Science-based health innovation in Ghana: health entrepreneurs point the way to a new development path

<p>Abstract</p> <p>Background</p> <p>Science, technology and innovation have long played a role in Ghana’s vision for development, including in improving its health outcomes. However, so far little research has been conducted on Ghana’s capacity for health innovation to address local diseases. This research aims to fill that gap, mapping out the key actors involved, highlighting examples of indigenous innovation, setting out the challenges ahead and outlining recommendations for strengthening Ghana’s health innovation system.</p> <p>Methods</p> <p>Case study research methodology was used. Data were collected through reviews of academic literature and policy documents and through open-ended, face-to-face interviews with 48 people from across the science-based health innovation system. Data was collected over three visits to Ghana from February 2007 to August 2008, and stakeholders engaged subsequently.</p> <p>Results</p> <p>Ghana has strengths which could underpin science-based health innovation in the future, including health and biosciences research institutions with strong foreign linkages and donor support; a relatively strong regulatory system which is building capacity in other West African countries; the beginnings of new funding forms such as venture capital; and the return of professionals from the diaspora, bringing expertise and contacts. Some health products and services are already being developed in Ghana by individual entrepreneurs, which are innovative in the sense of being new to the country and, in some cases, the continent. They include essential medicines, raw pharmaceutical materials, new formulations for pediatric use and plant medicines at various stages of development.</p> <p>Conclusions</p> <p>While Ghana has many institutions concerned with health research and its commercialization, their ability to work together to address clear health goals is low. If Ghana is to capitalize on its assets, including political and macroeconomic stability which underpin investment in health enterprises, it needs to improve the health innovation environment through increasing support for its small firms; coordinating policies; and beginning a dialogue with donors on how health research can create locally-owned knowledge and be more demand-driven. Mobilizing stakeholders around health product development areas, such as traditional medicines and diagnostics, would help to create trust between groups and build a stronger health innovation system.</p

Combining work and child care: The experiences of mothers in Accra, Ghana

Work-family research has focused predominantly on Western women. Yet the forms of economic labour in which women are typically involved and the meaning of motherhood are context-specific. This paper aims to explore the experience of combining economic activity and child care of mothers with young children using urban Ghana as a case study. Semi-structured interviews (n=24) were conducted in three locations in the Accra Metropolitan Area. Transcripts were analysed using the general inductive approach. The results found women’s experience of role conflict to be bi-directional. With regard to role enhancement, economic activity allowed women to provide materially for their children. The combination of work and child care had negative consequences for women’s wellbeing. This research questions policy makers’ strategy of frequently targeting women in their roles either as generators of income, or as the primary care-takers of children by highlighting the reality of women’s simultaneous performance of these roles

Ghana's evolving protein economy

This paper provides an initial analysis of Ghana's protein economy in the light on current debates about nutritional transition and livestock revolution. Ghana's strong economic growth and reducing levels of poverty make it a particularly interesting case. Protein-rich foods, including fish and livestock products, supply 20-40 percent of protein consumed. Overall fish is becoming less important and poultry more important; but there also are large difference in household expenditure on protein-rich foods across wealth categories, regions and areas. Specifically, the protein element of the nutritional transition and the consumption side of the livestock revolution would appear to be unfolding at different speeds and in different ways, along an axis that is urban-south-non-poor at one end, and rural-north-poor at the other. We explore the policy and political economy dimensions of these change

An assessment of mental health policy in Ghana, South Africa, Uganda and Zambia

<p>Abstract</p> <p>Background</p> <p>Approximately half of the countries in the African Region had a mental health policy by 2005, but little is known about quality of mental health policies in Africa and globally. This paper reports the results of an assessment of the mental health policies of Ghana, South Africa, Uganda and Zambia.</p> <p>Methods</p> <p>The WHO Mental Health Policy Checklist was used to evaluate the most current mental health policy in each country. Assessments were completed and reviewed by a specially constituted national committee as well as an independent WHO team. Results of each country evaluation were discussed until consensus was reached.</p> <p>Results</p> <p>All four policies received a high level mandate. Each policy addressed community-based services, the integration of mental health into general health care, promotion of mental health and rehabilitation. Prevention was addressed in the South African and Ugandan policies only. Use of evidence for policy development varied considerably. Consultations were mainly held with the mental health sector. Only the Zambian policy presented a clear vision, while three of four countries spelt out values and principles, the need to establish a coordinating body for mental health, and to protect the human rights of people with mental health problems. None included all the basic elements of a policy, nor specified sources and levels of funding for implementation. Deinstitutionalisation and the provision of essential psychotropic medicines were insufficiently addressed. Advocacy, empowerment of users and families and intersectoral collaboration were inadequately addressed. Only Uganda sufficiently outlined a mental health information system, research and evaluation, while only Ghana comprehensively addressed human resources and training requirements. No country had an accompanying strategic mental health plan to allow the development and implementation of concrete strategies and activities.</p> <p>Conclusions</p> <p>Six gaps which could impact on the policies' effect on countries' mental health systems were: lack of internal consistency of structure and content of policies, superficiality of key international concepts, lack of evidence on which to base policy directions, inadequate political support, poor integration of mental health policies within the overall national policy and legislative framework, and lack of financial specificity. Three strategies to address these concerns emerged, namely strengthening capacity of key stakeholders in public (mental) health and policy development, creation of a culture of inclusive and dynamic policy development, and coordinated action to optimize use of available resources.</p

Household and market survey on availability of adequately iodized salt in the Volta region, Ghana

This is an Accepted Manuscript of an article published by Taylor & Francis in International Journal of Health Promotion and Education on 27/10/2016, available online: http://www.tandfonline.com/doi/full/10.1080/14635240.2016.1250658Consumption of adequately iodized salt (AIS) ≥15ppm is one of the criteria for measuring progress towards universal salt iodization (USI) and sustainable elimination of iodine deficiency disorders. After series of health promotion activities, this survey was conducted to evaluate the extent to which USI was achieved. Cross-sectional survey was conducted in 1,961 households and 350 markets to estimate the iodine levels of salt consumed or sold. Three degrees of iodization were estimated from fine, coarse and granular texture salt using MBI rapid field test kits. Differences in iodization levels were determined using Bonferroni test in STATA. Determinants for household utilization of AIS were identified using regression analysis and reported as odds ratio (OR). Availability of AIS in households (24.5%) and markets (30.9%) was far below the 90% recommendation. No differences where observed in urban (26.8%) and rural (24.1%) households. Households that used fine-texture salt (OR: 40.13; CI: 30.1-53.4) or stored salt in original packs (OR: 8.02; CI: 6.01-10.70) were more likely to consume AIS. Across districts, highest household availability of AIS was 51.7% while the least was 7.5%. The district with the highest market availability of AIS was 85.7% while the least was 8.3%. Almost 32% of the traders were aware that selling non-iodized salt was unauthorized but out of this, only 12% sold AIS. Public education should emphasis appropriate handling and storage of salt throughout the supply chain. To ensure adequate salt fortification with iodine, improved surveillance of factories and mining sites is recommended

Understanding and Optimising the Social Impact of Venture Capital: Three Lessons from Ghana

Background: Mobilising investment for sustainable development is a priority for many African governments and their international allies. There are many claims about the social impact of investments in small and growing businesses, and yet these mostly focus on good news stories or a narrow set of metrics (jobs created, tax revenue, etc.). There are relatively few studies that consider the diversity of social impacts, particularly in an African context.Objectives: The aim of this research was to work collaboratively with investors in Ghana to better understand social change and contribute to their own work on improved performance and reporting.Method: Using a theory-based examination of social impacts, the research purposively selected a subset of 13 investments from the Venture Capital Trust Fund (VCTF) in Ghana. Theories of change were used to explore the available documentation, triangulated with insights from fund managers, entrepreneurs, senior managers and, where possible, employees. The findings were validated with VCTF staff.Results: While the research demonstrated the usefulness of a theory-based approach, it found it helpful to develop a smaller set of typologies to capture different impact pathways – a more efficient way to assess and report on social returns. In particular, the research highlights how commonly used metrics like job creation undervalue the social impact of some types of investment. Other lessons also included the value of rural businesses (not typically favoured by venture capitalists) and the potential to further extend impacts to lower income groups, but that this required real intent and leadership on the part of investors and entrepreneurs.Conclusion: We conclude that further research is merited on two fronts. Firstly, research into the scale of the small and medium enterprises and the associated investment required to support the operating costs to really manage, improve, monitor and evaluate social impact. And secondly, further field testing of different evaluation techniques to help stakeholders better understand and improve the social benefits of venture capital

The African Political Business Cycle: Varieties of Experience

We seek to understand both the incidence and the impact of the African political business cycle in the light of a literature which has argued that, with major extensions of democracy since the 1990s, the cycle has both become more intense and has made African political systems more fragile. With the help of country-case studies, we argue, first, that the African political business cycle is not homogeneous, and occurs relatively infrequently in so-called ‘dominant-party systems’ where a pre-election stimulus confers little political advantage. Secondly, we show that, in those countries where a political cycle does occur, it does not necessarily cause institutional damage. Whether it does or not depends not so much on whether there is an electoral cycle as on whether this cycle calms or exacerbates fears of an unjust allocation of resources. In other words, the composition of the pre-election stimulus, in terms of its allocation between different categories of voter, is as important as its size

Who watches Korean TV dramas in Africa? A preliminary study in Ghana

More and more Ghanaians are watching Korean TV dramas. These are not just ordinary Ghanaians because they are from a particular socioeconomic bracket; they have a certain level of education, access to screen devices and Internet, accumulated previous experience of watching other foreign screen products and, most importantly, a peer network with those who can afford these items. Drawing from qualitative work and focus-group interviews, the article argues that Korean TV dramas are spread efficiently by taking advantage of those contributing components within the privileged network, but they remain within the network due to the lack of those necessary components outside the bracket. The recipients find Korean media products attractive because they are fresh, funny, socially decent, different, yet close to them vis-à-vis Hollywood and Nollywood

Health-industry linkages for local health: reframing policies for African health system strengthening

The benefits of local production of pharmaceuticals in Africa for local access to medicines and to effective treatment remain contested. There is scepticism among health systems experts internationally that production of pharmaceuticals in sub-Saharan Africa (SSA) can provide competitive prices, quality and reliability of supply. Meanwhile low-income African populations continue to suffer poor access to a broad range of medicines, despite major international funding efforts. A current wave of pharmaceutical industry investment in SSA is associated with active African government promotion of pharmaceuticals as a key sector in industrialization strategies. We present evidence from interviews in 2013–15 and 2017 in East Africa that health system actors perceive these investments in local production as an opportunity to improve access to medicines and supplies. We then identify key policies that can ensure that local health systems benefit from the investments. We argue for a ‘local health’ policy perspective, framed by concepts of proximity and positionality, which works with local priorities and distinct policy time scales and identifies scope for incentive alignment to generate mutually beneficial health–industry linkages and strengthening of both sectors. We argue that this local health perspective represents a distinctive shift in policy framing: it is not necessarily in conflict with ‘global health’ frameworks but poses a challenge to some of its underlying assumptions