Critical Interactions Between the Global Fund-Supported HIV Programs and the Health System in Ghana
Identifieur interne : 000902 ( Main/Exploration ); précédent : 000901; suivant : 000903Critical Interactions Between the Global Fund-Supported HIV Programs and the Health System in Ghana
Auteurs : Rifat Atun [Suisse, Royaume-Uni] ; Sai Kumar Pothapregada [Suisse] ; Janet Kwansah [Ghana] ; D. Degbotse [Ghana] ; Jeffrey V. Lazarus [Suisse, Danemark]Source :
- Journal of acquired immune deficiency syndromes : (1999) [ 1525-4135 ] ; 2011.
Descripteurs français
- Pascal (Inist)
- Wicri :
- geographic : Ghana.
English descriptors
- KwdEn :
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.
Affiliations:
- Danemark, Ghana, Royaume-Uni, Suisse
- Angleterre, Grand Londres, Hovedstaden, Région du Grand Accra
- Accra, Copenhague, Londres
Links toward previous steps (curation, corpus...)
- to stream PascalFrancis, to step Corpus: 000030
- to stream PascalFrancis, to step Curation: 000102
- to stream PascalFrancis, to step Checkpoint: 000027
- to stream Main, to step Merge: 000905
- to stream Main, to step Curation: 000902
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Critical Interactions Between the Global Fund-Supported HIV Programs and the Health System in Ghana</title><author><name sortKey="Atun, Rifat" sort="Atun, Rifat" uniqKey="Atun R" first="Rifat" last="Atun">Rifat Atun</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Strategy, Performance and Evaluation Center, The Global Fund to Fight AIDS, Tuberculosis, and Malaria</s1><s2>Geneva</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>Geneva</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Imperial College Business School, Imperial College London</s1><s2>London</s2><s3>GBR</s3><sZ>1 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Pothapregada, Sai Kumar" sort="Pothapregada, Sai Kumar" uniqKey="Pothapregada S" first="Sai Kumar" last="Pothapregada">Sai Kumar Pothapregada</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Strategy, Performance and Evaluation Center, The Global Fund to Fight AIDS, Tuberculosis, and Malaria</s1><s2>Geneva</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>Geneva</wicri:noRegion></affiliation></author><author><name sortKey="Kwansah, Janet" sort="Kwansah, Janet" uniqKey="Kwansah J" first="Janet" last="Kwansah">Janet Kwansah</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Policy Planning Monitoring Evaluation Directorate, Ghana Ministry of Health</s1><s2>Accra</s2><s3>GHA</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Ghana</country><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Degbotse, D" sort="Degbotse, D" uniqKey="Degbotse D" first="D." last="Degbotse">D. Degbotse</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Policy Planning Monitoring Evaluation Directorate, Ghana Ministry of Health</s1><s2>Accra</s2><s3>GHA</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Ghana</country><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Lazarus, Jeffrey V" sort="Lazarus, Jeffrey V" uniqKey="Lazarus J" first="Jeffrey V." last="Lazarus">Jeffrey V. Lazarus</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Strategy, Performance and Evaluation Center, The Global Fund to Fight AIDS, Tuberculosis, and Malaria</s1><s2>Geneva</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>Geneva</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>International Health Unit, University of Copenhagen</s1><s2>Copenhagen</s2><s3>DNK</s3><sZ>5 aut.</sZ></inist:fA14><country>Danemark</country><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">11-0389582</idno><date when="2011">2011</date><idno type="stanalyst">PASCAL 11-0389582 INIST</idno><idno type="RBID">Pascal:11-0389582</idno><idno type="wicri:Area/PascalFrancis/Corpus">000030</idno><idno type="wicri:Area/PascalFrancis/Curation">000102</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000027</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000027</idno><idno type="wicri:doubleKey">1525-4135:2011:Atun R:critical:interactions:between</idno><idno type="wicri:Area/Main/Merge">000905</idno><idno type="wicri:Area/Main/Curation">000902</idno><idno type="wicri:Area/Main/Exploration">000902</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Critical Interactions Between the Global Fund-Supported HIV Programs and the Health System in Ghana</title><author><name sortKey="Atun, Rifat" sort="Atun, Rifat" uniqKey="Atun R" first="Rifat" last="Atun">Rifat Atun</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Strategy, Performance and Evaluation Center, The Global Fund to Fight AIDS, Tuberculosis, and Malaria</s1><s2>Geneva</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>Geneva</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Imperial College Business School, Imperial College London</s1><s2>London</s2><s3>GBR</s3><sZ>1 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Pothapregada, Sai Kumar" sort="Pothapregada, Sai Kumar" uniqKey="Pothapregada S" first="Sai Kumar" last="Pothapregada">Sai Kumar Pothapregada</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Strategy, Performance and Evaluation Center, The Global Fund to Fight AIDS, Tuberculosis, and Malaria</s1><s2>Geneva</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>Geneva</wicri:noRegion></affiliation></author><author><name sortKey="Kwansah, Janet" sort="Kwansah, Janet" uniqKey="Kwansah J" first="Janet" last="Kwansah">Janet Kwansah</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Policy Planning Monitoring Evaluation Directorate, Ghana Ministry of Health</s1><s2>Accra</s2><s3>GHA</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Ghana</country><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Degbotse, D" sort="Degbotse, D" uniqKey="Degbotse D" first="D." last="Degbotse">D. Degbotse</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Policy Planning Monitoring Evaluation Directorate, Ghana Ministry of Health</s1><s2>Accra</s2><s3>GHA</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Ghana</country><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Lazarus, Jeffrey V" sort="Lazarus, Jeffrey V" uniqKey="Lazarus J" first="Jeffrey V." last="Lazarus">Jeffrey V. Lazarus</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Strategy, Performance and Evaluation Center, The Global Fund to Fight AIDS, Tuberculosis, and Malaria</s1><s2>Geneva</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>Geneva</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>International Health Unit, University of Copenhagen</s1><s2>Copenhagen</s2><s3>DNK</s3><sZ>5 aut.</sZ></inist:fA14><country>Danemark</country><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Journal of acquired immune deficiency syndromes : (1999)</title><title level="j" type="abbreviated">J. acquir. immune defic. syndr. : (1999)</title><idno type="ISSN">1525-4135</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Journal of acquired immune deficiency syndromes : (1999)</title><title level="j" type="abbreviated">J. acquir. immune defic. syndr. : (1999)</title><idno type="ISSN">1525-4135</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AIDS</term><term>Ghana</term><term>Human immunodeficiency virus</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Virus immunodéficience humaine</term><term>Ghana</term><term>SIDA</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>Danemark</li><li>Ghana</li><li>Royaume-Uni</li><li>Suisse</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Hovedstaden</li><li>Région du Grand Accra</li></region><settlement><li>Accra</li><li>Copenhague</li><li>Londres</li></settlement></list><tree><country name="Suisse"><noRegion><name sortKey="Atun, Rifat" sort="Atun, Rifat" uniqKey="Atun R" first="Rifat" last="Atun">Rifat Atun</name></noRegion><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></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Atun, Rifat" sort="Atun, Rifat" uniqKey="Atun R" first="Rifat" last="Atun">Rifat Atun</name></region></country><country name="Ghana"><region name="Région du Grand Accra"><name sortKey="Kwansah, Janet" sort="Kwansah, Janet" uniqKey="Kwansah J" first="Janet" last="Kwansah">Janet Kwansah</name></region><name sortKey="Degbotse, D" sort="Degbotse, D" uniqKey="Degbotse D" first="D." last="Degbotse">D. Degbotse</name></country><country name="Danemark"><region name="Hovedstaden"><name sortKey="Lazarus, Jeffrey V" sort="Lazarus, Jeffrey V" uniqKey="Lazarus J" first="Jeffrey V." last="Lazarus">Jeffrey V. Lazarus</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/SidaGhanaV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000902 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000902 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= SidaGhanaV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= Pascal:11-0389582
|texte= Critical Interactions Between the Global Fund-Supported HIV Programs and the Health System in Ghana
}}
| This area was generated with Dilib version V0.6.31. |  |