Browsing by Author "Kipo-Sunyehzi, D.D."

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Frontline Workers’ Use of Discretion in the Implementation of National Health Insurance Scheme in Ghana
(International Journal of Public Administration, 2023) Kipo-Sunyehzi, D.D.; Brenya, E.; Fusheini, A.
The article examines frontline workers’ use of discretion in the implementation of the National Health Insurance Scheme in Ghana. It answers two questions: 1) how does discretion affect service delivery? 2) Whose interest does discretion serve in service delivery? The article provides three contributions. First, it brings a new direction in the use of discretion in organisations in a developing world context. Second, it adds to ‘how’ and ‘why’ frontline workers use discretion. Finally, it reveals whose interest the use of discretion serves. It utilises qualitative methods to reveal both positively motivated and negatively motivated discretion relationships that exist between frontline workers and clients. Most of the negatively inclined discretion is exercised largely by frontline workers in public organisations. It concludes that most of the frontline workers’ discretion serves the interest of their clients rather than service providers’ self-interest or the interest of their organisations.
Global Social Welfare and Social Policy Debates: Ghana’s Health Insurance Scheme Promotion of the Well-Being of Vulnerable Groups
(Journal of Social Service Research, 2020-01-23) Kipo-Sunyehzi, D.D.
This article analyses social welfare, social policy with individualist and collectivist theoretical perspectives. It discusses the well-being of vulnerable groups and their access to social services including healthcare in the implementation of the National Health Insurance Scheme (NHIS) in Ghana. The aim is to find out the extent of vulnerable groups enrollment and if their welfare and well-being have improved in the implementation of Ghana’s health insurance scheme. Also, it examines whether NHIS is a pro-poor social intervention program or not. Data sources include census data, documents from health insurance authority, in-depth interviews, focus group discussions, direct observations at social service delivery points. Purposive, cluster and snowball sampling techniques are used to select participants. The sample size is 107 participants with 12 months of intensive data collection in three phases from 2012, 2013 and ended on October 2014. Results show more vulnerable groups are enrolled in NHIS compared with contributors. This suggests people who do not pay annual premiums constituted most health insurance subscribers. Also, the results show health insurance covered 38% of Ghana’s population for the 10 years of implementation of NHIS (2004–2013). Despite the progressive increase in coverage of NHIS, there are still some implementation challenges. The research found certain behaviors, practices, and attitudes of some social service providers as inhibiting subscribers’ enrollment. Future research may focus on social intervention programs for vulnerable groups across states.Health insurance scheme
Human resource mobilisation and management in health systems of Africa: a comparative study of health insurance scheme and health facilities in Ghana
(Inderscience, 2022) Kipo-Sunyehzi, D.D.
This paper analyses the human resource mobilisation and management in the health systems of Africa. It compares five health organisations from public-private sectors in terms of how they mobilise and manage human resources in the implementation of Ghana's health insurance scheme. It adds to comparative research on HRM practices and organisational culture in a developing world context. It makes two unique contributions: from public-private organisational perspectives and employees/workers and clients perspectives on HR practices to improve workers skills/knowledge and meet clients' health needs. A multi-actor research methodology was adopted with in-depth interviews, focus group discussions, on-site direct observations and documents with a sample size of 107. The results reveal some ironies in public-private organisational behaviour, faith-based, profit-client oriented styles of HRM practices and how such factors affect clients' access to services. It found organisations with more bureaucracies/red tape and professionalism were the least preferred as clients experienced more waiting times.
Implementation Research in Developed and Developing Countries: an Analysis of the Trends and Directions
(Public Organization Review, 2022) Kipo-Sunyehzi, D.D.
The article examines implementation research across developed countries (North America, Europe), developing countries (Asia, Pacific) and Africa. It examines some key trends and directions of implementation research across regions. It revisits policy debate among scholars on approaches to implementation-top-down, bottom-up and mixed, which characterised the developed world. Also, it adds some perspectives on the developing world, including Africa. The paper has three contributions: it highlights trends in implementation research in developed and developing countries. It gives some directions on implementation research in Africa. It recommends that the policy design process should not be neglected. is inimical to implementation.
Principal-agent problems in implementation of Ghana’s health insurance scheme
(Journal of Operations and Supply Chain Management, 2018-07) Kipo-Sunyehzi, D.D.
Principal-agent relationship exists between health service providers and their authority and clients. It asserts that health service providers as ‘imperfect agents’ of the authority and clients will take actions that aim to maximise profits at the expense of authority and clients (principal). The situation is possible when reimbursement is based on fee-for-service or a diagnosis-related groups. It looks at relationships between health service providers as agents and health insurance authority, and clients as principals in areas of provision of health services, supply of drugs, medicines and reimbursement. Results showed the private health service providers prescribed more drugs and medicines for clients towards profit maximisation (agency) than their public counterparts. Also, it was found that the public health service providers continued to provide health services and drugs despite health insurance authority indebtedness to them exhibiting more stewardship towards health insurance authority. It recommends strict regulations in tariffs/vetting claims and prompt reimbursement.
Public procurement policies of Nigeria and Ghana: an analysis of the administrative challenges in achieving value for money
(Journal of Public Procurement, 2024) Kipo-Sunyehzi, D.D.; Abubakari, A-F.; Banchani, J-P. S.
Purpose – This study aims to focus on public policy concerning the implementation of public procurement policies in Nigeria and Ghana toward achieving value for money in the procurement of goods, services and works. It specifically analyzes some major administrative challenges Nigeria and Ghana are faced with in the administration/implementation of public procurement policies toward achieving value for money. It looks at the relationship between the state (regulatory authorities) and substate (procurement entities) in the public sectors of Nigeria and Ghana. Design/methodology/approach – A comparative case study approach is adopted, where the two countries are compared in terms of achieving value for money. Data was collected from multiple sources, including in-depth interviews. The use of official documents and direct observations at the procurement regulatory authorities and entities’ premises. Findings – This study found Nigeria often used the four Es – economy, efficiency, effectiveness and equity while Ghana mainly used the traditional five rights (right quantity, right quality, right price, right place and right time) as their criteria for ensuring value for money. The major administrative challenges found include corruption, low capacity of procurement personnel and poor knowledge of the procurement laws. Social implications – It recommends effective collaboration between government and civil society groups in the fight against corruption in procurement-related activities, with the implication that there is a need for periodic training for public procurement officials. Originality/value – It adds to the field of public procurement in terms of value for money in the procurement of goods, services and works in developing countries context.
Street-level bureaucrats’ coping strategies and how they affect public service delivery in Ghana
(Journal of Social Science, 2019-09-20) Kipo-Sunyehzi, D.D.; Attuquayefio, P.K.; Sunyehzi, J.K.
Street-level bureaucrats (SLBs) are at the front of public social policy-making and implementation. This paper examines actions, behaviours and SLBs coping strategies in social service delivery. It uses interviews, documentation and observations with a comparative case study approach. It contributes to public social policy implementation in developing world context. It adds to street-level bureaucracy debates that actions and behaviour of SLBs are not only influenced by workload and working conditions but are influenced by their organisational culture. It moves away from the traditional public bureaucracy perspective and brings a new dimension on SLBs coping strategies within public-private organisational contexts. Findings suggest that organisational behaviour, interests, resources and culture influence the coping strategies SLBs adopt in organisations, which affect their clients’ access to social services. Ironically, findings suggest SLBs in private organisations seem more inclined
Towards Resilient Health Systems in Sub-Saharan Africa: A Systematic Review of the English Language Literature on Health Workforce, Surveillance, and Health Governance Issues for Health Systems Strengthening.
(Annals of Global Health, 2019-08-16) Kipo-Sunyehzi, D.D.; Ayanore, M.A.; Amuna, N.; Aviisah, M.; Awolu, A.; Mogre, V.; Ofori-Asenso, R.; Gmanyami, J.M.; Kugbey, N.; Gyapong, M.
Background: Meeting health security capacity in sub-Saharan Africa will require strengthening existing health systems to prevent, detect, and respond to any threats to health. The purpose of this review was to examine the literature on health workforce, surveillance, and health governance issues for health systems strengthening. Methods: We searched PubMed, Science Direct, Cochrane library, CINAHL, Web of Science, EMBASE, EBSCO, Google scholar, and the WHO depository library databases for English-language publications between January 2007 and February 2017. Electronic searches for selected articles were supplemented by manual reference screening. The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Results: Out of 1,548 citations retrieved from the electronic searches, 31 articles were included in the review. Any country health system that trains a cadre of health professionals on the job, reduces health workforce attrition levels, and builds local capacity for health care workers to apply innovative mHealth technologies improves health sector performance. Building novel surveillance systems can improve clinical care and improve health system preparedness for health threats. Effective governance processes build strong partnerships for health and create accountability mechanisms for responding to health emergencies. Conclusions: Overall, policy shifts in African countries’ health systems that prioritize training a cadre of willing and able workforce, invest in robust and cost-effective surveillance capacity, and create financial accountability and good governance are vital in health strengthening efforts.