Abstract
BackgroundAssessing the performance of health systems through quantitative and qualitative methods is recognized as an effective approach to strengthening national health systems. However, while many high-income countries have institutionalized health system performance assessment (HSPA) as an integral component of their respective health systems, few studies on HSPA have been documented in low- and middle-income countries, including Ghana. This study aims at providing a comprehensive framework for periodic assessment of the performance of the entire health system in Ghana.MethodsThe study will have four work packages. First, a structured review will be conducted to identify both international and national HSPA frameworks that could be applied to the Ghanaian context. Second, based on the structured review, an assessment framework tailored to the Ghanaian health system context will be developed. Third, the draft framework will be presented and discussed with experts and stakeholders for its appropriateness, feasibility and acceptability. Finally, the framework will be piloted to assess its effectiveness and suitability for full-scale implementation.DiscussionCurrently, Ghana does not have a full-fledged HSPA tool that provides a holistic health sector-wide approach to assessing health system performance. Thus, developing this HSPA framework for the country will provide a tool for periodic and comprehensive assessment of the performance of the health system, which can be compared with that of other countries. Such a comparison will offer the opportunity for mutual learning and for exploring new options for formulating more effective national health policies. As this is expected to be the first attempt to develop a comprehensive HSPA framework in Ghana, this study will provide a basis for future discussions on how to further develop and implement HSPA programmes in the country.
Highlights
Assessing the performance of health systems through quantitative and qualitative methods is recog‐ nized as an effective approach to strengthening national health systems
Despite the existence of the aforementioned assessment programmes, Ghana does not have a full-fledged health system performance assessment (HSPA) tool that provides a holistic health sector-wide approach to assessing health system performance
We will ensure that the framework aligns with the health system objectives of Ghana, is integrated with information technology (IT) and routine data collection in the country, includes highpriority and hard-to-measure areas, and has measurement indicators that are internationally comparable
Summary
The study has four work packages (WPs): a literature review, development of an HSPA framework suitable for the Ghanaian context, presentation and discussion of the framework with experts and stakeholders, and piloting the framework. Systematic review (WP1) We will conduct a structured review to identify and examine the existing HSPA frameworks, especially the more established ones. The purpose of this task is to determine which framework or aspects of particular frameworks could be applied to the Ghanaian context. The review will inform the stage of the study, where a draft framework will be developed with the input of the major important and relevant stakeholders, both public and private, in the health sector of Ghana and appropriate indicators extracted and mapped onto it. Piloting the draft framework to ensure its feasibility for full-scale implementation
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