Department of Public Administration and Health Service Management
Permanent URI for this collectionhttp://197.255.125.131:4000/handle/123456789/23063
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Item Implementing decentralised management in Ghana: The experience of the Sekyere West District health administration(Leadership in Health Services, 2008) Bowerman, J.; Sakyi, K.E.Purpose The purpose of this paper is to examine the barriers to the implementation of management decentralisation of health services and programmes at district level in Ghana. Design/methodology/approach Data for the study were collected through a qualitative technique in the Sekyere West district. Findings The findings are: transfer of authority for management decision making and planning was rarely operational at district level; and control over financial and personnel decisions remained centralised. The paper identified lack of staff capacity, lack of commitment and interorganisational conflict between health managers and local government officials as factors obstructing the implementation of management decentralisation in the district. Originality/value The lesson from the study is that the implementation of health care management decentralisation at district level has stalled because of the combined effect of internal and external constraints. The paper suggests that given the enormity of the problem of paucity of capacity to undertake new service management responsibilities, the process of transferring responsibilities, resources and control to lower level health managements should be gradual and incremental; the sequencing of reform too should be such that district health officers and stakeholders are given adequate training prior to the inauguration of new management reform. © 2008, Emerald Group Publishing LimitedItem Service quality in healthcare institutions: Establishing the gaps for policy action(International Journal of Health Care Quality Assurance, 2013-06) Abuosi, A.A.; Atinga, R.A.Purpose: The authors seek to examine two key issues: to assess patients' hospital service quality perceptions and expectation using SERVQUAL; and to outline the distinct concepts used to assess patient perceptions. Design/methodology/approach: Questionnaires were administered to 250 patients on admission and follow-up visits. The 22 paired SERVQUAL expectation and perception items were adopted. Repeated t-measures and factor analysis with Varimax rotation were used to analyse data. Findings: Results showed that patient expectations were not being met during medical treatment. Perceived service quality was rated lower than expectations for all variables. The mean difference between perceptions and expectations was statistically significant. Contrary to the SERVQUAL five-factor model, four service-quality factors were identified in the study. Practical implications: Findings have practical implications for hospital managers who should consider stepping up staffing levels backed by client-centred training programmes to help clinicians deliver care to patients' expectations. Originality/value: Limited studies are tailored towards patients' service-quality perception and expectation in Ghanaian hospitals. The findings therefore provide valuable information for policy and practice. © Emerald Group Publishing Limited.Item Determinants of antenatal care quality in Ghana(Emerald Group Publishing Limited, 2013) Atinga, R.A.; Baku, A.A.Purpose – To achieve Goal 5 of the MDGs, the Government of Ghana introduced the free maternal health service system to break financial barriers of access to maternal care services. In spite of this, facility‐based deliveries continue to be low due partly to poor quality of antenatal care that prevents pregnant women from giving birth in hospitals. The aim of this study is to examine factors shaping quality of antenatal care in selected public hospitals in the country. Design/methodology/approach – 363 expectant mothers were randomly selected for interview. Women who have previously received antenatal care in the health facilities for at least two occasions were interviewed. Multivariate logistic regression model were computed to examine correlates of antenatal care quality. Findings – The odds of reporting quality of antenatal care as good was higher among women aged between 30 and 34 years. Similarly women with junior/senior high education were more likely to report antenatal care quality as good. Distance to the health facilities generally influence women perception of antenatal care quality but the relative odds of reporting quality of care as good attenuated with proximity to the health facility. Five factors (pleasant interaction with providers, privacy during consultation, attentiveness of providers, adequate facilities and availability of drugs) emerged as statistically significant in explaining antenatal care quality after controlling for selected demographic variables. Originality/value – Results of the study generally demonstrate the need to improve maternal services in public facilities to stimulate utilisation and facility‐based deliveries.Item Improving maternal healthcare utilisation in sub‐Saharan Africa through micro‐finance(Emerald Group Publishing Limited, 2011) Abekah-Nkrumah, G.; Abor, P.; Adjasi, C.; Abor, J.Purpose – This paper aims to examine links between women's access to micro‐finance and how they use maternal healthcare services in sub‐Saharan Africa (SSA). Design/methodology/approach – The authors use theoretical and empirical literature to propose a framework to sustain and improve women's access to maternal healthcare services through micro‐financing. Findings – It is found that improved access to micro‐finance by women, combined with education may enhance maternal health service uptake. Research limitations/implications – The paper does not consider empirical data in the analysis. The authors advocate empirically testing the framework proposed in other SSA countries. Social implications – It is important to empower women by facilitating their access to education and micro‐finance. This has implications for improving maternal healthcare utilization in SSA. Originality/value – The paper moves beyond poor access to maternal health services in SSA and proposes a framework for providing sustainable solutions.Item Assessing the implementation of Ghana's Patient Charter(Emerald, 2010-04) Abekah-Nkrumah, G.; Manu, A.; Atinga, R.A.Purpose – This paper seeks to assess the implementation of Ghana’s Patients’ Charter by investigating the level of awareness and knowledge of the Charter’s content, some socio-demographic factors that may influence awareness and knowledge of the Charter and how providers have discharged their responsibilities under the Charter. Design/methodology/approach – A survey research approach, sampling respondents from providers and patients in four facilities from the Greater Accra region, was used. Simple frequencies and Chi-square test were used for analysing responses. Findings – Study findings show that the majority of patients (53.4 per cent) are not aware of the existence of the Charter of those that know about it, a sizeable minority (33.7 per cent) are not knowledgeable about its contents. Relative to patients, providers exhibit better awareness (61.8 percent) and content knowledge (61.8 per cent) of the Patients’ Charter, but on the whole are not yet carrying out their responsibilities under it. In terms of socio-demographic factors influencing awareness and knowledge of content, only education was found to be a positive correlate of awareness and knowledge. The relationship between providers and patients is generally cordial and could be used as a platform for improving awareness and knowledge of the charter, which could be crucial for improving service delivery. Research limitations/implications – This is an initial exploratory research with a limited sample, which was biased towards the educated. Findings are, however, instructive and essential for more extensive and representative research in this area. Originality/value – Since the Charter was launched in 2002, this study is the first of its kind and therefore provides important information for policy and further research.