A TIME OF CHANGE - HEALTH-POLICY, PLANNING AND ORGANIZATION IN GHANA

This paper presents the results of a rapid health sector policy analysis carried out in Ghana in October 1990. Its purpose is to illustrate the dynamics of the policy debate at a time of major change, and to provoke discussion about the practical implications of current policy directions. In addition, it demonstrates the range and nature of issues of concern to decision makers in the Ministry of Health, Ministry of Local Government and National Development Planning Commission. Issues discussed include: the restructuring of the Ministry of Health; resource allocation under decentralization; health planning responsibilities at different levels; the case for an intermediate level of management in a decentralized health system; the relationship between different forms of cost-recovery programme; the future of EPI and; the implications of establishing a national health service. The final section presents some preliminary conclusions concerning the process of organizational change in the health sector resulting from decentralization policies.