Strengths, disconnects and lessons in local and central governance of the response to the first wave of COVID-19 in Ghana
Date
2022
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Ghana Medical Journal
Abstract
Objectives: To explore governance, coordination and implementation actors, structures and processes, facilitators,
and barriers within local government and between central and local government in Ghana’s COVID-19 response dur ing the first wave of the outbreak.
Design: Cross-sectional single case study. Data collection involved a desk review of media, policy and administrative
documents and key informant in-depth interviews.
Setting: Two municipalities in the Greater Accra region of Ghana
Participants: Local government decentralised decision makers and officials of decentralised departments.
Interventions: None.
Main Outcome Measures: None
Results: Coordination between the national and local government involved the provision of directives, guidelines,
training, and resources. Most of the emergency response structures at the municipal level were functional except for
some Public Health Emergency Management Committees. Inadequate resources challenged all aspects of the re sponse. Coordination between local government and district health directorates in risk communication was poor. Dur ing the distribution of relief items, a biased selection process and a lack of a bottom-up approach in planning and
implementation were common and undermined the ability to target the most vulnerable beneficiaries.
Conclusions: Adequate financing and equipping of frontline health facilities and workers for surveillance, laboratory
and case management activities, transparent criteria to ensure effective targeting and monitoring of the distribution of
relief items, and a stronger bottom-up approach to the planning and implementation of interventions need to be given
high priority in any response to health security threats such as COVID-19.
Description
Research Article
Keywords
COVID-19, Health Security, Governance, Ghana