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Ghana - Second Health Program Support Project (HSPSP-II) (Inglês)

Ratings for the Second Health Program Support Project (HSPSP-II) for Ghana were as follows: outcomes were moderately satisfactory, the risk to development outcome was moderate, the Bank performance was moderately satisfactory, and the Borrower performance was moderately unsatisfactory. Some lessons learned included: With the completion of HSPSP-II's support to Ghana's health sector-wide approach (SWAp), reflection on its achievements as well as weaknesses reveals several lessons. One lesson is that a stronger analytic base is needed even when things appear to be going well, as was the case when the HSPSP-II was approved. In-depth analysis and debate concerning equity of health services and outcomes, efficiency of health services, and institutional analyses would have been particularly helpful in anticipating problems and furthering the agenda set by the program of work (POW-II) and the Ghana poverty reduction strategy (GPRS). It is also clear that donor behavior is critical to the success or failure of a SWAp. Donors need to be disciplined about their funding support to a sector and hold other donors accountable for their actions. Donors can easily revert back to earmarked, off-budget funding that compromises the Government's attention to the SWAp's implementation and success, while tempting other donors to follow suit and push for their own agendas as well. Other development partners moved towards budget support, which can also cause disruptions at the sectoral level. Safeguards should be instituted to ensure that shifts to general budget support are upheld by processes to ensure a smooth transition in financing modalities. Donor shifts to budget support are in line with the Paris declaration; however, countries need to be ready for this transition ahead of time to ensure that the predictability of funds is not interrupted.


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    Conclusão da Implementação e Relatórios sobre Resultados

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    Ghana - Second Health Program Support Project (HSPSP-II)

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    Demographic and Health Survey;access to health service;monitoring and evaluation system;quality of health services;Human Resources for Health;social and economic development;indicators of health status;accessibility of health care;public expenditure on health;quality health care;quality of health care;health outcome;infant mortality rate;method of estimation;general budget support;quality at entry;Health Service Delivery;strategic objective;Financial Management System;health sector financing;skilled birth attendance;world development indicator;Budget Management;inequity in health;family planning acceptors;lack of focus;areas of expertise;private sector activity;Human Immunodeficiency Virus;weight for age;Oral rehydration therapies;family planning use;exchange rate;Health Care Waste;health sector investment;rate of change;quality of supervision;equity of access;improvements in access;decline in productivity;Exchange Rates;hospital admission rates;antenatal care coverage;improvements in mortality;budget &disbursement;health service use;areas of health;public service management;financial management procedure;source of revenue;people with hiv;bed occupancy rate;indicators of access;maternal mortality rate;purpose of evaluation;conflict over control;human resource development;improving service delivery;inequality in health;duplication of efforts;disparity in mortality;millennium development goal;development partner;gender inequalities;survey period;Gender Inequality;neonatal death;logical framework;recurrent budgets;live birth;Health Workers;confidence interval;financial resource;institutional analysis;health finance;capital expenditure;regression analysis;health interventions;neonatal mortality;fertility survey;economic reform;public health;results framework;poverty group;involuntary resettlement;Child Mortality;Wage Bill;childhood malnutrition;wealth group;Brain Drain;risk status;malaria case;fund allocations;budget shortfall;malnutrition indicators;fatality rate;guinea worm;equitable access;private provider;prepayment schemes;malaria prevention;comparative advantage;Earmarked Funding;equitable distribution;democratic reform;international aid;traditional medicine;human service;urban population;socioeconomic differences;relative inequality;respective year;government's commitment;national system;annual procurement;budget planning;Public Goods;financing service;contractual arrangement;alternative medicine;sustainable financing;financing system;list serve;linear trend;infant death;Prenatal Care;political climate;strategic framework;performance reviews;financial protection;measure output;exemption policy;outpatient visits;antenatal coverage;fiscal discipline;procurement contract;standard deviation;gender difference;political parties;standard asset;political transition;social indicator;mortality data;financial managment;point estimate;government system;political factor;driving force;investment lending;stated objective;hospital occupancy;national health;regulatory environment;donor behavior;girls' education;project indicator;maternal tetanus;outreach service;national capacity;Financing plans;exemption category;regional disparity;inequality gap;reproductive age;skilled attendant;Community Services;Financial Access;quality improvement;donor collaboration;sector-wide approaches;Rural Poor;community insurance;common policies;vaccination coverage;management science;institution need;potential contribution;Child Health;unequal distribution;operational level;hospital using;primary source;international partners;transitional arrangement;institutional strengthening;political party;sectoral inputs;causal linkage;informal sector;district hospital;client needs;good health;positive impact;health workforce;assessing progress;unsatisfactory performance;community resident;public resource;equitable allocation;capital development;reducing inequality;Job Creation;maternal death;academic institution;stakeholder workshop;external review;beneficiary survey



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