ghanaopendata/ghanaian-research-english huggingface dataset:
Implementation of Ghana's health user fee policy and the exemption of the poor: Problems and prospects

Like many other African countries, Ghana has been implementing a cost-sharing policy in its health sector since the 1990s. The adoption of this policy and the consequent charging of user fees for health services was due to stagnating economies and associated budgetary constraints and increasing gaps between supply and demand for basic social services that have been characteristic of African countries since the 1970s. The main objectives for the adoption of cost-sharing policies have been to improve both quality and access to health services. Studies focusing on the experience of African countries with the implementation of user fees indicate varying findings on the impact of user fees on their health delivery systems. The access of the poor, in particular, has been adversely affected, according to the findings of a number of studies. Policies, such as targeting the poor, have not been effectively implemented to mitigate the impacts of the user fee policy on their access. This paper examines the problems associated with granting exemption to the poor in Ghana. It also discusses the prospects of considering the poor in alternative policies that may be adopted in future. Its main findings indicate that a number of shortcomings of policy adoption, particularly the lack of specification of criteria by which the poor can be identified, make it difficult for health workers to grant exemptions. Further findings show that declining government budget allocations and supplies might have made it imperative for the facility manager to be more concerned about collecting revenue than attending to financial access of the poor. The study, however, suggests that despite the shortcomings of the targeting policy and its implementation, it should continue to be an important component of health policy, considering the vast inequalities in income in the population. © Copyright 2004 - Union for African Population Studies.

Source: UG
Implementation of healthy food environment policies to prevent nutrition related non-communicable diseases in Ghana: National experts’ assessment of government action

Nutrition-related non-communicable diseases (NR-NCDs) are a global health problem, increasingly recognised as driven by unhealthy food environments. Yet little is known about government action to implement food en vironment-relevant policies, particularly in low-and lower-middle income countries. This study assessed gov ernment action, implementation gaps, and priorities to improve the food environment in Ghana. Using the Healthy Food-Environment Policy Index (Food-EPI), a panel comprising government and independent experts (n = 19) rated government action to improve the healthiness of food environment in Ghana against interna tional best practices and according to steps within a policy cycle. Forty-three good practice indicators of food environment policy and infrastructure support were used, with ratings informed by systematically collected evidence of action validated by government officials. Following the rating exercise, the expert panel proposed and prioritized actions for government implementation. Three-quarters of all good practice indicators were rated at ‘low’/‘very little’ implementation. Restricting the marketing of breast milk substitutes was the only indicator rated “very high”. Of ten policy actions prioritized for implementation, restricting unhealthy food marketing in children’s settings and in the media were ranked the highest priority. Providing sufficient funds for nationally relevant research on nutrition and NCDs was the highest priority infrastructure-support action. Other priority infrastructure-support actions related to leadership, monitoring and evaluation. This study identified gaps in Ghana’s implementation of internationally-recommended policies to promote healthy food environments. National stakeholders recommended actions, which will require legislation and leadership. The findings provide a baseline for measuring government progress towards implementing effective policies to prevent NR-NCDs.

Source: UG
Implementation of healthy food environment policies to prevent nutrition related non-communicable diseases in Ghana: National experts’ assessment of government action

Nutrition-related non-communicable diseases (NR-NCDs) are a global health problem, increasingly recognized as driven by unhealthy food environments. Yet little is known about government action to implement food en environment-relevant policies, particularly in low- and lower-middle-income countries. This study assessed government action, implementation gaps, and priorities to improve the food environment in Ghana. Using the Healthy Food-Environment Policy Index (Food-EPI), a panel comprising government and independent experts (n = 19) rated government action to improve the healthiness of the food environment in Ghana against international best practices and according to steps within a policy cycle. Forty-three good practice indicators of food environment policy and infrastructure support were used, with ratings informed by systematically collected evidence of action validated by government officials. Following the rating exercise, the expert panel proposed and prioritized actions for government implementation. Three-quarters of all good practice indicators were rated at ‘low’/‘very little’ implementation. Restricting the marketing of breast milk substitutes was the only indicator rated “very high”. Of ten policy actions prioritized for implementation, restricting unhealthy food marketing in children’s settings and the media was ranked the highest priority. Providing sufficient funds for nationally relevant research on nutrition and NCDs was the highest priority infrastructure-support action. Other priority infrastructure-support actions related to leadership, monitoring, and evaluation. This study identified gaps in Ghana’s implementation of internationally-recommended policies to promote healthy food environments. National stakeholders recommended actions, which will require legislation and leadership. The findings provide a baseline for measuring government progress towards implementing effective policies to prevent NR-NCDs.

Source: UG
Implementation of healthy food environment policies to prevent nutritionrelated non-communicable diseases in Ghana: National experts’ assessment of government action

Nutrition-related non-communicable diseases (NR-NCDs) are a global health problem, increasingly recognised as driven by unhealthy food environments. Yet little is known about government action to implement food environment- relevant policies, particularly in low-and lower-middle income countries. This study assessed government action, implementation gaps, and priorities to improve the food environment in Ghana. Using the Healthy Food-Environment Policy Index (Food-EPI), a panel comprising government and independent experts (n = 19) rated government action to improve the healthiness of food environment in Ghana against international best practices and according to steps within a policy cycle. Forty-three good practice indicators of food environment policy and infrastructure support were used, with ratings informed by systematically collected evidence of action validated by government officials. Following the rating exercise, the expert panel proposed and prioritized actions for government implementation. Three-quarters of all good practice indicators were rated at ‘low’/‘very little’ implementation. Restricting the marketing of breast milk substitutes was the only indicator rated “very high”. Of ten policy actions prioritized for implementation, restricting unhealthy food marketing in children’s settings and in the media were ranked the highest priority. Providing sufficient funds for nationallyrelevant research on nutrition and NCDs was the highest priority infrastructure-support action. Other priority infrastructure-support actions related to leadership, monitoring and evaluation. This study identified gaps in Ghana’s implementation of internationally-recommended policies to promote healthy food environments. National stakeholders recommended actions, which will require legislation and leadership. The findings provide a baseline for measuring government progress towards implementing effective policies to prevent NR-NCDs.

Source: UG
Implementation of medicines pricing policies in sub-Saharan Africa: protocol for a systematic review

Ensuring universal availability and accessibility of medicines and supplies is critical for national health systems to equitably address population health needs. In sub-Saharan Africa (SSA), this is a recognised priority with multiple medicines pricing policies enacted. However, medicine prices have remained high, continue to rise and constrain their accessibility. In this systematic review, we aim to identify and analyse experiences of implementation of medicines pricing policies in SSA. Our ambition is for this evidence to contribute to improved implementation of medicines pricing policies in SSA. We will search: Medline, Web of Science, Scopus, Global Health, Embase, Cairn.Info International Edition, Erudit and African Index Medicus, the grey literature and reference from related publications. The searches will be limited to literature published from the year 2000 onwards that is, since the start of the Millennium Development Goals. Published peer-reviewed studies of implementation of medicines pricing policies in SSA will be eligible for inclusion. Broader policy analyses and documented experiences of implementation of other health policies will be excluded. The team will collaboratively screen titles and abstracts, then two reviewers will independently screen full texts, extract data and assess quality of the included studies. Disagreements will be resolved by discussion or a third reviewer. Data will be extracted on approaches used for policy implementation, actors involved, evidence used in decision making and key contextual influences on policy implementation. A narrative approach will be used to synthesise the data. Reporting will be informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guideline. No ethics approvals are required for systematic reviews. Results will be disseminated through academic publications, policy briefs and presentations to national policymakers in Ghana and mode widely across countries in SSA.

Source: UG
Implementation of medicines pricing policies in sub-Saharan Africa: systematic review

Background: High medicine prices contribute to increasing cost of healthcare worldwide. Many patients with limited resources in sub-Saharan Africa (SSA) are confronted with out-of-pocket charges, constraining their access to medicines. Different medicine pricing policies are implemented to improve affordability and availability; however, evidence on the experiences of implementations of these policies in SSA settings appears limited. Therefore, to bridge this knowledge gap, we reviewed published evidence and answered the question: what are the key determinants of implementation of medicines pricing policies in SSA countries? Methods: We identified policies and examined implementation processes, key actors involved, contextual influences on and impact of these policies. We searched five databases and grey literature; screening was done in two stages following clear inclusion criteria. A structured template guided the data extraction, and data analysis followed thematic narrative synthesis. The review followed best practices and reported using PRISMA guidelines. Results: Of the 5595 studies identified, 31 met the inclusion criteria. The results showed thirteen pricing policies were implemented across SSA between 2003 and 2020. These were in four domains: targeted public subsides, regulatory frameworks and direct price control, generic medicine policies and purchasing policies. Main actors involved were government, wholesalers, manufacturers, retailers, professional bodies, community members and private and public health facilities. Key contextual barriers to implementation were limited awareness about policies, lack of regulatory capacity and lack of price transparency in external reference pricing process. Key facilitators were favourable policy environment on essential medicines, strong political will and international support. Evidence on effectiveness of these policies on reducing prices of, and improving access to, medicines was mixed. Reductions in prices were reported occasionally, and implementation of medicine pricing policy sometimes led to improved availability and affordability to essential medicines. Conclusions: Implementation of medicine pricing policies in SSA shows some mixed evidence of improved avail ability and affordability to essential medicines. It is important to understand country-specific experiences, diversity of policy actors and contextual barriers and facilitators to policy implementation. Our study suggests three policy implications, for SSA and potentially other low-resource settings: avoiding a ‘one-size-fts-all’ approach, engaging both private and public sector policy actors in policy implementation and continuously monitoring implementation and effects of policies.

Source: UG
Implementation of Medicines Pricing Policies in Ghana: The Interplay of Policy Content, Actors’ Participation, and Context

Background: Implementing a medicine pricing policy effectively is important for ensuring equitable access to essential medicines and ultimately achieving universal health coverage. However, published analyses of policy implementations are scarce in low- and middle-income countries (LMICs). This paper contributes to bridging this knowledge gap by reporting analysis of implementation of two medicines pricing policies in Ghana: value-added tax (VAT) exemptions and framework contracting (FC) for selected medicines. We analysed implications of actor involvements, contexts, and contents on the implementation of these policies and the interplay between them. This paper should be of interest, and relevance to policy designers, implementers, the private sector, and policy analysts. Methods: Data were collected through document reviews (n = 18), in-depth interviews (IDIs) (n = 30), and focus group discussions (FGDs) (n = 2) and consultative meetings (n = 6) with purposefully identified policy actors. The data were analysed thematically, guided by the four components of the health policy triangle framework. Results: The nature and complexity of policy contents determined duration and degree of formality of implementation processes. For instance, in the FC policy, negotiating medicines prices and standardizing the tendering processes lengthened implementation. Highly varied stakeholder participation created avenues for decision-making and promoted inclusiveness, but also raised the need to manage different agendas and interests. Key contextual enablers and constraints implementation included high political support and currency depreciation, respectively. The interrelatedness of policy content, actors, and context influenced the timeliness of policy implementations and achievement of intended outcomes. and suggest five attributes of effective policy implementation: (1) policy nature and complexity, (2) inclusiveness, (3) organizational feasibility, (4) economic feasibility, and (5) political will and leadership. Conclusion: Varied contextual factors, active participation of stakeholders, nature and complexity of policy content, and structures have all influenced the implementation of medicine pricing policies in Ghana.

Source: UG
Implementation of Missing Data Imputation Schemes in Face Recognition Algorithm under Partial Occlusion

Face detection and recognition algorithms usually assume an image captured from a controlled environment. However, this is not always the case, especially in crowd control under surveillance or footage from a crime scene, where partial occlusions are unavoidable. Unfortunately, these occlusions have an adverse e ect on the performance of these classical recognition algorithms. In this study, the performance of some selected data imputation schemes is evaluated on SVD/PCA frontal face recognition algorithm. e experiment was done on two datasets: Ja e and MIT-CBCL, with immediate con rmation of the adverse e ect of occlusion on the facial algorithm without implementing the imputation scheme. Further experimentation shows that IA is an ideal missing data imputation scheme that works best with the SVD/PCA facial recognition algorithm.

Source: UG
Implementation of multidisciplinary care reduces maternal mortality in women with sickle cell disease living in low-resource setting

Sickle cell disease (SCD) is associated with adverse pregnancy outcome. In women with SCD living in low-resource settings, pregnancy is associated with significantly increased maternal and perinatal mortality rates. We tested the hypothesis that implementing a multidisciplinary obstetric and hematology care team in a low-resource setting would significantly reduce maternal and perinatal mortality rates. We conducted a before-and-after study, at the Korle-Bu Teaching Hospital in Accra, Ghana, to evaluate the effect of a multidisciplinary obstetric-hematology care team for women with SCD in a combined SCD-Obstetric Clinic. The pre-intervention period was assessed through a retrospective chart review to identify every death and the post-intervention period was assessed prospectively. Interventions consisted of joint obstetrician and hematologist outpatient and acute inpatient reviews, close maternal and fetal surveillance, and simple protocols for management of acute chest syndrome and acute pain episodes. Primary outcomes included maternal and perinatal mortality rates before and after the study period. A total of 158 and 90 pregnant women with SCD were evaluated in the pre- and post- intervention periods, respectively. The maternal mortality rate decreased from 10 791 per 100 000 live births at pre-intervention to 1176 per 100 000 at postintervention, representing a risk reduction of 89.1% (P50.007). Perinatal mortality decreased from 60.8 per 1000 total births at pre-intervention to 23.0 per 1000 at post-intervention, representing a risk reduction of 62.2% (P50.20). A multidisciplinary obstetric and hematology team approach can dramatically reduce maternal and perinatal mortality in a low-resource setting.© 2017 Wiley Periodicals, Inc.

Source: UG
Implementation of National Health Insurance Schemes in Africa: The need to include traditional and complementary medicine

Since the 1980s many developing nations have undertaken health reforms aimed at addressing the inequalities in health care delivery. The central feature of all these reforms has been the implementation of National Health Insurance Schemes (NHIS). Several studies carried out to review these reforms point out that although they have helped to minimise some of the difficulties citizens previously encountered in accessing proper healthcare, equitable healthcare delivery continues to elude many developing countries (Bermann 2000). Given the widespread use of traditional and complementary medicines (TM/CM) in many of these countries and the world at large, it seems ironic that most of the implemented NHI schemes do not cover the services of traditional and complementary medicine practitioners (TM/CMPs). Even in the few exceptional cases where TMs and CMs are covered, the schemes are biased towards those with the ability to pay. This paper provides an overview of the experiences of Chile, Colombia, China, Ghana, Hungary, Poland and Zambia and highlights lessons that can be drawn to help particularly African nations considering an NHIS to design a system that is fair, effective and reflects the healthcare practices of the people.

Source: UG
Implementation Of National Policies And Interventions (WHO Best Buys) For Non Communicable Disease Prevention And Control In Ghana: A Mixed Methods Analysis.

Background: The World Health Organization (WHO) encourages all member states to adopt and implement a pack‑ age of essential evidence-based interventions called the Best Buys to reduce the burden of non-communicable diseases (NCDs). To date, little is known about the implementation of national policies and interventions for NCD control in the WHO member states in sub-Saharan Africa. Our study aimed to evaluate the implementation of national policies and interventions (WHO Best Buys) for non-communicable disease prevention and control in Ghana. Methods: This was explanatory mixed methods research which started with a document review of Ghana’s WHO Best Buys scores from the 2015, 2017, 2018, 2020 and 2022 WHO NCD Progress Monitor Reports. Thereafter, we conducted 25 key informant interviews and one focus group discussion (11 participants) with key policymakers and stake‑ holders in the NCD landscape in Ghana to understand the implementation of the NCD policies and interventions, and the policy implementation gaps and challenges faced. Data from the NCD Progress reports were presented using mean scores whilst the qualitative data was analysed thematically. Results: Ghana has shown some advancements in the implementation of the WHO Best Buys measures. Ghana’s implementation scores for 2015, 2017, 2020 and 2022 were 5.0, 9.0, 5.0 and 5.5 respectively, against the mean implementation scores of 7.6/19 for lower-middle-income countries and 9.5/19 for upper-middle-income countries. Efforts to decrease major risk factors such as excessive alcohol consumption and unhealthy diet have been progressing slowly. The most common challenges were related to a) the role of socio-cultural factors, b) stakeholder engagement, c) enforcement and implementation of public health policies, d) implementation guidelines, e) public awareness and education on NCDs, f ) financing of NCD prevention and control, g) curative-centered health systems, and h) over centralization of NCD care.

Source: UG
Implementation of Ropaa through Ghana's Diplomatic Missions: Prospects and Challenges

Increased demand by citizens to engage in democratic processes to determine governmental leadership has heightened the importance of enfranchisement of voters. Significant constitutional developments across democracies over the last century has developed reliable and efficient ways to empower and facilitate suffrage. In most democracies around the world citizens are no longer disqualified from voting rights and contesting elections based on their gender, literacy, social status, or class; simply one man to one vote. This has added credibility to the belief that voting is as inclusive, with results providing a true representation of the will of citizens. In view of this, this study is aimed at examining the reasons why Ghanaian citizens are currently disenfranchised based on their geographical location; despite constitutional provisions to do so and to also offers measures which could facilitate external voting. The Representation of the People's Amendment Act (ROPAA) (Act 699), the law that allows for Ghanaian citizens to vote from outside the country has not been executed in any election in Ghana’s history. This study “Prospects and Challenges in the implementation Of ROPAA through Ghana's Diplomatic Missions” sought to identify the key processes involved in facilitating external voting for citizens living outside the country; explore the role of host nations and key actors involved in the processes associated with overseas voting; assess the main challenges States face in implementing the ROPAA act 699; and identify how eternal voting can be successfully operationalized through Ghanaian Embassies and High Commission overseas. The study used the semi-structured interview guide to gather primary data; however, secondary data was also used for the study analysis; the study revealed some challenges such as host country negotiation, logistic and financial support. The further explored the opportunity Ghana’s electoral management body (EMB) has to implement external voting by utilizing its missions abroad, potentially enabling the minimization of costs whilst also avoiding tedious negotiations with host countries.

Source: UG