Financing health care and policy issues in developing countries: Decision making in Ghana’s health insurance policy process

Abstract

Health care financing is a major challenge in developing countries. Ghana happens to be the first country in Africa to implement universal health insurance coverage. In view of the challenges of policy development in developing countries, the paper sought to analyse the policy making process of Ghana’s health finance policy, applying theoretically robust and well structured approaches to policy process analysis. The paper argues that policy is not only about the intentions or the content, but, also the policy making process. A policy may have the best of intentions but failure to pay attention to the processes that the policy go through, the institutional arrangements, rules of decision making, the political context, the interest and the participation of key actors and stakeholders in the policy making process may stifle a brilliant policy. The paper brings out lessons of experience that can be useful to other developing countries considering a health finance policy, as well as serve as a guide for future policy developments. Key words: Developing countries, Ghana, out of pocket payment, health costs, health insurance, health finance policy, policy making process, actors, institutional arrangements.