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

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Background Immunisation in Ghana

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

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Analytic Framework Immunisation in Ghana

Health Status

Availability & Utilisation

of health interventions

Availability and Utilisation

of health related interventions

Package of Health Interventions






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Cross cutting issues Immunisation in Ghana

  • 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

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Strategic Objectives Immunisation in Ghana

  • 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

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Ghana EPI Coverage 1986 - 2002 Immunisation in Ghana

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Districts above 80 %

Districts B/n 50 & 80 %

Districts Below 50 %

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Contributing factors Immunisation in Ghana

  • 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

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Health Financing Trend Immunisation in Ghana

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Constraints and challenges Immunisation in Ghana

  • 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.

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Way forward Immunisation in Ghana

  • 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

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Conclusion Immunisation in Ghana

  • 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

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THANK YOU vaccines : the case of Ghana