Challenges and facilitators to the provision of sexual, reproductive health and rights services in Ghana. Issue 2 (17th December 2020)

• Record Type: Journal Article
• Authors: Akazili, James; Kanmiki, Edmund Wedam; Anaseba, Dominic; Govender, Veloshnee; Danhoundo, Georges; Koduah, Augustina
• Is Part Of: Sexual & reproductive health matters. Volume 28:Issue 2(2020)
• Publication Date: 2020-12-17
• Subjects: sexual and reproductive health and rights -- challenges -- facilitators -- universal health coverage -- maternal and child health -- Ghana; Sexual health -- Periodicals; Reproductive health -- Periodicals; Women's health services -- Periodicals; Women's rights -- Periodicals; Women's rights; Women's health services; Sexual health; Reproductive health; Sexual Health; Reproductive Health; Women's Health; Women's Rights; Electronic journals; Periodicals; Periodical; 613.9
• DOI: 10.1080/26410397.2020.1846247
• Languages: English
• ISSNs: 2641-0397

Abstract

Abstract: Expanding access to sexual and reproductive health (SRH) services is one of the key targets of the Sustainable Development Goals. The extent to which sexual and reproductive health and rights (SRHR) targets will be achieved largely depends on how well they are integrated within Universal Health Coverage (UHC) initiatives. This paper examines challenges and facilitators to the effective provision of three SRHR services (maternal health, gender-based violence (GBV) and safe abortion/post-abortion care) in Ghana. The analysis triangulates evidence from document review with in-depth qualitative stakeholder interviews and adopts the Donabedian framework in evaluating provision of these services. Critical among the challenges identified are inadequate funding, non-inclusion of some SRHR services including family planning and abortion/post-abortion services within the health benefits package and hidden charges for maternal services. Other issues are poor supervision, maldistribution of logistics and health personnel, fragmentation of support services for GBV victims across agencies, and socio-cultural and religious beliefs and practices affecting service delivery and utilisation. Facilitators that hold promise for effective SRH service delivery include stakeholder collaboration and support, health system structure that supports continuum of care, availability of data for monitoring progress and setting priorities, and an effective process for sharing lessons and accountability through frequent review meetings. We propose the development of a national master plan for SRHR integration within UHC initiatives in the country. Addressing the financial, logistical and health worker shortages and maldistribution will go a long way to propel Ghana's efforts to expand population coverage, service coverage and financial risk protection in accessing essential SRH services.