Department of Public Administration and Health Service Management

Permanent URI for this collection

http://197.255.125.131:4000/handle/123456789/5025

Browse

Now showing 1 - 11 of 11

Conditionality, Citizenship And The Impact Of Cash Transfer Programmes In Ghana
(University of Ghana, 2022-04) Kotey, R.N.
Research on cash transfer programmes focuses on how they affect human capital development and poverty alleviation. It is well-established that people living in poverty face challenges that surpass their ability to meet their daily needs. Addressing challenges that meet the needs of people living in poverty is an effective way of improving the uptake of citizenship rights among them. This study aims to determine whether cash transfer programmes influence the uptake of citizenship rights among beneficiaries. In addition, the study investigates whether conditions attached to cash transfer programmes influence their beneficiaries' uptake of citizenship rights. It also looks at how local capacities support the implementation of conditional cash transfer programmes. Two cash transfer programmes, Ghana Luxembourg Social Trust (GLST) which strictly monitors and enforces its conditions and Livelihood Empowerment Against Poverty (LEAP) which minimally monitors its conditions are tested for their influence on the uptake of citizenship rights among their beneficiaries. Shai-Osudoku and Ningo-Prampram Districts have been adopted as case studies for this study. The study used the concurrent mixed-methods approach involving the use of both quantitative and qualitative data collection methods. Data were analysed using contingency tables for the quantitative and thematic analysis for the qualitative study. Findings reveal that cash transfer programmes positively influence the uptake of citizenship rights. However, the dimensions of this influence differ or are similar depending on the contextual factors on the ground in Shai-Osudoku and Ningo-Prampram districts. Contextual factors include the level of education of people who are three years and older in the district, the level of poverty in the district and the number of persons per household in the district. The study also indicates that conditionality influences the uptake of human capital development activities and that local-level capacities must be taken into consideration when implementing a CCT programme. These findings reveal that strict monitoring and enforcement of conditions attached to cash transfer programme influence the uptake of citizenship rights by their beneficiaries better than minimal monitoring and enforcement. On this basis, the strict monitoring and enforcement of conditions should be taken into consideration when designing conditional cash transfer programme for effective behavioural changes among beneficiaries.
Politics Of Educational Reform In Ghana: Explaining The Conversion Of Polytechnics To Technical Universities
(University Of Ghana, 2020-11) Gyedu, F.
Governments in developing countries are changing educational policies to ensure better access and quality of education at all levels. The success of educational reforms depends on cooperation among the government, political parties, educational institutions, international development donors, and other stakeholders in the society to formulate and adopt appropriate policies. How to achieve cooperation among these actors has usually become a problem for many developing countries. It is in the light of this problem that this study delves into how cooperation among stakeholders was achieved in Ghana for the conversion of ten polytechnics to technical universities under two different governments. The study is an attempt to understand and explain the dynamics of policy change in the tertiary education sector of Ghana. The study uses the Multiple Streams Framework (MSF) theoretical lens which argues that policy change such as the conversion of the polytechnics to technical universities occurs through the coupling of relatively separate streams of problems, policies, and politics at critical junctures by policy entrepreneurs. How these three separate streams are joined by policy entrepreneurs for successful governmental agenda setting, policy formulation, and policy adoption in the transformation of polytechnics to technical universities is the critical event that this study sought to understand. The study adopted a qualitative research methodology in the context of an interpretive philosophical paradigm. The study was conducted relying on data collected from semi-structured interviews and documentary analysis. The study found that the policy proposal for the conversion of the polytechnics to technical universities was conceived and advocated within the polytechnics. However, the policy proposal was taken up by the NDC government and made a key campaign promise during the 2012 electoral campaigns. After the elections, the government created a Technical Committee of policy experts in 2013, made up of Polytechnic Rectors and other relevant stakeholders, to generate proposals and a roadmap for the conversion to occur. The study also found that the policy proposals made by the experts strived to meet the criteria of technical feasibility, financial viability, and political acceptability to increase the chances of policy making success. Guided by the policy proposals, the policy experts, the NDC government, the Committee of Education in Parliament made up of Members of Parliament (MPs) from the NDC and opposition New Patriotic Party (NPP), polytechnic students associations, and polytechnic employees associations cooperated to form a coalition of policy entrepreneurs that pushed the policy proposal through the stages of agenda setting, policy formulation, and policy adoption in 2016 to convert six qualified polytechnics to technical universities. When the NPP took over the seat of government in 2017, the same coalition of policy entrepreneurs followed the conversion criteria to convert two polytechnics in 2018 and the final two polytechnics in 2020. The study found that although problems stream, the policy-making stream, and the political stream are separate processes, the actors involved in the processes are not always separate. Polytechnic Rectors who advocated for the problems of polytechnic education to be solved by government were the same actors who generated the solution of conversion of polytechnics to technical universities. The study also found that MPs and Ministers in the political stream were members of the parliamentary Committee on Education as policy experts who worked with committees of policy experts outside parliament to fine the process of policy formulation. Government and MPs exercised their authority of legislative adoption of the policy proposals formulated by the policy entrepreneurs. The study supports the views of many scholars, including the originator of the MSF, that there is the need for scholars of the MSF to reformulate the idea that the three streams are independent, and they only join during the open windows of opportunity for policy making. The study, however, supports, the core theoretical claim of the MSF that there is the need for the coupling of the three streams through bargaining and negotiations among stakeholders to ensure successful and sustainable policymaking. The study found that the use of bargaining and negotiations by the NDC and NPP governments, facilitated by trusted policy experts, ensured cooperation between governing and opposition parties to support and sustain the policy change. In the context of Ghana’s constitutional democracy, the study recommends that entrepreneurs of policy change in the tertiary education sector should use bargaining and negotiations rather than coercion, force, and authority to push for the acceptance of their policy proposals. This will ensure appropriate coupling of problem entrepreneurs, policy experts, and political interests to support and sustain policy change.
Health Care and Consumption Effect of Health Insurance Enrolment among Poorest Households in Selected Districts
(University of Ghana, 2020-07) Adjetey, R.A.
Social Health Insurance Schemes (SHIs) as Social Health Protection (SHP) interventions are an important tool for reducing poverty and ill health. For these reasons, governments employed SHI as a policy framework to promote access to healthcare, and to ensure financial protection among the poorest households to improve their health conditions. However, there is limited empirical studies on what motivates the poorest to get enrolled onto NHIS and how it helps them save income for consumption and other health outcomes. The study was conducted by engaging the Livelihood Empowerment Against Poverty (LEAP) household heads to identify the empirical evidence. The study also compared the consumption between insured and uninsured, and analysed the effects of NHIS membership on healthcare use and out-of-pocket health expenditure (OOPHE) among the poorest households. Decision making theories (Expected Utility Theory (EUT) and State Dependent Utility Theory (SDUT) and a Health behaviour theory (Health Belief Model (HBM)) were used as the theoretical lens for the study. The researcher adopted a pragmatic approach which involved the use of a mixed methodology, using both qualitative and quantitative approaches. A cross-sectional design was also adopted for the study. Entirely, the study was conducted in two districts; Shai Osudoku district in the Greater Accra Region and Amansie West district in the Ashanti Region and engaged LEAP beneficiary households Thematic analysis approach was used to reveal the result of NHIS enrolment decision. In the analyses, the theoretical constructs of HBM proved useful in uncovering factors that influence enrolment decisions among poorest households. The study also found illness vulnerability and guaranteed financial access to healthcare as dominant factors that generally influenced household heads decisions to enrol onto NHIS. Addressing possible selection bias due to the non-random enrolment to the NHIS, the propensity score matching (PSM) technique was used to estimate the difference in outcomes between treated and control groups. The results of the average treatment effects on the treated reveals that participation in NHIS tends to increase in consumption expenditure by GH₵ 263.43, hospital visits by 0.74 visits and reduce OOPHE statistically significant by GH₵ 79.77 with household members that are insured than households’ members that are uninsured. By employing a mixed method approach instead of a quantitative approach alone, the study has contributed to existing knowledge by revealing a unique perspective on effects of NHIS on enrolment decisions among poorest households in Ghana. These positive outcomes of the study point to future research options.
The Recursive Interaction of Structure and Action in Public Accountability in Ghana
(University of Ghana, 2018-07) Sey, E.E.
Public organizations in Africa continue to experience public accountability challenges despite introducing organizational controls intended to serve as public accountability mechanisms. Studies on public accountability challenges have explored, separately, the influence of public accountability mechanisms and socio-cultural expectations on bureaucrats’ decisions, but few have explored their joint influence on bureaucrats’ decisions. The objective of the study was to understand how bureaucrats in Ghanaian public organizations respond to the tension between formal organizational controls and informal sociocultural expectations, especially in exercising personal judgement or discretion, and unearth a theory that could deepen understanding of persistent accountability challenges in public organizations in Ghana. Grounded theory methodology was used. The study adopted the logic of appropriateness as a conceptual framework within which to examine values and expectations as a component of structure. Findings revealed that directors respond to the tension by informally integrating sociocultural expectations into their public decisions. Findings suggested Giddens (1984)’s Structuration Theory as the theory at play in the persistent accountability challenges in public organizations in Ghana, in that when public accountability mechanisms are introduced into a country without reconciling them with existing societal values and mechanisms, the society develops conflicted expectations. The more public officials find ways to meet those conflicted expectations, the more the society expects them to do so. This creates a recursive cycle between society’s expectations and public officials’ actions. Strengthening of PAMs if not reconciled with societal values, maintains the cycle. It is recommended that policy makers engage the Ghanaian society in a series of dialogues towards the reconciliation of public accountability values and socio-cultural values about accountability.
Work-Life Balance among Female Administrators in Public Universities in Ghana
(University of Ghana, 2018-07) Obimpeh, M.O.
Work-life balance is a major concern for people and institutions concerned about the quality of working life relative to the broader quality of life. The study sought to investigate sources, effects and the strategies adopted to manage work-life balance by female administrators in public universities in Ghana. The study adopted the qualitative research design. The study population comprised female administrators in three public universities, representatives of human resource departments in the selected public universities, Executives of women caucuses in the universities, National Executives of GAUA, and representatives from MGCSP and Social Welfare Department. A total of 74 respondents were sampled for the study. Purposive sampling was used to sample the institutional representatives, whereas snowball sampling was used to select the female administrators. Interview and focus group discussion guides were used as instruments for collecting data for the study. Narrative analysis was used to analyse the data. The study found that socio-cultural factors such as marriage, family stage, and reproductive processes were cardinal sources of competing for work-life demands on female administrators in public universities in Ghana. The universities had instituted some policies and strategies to ensure work-life balance for workers in Ghana, some of which were leave policies, welfare policies, educational policies, and accommodation policies. However, the study found that the policies were too general and less suited for the peculiar needs of female administrators. Strategies adopted by the female administrators in public universities in Ghana to ensure work-life balance included engaging the support of family members, and hiring nannies to support the performance of home duties. It was, however, found that having support from family members was the most effective strategy to achieve work-life balance. Poor background checks and lack of a national policy to regulate the services of nannies made it less effective and uncomfortable for female administrators to use them to attain work-life balance. Since most of the approaches were less effective in ensuring work-life balance for female administrators in public universities, many of the female administrators experienced work-life imbalances. The female administrators of public universities in Ghana experienced many negative effects of work-life imbalance relationships. Some of the undesirable effects of work-life imbalance were slowing down of career progression, deterioration in health, marital separation and divorce, and reduction in job performance. The study recommends that the Department of Social Welfare in collaboration with the MGCSP should embark on a vigorous sensitisation program on cultural reorientation to encourage husbands to understand the need to support their wives at home. The MGCSP in collaboration with the Ministry of Education should incorporate crèche schools in the formal education system. Also, the MGCSP in collaboration with the Department of Social Welfare should enact a policy to regulate the services of nannies in the country.
The Implementation of the Composite Budget System in Ghana - Using Three Local Governments
(University Of Ghana, 2018-07) Otchere-Ankrah, B.
Central governments recognize the key role played by local governments in the developmental agenda of these local areas, especially the effort at generating sufficient revenue locally to fund their own projects and programs. Local governance requires that stakeholders are involved in the planning and implementation of policies geared towards reducing and subsequently, eliminating poverty and improving upon the living standards of the residents. In lieu of the aforementioned, the study sought to examine the implementation of the composite budgeting system (CBS) using three selected assemblies in Ghana by adopting the Interactive Model by Thomas & Grindle (1990) & Integrated Model of Implementation by Winter (2003) theory of implementation which explains the factors that affect implementation of policies. The qualitative research approach was adopted with a sample size of 156 using both interviews and focus group discussions and Nvivo 11 software was employed in the data management. The study examines the achievements of the composite budgeting system, the resource challenges (financial and non-financial) of the CBS, the challenges posed by decentralized units in the implementation of the CBS in Ghana and the effect of external factors such as politicking in the successful implementation process. The study adopts an interpretive research paradigm which takes into consideration the personal views of the researcher based on what is experienced on the field. The study found out amongst others that the CBS has brought about efficiency in the various assemblies, there are different laws regulating the assemblies and thereby creating conflict between departments, and that the central government which sometimes delays the release of funds unnecessarily to the assemblies. The study recommends that the Ministry of Finance in collaboration with the Ministry of Local Government and Rural Development, should replace private commission collectors with permanent staff and that the regional coordinating directorates be resourced to execute their mandate as espoused in the Local Governance Act (ACT 936).
Social Capital and Enrolment in Social Health Insurance: The Experience of Ghana’s National Health Insurance Scheme (NHIS)
(University Of Ghana, 2018-07) Ayisi, E.K.
In response to calls for studies that highlight the social determinants of Social Health Insurance enrolment, this study investigated the forms of social capital (SC) in selected communities in Ghana and how they influence the enrolment decision. It also explored how SC structures in the selected communities could be leveraged to drive enrolment in Ghana’s National Health Insurance Scheme (NHIS). Situated in an interpretive paradigm, the study adopted a qualitative research methodology with semi-structured interviews, focus group discussions and documentary reviews as the key data collection tools. The data was analyzed thematically in a six staged process. The study established that SC capital facilitates enrolment decisions in three main ways; bonding, bridging and linking. Although weakening in recent years, bonding SC expressed through solidarity, trust and reciprocity within the familial unit is prevalent, providing social support to people in the communities. Bonding influences the enrolment decision in several ways. Solidarity creates a sense of responsibility in family members to impress on others to register. Family, friends and neighbours are trusted sources of information on the NHIS and whether positive or negative, such information influenced the enrolment decision. On the other hand, bridging SC in the form of groups and associations was also found to be predominant with religious groups, as the most important. The groups and associations compensated for the weakening bonds in traditional family structure. Linking SC in the form of relationships with state institutions seemed weak, with less engagement between community and state institutions, and mistrust in public officials and institutions reinforced some negative sentiments among respondents which affected decisions to enroll. The study revealed that key structures and local community organisations including, traditional rulers, religious groups, trade unions, business groups NGO’s, CBO’s and their leaders, are trusted and have a social advantage and their involvement in the NHIS will serve as a badge of assurance and accountability, and thereby drive people to enrol. The study makes a number of contributions to enhance understanding of enrolment in social health insurance (SHI). Situating the enrolment analysis in a SC framework moves the argument beyond the prevailing dominant explanation that economic factors are the most important determinants of enrolment. The study demonstrates that in addition to economic factors, other considerations based on solidarity, reciprocity and trust relations within and among communities shape people’s decision to enroll in voluntary SHI. By this, SC has proven to be sharper and comprehensive in explaining enrolment outcomes. Also, the study’s careful examination of the SC structures and actors that impinge on enrolment (policy outcomes) in a manner which hitherto, had not been so clearly articulated in this study offers a more nuanced understanding of the subtle relations between individuals, communities and government institutions, as well as the strategies through which policies can be embedded and complemented by these structures.
Public-Private Partnerships in Solid Waste Management in Ghana, The Case of Accra Metropolitan Assembly
(University Of Ghana, 2018-07) Akonnor, E.O.
Solid waste management in Accra Metropolitan Assembly (AMA), like most cities in developing countries, has been fraught with challenges in recent times. The rate at which household wastes are generated within AMA cannot be matched with the rate of collection or clearing waste from the city. The rapid generation of household wastes occurs as a result of rapid population growth, rapid urbanization and improvements in the socio-economic wellbeing of citizens who have occasioned the demand for consumable goods. In an attempt to ensure effective urban crisis management, AMA adopts the PPP as a dominant strategy to ameliorate the deteriorating urban solid waste situation. In this regard, the study aims at investigating the roles of the main actors in the partnership arrangement of solid waste management in Accra Metropolis. The population of the study consisted of AMA officials, contractors and householders who were purposively selected. AMA adopted the franchising typology of polluter pays principle as a dominant strategy to ameliorate the deteriorating urban solid waste situation. In order to strengthen her institutions for the arrangement, AMA established policy frameworks including procurement requirements, transparency and zoning as blue prints to guide the implementation of the PPP agreement. On a positive note, the study observed that the franchising arrangement has chalked successes as a result of the demarcation of territories to the contractors, active stakeholder participation, transparency and openness that characterized the transaction processes. Nonetheless, the study identified logistical constraints, inadequate flow of funds, inability to segregate solid wastes at the household level, the dominance of the tricyclers and weak enforcement of by-laws as some of the challenges AMA was confronted with, thus, preventing the effective achievement of the overall objective of eliminating solid wastes from homes of residents in the jurisdiction. The study recommends the establishment of a strong collaboration among stakeholders, the adoption of integrated solid waste management system, adequate and regular flow of funds to the contractors to sustainably resolve the solid waste crisis.
Serving the Public Interest: An Analysis of The Ghanaian Public Official’s Experience.
(University of Ghana, 2015-05) Ofei, S.B; Domfeh,K.A; Sakyi,E.K; Abor,J.; University of Ghana,College of Humanities, Business School, Department of Public Administration and Health Service Management
This study aims at analyzing the challenges of public officials in Ghana, who through stipulated guidelines, statutes, legislation and codes of conduct are required to serve the public interest. The extent to which public officials uphold the tenets of ethical behaviour including: provision of dedicated leadership, conditions for democracy; issues of protecting community legacy and creating the atmosphere for mutuality was examined. The Principal-Agent theory relating to public interest issues was deployed to develop a theoretical framework to explain the study. The design of the study was mainly exploratory. The mixed method approach was employed to collect data for both qualitative and quantitative analysis. The sampling techniques were purposive and convenience. Thus, the number, type of organisations and respondents were predetermined based on the unit of analysis, which was contingent on specific structural areas. Data analysis was partly descriptive through the use of charts, frequency tables and percentage responses. However, Chi-square tests were conducted to test some hypotheses. The study revealed largely, that the absence of appropriate conditions of service provides sufficient platform for the perpetuation of public sector corruption, conflict of interest and other unethical practices. The research reemphasized the challenges of bureaucracy and politicization in the public sector. Hence, reinforced the notion that public interest may be lacking without the active role of the judiciary in promoting and protecting public interest, and that public interest is more likely when there is dedicated leadership. It is thus recommended that the public official must not only be expected to serve the public interest but must also have his or her challenges met while performing his or her official duties.
Public-Private Partnership in the Context of Ghana’s Health Sector Reform: A Case Study of Private Not-For-Profit Organisations in the Volta Region of Ghana
(University of Ghana, 2014-12) Adzei, F. A.; Domfeh, K. A.; Sakyi, E. K.; Buabeng, T.; University of Ghana, College of Humanities, Business School, Department of Public Administration and Health Service
This study investigates public-private partnership for health delivery in the context of Ghana’s health sector reform. It sets out to understand the nature of collaboration between the government and private not-for-profit health organisations in Ghana by uncovering the factors that necessitated the partnership, the mechanisms by which the partners engage each other, how the partnership arrangement fits within the governance architecture of the health sector reform and how the partnership has shaped the organisational performance of the institutions involved. Neo-institutionalism forms the theoretical anchor for the study alongside other theories that have shaped inter-organisational studies over the years. Qualitative research paradigm was used in this study with the interpretivist epistemological orientation in a case study design. Data were collected through in-depth interviews, archival records and personal observations. Analyses were done by thematic content analysis and theoretical sampling. Results of the study show formal and informal partnership between the public and private health sector actors in Ghana and identified the main drivers for the partnership. Furthermore, the partnership shows a positive relationship between the actors, and the major arrangements for collaboration were identified as properly positioned within the architecture of the health sector reform of the country by contributing immensely to realising the objectives of the reform. The partnership also impacts positively on the organisational performance of the actors involved in the study. Despite these contributions, the study also found some difficulties that militate against the partnership. The conclusion of this thesis is that the partnership arrangement between the government and mission health service providers is yielding positive results. However, the outcome of the partnership could be better if the deep-seated mistrust is minimised or eliminated. For that reason, the partnership can be successful on condition that there is mutual trust and good behavioural leadership style in addition to all the instruments put in place for the joint action. The study makes a modest contribution to knowledge by extending the boundaries of theory, method and policy. The results of this study would help reform the national policy on PPP, which virtually ignores the non-profit service sector.
Politics-Administration Relations and Decision Making in Ghana’s Local Government
(University of Ghana, 2015-05) Azunu, R.; Domfeh, K. A.; Sakyi, E. K.; Asamoah, K.
This thesis on the politics-administration relations and decision making in local government of Ghana seeks to investigate how politicians and administrators relate to each other in policy formulation and implementation and the involvement of relevant stakeholders in decision making and execution in Ghana’s local government. The study was conducted in three purposively sampled districts from northern and southern Ghana. It employed qualitative research approach to determine whether policy formulation and implementation practices within the politics-administration interface of Ghana’s local government (district assemblies) conform to the politics-administration relations models. The study found out that there exists varying degrees of preference for the orthodox dichotomy, the modified dichotomy and the partnership or complementarity models which were comprehensively reviewed. The findings however revealed that the partnership and modified dichotomy models have an edge over the orthodox dichotomy; the study therefore proceeded to propose a bounded complementarity approach which is the synthesis of the modified dichotomy and the complementarity models, for possible adoption by Ghana’s local government (district assemblies).

Browse

Recent Submissions