Evidence map›Paper›PMID 37645704›Full record

ArticleFrontiers in public health2023

Why district assemblies disburse resources to district health systems for service delivery at district level in the context of decentralization: a comparative study of two districts in the Volta Region of Ghana.

Andrews Ayim, Irene Akua Agyepong, Nana Enyimayew

Abstract read
In one paragraph

Article in Frontiers in public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Andrews AyimPolicy, Planning, Monitoring and Evaluation Division, Ghana Health Service, Accra, Ghana.
Irene Akua AgyepongDodowa Health Research Center, Research and Development Division, Ghana Health Service, Dodowa, Ghana.
Nana EnyimayewPublic Health Faculty Ministries, Ghana College of Physicians and Surgeons, Accra, Ghana.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: To explore why the District Assembly disburses financial and other resources to the District Health System. Design: Multiple case study with a single unit of analysis (holistic) using quantitative and qualitative methods of data collection involving a desk review, analysis of routine health management information system data and key informant interviews. Setting: Two districts in the Volta Region of Ghana. Participants: Twelve key officials of each district assembly and the district health system (24 total) who had worked in the district at least a year or more. Interventions: None. Results: Both District Assemblies had moderate decision space which was influenced by their capacity, power and contextual factors like politics, economics, legal and situational factors. Disbursement of financial and other resources to the District Health Systems was influenced by financial capacity, use of power by stakeholders, context and the decision space of the District Assembly. Political actors appeared to have more power in resource disbursement decision making than community members and technocrats in a context of resource constraints and inadequate funding. The funding available was used predominantly for capital investments, mainly construction of Community Based Health Planning and Services (CHPS) compounds. Conclusion: It is important to make policies that will regulate the relative power among the political appointees like the District Chief Executives (DCEs), public and civil servants in decentralized departments and agencies and Community members to make resource disbursement more sensitive to communities and decentralized departments.

Indexed as

PolicyPoliticsGhanaHumansUnited Statesdecentralizationdevolutiondistrict assembliesdistrict health systemsfinancial disbursement

Identifiers

PMID37645704
PMCPMC10461447

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.