Article
Health Care Sciences & Services
Augustina Koduah, Justice Nonvignon, Abigail Colson, Amanj Kurdi, Alec Morton, Robert van der Meer, Genevieve Aryeetey, Itamar Megiddo
Summary: Population and patient factors contributing to challenges in delivering UHC for hypertension in Ghana include unhealthy lifestyles burdening the health system, poor health-seeking behavior, and poor medication adherence leading to uncontrolled cases. Health system factors such as inadequate capacity for early diagnosis, inequitable distribution of healthcare facilities, financial sustainability issues with the National Health Insurance Scheme, and use of non-standardized blood pressure measuring equipment by healthcare providers also pose significant challenges. Ghana will need to address these issues to achieve universal health coverage.
HEALTH POLICY AND PLANNING
(2021)
Article
Medicine, General & Internal
Agnes Bhakti Pratiwi, Hermawati Setiyaningsih, Maarten Olivier Kok, Trynke Hoekstra, Ali Ghufron Mukti, Elizabeth Pisani
Summary: The study analyzed the relationship between health need, insurance coverage, health service availability, service use, insurance claims, and out-of-pocket spending across Indonesia. Results showed a discrepancy between self-reported national health insurance registration and insurer's report, with higher insurance coverage in poorer areas where service provision is lower, impacting service use and health spending.
Article
Public, Environmental & Occupational Health
Amalia Hasnida, Maarten Olivier Kok, Elizabeth Pisani
Summary: This study investigated the political and economic factors that drive production and trade of poor-quality medicines in Indonesia. The expansion of universal health coverage has reduced revenues for physicians and pharmaceutical manufacturers, leading to market factors, such as shortages and physician-promoted irrational demand, which can drive markets for substandard and falsified medicines. Policy-makers must consider the potential impact on medicine quality when formulating rules governing health financing, procurement, taxation and industry to protect progress towards UHC.
Article
Multidisciplinary Sciences
Moses Aikins, Philip Teg-Nefaah Tabong, Paola Salari, Fabrizio Tediosi, Francis M. Asenso-Boadi, Patricia Akweongo
Summary: Stakeholders acknowledged that the NHIS is currently unable to fulfill its financial obligations and suggested adopting capitation as a provider payment mechanism to reduce fraud and political interference. They also recommended rapid releases of specific statutory deductions and taxes for NHIS providers to address delays in claims' reimbursement, as well as aligning the NHIS with community-based health planning and including preventive and promotive health services to achieve Universal Health Coverage.
Article
Public, Environmental & Occupational Health
Teri Reynolds, Thomas Wilkinson, Melanie Y. Bertram, Matthew Jowett, Rob Baltussen, Awad Mataria, Ferozuddin Feroz, Mohamed Jama
Summary: As no country or health system can provide all possible health services, prioritizing a subset of services for universal availability is integral to universal health coverage. However, creating a package of priority services alone is not enough; implementation is crucial for their impact. There are tensions between criteria-driven prioritization and implementation-oriented formulations, and service delivery considerations are often overlooked. Bridging the gap from a package of services to actual delivery presents challenges for countries. Failure to incorporate delivery considerations during prioritization and design stages can undermine the goals of service delivery. Drawing from country experiences, we discuss choices in package structure and content, and propose ideas to build more implementable service packages to effectively bridge the gap between intent and implementation.
Article
Public, Environmental & Occupational Health
Humphrey Cyprian Karamagi, Sokona Sy, Hillary Kipruto, Bertha Kembabazi, Solyana Ngusbrhan Kidane, Thandekile Ntombikayise Moyo, Regina Titi-Ofei, Dominic Atweam, Cornelius Debpuur, Anthony Ofosu, Francis Chisaka Kasolo
Summary: Ensuring effective functioning of sub national level in the health system is crucial for achieving health results in countries. However, the current health agenda lacks prioritization of how districts can use their existing resources efficiently to maximize equity and effectiveness. Ghana conducted a self-assessment to understand district functionality in delivering health results, highlighting the need for specific improvements in investments, access to services, and management architecture to achieve Universal Health Care. The study revealed a lack of correlation between functionality and performance as currently defined in Ghana, with higher functionality in oversight capacity compared to service provision or management capacities.
FRONTIERS IN PUBLIC HEALTH
(2023)
Review
Health Care Sciences & Services
Prakash Babu Kodali
Summary: This article reviews the policy challenges to achieve universal health coverage (UHC) in a post-pandemic world, including weak public health care systems, challenges to building resilient health systems, healthcare financing and financial risk protection, epidemiological and demographic challenges, and governance and leadership. Low- and middle-income countries in Africa and South Asia face significant challenges to achieving UHC by 2030, requiring efficient resource mobilization through internal accruals, international cooperation, and resource sharing.
RISK MANAGEMENT AND HEALTHCARE POLICY
(2023)
Article
Public, Environmental & Occupational Health
Simon Mariwah, Albert Machistey Abane, Samuel Asiedu Owusu, Adetayo Kasim, Elsbeth Robson, Michele Castelli, Kate Hampshire
Summary: While scaling up 'formal mhealth' remains a challenge in Ghana, the study found that almost all CHNs are utilizing their personal mobile phones 'informally' to bridge healthcare gaps, showcasing opportunities for promoting (or formalizing) 'informal' mhealth. Despite practical challenges in the use of personal mobile phones, addressing them can ensure sustainable healthcare delivery in the country.
GLOBAL PUBLIC HEALTH
(2022)
Article
Public, Environmental & Occupational Health
John Koku Awoonor-Williams, Stephen Apanga, Ayaga A. Bawah, James F. Phillips, Patrick S. Kachur
Summary: Ghana is set to become the first country in sub-Saharan Africa to achieve universal health coverage through the expansion of geographic access. This achievement is the result of 30 years of implementation research and a continuous process of knowledge capture and utilization. While challenges remain in achieving financial access, Ghana's efforts in primary health care and national health insurance are crucial for future health systems strengthening.
GLOBAL HEALTH-SCIENCE AND PRACTICE
(2022)
Review
Health Care Sciences & Services
Chinyere Okeke, Uchenna Ezenwaka, Adanma Ekenna, Chioma Onyedinma, Obinna Onwujekwe
Summary: The research indicates a slow improvement in service delivery coverage across tracer indicators, and significant disparities in healthcare service utilization among rural residents, lower educated individuals, and those with poor socioeconomic status over the past 20 years. However, there has been notable progress in ownership and use of long-lasting insecticide-treated nets among rural and lowest-wealth quantile households compared to urban counterparts.
BMC HEALTH SERVICES RESEARCH
(2023)
Article
Multidisciplinary Sciences
Vivian Naidoo, Fatima Suleman, Varsha Bangalee
Summary: The study in South Africa aims to assess pharmacists' readiness and perceptions to expand their roles in the integrated health care system, focusing on primary health care (PHC) revitalization. While pharmacists recognize the benefits of transitioning into a more patient-centered role with proper training, appropriate reimbursement structures are necessary to support their new roles. Inconsistencies in fee structures for PHC services highlight the need for comprehensive service package guidelines and policy standardization to ensure fair compensation.
Article
Public, Environmental & Occupational Health
Anuska Kalita, Bijetri Bose, Liana Woskie, Annie Haakenstad, Jan E. Cooper, Winnie Yip
Summary: This study is the first large-scale research on private pharmacies in India and compares them with other healthcare providers. The study also explores the reasons why patients choose private pharmacies and evaluates the quality and cost of care provided by these pharmacies. The findings suggest that incorporating private pharmacies into a comprehensive health systems approach is important for achieving universal health coverage in India.
Review
Medicine, General & Internal
Wenhui Mao, Osondu Ogbuoji, David Watkins, Ipchita Bharali, Eric Boateng, Mohamed Mustafa Diab, Duah Dwomoh, Dean T. Jamison, Preeti Kumar, Kaci Kennedy McDade, Justice Nonvignon, Yewande Ogundeji, Fan-Gang Zeng, Armand Zimmerman, Gavin Yamey
Summary: Wenhui Mao and his coauthors discuss the potential implications of the COVID-19 pandemic on health aspirations in low- and middle-income countries, highlighting the need for further research and attention to address these impacts.
Article
Public, Environmental & Occupational Health
Joel Arthur Kiendrebeogo, Andrea Thoumi, Keith Mangam, Cheickna Toure, Seyni Mbaye, Patricia Odero, Edward Owino, Claire Jones, Grace Ssali Kiwanuka, Zilper Audi, Danielle Bloom, Amelia Kinter, Allison Gamble Kelley
Summary: This article discusses how low-income and middle-income countries can gain more control over their development assistance programming to achieve universal health coverage. It presents new ways for development partners to support UHC processes in countries, focusing on changing long-standing paradigms and implementing five action steps to facilitate progress towards UHC.
Article
Public, Environmental & Occupational Health
Agnes Soucat, Ajay Tandon, Eduardo Gonzales Pier
Summary: Essential packages of health services (EPHS) have the potential to contribute to universal health coverage (UHC) financing through various pathways. However, the mechanisms to achieve desired outcomes are often unclear. Although using EPHS to directly leverage funds for health has had limited success, EPHS can indirectly increase revenue through fiscal measures. Improved dialogue between health policy-makers and public finance authorities can help communicate the value of additional public spending connected to UHC indicators. EPHS development exercises have been more successful in advancing resource pooling across different schemes and improving strategic purchasing activities.
Article
Multidisciplinary Sciences
Patricia Akweongo, Samuel Tamti Chatio, Richmond Owusu, Paola Salari, Fabrizio Tedisio, Moses Aikins
Summary: The study highlighted barriers such as lack of qualified staff for claims processing, unclear vetting procedures, and failure to address discrepancies in a timely manner by NHIS officers. This resulted in delays in reimbursement and affected the operations of health facilities. Stakeholders recommended genuine claims submission and regular monitoring of health facilities to reduce errors and delays in claims reimbursement.
Article
Health Care Sciences & Services
Patricia Akweongo, Moses Aikins, Kaspar Wyss, Paola Salari, Fabrizio Tediosi
Summary: In Ghana's National Health Insurance Scheme, insured clients often need to pay out-of-pocket for consultation and drugs at accredited health facilities. The out-of-pocket payments are mainly due to the unavailability of drugs at the facilities, while consultation fees cover administrative costs of services. This reliance on out-of-pocket payments occurs in disadvantaged regions and all health facilities.
BMC HEALTH SERVICES RESEARCH
(2021)
Article
Infectious Diseases
Fatima Mahmud Muhammad, Saharnaz Nedjat, Haniye Sadat Sajadi, Mahboubeh Parsaeian, Abraham Assan, Reza Majdzadeh
Summary: The study identified poor policy implementation, low antenatal care attendance, inadequate access to intermittent preventive treatment at community levels, lack of sustainable funding, and poor community engagement as major barriers to IPTp usage among pregnant women in Nigeria.
BMC INFECTIOUS DISEASES
(2021)
Article
Health Care Sciences & Services
Abraham Assan, Hawawu Hussein, David N. K. Agyeman-Duah
Summary: This article presents the perspectives of the public in Ghana on the implementation of lockdown measures. Most respondents characterized the lifting of the lockdown as hasty, poorly communicated, and lacking transparency, and expressed a preference for a longer lockdown. Concerns were raised about the health systems' ability to respond to increased disease transmission and provide necessary education and engagement in communities.
JOURNAL OF PUBLIC HEALTH POLICY
(2022)
Article
Health Policy & Services
Jacob Novignon, Genevieve Aryeetey, Justice Nonvignon, Keziah Malm, Nana Yaw Peprah, Samuel Agyei Agyemang, Samuel Amon, Moses Aikins
Summary: This study aimed to estimate the efficiency in the use of malaria resources and identify potential determinants. Findings from Ghana showed an average technical efficiency score of 0.61, with private facilities being more efficient. Productivity changes were driven by technology/innovation advancements. The study emphasizes the need to improve resource use in delivering specific services such as malaria.
Article
Public, Environmental & Occupational Health
Solip Ha, Sonam Yangchen, Abraham Assan
Summary: This study explores the facilitators and barriers to COVID-19 testing in the Greater Accra region of Ghana. The findings highlight the importance of better health governance, community participation, multisectoral collaboration, effective resource management, and information systems in driving COVID-19 testing. The primary barriers include the COVID-19 infodemic, inadequate material resources, and limited access to testing services. Testing remains crucial in controlling the virus, even with the rollout of vaccines.
FRONTIERS IN PUBLIC HEALTH
(2022)
Article
Multidisciplinary Sciences
Kwasi Adjepong Darkwah, Samuel Iddi, Justice Nonvignon, Moses Aikins
Summary: Functional disability is common among older adults in Ghana, with female gender, age above 70, and having three or more chronic conditions being associated with higher disability. Adequate fruit intake and higher household wealth were found to be linked to lower functional disability. Preventing functional disability in old age in Ghana is of great social and economic concern, requiring coordinated efforts to address this public health challenge.
Article
Primary Health Care
Leila Doshmangir, Ahmad Shirjang, Abraham Assan, Vladimir Sergeevich Gordeev
Summary: This study aims to explore the challenges facing Iran's Primary Health Care (PHC) network and propose possible solutions. The PHC network faces financial challenges, unfair resource distribution, lack of community health workers, and a sustainable financing model. Policy makers should prioritize innovative, preventive, and health promotion initiatives, and encourage community participation, private sector engagement, and involvement of non-government organizations to improve the functioning of the PHC network in Iran.
PRIMARY HEALTH CARE RESEARCH AND DEVELOPMENT
(2023)
Review
Health Care Sciences & Services
Adane Nigusie, Berhanu F. Endehabtu, Dessie Abebaw Angaw, Alemayehu Teklu, Zeleke Abebaw Mekonnen, Marta Feletto, Abraham Assan, Assegid Samuel, Kabir Sheikh, Binyam Tilahun
Summary: This scoping review identified the limited provision of CRC service. Lack of training, high patient flow volume, and bed shortages were found to be the main contributors to CRC health care delivery. Therefore, the health care system should consider the implementation of CRC in training, monitoring and evaluation processes.
JMIR HUMAN FACTORS
(2022)
Article
Public, Environmental & Occupational Health
Sonam Yangchen, Solip Ha, Abraham Assan, Tashi Tobgay
Summary: This study explores the factors influencing COVID-19 testing in Bhutan. It finds that political will, leadership, a whole society approach, functional health systems, community-based approaches, and information technology play important roles in the success of COVID-19 testing. These efforts are made possible through improved health governance and leadership at all levels of the society.
GLOBAL HEALTH RESEARCH AND POLICY
(2022)
Article
Public, Environmental & Occupational Health
Patricia Akweongo, Edmund Voetagbe, Fabrizio Tediosi, Dominic Dormenyo Gadeka, Paola Salari, Moses Aikins
Summary: The study explores community perceptions of enrolling the poor into the National Health Insurance Scheme (NHIS) through the Livelihood Empowerment against Poverty (LEAP) program in Ghana. The findings suggest a general belief that the selection process lacks transparency and has been politicized. However, the study also highlights the community's ability to identify the poor.
GLOBAL HEALTH RESEARCH AND POLICY
(2022)
Review
Substance Abuse
Rita Patricia Frimpong-Mansoh, Samuel Amon, Samuel Agyei Agyemang, Samuel Sackey, Moses Aikins
Summary: The study conducted in a coastal commercial community in Ghana found that adults on average spent $5.06 daily on alcohol, with both men and women preferring beer. It also showed that education level and income were associated with alcohol use among the participants.
JOURNAL OF SUBSTANCE USE
(2022)
Article
Public, Environmental & Occupational Health
Abebaw Addis Gelagay, Alehegn Bishaw Geremew, Alemayehu Teklu, Zeleke Abebaw Mekonnen, Alyssa Sharkey, Abraham Assan, Binyam Tilahun
Summary: The study in Ethiopia found that women's household decision making power plays a significant role in their autonomy regarding child vaccinations. While majority of women have autonomy to vaccinate their children, a considerable proportion of women have low household decision making power.
ETHIOPIAN JOURNAL OF HEALTH DEVELOPMENT
(2021)
Article
Medicine, General & Internal
Samer Abuzerr, Kate Zinszer, Abraham Assan
Summary: This study identified barriers to implementing an integrated One Health surveillance system in Palestine, including lack of policy coherence, limited financial resources, poor governance and leadership, and absence of One Health training programs. Improved understanding and control of zoonotic diseases like COVID-19 require addressing these barriers.
SAGE OPEN MEDICINE
(2021)
Article
Public, Environmental & Occupational Health
Hawawu Hussein, Mansour Shamsipour, Masud Yunesian, Mohammad Sadegh Hassanvand, Abraham Assan, Akbar Fotouhi
Summary: A study conducted in three districts of Northern region, Ghana found that prevalence of hypertension in pregnant women was not high, with obesity, gestational diabetes, and number of children being independent predictors of pre-existing hypertension.
IRANIAN JOURNAL OF PUBLIC HEALTH
(2021)
