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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Critical interactions between the global fund-supported HIV programs and the health system in Ghana
Journal of Acquired Immune Deficiency Syndromes, Volume 57, No. SUPPL. 2, Year 2011
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Description
The support of global health initiatives in recipient countries has been vigorously debated. Critics are concerned that disease-specific programs may be creating vertical and parallel service delivery structures that to some extent undermine health systems. This case study of Ghana aimed to explore how the Global Fund-supported HIV program interacts with the health system there and to map the extent and nature of integration of the national disease program across 6 key health systems functions. Qualitative interviews of national stakeholders were conducted to understand the perceptions of the strengths and weaknesses of the relationship between Global Fund-supported activities and the health system and to identify positive synergies and unintended consequences of integration. Ghana has a well-functioning sector-wide approach to financing its health system, with a strong emphasis on integrated care delivery. Ghana has benefited from US $175 million of approved Global Fund support to address the HIV epidemic, accounting for almost 85% of the National AIDS Control Program budget. Investments in infrastructure, human resources, and commodities have enabled HIV interventions to increase exponentially. Global Fund-supported activities have been well integrated into key health system functions to strengthen them, especially financing, planning, service delivery, and demand generation. Yet, with governance and monitoring and evaluation functions, parallel structures to national systems have emerged, leading to inefficiencies. This case study demonstrates that interactions and integration are highly varied across different health system functions, and strong government leadership has facilitated the integration of Global Fund-supported activities within national programs. © 2011 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Atun, Rifat Ali
Switzerland, Geneva
Fonds Mondial de Lutte Contre le Sida, la Tuberculose et le Paludisme
United Kingdom, London
Imperial College Business School
Pothapregada, Sai Kumar
Switzerland, Geneva
Fonds Mondial de Lutte Contre le Sida, la Tuberculose et le Paludisme
Kwansah, Janet
Ghana, Accra
Ghana Ministry of Health
Degbotse, D.
Ghana, Accra
Ghana Ministry of Health
Lazarus, J. V.
Switzerland, Geneva
Fonds Mondial de Lutte Contre le Sida, la Tuberculose et le Paludisme
Denmark, Copenhagen
Københavns Universitet
Statistics
Citations: 54
Authors: 5
Affiliations: 4
Identifiers
Doi:
10.1097/QAI.0b013e318221842a
ISSN:
15254135
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Case Study
Study Approach
Qualitative
Study Locations
Ghana