Data for: "Public accountability needs to be enforced - a case study of the governance arrangements and accountability practices in a rural health district in Ghana"

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http://eprints.org/relation/isVersionOf https://datacompass.lshtm.ac.uk/id/document/3082 http://eprints.org/relation/isVolatileVersionOf https://datacompass.lshtm.ac.uk/id/document/3082 http://eprints.org/relation/issmallThumbnailVersionOf https://datacompass.lshtm.ac.uk/id/document/3082 indefinite Thumbnails conversion from Text to thumbnail_small archive 3 disk0/00/00/03/04 2016-11-03 11:32:13 2025-09-18 14:24:53 2016-11-03 11:32:13 data_collection show Van Belle Sara 0000-0003-2074-0359 FALSE Mayhew Susannah 0000-0002-2433-3809 TRUE 4b2f94dbc9329e27e31e98090f9de68e Institute of Tropical Medicine, Antwerp, Belgium London School of Hygiene & Tropical Medicine, London, United Kingdom Data for: "Public accountability needs to be enforced - a case study of the governance arrangements and accountability practices in a rural health district in Ghana" PHGH Accountability Health districts Ghana Governance NGO Improving public accountability is currently high on the global agenda. At the same time, the organisation of health services in low- and middle-income countries is taking place in fragmented institutional landscapes. State and non-state actors are involved in increasingly complex governance arrangements. This often leads to coordination problems, confusion of roles and responsibilities and possibly accountability gaps. This study aimed at assessing the governance arrangements and the accountability practices of key health actors at the level of a Ghanaian health district with the aim to understand how far public accountability is achieved. We adopted the case study design as it allows for in-depth analysis of the governance arrangements and accountability relations between actors, their formal policies and actual accountability practices towards the public and towards stakeholders. Data were collected at a rural health district using in-depth interviews, observation and document review. In the analysis, we used a four-step sequence: identification of the key actors and their relationships, description of the multi-level governance arrangements, identification of the actual accountability relations and practices between all actors and finally appraisal of the public accountability practices, which we define as those practices that ensure direct accountability towards the public. In this rural health district with few (international) non-governmental organisations and private sector providers, accountability linkages towards management and partners in health programmes were found to be strong. Direct accountability towards the public, however, was woefully underdeveloped. This study shows that in settings where there is a small number of actors involved in organising health care, and where the state actors are underfunded, the intense interaction can lead to a web of relations that favours collaboration between partners in health service delivery, but fails public accountability. It is clear that new formal channels need to be created by all actors involved in health service delivery to address the demand of the public for accountability. If the public does not find an adequate response to its genuine concerns, distrust between communities and service users on one hand, and providers, international non-governmental organisations and District Health Management Teams on the other is likely to increase to the detriment of all parties' interests. 2016-11-12 published Figshare Dataset Institute of Tropical Medicine, Antwerp, Belgium London School of Hygiene & Tropical Medicine, London, United Kingdom Interview.FaceToFace Observation.Field public Dataset Quantitative We used in-depth interviews, observations, and document review to collect data. We developed semi-structured interview topic guides for different types of respondents and these were pre-tested with SRH INGO representatives and GHS managers outside the study site. Interviewees were purposely sampled, as the objective was to collect data on perceptions of different categories of actors (e.g. DHMT, INGO, District Assembly, community leaders, etc.) operating at different levels (e.g. INGO headquarters, INGO national office, district representation of the INGO). We conducted 23 in-depth interviews and a further 13 informal discussions with resource persons. The study was explained in detail to all interviewees, and informed consent obtained in all cases. The duration of the interviews ranged from 45 min to two hours. Interviews were recorded when allowed by the interviewee. The recorded interviews were transcribed by an experienced Ghanaian transcriber, who was bound by a confidentiality agreement. As formal DHMT-(I)NGO meetings were not held regularly during our stay, we used any opportunity that arose during the visits. For instance, we attended a half-day regional forum of the Ghana Coalition of NGOs in Health, where GHS representatives were invited to speak and a meeting between a District Chief Executive and a District Director of Health Services. Additional opportunities for observation were provided during our visits to health facilities in the district. Documents reviewed include project descriptions of SRH INGO programmes, GHS annual reports and GHS half-year performance reviews at different levels, GHS policies, guidelines and tools, reports from the district administration, policy reviews from donors and INGOs, and articles in the press. 11.1019 0.823975 5.25404 -2.8894 en Figshare https://doi.org/10.6084/m9.figshare.c.3632219_D1.v1 dataresource Public accountability needs to be enforced -a case study of the governance arrangements and accountability practices in a rural health district in Ghana. http://researchonline.lshtm.ac.uk/id/eprint/2997217 2016-11-12