The impact of decentralisation on sexual and reproductive health services in Ghana.
Identifieur interne : 000F85 ( Main/Exploration ); précédent : 000F84; suivant : 000F86The impact of decentralisation on sexual and reproductive health services in Ghana.
Auteurs : Susannah H. Mayhew [Royaume-Uni]Source :
- Reproductive health matters [ 0968-8080 ] ; 2003.
Descripteurs français
- KwdFr :
- Allocation des ressources (organisation et administration), Attitude du personnel soignant, Financement du gouvernement (organisation et administration), Ghana, Humains, Innovation organisationnelle, Modèles d'organisation, Politique, Prise décision institutionnelle, Programmes nationaux de santé (organisation et administration), Réforme des soins de santé (organisation et administration), Services de planification familiale (organisation et administration), Services de santé communautaires (organisation et administration), Services de santé génésique (organisation et administration), Vénéréologie (organisation et administration), Évaluation de programme.
- MESH :
- organisation et administration : Allocation des ressources, Financement du gouvernement, Programmes nationaux de santé, Réforme des soins de santé, Services de planification familiale, Services de santé communautaires, Services de santé génésique, Vénéréologie.
- Attitude du personnel soignant, Ghana, Humains, Innovation organisationnelle, Modèles d'organisation, Politique, Prise décision institutionnelle, Évaluation de programme.
- Wicri :
- geographic : Ghana.
English descriptors
- KwdEn :
- Attitude of Health Personnel, Community Health Services (organization & administration), Decision Making, Organizational, Family Planning Services (organization & administration), Financing, Government (organization & administration), Ghana, Health Care Reform (organization & administration), Humans, Models, Organizational, National Health Programs (organization & administration), Organizational Innovation, Politics, Program Evaluation, Reproductive Health Services (organization & administration), Resource Allocation (organization & administration), Venereology (organization & administration).
- MESH :
- geographic : Ghana.
- organization & administration : Community Health Services, Family Planning Services, Financing, Government, Health Care Reform, National Health Programs, Reproductive Health Services, Resource Allocation, Venereology.
- Attitude of Health Personnel, Decision Making, Organizational, Humans, Models, Organizational, Organizational Innovation, Politics, Program Evaluation.
Abstract
This paper analyses the impact of decentralisation on the political organisation, management and provision of sexual and reproductive health services in Ghana. It draws on qualitative research and interviews with key informants from the Ministry of Health, donors, NGOs, regional and district health management teams, local government and community leaders. Within a national reproductive health policy framework, previously disparate family planning, maternal and child health, STI and HIV/AIDS programmes have become more integrated, and donors have pooled or co-ordinated their funding. Some decision-making about resource allocation is meant to happen at district and regional level but in practice, this remains centrally controlled, which may be a necessary safeguard for sexual and reproductive health services. Earmarked donor funds still ensure a regular supply of contraceptives and STI drugs. However, paying for these is problematic at local level. Sexual and reproductive health staff make up a large proportion of primary health care staff, but especially in rural areas they experience poor working conditions, and there is high turnover and vacancies. District and sub-district level links are working well in this new system, but clarity is still needed on how different national sexual and reproductive health bodies relate to each other and to regional and district health authorities. The development of formal mechanisms for priority setting and advocacy at local levels could help to secure benefits for sexual and reproductive health care.
PubMed: 12800705
Affiliations:
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Le document en format XML
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It draws on qualitative research and interviews with key informants from the Ministry of Health, donors, NGOs, regional and district health management teams, local government and community leaders. Within a national reproductive health policy framework, previously disparate family planning, maternal and child health, STI and HIV/AIDS programmes have become more integrated, and donors have pooled or co-ordinated their funding. Some decision-making about resource allocation is meant to happen at district and regional level but in practice, this remains centrally controlled, which may be a necessary safeguard for sexual and reproductive health services. Earmarked donor funds still ensure a regular supply of contraceptives and STI drugs. However, paying for these is problematic at local level. Sexual and reproductive health staff make up a large proportion of primary health care staff, but especially in rural areas they experience poor working conditions, and there is high turnover and vacancies. District and sub-district level links are working well in this new system, but clarity is still needed on how different national sexual and reproductive health bodies relate to each other and to regional and district health authorities. The development of formal mechanisms for priority setting and advocacy at local levels could help to secure benefits for sexual and reproductive health care.</div></front></TEI><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Mayhew, Susannah H" sort="Mayhew, Susannah H" uniqKey="Mayhew S" first="Susannah H" last="Mayhew">Susannah H. Mayhew</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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