Ghana: Cross-Programmatic Efficiency Analysis

Overview

Over the past decade, Ghana has made significant progress in health coverage gains. These gains, however, are at risk with Ghana’s reclassification as a middle-income economy, which means that support from donors is set to decline over the next five years. The Ministry of Finance has indicated that in order to meet the co-financing targets set by donors, total government spending on health will need to increase dramatically both in real terms and as a share of the overall government budget.  However, limited fiscal space will continue to constrain the ability to meet these targets. This has implications at all levels of service delivery: with a constrained resource envelope in a rather vertically designed architecture, the impact of declines in support from development partners will be felt acutely by disease programmes, which have been funded in large part through external support. In this context, a cross-programmatic efficiency analysis was performed in 2017 with aim of identifying ways to overcome these inefficiencies.   

This policy brief, which outlines the identified inefficiencies, their implications, and policy options, is written based on that analysis, with recognition that changes in the health system may have taken place since the study was conducted.