This review considered possible scenarios for the health sector over the
next three years and a range of associated options for future support
from the Department for International Development (DFID). The review
concludes the best option to be: provision of non-budget support
financial aid for primary care.
The report makes the following recommendations:
- DFID should reach a definitive and agreed position with the Ministry
of Health (MOH) concerning the reasons for the non-achievement of the
existing sector budget support (SBS) performance targets and make an
assessment of when/if these targets can actually be achieved.
- If a decision is made to adopt the option of continuing SBS with a
focus on services and strong earmarking of funds for that purpose,
then the basis for tranche release should be considered as a first
- If a decision is made to adopt provision of non-budget support
financial aid for primary care, then discussions should be opened with
the GHS to agree objectives and management arrangements and to develop
a programme delivery plan drawing on those already being developed for
the planned World Bank project.
- DFID should contact the World Bank task manager and consider the
possibility of co-funding of its new primary health care (PHC)
- There should be further discussion of the technical assistance plan
with the MOH and agreement of its objectives, indicators and allocated
responsibilities. DFID should hold the MOH director of policy,
planning, monitoring and evaluation (PPME) accountable for its
- DFID should encourage the MOH to give priority to achieving
ministerial approval and early implementation of the health financing
strategy as a core area for future reform in the sector.
- DFID should engage more directly and on a systematic basis with the
deputy minister to achieve progress with the financing strategy, the
primary healthcare policy and workforce optimisation.
- DFID should revitalise the donor dialogue by encouraging stronger
leadership from Government of Ghana including ministerial engagement.
- Consideration should be given by DFID to increase working with
community service organisations on the voice and public accountability
aspects of health issues, regardless of which option is chosen for
taking forward financial aid.
Clarke, J.; Tyson, S. Assignment Report: Ghana health sector support programme: scenario planning and risk management. HEART, UK (2014) 63 pp.