Department of Public Administration and Health Service Management
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Item Local economic development and poverty reduction in developing societies: The experience of the ILO decent work project in Ghana(Local Economy, 2019) Azunu, R.; Mensah, J.K.There have been a series of contest analyses of the developmental role of international development partners in sub-Saharan Africa. However, evidence abounds that while international development partners have over the past three decades participated actively in local economic development the academic literature has barely focused on this area. As a result, very little is known about how development partners-led local economic development has translated into poverty reduction and economic prosperity. Through a qualitative case study of the ILO decent work project in Ghana, this study provides an empirical assessment and impact of development partners’ role in conceptualizing, implementing, and monitoring local economic development interventions in sub-Saharan Africa. The findings show that ILO decent work project has led to the creation of jobs, enabled participants to improve their businesses, improve their economic situation, and meet their health needs and also adopt strategies to pull themselves out of poverty. The outcome of this paper is useful for both national and international development agencies in their attempt to improve societal development.Item Urban social assistance: Evidence, challenges and the way forward, with application to Ghana(Development Policy Review, 2020) Cuesta, J.; Abdulai, A.G.; Devereux, S.; et.alMotivation: Urban areas are growing as is urban poverty, yet few countries have developed comprehensive programmes for social assistance in urban areas. Those programmes that exist, moreover, are often extensions or duplicates of rural schemes. Urban social protection needs to reflect the distinct characteristics and vulnerabilities of the urban poor, especially since they usually work in informal activities and face higher living costs than rural dwellers. Purpose: This article addresses two questions: what is the current evidence on effective social assistance programmes in urban areas? How can such programmes be designed and implemented in practice? The article surveys the challenges of designing social assistance programmes in urban areas, focusing on specific urban vulnerabilities, targeting the urban poor, and setting appropriate payments. Approach and methods: Existing evidence on programmes for urban social assistance, including cases from seven countries, are reviewed. Issues are examined in detail for Ghana, a rapidly urbanizing country. Findings: Ghana’s flagship social assistance programme, Livelihood Empowerment Against Poverty (LEAP), which operates largely in rural areas, can and should be adjusted to urban areas. Registration by using community leaders is less effective in urban than rural areas. Instead, advertising, (social) media, direct text messaging, and identification through local non-governmental organizations (NGOs) would be better options. Targeting can be improved by developing an urban-specific proxy means test. Cash benefits should be increased, and then adjusted regularly to counter inflation. These benefits should possibly be accompanied by subsidies for utilities and services. Policy implications: Several principles to consider when designing urban social assistance emerge. Benefit levels should reflect higher living costs in urban areas and respond to inflation, especially for food and other necessities. Urban social assistance should go beyond cash transfers to focus on generating jobs (especially for young people and women), and to ensure basic services such as health care reach the urban poor, through subsidies, vouchers, or case management. Urban contexts also offer more opportunities to deliver and target social assistance through digital technologies such as mobile phones and automatic teller machines (ATM).Item Competitive clientelism, donors and the politics of social protection uptake in Ghana(Critical Social Policy, 2021) Abdulai, A.G.Ghana’s Livelihood Empowerment Against Poverty (LEAP) cash transfer programme has been widely characterised as ‘homegrown’. This article challenges such accounts of the LEAP by showing how donors used their financial muscle to shape the LEAP both at the level of programme adoption and implementation. However, the extent to which donor interests and ideas influenced the programme’s design and implementation depended on the degree to which such interests were aligned with those of domestic political elites. While it was donors who first pushed cash transfers on the agenda of the Ghanaian government, electoral calculus took centre stage in driving the programme’s subsequent expansion and institutionalisation. The article suggests the need to move beyond the donor-driven versus the state-led type of arguments to explore the complex ways in which transnational factors and the formal and informal aspects of domestic politics interact to produce different levels and types of commitment to social protection in Africa.Item 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.Item 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.Item 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.Item 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.Item 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.Item 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).Item 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.