Department of Public Administration and Health Service Management
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Item “It’s the patient that suffers from poor communication”: Analyzing communication gaps and associated consequences in handover events from nurses’ experiences(SSM - Qualitative Research in Health, 2024) Atinga,R.A.; Gmaligan,M.N.; Ayawine,A.; Yambah,J.K.Background: Although routine communication gaps among clinical shift teams significantly account for adverse care and treatment outcomes, existing analysis of the phenomenon remain limited in low middle income countries battling with patient safety issues. This study analyzed the drivers and associated episodic consequences of communication gaps from nurses’ experiences in Ghana. Methods: Qualitative design implemented in two referral hospitals. Data collection involved site observations and in-depth interviews with general nurses, midwives, and staff nurses across 3-cycle shift regimes in the emergency, ICU, inpatient wards, and maternity units. A two-stage data analysis was adopted by integrating deductive and inductive codes into broad thematic typologies explaining drivers of communication gaps and the consequences thereof. Results: Communication gaps among shift teams were largely driven by a combination of three broad factors: a) Attitudinal elements of poor work ethics, poor documentation, interpersonal conflicts and use of unconventional language that impaired effective communication; b) organizational dynamics of taxing job demands, limited training exposure and lack of formal handover communication procedures which allowed shift teams to adopt default patterns of communication behavior; and c) cultural values, stereotyping and prejudicing behaviors that restricted inclusive interactions among shift teams. These communication gaps produced adverse episodic effects of diagnostic and treatment errors, complications, and extended hospitalizations. Conclusion: The findings underscore the need to develop standard guidelines to direct structured communication alongside equipping shift teams with competences on emotional intelligence to overcome cultural and behavioral adversities that influence communication breakdown.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 Ghana