Browsing by Author "Ruger, J.P."
Now showing 1 - 4 of 4
Results Per Page
Sort Options
Item Global Health Justice and Governance(2019-08-21) Ruger, J.P.; Torpey, K.; Ackah, C.; Gyekye-Jandoh, M.A.In a world beset by serious and unconscionable health disparities, by dangerous contagions that can circle our globalized planet in hours, and by a bewildering confusion of health actors and systems, humankind needs a new vision, a new architecture, new coordination among renewed systems to ensure central health capabilities for all. Professor Jennifer Prah Ruger's book Global Health Justice and Governance (Oxford University Press, 2018) lays out the critical problems facing the world today and offers a new theory of justice and governance as a way to resolve these seemingly intractable issues. In this seminar, Professor Prah Ruger will address the fundamental responsibility of society to ensure human flourishing; the central role that health plays in flourishing and how that places a unique claim on our public institutions and resources to ensure central health capabilities to reduce premature death and avoid preventable morbidities; and the new global health architecture that is needed in order to address staggering inequalities, imperiling epidemics, and inadequate systems.Item Is enrolment in the national health insurance scheme in Ghana pro-poor? Evidence from the Ghana Living Standards Survey(BMJ Open, 2019-06-14) Nsiah-Boateng, E.; Ruger, J.P.; Nonvignon, J.Objectives This article examines equity in enrolment in the Ghana National Health Insurance Scheme (NHIS) to inform policy decisions on progress towards realisation of universal health coverage (UHC). Design Secondary analysis of data from the sixth round of the Ghana Living Standards Survey (GLSS 6). Setting Household based. Participants A total of 16 774 household heads participated in the GLSS 6 which was conducted between 18 October 2012 and 17 October 2013. Analysis Equity in enrolment was assessed using concentration curves and bivariate and multivariate analyses to determine associated factors. Main outcome measure Equity in NHIS enrolment. Results Survey participants had a mean age of 46 years and mean household size of four persons. About 71% of households interviewed had at least one person enrolled in the NHIS. Households in the poorest wealth quintile (73%) had enrolled significantly (p<0.001) more than those in the richest quintile (67%). The concentration curves further showed that enrolment was slightly disproportionally concentrated among poor households, particularly those headed by males. However, multivariate logistic analyses showed that the likelihood of NHIS enrolment increased from poorer to richest quintile, low to high level of education and young adults to older adults. Other factors including sex, household size, household setting and geographic region were significantly associated with enrolment. Conclusions From 2012 to 2013, enrolment in the NHIS was higher among poor households, particularly male-headed households, although multivariate analyses demonstrated that the likelihood of NHIS enrolment increased from poorer to richest quintile and from low to high level of education. Policy-makers need to ensure equity within and across gender as they strive to achieve UHC.Item Responses to donor proliferation in Ghana’s health sector: a qualitative case study(Bull World Health Organ, 2015) Pallas, S.W.; Nonvignon, J.; Aikins, M.; Ruger, J.P.Objective To investigate how donors and government agencies responded to a proliferation of donors providing aid to Ghana’s health sector between 1995 and 2012. Methods We interviewed 39 key informants from donor agencies, central government and nongovernmental organizations in Accra. These respondents were purposively selected to provide local and international views from the three types of institutions. Data collected from the respondents were compared with relevant documentary materials – e.g. reports and media articles – collected during interviews and through online research. Findings Ghana’s response to donor proliferation included creation of a sector-wide approach, a shift to sector budget support, the institutionalization of a Health Sector Working Group and anticipation of donor withdrawal following the country’s change from low income to lower-middle income status. Key themes included the importance of leadership and political support, the internalization of norms for harmonization, alignment and ownership, tension between the different methods used to improve aid effectiveness, and a shift to a unidirectional accountability paradigm for health-sector performance. Conclusion In 1995–2012, the country’s central government and donors responded to donor proliferation in health-sector aid by promoting harmonization and alignment. This response was motivated by Ghana’s need for foreign aid, constraints on the capacity of governmental human resources and inefficiencies created by donor proliferation. Although this decreased the government’s transaction costs, it also increased the donors’ coordination costs and reduced the government’s negotiation options. Harmonization and alignment measures may have prompted donors to return to stand-alone projects to increase accountability and identification with beneficial impacts of projects.Item Responses to donor proliferation in Ghana’s health sector: A qualitative case study [Réponse à la prolifération des donateurs dans le secteur de la santé au Ghana: Une étude de cas qualitative] [Las respuestas a la proliferación de donantes en el sector sanitario de Ghana: Un estudio de caso cualitativo](Bulletin of the World Health Organization, 2015-01) Pallas, S.W.; Nonvignon, J.; Aikins, M.; Ruger, J.P.Objective To investigate how donors and government agencies responded to a proliferation of donors providing aid to Ghana’s health sector between 1995 and 2012. Methods We interviewed 39 key informants from donor agencies, central government and nongovernmental organizations in Accra. These respondents were purposively selected to provide local and international views from the three types of institutions. Data collected from the respondents were compared with relevant documentary materials – e.g. reports and media articles – collected during interviews and through online research. Findings Ghana’s response to donor proliferation included creation of a sector-wide approach, a shift to sector budget support, the institutionalization of a Health Sector Working Group and anticipation of donor withdrawal following the country’s change from low-income to lower-middle income status. Key themes included the importance of leadership and political support, the internalization of norms for harmonization, alignment and ownership, tension between the different methods used to improve aid effectiveness, and a shift to a unidirectional accountability paradigm for health-sector performance. Conclusion In 1995–2012, the country’s central government and donors responded to donor proliferation in health-sector aid by promoting harmonization and alignment. This response was motivated by Ghana’s need for foreign aid, constraints on the capacity of governmental human resources and inefficiencies created by donor proliferation. Although this decreased the government’s transaction costs, it also increased the donors’ coordination costs and reduced the government’s negotiation options. Harmonization and alignment measures may have prompted donors to return to stand-alone projects to increase accountability and identification with beneficial impacts of projects.