Framework for assessing the performance of the Ghanaian health system: study protocol

Emmanuel Kumah; Samuel E Ankomah; Adam Fusheini; Peter Agyei-Baffour; Martin A Ayanore; Richard K Asravor; Felix O Kesse; Emmanuel Mwini; Godfred Otchere

doi:10.1186/s12961-021-00802-1

Framework for assessing the performance of the Ghanaian health system: study protocol

Health Res Policy Syst. 2021 Dec 20;19(1):149. doi: 10.1186/s12961-021-00802-1.

Authors

Emmanuel Kumah¹, Samuel E Ankomah², Adam Fusheini^{2

3}, Peter Agyei-Baffour⁴, Martin A Ayanore⁵, Richard K Asravor⁶, Felix O Kesse⁷, Emmanuel Mwini⁸, Godfred Otchere⁹

Affiliations

¹ Department of Health Administration and Education, Faculty of Science Education, University of Education, Winneba, Ghana. emmanuelkumah@uew.edu.gh.
² Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
³ Center for Health Literacy and Rural Health Promotion, P.O. Box GP1563, Accra, Ghana.
⁴ Department of Health Policy, Management and Economics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
⁵ Department of Health Policy, Planning and Management, School of Public Health, University of Health and Allied Sciences, Ho, Ghana.
⁶ Ghana Technology University College, Accra, Ghana.
⁷ Department of Administration, Kwesimintsim Government Hospital, Takoradi, Western Region, Ghana.
⁸ Planning, Monitoring and Evaluation Directorate, Ministry of Health, Accra, Ghana.
⁹ Faculty of Humanities, Center for Medicine and Society, University of Freiburg, Freiburg, Germany.

Abstract

Background: Assessing the performance of health systems through quantitative and qualitative methods is recognized as an effective approach to strengthening national health systems. However, while many high-income countries have institutionalized health system performance assessment (HSPA) as an integral component of their respective health systems, few studies on HSPA have been documented in low- and middle-income countries, including Ghana. This study aims at providing a comprehensive framework for periodic assessment of the performance of the entire health system in Ghana.

Methods: The study will have four work packages. First, a structured review will be conducted to identify both international and national HSPA frameworks that could be applied to the Ghanaian context. Second, based on the structured review, an assessment framework tailored to the Ghanaian health system context will be developed. Third, the draft framework will be presented and discussed with experts and stakeholders for its appropriateness, feasibility and acceptability. Finally, the framework will be piloted to assess its effectiveness and suitability for full-scale implementation.

Discussion: Currently, Ghana does not have a full-fledged HSPA tool that provides a holistic health sector-wide approach to assessing health system performance. Thus, developing this HSPA framework for the country will provide a tool for periodic and comprehensive assessment of the performance of the health system, which can be compared with that of other countries. Such a comparison will offer the opportunity for mutual learning and for exploring new options for formulating more effective national health policies. As this is expected to be the first attempt to develop a comprehensive HSPA framework in Ghana, this study will provide a basis for future discussions on how to further develop and implement HSPA programmes in the country.

Keywords: Developing country; Health indicators; Health system in Ghana; Health systems; Performance assessment framework.

MeSH terms

Delivery of Health Care*
Ghana
Government Programs*
Health Policy
Humans
Income