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. 2018 Oct 5;17(1):97.
doi: 10.1186/s12939-018-0810-4.

Towards universal health coverage: a mixed-method study mapping the development of the faith-based non-profit sector in the Ghanaian health system

Annabel Grieve  1 , Jill Olivier  2
Affiliations

Towards universal health coverage: a mixed-method study mapping the development of the faith-based non-profit sector in the Ghanaian health system

Annabel Grieve et al. Int J Equity Health. .

Abstract

Background: Faith-based non-profit (FBNP) providers have had a long-standing role as non-state, non-profit providers in the Ghanaian health system. They have historically been considered to be important in addressing the inequitable geographical distribution of health services and towards the achievement of universal health coverage (UHC), but in changing contexts, this contribution is being questioned. However, any assessment of contribution is hampered by the lack of basic information about their comparative presence and coverage in the Ghanaian health system. In response, since the 1950s, there have been repeated calls for the 'mapping' of faith-based health assets.

Methods: A historically-focused mixed-methods study was conducted, collecting qualitative and quantitative data and combining geospatial mapping with varied documentary resources (secondary and primary, current and archival). Geospatial maps were developed, providing a visual representation of changes in the spatial footprint of the Ghanaian FBNP health sector.

Results: The geospatial maps show that FBNPs were originally located in rural remote areas of the country but that this service footprint has evolved over time, in line with changing social, political and economic contexts.

Conclusion: FBNPs have had a long-standing role in the provision of health services and remain a valuable asset within national health systems in Ghana and sub-Saharan Africa more broadly. Collaboration between the public sector and such non-state providers, drawing on the comparative strengths and resources of FBNPs and focusing on whole system strengthening, is essential for the achievement of UHC.

Keywords: Faith-based providers; GIS; Ghana; Health system; History; Map; Non-state providers; Public-private partnership; Universal health coverage.

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Conflict of interest statement

Authors’ information

Annabel Grieve is a post-graduate student at the University of Cape Town, School of Public Health and Family Medicine, Health Policy and Systems Division. This article was developed as part of a post-graduate dissertation project.

Jill Olivier is a Professor in the University of Cape Town, School of Public Health and Family Medicine, Health Policy and Systems Division. She is the co-PI of the larger study in Ghana (running from 2015 to 2018, funded by the AHPSR WHO), and was the thesis supervisor of the mapping sub-study.

Ethics approval and consent to participate

Although considered minimal risk, ethical approval was obtained from the University of Cape Town’s (UCT) Human Research Ethics Committee (HREC) (Reference 303/2017). The study also operated under the existing ethical considerations of the primary study, approval for which has been obtained from the WHO Research Ethics Committee, GHS Ethical Review Committee and UCT HREC (annually updated, 2015–2018).

Consent for publication

Yes, consent forms utilised in interviews – as part of larger primary study.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
a The Current Public-Private Health System b 2010 Population Density
Fig. 2
Fig. 2
Map of current distribution
Fig. 3
Fig. 3
Hospitals in 1957. a Hospitals (government and CHAG) in 1957. b The Gold Coast under UK Trusteeship in 1955
Fig. 4
Fig. 4
Evolution of FBNPs
Fig. 5
Fig. 5
a CHAG membership numbers from annual reports and self report b Year members joined CHAG from self support
Fig. 6
Fig. 6
a CHAG facilities against population figures b CHAG facilities against poverty incidence
See this image and copyright information in PMC

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