on health care providers (quality of care, service delivery adequacy, staff attitudes), health insurance schemes (price, benefits and convenience) and community attributes (health 'beliefs and attitudes' and peer pressure). In addition, it explores the association of these perceptions with household decisions to voluntarily enroll and rem…
Community concepts of poverty
BACKGROUND: Poverty is multi dimensional. Beyond the quantitative and tangible issues related to inadequate income it also has equally important social, more intangible and difficult if not impossible to quantify dimensions. In 2009, we explored these social and relativist dimension of poverty in five communities in the South of Ghana with differing socio economic characteristics to inform the development and implementation of policies and progra…
Republished research: Implementation research: what it is and how to do it
The field of implementation research is growing, but it is not well understood despite the need for better research to inform decisions about health policies, programmes, and practices. This article focuses on the context and factors affecting implementation, the key audiences for the research, implementation outcome variables that describe various aspects of how implementation occurs, and the study of implementation strategies that support the d…
Your health our concern, our health whose concern
Taking a perspective of frontline health workers as internal clients within health systems, this study explored how perceived injustice in policy and organizational matters influence frontline health worker motivation and the consequent effect on workers' attitudes and performance in delivering maternal and neonatal health care in public hospitals. It consisted of an ethnographic study in two public hospitals in Southern Ghana. Participant observ…
Sustainability of recurrent expenditure on public social welfare programmes
OBJECTIVE: Sustainability of public social welfare programmes has long been of concern in development circles. An important aspect of sustainability is the ability to sustain the recurrent financial costs of programmes. A free maternal care programme (FMCP) was launched under the Ghana National Health Insurance Scheme (NHIS) in 2008 with a start-up grant from the British Government. This article examines claims expenditure under the programme and…
Temporal trends in childhood mortality in Ghana
BACKGROUND: Following the adoption of the Millennium Development Goal 4 (MDG 4) in Ghana to reduce under-five mortality by two-thirds between 1990 and 2015, efforts were made towards its attainment. However, impacts and challenges of implemented intervention programs have not been examined to inform implementation of Sustainable Development Goal 3.2 (SDG 3.2) that seeks to end preventable deaths of newborns and children aged under-five. Thus, thi…
Can health insurance protect against out-of-pocket and catastrophic expenditures and also support poverty reduction? Evidence from Ghana’s National Health Insurance Scheme
This study provides evidence that high OOPE leads to CE and poverty in Ghana but enrolment into the NHIS reduces OOPE, provides financial protection against CE and reduces poverty. These findings support the pro-poor policy objective of Ghana's National Health Insurance Scheme and holds relevance to other low and middle income countries implementing or aiming to implement insurance schemes
The path dependence of district manager decision-space in Ghana
The district health system in Ghana today is characterized by high resource-uncertainty and narrow decision-space. This article builds a theory-driven historical case study to describe the influence of path-dependent administrative, fiscal and political decentralization processes on development of the district health system and district manager decision-space. Methods included a non-exhaustive literature review of democratic governance in Ghana, …
The one with the purse makes policy
Postings and transfers in the Ghanaian health system
These findings point to tensions between individual and organisational goals. This article contributes to a burgeoning literature on postings and transfers as a distinct dynamic which bridges the interactions between health systems governance and health workforce development. Importantly, this article helps to expand the notion of health systems governance beyond 'good' governance towards understanding governance as a process of negotiation
Countdown to 2030
Leadership styles in two Ghanaian hospitals in a challenging environment
Hospital managers' power to exercise effective leadership in daily management can affect quality of care directly as well as through effects on frontline workers' motivation. This paper explores the influence of contextual factors on hospital managers' leadership styles and the motivation of frontline workers providing maternal and new born care in two public district hospitals in Ghana. It draws on data from an ethnographic study that involved p…
Strengthening health system leadership for better governance
This editorial provides an overview of the six papers included in this special supplement on health leadership in Africa. Together the papers provide evidence of leadership in public hospital settings and of initiatives to strengthen leadership development. On the one hand, they demonstrate both that current leadership practices often impact negatively on staff motivation and patient care, and that contextual factors underpin poor leadership. On …
Strategic leadership capacity building for Sub-Saharan African health systems and public health governance
Leadership capacity needs development and nurturing at all levels for strong health systems governance and improved outcomes. The Doctor of Public Health (DrPH) is a professional, interdisciplinary terminal degree focused on strategic leadership capacity building. The concept is not new and there are several programmes globally–but none within Africa, despite its urgent need for strong strategic leadership in health. To address this gap, a consor…
Ghana's community-based primary health care
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