Frontline Workers’ Use of Discretion in the Implementation of National Health Insurance Scheme in Ghana
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Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
International Journal of Public Administration
Abstract
The article examines frontline workers’ use of discretion in the implementation of the National
Health Insurance Scheme in Ghana. It answers two questions: 1) how does discretion affect service
delivery? 2) Whose interest does discretion serve in service delivery? The article provides three
contributions. First, it brings a new direction in the use of discretion in organisations in a developing
world context. Second, it adds to ‘how’ and ‘why’ frontline workers use discretion. Finally, it reveals
whose interest the use of discretion serves. It utilises qualitative methods to reveal both positively
motivated and negatively motivated discretion relationships that exist between frontline workers
and clients. Most of the negatively inclined discretion is exercised largely by frontline workers in
public organisations. It concludes that most of the frontline workers’ discretion serves the interest
of their clients rather than service providers’ self-interest or the interest of their organisations.
Description
Research Article
Keywords
Frontline workers, discretion, national health insurance scheme, Ghana
Citation
To cite this article: Daniel Dramani Kipo-Sunyehzi, Edward Brenya & Adam Fusheini (2023): Frontline Workers’ Use of Discretion in the Implementation of National Health Insurance Scheme in Ghana, International Journal of Public Administration, DOI: 10.1080/01900692.2022.214530