Resistance and change: a multiple streams approach to understanding health policy making in Ghana

J Health Polit Policy Law. 2015 Feb;40(1):195-219. doi: 10.1215/03616878-2854711. Epub 2014 Dec 5.

Abstract

Although much has been written on health policy making in developed countries, the same cannot be said of less developed countries, especially in Africa. Drawing largely on available historical and government records, newspaper publications, parliamentary Hansards, and published books and articles, this article uses John W. Kingdon's multiple streams framework to explain how the problem, politics, and policy streams converged for Ghana's National Health Insurance Scheme (NHIS) to be passed into law in 2003. The article contends that a change in government in the 2000 general election opened a "policy window" for eventual policy change from "cash-and-carry" to the NHIS.

Keywords: Ghana; agenda setting; health politics; multiple streams framework.

MeSH terms

  • Ghana
  • Health Policy*
  • Humans
  • National Health Programs / economics
  • National Health Programs / legislation & jurisprudence
  • National Health Programs / organization & administration*
  • Policy Making*
  • Politics*
  • Universal Health Insurance / economics
  • Universal Health Insurance / legislation & jurisprudence
  • Universal Health Insurance / organization & administration*