Appraising two decades of public sector health financing and service delivery reforms in Ghana between 2000-2020: a scoping review protocol (Preprint)

Abstract

Many countries have committed to health systems reforms to achieve universal health coverage (UHC). The World Health Report 2013 calls for research to provide robust evidence to achieve UHC. In Ghana, the national health insurance scheme (NHIS) implemented about two decades ago is one of the leading policies in the country, with significant research evaluations. Apart from the NHIS, there is limited synthesized evidence on the implications of other health financing and health service delivery reforms for sustainability, efficiency, equity of access, and quality of care in Ghana.

This review aims to systematically and comprehensively appraise the literature on the country’s health financing and service delivery reforms over two decades (2000-2020) to provide evidence for policy.

This scoping review approach was adopted, guided by Arksey and O’Malley and Levac et al. frameworks following the Joanna Briggs Institute (JBI) recommendations. JBI’s 3-step strategy was used to identify relevant articles through a comprehensive and systematic search in PubMed, Embase, Web of Science, Cochrane library, CINAHL, and Hinari databases. Grey literature search will be done using the Google Scholar search engine and ProQuest Dissertation & Theses Global database, as well as by reviewing official documents and reports from the Ghana Ministry of Health, the Ghana Health Service, and other state institutions responsible for health policy formulation. Additional documents will be identified by reviewing the included studies' reference lists. A data charting template adapted from the JBI will guide data extraction.

A narrative reporting format will be used to summarize all the extracted data while describing the studies’ characteristics, including their objectives. The results will mainly focus on a broad range of health sector reforms, identify gaps for further research, and present an overview of the status for priority-setting and decision-making for health policy administrators.

This study will explore a broad range of health financing and service delivery reforms in Ghana’s health sector and identify gaps for research agenda-setting and policy decision-making purposes toward UHC. Dissemination of evidence from this review will be in two folds: to scientific and academic audiences and for policy and practice.

This scoping review was registered in the Open Science framework with the following Registration DOI 10.17605/OSF.IO/9DMXW