Critical interactions between the Global Fund-supported HIV programs and the health system in Ghana.
Identifieur interne : 000835 ( Main/Exploration ); précédent : 000834; suivant : 000836Critical interactions between the Global Fund-supported HIV programs and the health system in Ghana.
Auteurs : Rifat Atun [Suisse] ; Sai Kumar Pothapregada ; Janet Kwansah ; D. Degbotse ; Jeffrey V. LazarusSource :
- Journal of acquired immune deficiency syndromes (1999) [ 1944-7884 ] ; 2011.
Descripteurs français
- KwdFr :
- Adulte, Agents antiVIH (usage thérapeutique), Agents antiVIH (économie), Antirhumatismaux (usage thérapeutique), Antirhumatismaux (économie), Besoins et demandes de services de santé (), Besoins et demandes de services de santé (économie), Coopération internationale, Enfant, Femelle, Ghana (épidémiologie), Humains, Infections à VIH (traitement médicamenteux), Infections à VIH (économie), Infections à VIH (épidémiologie), Mâle, Pays en voie de développement (), Pays en voie de développement (économie), Personnel de santé (), Personnel de santé (enseignement et éducation), Personnel de santé (économie), Prestations des soins de santé (), Prestations des soins de santé (économie), Études de cas sur les organisations de santé (), Études de cas sur les organisations de santé (économie).
- MESH :
- enseignement et éducation : Personnel de santé.
- traitement médicamenteux : Infections à VIH.
- usage thérapeutique : Agents antiVIH, Antirhumatismaux.
- économie : Agents antiVIH, Antirhumatismaux, Besoins et demandes de services de santé, Infections à VIH, Pays en voie de développement, Personnel de santé, Prestations des soins de santé, Études de cas sur les organisations de santé.
- épidémiologie : Ghana, Infections à VIH.
- Adulte, Besoins et demandes de services de santé, Coopération internationale, Enfant, Femelle, Humains, Mâle, Pays en voie de développement, Personnel de santé, Prestations des soins de santé, Études de cas sur les organisations de santé.
- Wicri :
- geographic : Ghana.
English descriptors
- KwdEn :
- Adult, Anti-HIV Agents (economics), Anti-HIV Agents (therapeutic use), Antirheumatic Agents (economics), Antirheumatic Agents (therapeutic use), Child, Delivery of Health Care (economics), Delivery of Health Care (statistics & numerical data), Developing Countries (economics), Developing Countries (statistics & numerical data), Female, Ghana (epidemiology), HIV Infections (drug therapy), HIV Infections (economics), HIV Infections (epidemiology), Health Personnel (economics), Health Personnel (education), Health Personnel (statistics & numerical data), Health Services Needs and Demand (economics), Health Services Needs and Demand (statistics & numerical data), Humans, International Cooperation, Male, Organizational Case Studies (economics), Organizational Case Studies (statistics & numerical data).
- MESH :
- chemical , economics : Anti-HIV Agents, Antirheumatic Agents.
- chemical , therapeutic use : Anti-HIV Agents, Antirheumatic Agents.
- geographic , epidemiology : Ghana.
- drug therapy : HIV Infections.
- economics : Delivery of Health Care, Developing Countries, HIV Infections, Health Personnel, Health Services Needs and Demand, Organizational Case Studies.
- education : Health Personnel.
- epidemiology : HIV Infections.
- statistics & numerical data : Delivery of Health Care, Developing Countries, Health Personnel, Health Services Needs and Demand, Organizational Case Studies.
- Adult, Child, Female, Humans, International Cooperation, Male.
Abstract
The support of global health initiatives in recipient countries has been vigorously debated. Critics are concerned that disease-specific programs may be creating vertical and parallel service delivery structures that to some extent undermine health systems. This case study of Ghana aimed to explore how the Global Fund-supported HIV program interacts with the health system there and to map the extent and nature of integration of the national disease program across 6 key health systems functions. Qualitative interviews of national stakeholders were conducted to understand the perceptions of the strengths and weaknesses of the relationship between Global Fund-supported activities and the health system and to identify positive synergies and unintended consequences of integration. Ghana has a well-functioning sector-wide approach to financing its health system, with a strong emphasis on integrated care delivery. Ghana has benefited from US $175 million of approved Global Fund support to address the HIV epidemic, accounting for almost 85% of the National AIDS Control Program budget. Investments in infrastructure, human resources, and commodities have enabled HIV interventions to increase exponentially. Global Fund-supported activities have been well integrated into key health system functions to strengthen them, especially financing, planning, service delivery, and demand generation. Yet, with governance and monitoring and evaluation functions, parallel structures to national systems have emerged, leading to inefficiencies. This case study demonstrates that interactions and integration are highly varied across different health system functions, and strong government leadership has facilitated the integration of Global Fund-supported activities within national programs.
DOI: 10.1097/QAI.0b013e318221842a
PubMed: 21857300
Affiliations:
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Le document en format XML
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Degbotse</name></author><author><name sortKey="Lazarus, Jeffrey V" sort="Lazarus, Jeffrey V" uniqKey="Lazarus J" first="Jeffrey V" last="Lazarus">Jeffrey V. 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Personnel (education)</term><term>Health Personnel (statistics & numerical data)</term><term>Health Services Needs and Demand (economics)</term><term>Health Services Needs and Demand (statistics & numerical data)</term><term>Humans</term><term>International Cooperation</term><term>Male</term><term>Organizational Case Studies (economics)</term><term>Organizational Case Studies (statistics & numerical data)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Agents antiVIH (usage thérapeutique)</term><term>Agents antiVIH (économie)</term><term>Antirhumatismaux (usage thérapeutique)</term><term>Antirhumatismaux (économie)</term><term>Besoins et demandes de services de santé ()</term><term>Besoins et demandes de services de santé (économie)</term><term>Coopération internationale</term><term>Enfant</term><term>Femelle</term><term>Ghana (épidémiologie)</term><term>Humains</term><term>Infections à VIH (traitement médicamenteux)</term><term>Infections à VIH (économie)</term><term>Infections à VIH (épidémiologie)</term><term>Mâle</term><term>Pays en voie de développement ()</term><term>Pays en voie de développement (économie)</term><term>Personnel de santé ()</term><term>Personnel de santé (enseignement et éducation)</term><term>Personnel de santé (économie)</term><term>Prestations des soins de santé ()</term><term>Prestations des soins de santé (économie)</term><term>Études de cas sur les organisations de santé ()</term><term>Études de cas sur les organisations de santé (économie)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="economics" xml:lang="en"><term>Anti-HIV Agents</term><term>Antirheumatic Agents</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-HIV Agents</term><term>Antirheumatic Agents</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Ghana</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Delivery of Health Care</term><term>Developing Countries</term><term>HIV Infections</term><term>Health Personnel</term><term>Health Services Needs and Demand</term><term>Organizational Case Studies</term></keywords><keywords scheme="MESH" qualifier="education" xml:lang="en"><term>Health Personnel</term></keywords><keywords scheme="MESH" qualifier="enseignement et éducation" xml:lang="fr"><term>Personnel de santé</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Delivery of Health Care</term><term>Developing Countries</term><term>Health Personnel</term><term>Health Services Needs and Demand</term><term>Organizational Case Studies</term></keywords><keywords scheme="MESH" qualifier="traitement 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santé</term><term>Coopération internationale</term><term>Enfant</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Pays en voie de développement</term><term>Personnel de santé</term><term>Prestations des soins de santé</term><term>Études de cas sur les organisations de santé</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Ghana</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The support of global health initiatives in recipient countries has been vigorously debated. Critics are concerned that disease-specific programs may be creating vertical and parallel service delivery structures that to some extent undermine health systems. This case study of Ghana aimed to explore how the Global Fund-supported HIV program interacts with the health system there and to map the extent and nature of integration of the national disease program across 6 key health systems functions. Qualitative interviews of national stakeholders were conducted to understand the perceptions of the strengths and weaknesses of the relationship between Global Fund-supported activities and the health system and to identify positive synergies and unintended consequences of integration. Ghana has a well-functioning sector-wide approach to financing its health system, with a strong emphasis on integrated care delivery. Ghana has benefited from US $175 million of approved Global Fund support to address the HIV epidemic, accounting for almost 85% of the National AIDS Control Program budget. Investments in infrastructure, human resources, and commodities have enabled HIV interventions to increase exponentially. Global Fund-supported activities have been well integrated into key health system functions to strengthen them, especially financing, planning, service delivery, and demand generation. Yet, with governance and monitoring and evaluation functions, parallel structures to national systems have emerged, leading to inefficiencies. This case study demonstrates that interactions and integration are highly varied across different health system functions, and strong government leadership has facilitated the integration of Global Fund-supported activities within national programs.</div></front></TEI><affiliations><list><country><li>Suisse</li></country></list><tree><noCountry><name sortKey="Degbotse, D" sort="Degbotse, D" uniqKey="Degbotse D" first="D" last="Degbotse">D. Degbotse</name><name sortKey="Kwansah, Janet" sort="Kwansah, Janet" uniqKey="Kwansah J" first="Janet" last="Kwansah">Janet Kwansah</name><name sortKey="Lazarus, Jeffrey V" sort="Lazarus, Jeffrey V" uniqKey="Lazarus J" first="Jeffrey V" last="Lazarus">Jeffrey V. Lazarus</name><name sortKey="Pothapregada, Sai Kumar" sort="Pothapregada, Sai Kumar" uniqKey="Pothapregada S" first="Sai Kumar" last="Pothapregada">Sai Kumar Pothapregada</name></noCountry><country name="Suisse"><noRegion><name sortKey="Atun, Rifat" sort="Atun, Rifat" uniqKey="Atun R" first="Rifat" last="Atun">Rifat Atun</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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