Abstract
BackgroundMeasuring the performance of a health system is an essential requirement in creating systems that generate efficient, equitable, patient-focused, accessible and sustainable results. A fundamental requirement for a performance measurement system is the development of an assessment framework within which specific performance measures could be defined and applied regularly. This paper examines the comprehensiveness of Ghana’s health system assessment framework called the Holistic Assessment Tool in relation to some of the internationally recognized frameworks. The paper also analyzes trends in the performance of the health system to understand whether or not an improvement has been recorded following the adoption and implementation of the Holistic Assessment Tool.MethodsMainly secondary data were used in this analysis. Searches were conducted on Google Scholar, PubMed, Scopus and Science Direct between May and July, 2019 for published documents on health system performance assessment. We also obtained unpublished documents from Ghana’s Ministry of Health, Ghana Health Service website, and Ghana Statistical Service database. Descriptive statistics were used to examine trends in the performance of the Ghanaian health system.ResultsWhile the tool provides a national framework for evaluating the performance of the Ghana Health system in several domains, the Holistic Assessment Tool does not cover key health system domains such as information systems for health, access to essential medicines, and patient-centeredness. Also, the scope of the assessment program seems limited to the evaluation of the Ministry of Health’s annual plans, programs and projects. However, the health system has recorded improvements in population health indicators, such as life expectancy at birth, infant mortality, under-5 mortality, HIV prevalence and disease burden (in terms of disability adjusted life years).ConclusionsThe Holistic Assessment Tool is a useful framework, but needs further refinement, both in scope and in conceptual robustness. Future studies should consider exploring factors influencing performance of the Ghanaian health system. Such information will help in strategizing for better and more improvements.
Highlights
Health system performance assessment (HSPA) has become a central instrument in governing modern health systems
This is especially crucial as countries make efforts towards attaining the Post-2015 Development Agenda or the Sustainable Development Goals (SDGs), target 3.8 of Goal 3 (Universal Health Coverage) [1], which is at the center of current efforts of strengthening health systems [2]
Questions remain as to what constitutes a comprehensive health system performance assessment framework, especially, for developing and low-income countries in view of the consideration given to the peculiarities of health systems [5]
Summary
Health system performance assessment (HSPA) has become a central instrument in governing modern health systems. Frameworks developed largely in the context of high-income countries (HICs) have dominated these efforts [5,6,7,8] In this regard, questions remain as to what constitutes a comprehensive health system performance assessment framework, especially, for developing and low-income countries in view of the consideration given to the peculiarities of health systems [5]. Questions remain as to what constitutes a comprehensive health system performance assessment framework, especially, for developing and low-income countries in view of the consideration given to the peculiarities of health systems [5] It is against this background that we adopt the definition by Tashobya et al in this study.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
