Dynamics Shaping Health Care Policy Adoption And Implementation In Ghana

Abstract

The paper examined the health care policies implemented in Ghana from the pre-colonial era to the current Fourth Republic of Ghana. The study was based on a desktop review of literature and official government publications. The study found that pre-colonial health care was championed by traditional healers and leaders and the strategies took the form of communal labour, taboos and herbal medicines as well as amulets.  The colonial era witnessed the introduction of medicine into the Gold Coast. However, this strategy was mostly selective in favour of the Europeans. When the selective application or implementation failed, the medication was extended to the indigenes with European affinity.  Health care policy during the post-colonial era was aimed at ensuring access, affordability and equity for the citizenry. As such, successive governments implemented a three-prone health care policy: financing, infrastructure and human resource. However, lack of policy continuity due to unstable and punctuated political leadership derailed the fruition of these policies. Nevertheless, the Fourth Republic has experienced some level of policy stability in health care financing with the implementation of the National Health Insurance Scheme. However, the scheme is also plagued with diverse hiccups like excessive politicization of appointments, delay in reimbursing accredited service providers etc. The study also revealed that health care policies were shaped by multiple dynamics; key among them were ideology, demography, partisan politics, external factors and global public health issues. The study concludes and recommends that health care policy have been on the front burner since the pre-colonial era until date. But selectivity, lack of continuity and politicization have denied the country of its fruits as such the paper recommends fine tuning the current National Health Insurance Scheme to suit the exigency of the time and politicization should be minimized if it cannot be neutralized.

Keywords: Ghana; public policy; health care financing; National Health Insurance Scheme; Cash and Carry.

DOI: 10.7176/PPAR/13-6-07

Publication date:December 30^th 2023