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Item Pooled procurement program in the quality improvement of medicines of the National Catholic Health Service in Ghana: using the Donabedian model(Journal of Pharmaceutical Health Services Research, 2020) Domfeh, K.A.Objectives This study evaluates structures that determine the quality of medicines procured through the pooled procurement program (PPP) in the National Catholic Health Service (NHS) using the Donabedian model. The challenges faced in the PPP are also revealed. Method A qualitative multiple case study was used to collect information from twenty top and middle-level administrators in the NCHS through in-depth interviews. After the data transcription, it was then analyzed using the thematic content analysis approach. Key findings The study found that the structures for quality of services in the health facilities are moderately satisfactory. The structures of the NCHS included experienced healthcare workers, adequate physical infrastructures, functional Drug and Therapeutic Committees (DTCs), and a rapid-testing laboratory facility to ensure that medicines procured were of high quality. This paper established that suppliers of medicines to the health facilities in the NCHS had to register with the NCHS subject to annual renewal. Suppliers are also required to have the Pharmacy Council (PC) and the Food and Drug Authority (FDA), certification to supply medicines to health facilities. However, the predominant challenges that confronted the health facilities were delays in health insurance claims processing and payments and lack of management commitment in implementing the PPP. Conclusion The study contributes to the pharmaceutical health services literature in the context of the pooled procurement approach in the sourcing of medical goods in the health sector. Significant implications for research and management are also presented.Item Policy Responses to fight COVID-19; the case of Ghana(Brazilian Journal Of Public Administration, 2020) Antwi-Boasiako, J.; Abbey, C.O.A.; Ofori, R.A.; Ogbey, P.This paper focuses on the policy responses of Ghana’s government with a focus on three areas: health, economic, and social. Ghana has made several policy interventions in these three areas. The study highlighted the adoption of the 3T approach in health, CAP-20 in economics, and free water and subsidized electricity for citizens as social interventions. The study concludes that the measures undertaken by the Government of Ghana have yielded significant results even though some challenges with delivery mechanisms are identified. The available statistics as of October 25, 2020, on the COVID-19 situation in Ghana further affirm the gains.Item Urban agriculture, local economic development and climate change: conceptual linkages(International Journal of Urban Sustainable Development, 2023) Mensah, J.K.Globally, cities have become hubs for economic activity, productivity, and important platforms for achieving sustainable development goals. The potential of urban agriculture (UA) in improving urban local economies and urban micro-climate has been acknowledged in the literature. The study looked at how the concepts of UA, local economic development (LED) and climate change can be treated in unison. Based on the review of credible published papers on the various concepts of UA, LED, and climate change and nature-based solutions (NBS), a proposed conceptual framework was developed in this paper, showing the linkages. The paper established that UA could boost LED, build resilient urban settlements, and promote social inclusiveness, but with social challenges. It is therefore recommended that policymakers make UA a crucial aspect of their agenda in the coming years to address the local economic and climate challenges now and in the future.Item User and community coping responses to service delivery gaps in emergency obstetric care provision in a rural community in Ghana(Health & Social Care in the Community, 2022) Ayawine, A.; Atinga, R.A.The study sought to explore user and community responses to service delivery gaps in emergency obstetric care provision in rural Ghana. A qualitative design was employed to draw evidence from observations, interviews and focus group discussion among healthcare providers, clients and community members. Data processing and analysis followed a thematic approach. Findings reveal community interference in obstetric care delivery processes, reliance on unskilled providers, recourse to local oxytocin use, non-compliance to prescribed treatment and mistrust in healthcare providers as user and community coping mechanisms for perceived poor quality obstetric care. These behaviours have serious consequences on the life chances of pregnant women. and parturient women. The need to adapt to a more responsive and affordable national healthcare delivery system is essential for uptake of services in rural areas. Also, Standardized guidelines to regulate health worker behaviour is critical to instilling trust in the healthcare system.Item Community participation in enterprise development programmes for poverty reduction and sustainable development in Ghana(Community Development, 2023) Nordjo, E.; Ahenkan, A.; Boadu, E.S.To trickle down poverty in rural areas, development partners and national governments have instituted enterprise development programs which call for the establishment of some participatory frameworks to enable rural entrepreneurs determine for themselves the exact Business Development Service (BDS) they desire to bring about economic improvement and social change. In ensuring that the concept of participation is not merely a wish list, the article modified Choguill’s ladder of community participation as a de facto lens to examine whether “participation” really exists in these programmes by drawing on evidence from the Rural Enterprises Programme (REP) in Ghana. Using qualitative, in-depth interviews grounded in a single case study design (REP), the study observed that despite the existence of structures that appear to involve entrepreneurs at all stages of the decision-making process, beneficiaries think otherwise. Notwithstanding, some context and power-induced factors were identified to have accounted for these discrepancies.Item Recognizing, supporting and embracing the urban informal economy in Ghana: A local economic development perspective(Urban Research & Practice, 2021) Mensah, J.K.The informal economy has become a vibrant and growing phenomenon across the world. Within the context of sustainable development, connecting local economic development (LED) to the informal economy is imperative. However, the informal economy remains largely neglected within the conventional LED literature. Using key informant interviews and focus group discussions, this paper found that recognizing, embracing and supporting informal economy contributes to a more inclusive form of LED. The study concluded that local government authorities need to be more innovative in recognising the informal economy as part of local governments’ strategies for addressing unemployment, and supporting livelihoods.Item Administrative Reforms in the Ghanaian Public Services for Government Business Continuity During the COVID-19 Crisis(Public Organization Review, 2022) Bawole, J.N.; Langnel, Z.The COVID-19 pandemic caused significant disruptions to public service delivery but heightened citizens demand for services. We examined public sector reforms implemented in the Ghanian public sector to ensure public service continuity during the COVID-19 pandemic. Using content analysis and key informant interviews, found that reforms such as flexible working schedule, redesign of offices, directorates, and installations of equipment, online monitoring and assessment of targets, and conducting services online were instrumental in ensuring the continuity of government business. We recommend that public sector managers allocate adequate resources to digital-based public sector reforms to better prepare for transboundary human threats such as Covid-19.Item Stimulating and developing sustainable urban local economies: The role of urban agriculture(Development Southern Africa, 2023) Mensah, J.K.Whereas urban agriculture is a potential tool for urban local economic development (LED), there appears to be little empirical evidence that has examined how urban agriculture affects the urban local economy from a LED perspective. This research aims to to examine the role of urban agriculture in the urban local economy in a developing country, Ghana. Data for the research was obtained through focus group discussions and key informants interviews with urban agriculturalists and urban local authorities in two assemblies, respectively, in the Greater Accra region of Ghana. The findings showed that, if properly supported, urban agriculture can improve the local economy because of its multiple benefits of employment, income, and improved livelihood and food security. This study contributed to expanding the international scholarship on LED from the perspective of using urban agriculture as an LED strategy by examining the case in Ghana.Item Corruption-Induced Inhibitions to Business: What Business Leaders Have to Say in Ghana(Journal of African Business, 2021) Bawole, J.N.; Langnel, Z.The paper examines how corruption-induced inhibitions influence business-related corruption from the perspectives of business leaders in Ghana. Data were collected through focus group discussion with Chief Executive Officers (CEOs) of multi-national and local companies operating in Ghana. The findings show that business leaders encounter multiple regulatory agencies with duplicate and overlapping functions, multiple charges for virtually the same and duplicated services, multiple law enforcement agencies also performing regulatory functions at the Ports of entry, inadequate information on processes and costs of services, and inadequate channels for reporting corrupt activities in Ghana. The paper argues that these challenges trigger corruption-induced inhibitors, which in turn, negatively affect the growth of the private-sector in GhanaItem The effect of the capitation policy withdrawal on maternal health service provision in Ashanti Region, Ghana: an interrupted time series analysis(Global Health Research and Policy, 2022) Yambah, J.K.; Atinga, R.A.; Mensah, K.A.; et al.Background: Payment methods are known to influence maternal care delivery in health systems. Ghana suspended a piloted capitation provider payment system after nearly five years of implementation. This study aimed to examine the effects of Ghana’s capitation policy on maternal health care provision as part of lesson learning and bridging this critical literature gap. Methods: We used secondary data in the District Health Information Management System-2 and an interrupted time series design to assess changes in level and trend in the provision of ANC4+ (visits of pregnant women making at least the fourth antenatal care attendance per month), HB36 (number of hemoglobin tests conducted for pregnant women who are at the 36th week of gestation) and vaginal delivery in capitated facilities (CHPS) (community-based Health Planning and Services) facilities and hospitals. Results: The results show that the capitation policy withdrawal was associated with a statistically significant trend increase in the provision of ANC4+ in hospitals (coefficient 70.99, p<0. 001) but no effect in CHPS facilities. Also, the policy withdrawal resulted in contrasting effects in hospitals and CHPS in the trend of provision of Hb36; a statistically A significant decline was observed in CHPS (coefficient −7.01, p<0.05), while that of hospitals showed a statistically significant trend increase (coefficient 32.87, p<0.001). Finally, the policy withdrawal did not affect trends of vaginal delivery rates in both CHPS and hospitals. Conclusions: The capitation policy in Ghana appeared to have had a different effect on the provision of maternal services in both CHPS and hospitals; repressing maternal care provision in hospitals and promoting adherence to anemia testing at term for pregnant women in CHPS facilities. Policy makers and stakeholders should consider the possible detrimental effects on maternal care provision and quality in the design and implementation of per capita primary care systems as they can potentially impact the achievement of SDG 3Item An examination of national climate policy integration at the local level of development in Ghana(Local Environment, 2022) Adzei, F.A.; Alornu, M.A.This paper assessed the extent to which local government authorities have mainstreamed climate change adaptation strategies in their development policies in selected districts in Ghana, using a qualitative case study design within the phenomenological epistemology. Forty-four respondents studied from the decentralized departments of local authorities key informant interviews (KIIs) were used for data collection in the study areas. The study findings revealed that climate policy integration at the study districts was done as a compliance measure rather than a response to the real needs of the districts. A gaping chasm therefore exists between stated and actual climate change-related goals. Lack of collaboration, weak coordination of sector plans and weak community and private sector engagement were identified as the causal factors of the gap between the rhetoric and the reality of integrating climate change concerns into the district development plans in the study areas. Further, competing local priorities on the district agenda, institutional capacity constraints and information and technological constraints were identified as major barriers for the local authorities in adaptation to climate change. It is concluded that although climate change and its related policies have been integrated into the various national development policies, climate policy integration remains a challenge at the district level.Item Mitigating Corruption in Sub-Saharan Africa: Does Heterogeneity in Corruption Levels Matter?(Public Integrity, 2021) Amegavi, G.B.; Mensah, J.K.; Quarshie, A.In line with Africa’s Agenda 2063 goal 12 of improving governance and building accountability institutions, this article contributes to the literature by examining corruption determinants using survey data from the Afrobarometer. Quantile regression estimates across 31 sub-Saharan African countries show that the effects of the determinants of corruption are heterogeneous across the quantiles. We observe that press freedom, parliamentary oversight, and human development have a reducing effect on corruption, whereas government size, ethnic fractionalization, and bureaucratic quality appear to exert a significant positive effect on corruption. Given the heterogeneity of findings, the “one size fits all” strategy in fighting corruption could be inadequate in mitigating corruption in SSA.Item Number of students in clinical placement and the quality of the clinical learning environment: A cross-sectional study of nursing and midwifery students(Nurse Education Today, 2021) Abuosi, A.A.; Anaba, E.A.; Kwadan, A.N.; et al.Background: Clinical placement is an important component of nursing and midwifery education. It exposes students to the real-world healthcare environment, where theoretical knowledge is put into practice. However, the quality of the clinical learning environment in sub-Sahara Africa has not been well explored. Objective: The objectives of this study were to assess trainees' perceptions of the number of students on the ward or clinical unit, and the quality of the clinical learning environment. Design: Cross-sectional survey. Setting: Nursing and midwifery students were recruited from three public hospitals in the Upper East Region. Ghana, between July and August 2019. Participants: 254 nursing and midwifery students were recruited using the convenience sampling technique. Methods: Data were collected with the Clinical Learning Environment and Supervision + Nurse Teacher Questionnaire. Data were analysed using univariate, bivariate and multivariable analyses. Results: It was found that the participants rated supervisory relationship; pedagogical atmosphere; role of nurse teacher; leadership style of ward managers; and premises of care on the ward as average. Students' perceptions of the quality of the clinical learning environment were predicted by the supervisory relationship (β = 0.219, 95% CI: 0.016-0.070), leadership style (β = 0.199, 95% CI: 0.011-0.133) and perception of number of students in clinical placement (β = 0.224, 95%CI: 0.022-0.093). The trainees indicated that the number of students on the ward did not correspond with the amount of medical equipment and supervisors. Conclusion: The quality of the clinical learning environment was perceived to be suboptimal. Leadership style, supervisory relationship and perceptions of the number of students on the ward were the salient factors that influenced students' perceptions of the quality of the clinical learning environment. Leaders of nursing and midwifery training institutions must liaise with stakeholders to enhance the quality of clinical learning environment.Item Sounds good on paper but problematic in practice: PPP in Ghana’s transport sector(Research in Transportation Business & Management, 2021) Asamoah, K.; Yeboah-Assiamah, E.; Damoah, C.M.; Adu, E.P.The study sought to examine the complexities involved in the implementation of public-private partnerships in the transport sector using the experience of Intercity STC Coaches Limited and private partners in Ghana. The study seeks to contribute to the literature on public-private partnership by examining the implementation challenges associated with the partnership between public and private transport entities. An exploratory qualitative design through semi-structured interviews and document reviews is adopted for the study. The paper uses the complexity of joint action as the theoretical framework. The study contends that the presence of a challenge, the threat of a challenge or the quest to realize an untapped opportunity offers the basis for a PPP to kick-start. Despite the ideals, there are challenges which impede the effective operationalization of partnerships. These are discussed with clear policy suggestions to address them.Item Governance and effectiveness of public–private partnership in Ghana’s rural-water sector(International Journal of Public Sector Management, 2022) Nyanyofio, J.G.T.; Domfeh, K.A.; Buabeng, T.; et al.Purpose: This study examined the governance and implementation of public-private partnership (PPP) based on the management contract model in the water sector in rural Ghana. Design/methodology/approach: It employed in-depth interviews with key management officials and focus-group discussions among residents in selected water-stressed communities in the beneficiary District Assemblies. Thematic analysis was employed for the analyses. Findings – The governance of the PPP project was characterized by a well-structured institutional arrangement and effective governance mechanisms. The PPP project has increased residents’ access to potable and affordable water and facilitated local economic and social development in its catchment areas. However, insufficient funding, political interference, limited infrastructural capacity and pollution are threatening its success. Originality/value – The study contributes to the literature on effective governance and performance of rural-based PPP water supply projects for the achievement of Sustainable sustainable Goal 6 on access to affordable and quality water.Item Electricity and informal settlements: Towards achieving SDG 7 in developing countries(Energy Research & Social Science, 2022) Mensah, J.K.Despite many academic discussions on the importance of sustainable and reliable energy to informal settlement dwellers, there is limited evidence on the delivery of electricity in informal settlements, especially in Sub-Saharan Africa. Using the concept of tactical urbanism, this study examined electricity delivery and access to informal settlement dwellers in Accra, Ghana, as an important component of meeting SDG 7. The paper analyses evidence collected through three focus group discussions of thirty informal settlement dwellers in three communities in Accra. The findings showed that, whereas access to electricity in informal settlements has improved significantly; this increase is a result of corruption and connivance with electricity officials and that informal settlement dwellers pay exorbitantly to access and use electricity. This paper contributes to the growing body of scholarship on sustainable electricity in urban informal settlements in the Global South by documenting the experiences of informal settlement dwellers in Accra, Ghana.Item The impact of an additional year in high school on academic performance at university: Evidence from a policy experiment in Ghana(Development Policy Review, 2021) Abekah-Nkrumah, G.; Asuming, P.O.; Yusif, H.Motivation: While education plays a fundamental role in economic development, the design of an appropriate educational structure, including duration of study at various levels, remains an issue of major policy debate in many low-income countries. In Ghana, the issue of the length of high school education is an issue of ongoing policy debate. Purpose: This study estimates the effects of an additional year in senior high school (SHS) on academic performance at university level. Methods and approach: Using data from the two largest public universities in Ghana, the article exploits a unique natural experiential variation in the years of secondary education created by policy changes in pre-university education in Ghana to estimate the impact of an additional year in SHS on a number of academic outcomes at university level. Findings: We find that an additional year of SHS education has no impact on academic performance. We did not find any statistical significant difference in the likelihood of completing undergraduate studies in four years, or of graduating with a first-class degree, or the final grade point average (GPA) of students who attended SHS for four years versus their counterparts, who attended SHS for only three years. However, our descriptive analyses show that an additional year in SHS improves chances of students from less-endowed SHS gaining admission to university, especially to health sciences programmes. Policy implications: The nuanced nature of the results suggests the need to further interrogate the policy on SHS duration in Ghana. This may help ensure that the implementation of the policy does not end up making some segment of the student population worse offItem Recovered but Constrained: Narratives of Ghanaian COVID-19 Survivors Experiences and Coping Pathways of Stigma, Discrimination, Social Exclusion and Their Sequels(International Journal of Health Policy and Management, 2021) Atinga, R.A.; Alhassan, N.M.I.; Ayawine, A.Background: Research about the coronavirus disease 2019 (COVID-19), its epidemiology and socio-economic impact on populations worldwide has gained attention. However, there is dearth of empirical knowledge in low- and middle-income settings about the pandemic’s impact on survivors, particularly the tension of their everyday life arising from the experiences and consequences of stigma, discrimination and social exclusion, and how they cope with these behavioral adversities. Methods: Realist qualitative approach drawing data from people clinically diagnosed positive of COVID-19, admitted into therapy in a designated treatment facility, and subsequently recovered and discharged for or without follow-up domiciliary care. In-depth interviews were conducted by maintaining a code book for identifying and documenting. thematic categories in a progression leading to thematic saturation with 45 participants. data were transcribed and coded deductively for broad themes at the start before systematically nesting emerging themes into the broad ones with the aid of NVivo 12 software. Results: Everyday lived experiences of the participants were disrupted with acts of indirect stigmatization (against relatives and family members), direct stigmatization (labeling, prejudices and stereotyping), barriers to realizing full social life and discriminatory behaviors across socio-ecological structures (workplace, community, family, and social institutions). These behavioral adversities were associated with self-reported poor health, anxiety and psychological disorders and frustrations, among others. Consequently, supplicatory prayers, societal and organizational withdrawal, aggressive behaviors, supportive counseling, and self-assertive behaviors were adopted to cope and modify the adverse behaviors driven by misinformation and fearful perceptions of COVID-19 and its contagious proportions. Conclusion: In the face of the analysis, social campaigns and dissemination of toolkits that can trigger behavior change and responsible behaviors toward COVID-19 survivors are proposed to be implemented by health stakeholders, policy and decision makers in partnership with social influencers, the media, and telecoms.Item Informal settlement and urban development discourse in the Global South: Evidence from Ghana(Norsk Geografisk Tidsskrift - Norwegian Journal of Geography, 2022) Agyabeng, A.N.; Mensah, J.K.; Peprah, A.A.; Mensah, E.A.The growth of informal settlements across the Global South has generated concomitant empirical research, and research attention has focused on a different aspect of informal settlements. However, despite the plethora of literature in the growing field of informal settlements research, there is a paucity of research concerning the contribution of informal settlement dwellers to the economic development of the urban economy and the perception of informal settlement dwellers and their challenges, particularly in the context of many countries in Africa. The article contributes to filling this gap by examining the contribution of informal dwellers to urban economic development and the challenges they encounter in the process. Based on a case study involving In in-depth interviews and focus group discussions in Accra, Ghana, the authors found that despite the challenges confronting informal dwellers and their characteristics, they contributed to urban development through revenue generation, labour provision, and the creation of employment. Furthermore, the findings uncovered context-specific contributions of informal settlements to urban development that helped both policy actors and practitioners. The authors conclude that the findings imply that urban managers should focus on the settlers and recognize the contributions of informal settlements to urban development.Item Collective learning and COVID-19 mitigation in Ghana(Review of Policy Research, 2021) Osei-Kojo, A.; Ahenkan, A.; Kenney, P.L.; Damoah, C.M.COVID-19 has created significant uncertainty and disruption among governments and people acrossthe globe. Policy studies present various theoretical frameworks that allow scholars and practitioners to make sense of these developments in a structured and systematic fashion. In this paper, we combined the collective learning framework with documentary data and process tracing analysis to describe, first, the features of the COVID-19 collective learning setting in Ghana. Next, we explored the linkages among learning processes, learning products, and COVID-19 mitigation. We found that diverse policy actors operated at distinct levels of government and performed different functions in managing the pandemic. Furthermore, we confirmed all three phases of learning (acquisition, translation, and dissemination) in Ghana's context. Lastly, policies such as public grooming management, mandatory mask-wearing, partial lockdown, and fiscal and tax reliefs enabled the government to mitigate the pandemic's impact on people. We conclude by highlighting the implications of these findings for policy learning scholarship