Health policy analysis institutes: landscaping and learning from experience, Ghana
A Case Study on the Centre for Health and Social Services (CHESS), Ghana
The multi-national landscaping study of Health Policy Analysis Institutes supported by the Alliance HPSR and funded by the Rockefeller Foundation aims to achieve three goals: (i) mapping existing national and regional health policy analysis institutes and initiatives; (ii) deriving lessons about the different organizational models and factors that contribute to the effectiveness and sustainability of such institutes and (iii) making recommendations to the Rockefeller Foundation and other stakeholders about how best to support the development of health policy analysis institutes in low- and middle-income countries (LMICs).
The University of Ghana selected the Centre for Health and Social Services (CHeSS) as a case study to illustrate the challenges and opportunities for an LMIC health policy analysis institute. CHeSS is an independent Health Research NGO run by individuals with extensive experience in service delivery and policy development in Ghana’s health sector. The remit of CHeSS is to conduct research linked to the Ministry of Health (MOH), particularly in the areas of strengthening health systems; in studying the interface between health systems and social services; in addressing gaps in specific MOH needs and priorities regarding health systems; and in facilitating health policy dialogue.
Findings: Using a range of key informant interviews to explore the history and goals of the organization, along with comparisions of insider and outsider knowledge and an assessment of its intersections with the MOH, the Ghana Health Service and development partners, researchers determined that:
- CHeSS can be a major player on the local HPSR scene. The institution has a strong portfolio after only one year of service. It has set clear areas for research and advocacy that address three key areas of the six building blocks of health systems: capacity building in health services; healthcare financing; and leadership and governance.
- Most informants highlighted the human resource challenges within CHeSS, chiefly the need to recruit a full-time staff of multidisciplinary researchers. CHeSS will need to prioritise fundraising to address this gap in its administrative and management structure.
- The potential for policy-makers turning to CHeSS to conduct original research, as well as institutional reviews and monitoring and evaluation of services, is high. Local policy-makers do not have funding for these purposes but outline the potential of developing creative payment systems, for example providing in-kind human resources and logistical support for research.
- Insider knowledge and practice do not correspond with outsider knowledge and perceptions. There is some level of name recognition, but it is largely tied to a well-known and influential individual in the health sector. This is a positive as well as negative issue for all the key informants. It is positive because all respondents stressed that deep knowledge of the health sector was important to conducting robust, collaborative and long-term research; it is negative because for the institution to thrive it must build strong research capacity around different disciplines and proven expertise, and the potential for conflict of interest.
Project description
Programme: Health policy analysis institutes: landscaping and learning from experience
Research title: A Case Study on the Centre for Health and Social Services (CHESS), Ghana
Thematic Research Area: Evidence to Policy
Grantee Country: Ghana
Grantee Institution: University of Ghana
Program Coordinator/Principle Investigator:Dr Ama de-Graft Aikins
Start date: July 2009
Status of grant: Completed (September 2010)