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Health Sector Reforms and Financial sustainability in Immunisation in Ghana

Ghana has made positive strides in immunization through its reforms. ... out of GAVI / VF contribution for pentavalent vaccines : the case of Ghana ...

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Health Sector Reforms and Financial sustainability in Immunisation in Ghana

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  1. Health Sector Reforms and Financial sustainability in Immunisation in GhanaByProf A.B.AkosaDirector-GeneralGhana Health Service

  2. Background Reforms in Ghana have a 20 year cycle: • 1957- Basic Health Services • Emphasis on infrastructure & HR development • 1977- PHC era • Emphasis on expansion of services eg UCI • 1997- Health Sector Reforms based on SWAps • Emphasis on systems strengthening

  3. Analytic Framework Health Status Availability & Utilisation of health interventions Availability and Utilisation of health related interventions Package of Health Interventions Access Quality Efficiency Collaboration Resources

  4. Cross cutting issues • Poor access to services due to: • Social, economic and geographical barriers • Poor quality of care due to: • Poor staff attitude and competencies • Inefficiencies and wastage due to: • Poor logistic, financial, planning and evaluation • Poor collaboration due to: • Inadequate engagement of communities, private sector • Inadequate financing and equity due to: • Absence of appropriate financial strategy

  5. Strategic Objectives • To improve the quality of health care • To improve access to health care • To foster partnerships in improving health • To improve equity infinancing and ensure financial sustainability in the provision of health services • To improve efficiency in the sector

  6. Ghana EPI Coverage 1986 - 2002

  7. PENTA 3 PERFORMANCE BY DISTRICTS Districts above 80 % Districts B/n 50 & 80 % Districts Below 50 %

  8. Contributing factors • Continual political commitment • Increasing of govt allocation to health • SWAps approach to donor relations • Decentralized Budget Management Centers • Shift of funds from center to districts (19% - 42%) • Donor pooled, flexible, untied funds • Increased outreach sites • Increasing participation of the private sector

  9. Health Financing Trend

  10. Constraints and challenges • Funding targets not met, threatening financial sustainability • Common basket not full • Human resource causing major strain • Brain drain likely to erode gains • Logistics and supplies still a problem especially transport.

  11. Way forward • Learn from the FSP of immunization to draw sector-wide FSP by • Costing services • Greater linkage to GPRS • Take advantage of HIPC funds • Explore insurance reforms as a strategy • Obtain more external commitments on longer term basis • Deal with brain drain by emphasis on middle level staff • Invest in logistics

  12. Conclusion • Ghana has made positive strides in immunization through its reforms. • SWAp 1 is ended and SWAp 2 started in 2002 • Pentavalent vaccine successfully introduced • The current cost of new vaccine is a major challenge • Benefit from it is however great • More donor commitment will however be needed

  13. Phasing out of GAVI / VF contribution for pentavalent vaccines : the case of Ghana

  14. THANK YOU

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