Gov’t monitoring mechanisms in health sector ineffective

A research conducted by Effective States and Inclusive Development (ESID) has identified weakness of accountability in the Ghanaian health sector as more of political than a technical or cultural factor.

The research, which focused on the challenges of states’ effectiveness and the promise of inclusive development in Ghana, detected that the health sector lacks accountability because government monitoring mechanisms are ineffective.

That was evident in the significant variations between public and private health facilities, in terms of the functionality, accountability mechanisms and the ways these shape health worker productivity.

The ESID reports on key sectors of the economy were made at a research dissemination workshop held at Ghana Centre for Democratic Development (CDD) in Accra recently.

ESID is a research programme sponsored by UK Aid and conducted education institutions like University of Manchester, University of Ghana, University of Cape Town and Harvard to support developing countries.

Delivering the findings on politics and health service delivery, “Insights from Ghana”, Dr. Abdul-Gafaru Abdulai, a lecturer at the Department of Public Administration, University of Ghana Business School indicated that: “in the public sector, accountability and disciplinary measures are undermined by unclear line of Authority, and promotional is often based on patronage rather than performance.”

He said public health administration has been characterized with weak supervision at both regional and district levels, citing Volta region for being relatively-resourced but has poor performance indicators as a result of ineffective monitoring.

Dr. Gafaru suggested a well-designed bottom-up approach that involves traditional rulers in improving performance and quality service delivery.

On the findings of the politics of governing natural resources in Ghana, “Towards Inclusive Development”, it was established that Ghana’s capacity to forge favourable deals with international oil companies has been undermined by political interference.

According to Kojo Asante-Senor Researcher at CDD, political interference has reduced the government’s capacity to enforce tax law and negotiation stability agreement with mining companies to secure good deal for the country, citing “these stability agreements freeze taxes and other benefits offered by government to mining companies for long periods.”

He noted that what are referred to as Ghana’s “best practices” institutional arrangements are often not enforced because they do not fit with the prevailing balance of power within its competitive clienteles’ form of politics.

He said though Ghana made an explicit commitment to use oil revenue to catalyse socio-economic transformation and overcome regional inequalities, oil revenues have so far been spread too thinly to achieve structural transformation.

“Allocations of oil revenues are frequently driven by electoral calculus, undermining prospects for inclusive development,” he stated.

On the findings of Ghana’s political settlement and constraints to structure transformation, it was revealed that Ghana has experienced sustainable growth without structural transformation.

The research, which was led by David Hulme, Chief Executive of ESID, further explained that the growth had majorly been in the service sector, but it was characterized by low productivity and low wages.

It noted that though most firms in Ghana are small and medium sized enterprises in the manufacturing sector, mining firms have close relation with political elite.