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This paper aims to examine empirically the ways in which workforce knowledge and organisational factors of an implementing agency affected the implementation of health sector administration decentralisation in Ghana with insights from the Nkwanta district health administration.

This is a qualitative study using data from individual and group interviews through purposive selection of health officials, who were directly involved in the work of actual implementation of the programme. Specifically, participants included senior management, middle management and junior workers, who had worked at least for the past three months in the district.

The study found that most of the interviewees involved in the implementation process are knowledgeable of the objectives of the decentralisation process. Also, major factors that are militating against effective decentralisation in the district include inadequate funds, lack of qualified personnel, inadequate logistics and equipment, poor interpersonal relationships, lack of transparency and a good operational system, lack of incentives to motivate the staff, political interference, poor infrastructure and high rate of illiteracy.

The findings of this study will help improve the implementation of decentralisation within the health sector in Ghana. The paper provides recommendations, which, if considered for implementation, will help improve the decentralisation process.

The aim of this paper is to examine how internal communication of reform objectives to health workforces and stakeholders has influenced the implementation of Ghana's health sector decentralisation at district level.

Data collection involved in‐depth interviews with district public health officials, private health providers, local government officials and health‐related non‐government organisations which had been working in the district for at least two years.

The study's findings showed that communication (the sharing of information) about reform objectives were centralised among the top hierarchy of the District Health Management Teams; and the process of transferring reform information to district health workforces and stakeholders was through a top‐downward approach. This vertical style of communication resulted in limited information getting through to district health workforces tasked with the implementation. This impacted negatively on reform implementation.

The paper reveals that there is a connection between the level of comprehension of the objectives for decentralisation reform both by the health workforce and stakeholders, particularly the expected new roles they are supposed to play. A lack of effective transfer of information affects commitment and ownership of the decentralisation reform at district level; contributing significantly to the poor implementation of the reform programme.

The study explores the sustainability practices among Indigenous butchery businesses in a developing country, and in this context, Ghana. Qualitative interview data are employed to understand the start-up procedures, sustainable factors, benefits, opportunities, challenges and strategies that advance the sustainability of butchery businesses. The results show that starting a butchery business depends on a person's tradition or cultural heritage, apprenticeship, training and skills or past experiences. Other factors include support from family and suppliers, dedication and diligence to work, managerial experiences and good luck that may be relatively linked to religious prayers. This study is one of the few studies that extensively explore the possibility and sustainability of Indigenous butchery businesses in Ghana. The approach used does not only provide practicable findings limited to research purposes but also suggestions that are applicable to daily practices and policy formulation.

This paper aims to examine lecturers' experiences of moonlighting in the Ghana Institute of Management and Public Administration (GIMPA).

A qualitative approach was used. Data were collected through in-depth semi-structured interviews with 18 purposively selected informants. Data were transcribed and analyzed thematically.

The findings are that moonlighting is common at GIMPA, and the institutional environment is conducive for the practice. Knowledge of the practice is unclear. However, moonlighting serves as a source of additional income for lecturers, which a significant majority describe as enabling their continuing employment at GIMPA, but many pointed out the negative effects as well. Lack of a policy to control the behavior has been cited as a reason for the problem, which left lecturers to self-determine what to do. Moonlighting practice is affecting the quality of teaching and support to students by the lecturers.

The sample of the respondents who participated in the study is small and limited to 18. Their views cannot be generalized to all higher education institutions. But, the results show the seriousness of the problem and its implications.

Moonlighting is prevalent in GIMPA. It suggests that employees of other public higher education institutions are no immune to it.

This study is the first of its kind to explore the practice of moonlighting in a quasi-public higher education institution in Ghana. It has added to the empirical literature on the practice and the effects on the institution.

The purpose of this paper is to examine the barriers to the implementation of management decentralisation of health services and programmes at district level in Ghana.

Data for the study were collected through a qualitative technique in the Sekyere West district.

The findings are: transfer of authority for management decision making and planning was rarely operational at district level; and control over financial and personnel decisions remained centralised. The paper identified lack of staff capacity, lack of commitment and inter‐organisational conflict between health managers and local government officials as factors obstructing the implementation of management decentralisation in the district.

The lesson from the study is that the implementation of health care management decentralisation at district level has stalled because of the combined effect of internal and external constraints. The paper suggests that given the enormity of the problem of paucity of capacity to undertake new service management responsibilities, the process of transferring responsibilities, resources and control to lower level health managements should be gradual and incremental; the sequencing of reform too should be such that district health officers and stakeholders are given adequate training prior to the inauguration of new management reform.

The study aims to examine the socio‐economic determinants of maternal health services utilization in Ghana.

Probit and ordered probit models are employed in this study.

The results generally indicate that most women in Ghana undertake the required visits for antenatal services and also take both doses of the tetanus toxoid vaccine as required by World Health Organization. However, the results show low levels of usage in terms of the other maternal health care services (i.e. prenatal care, delivery at a health facility, and postnatal care). There is clearly an urgent need to develop innovative strategies that will help upscale intervention especially for improvement in the use of these services by women in Ghana. The regression results reveal that utilization of maternal health services and intensity of use of antenatal services are influenced by age of mother, type of birth, education of mother, ethnicity, economic status, geographic location, residence, and religious affiliation. Obviously, this suggests that more than medical factors are responsible for the differences in the use of maternal health services by women in Ghana as well as the decision on the number of visits to undertake with respect to antenatal visits.

The findings of this study have important implications for health policy formulation targeted at improving maternal health care service utilization.

The study drew on capacity framework around the individual, organisational, health system and wider context to explore gaps in health supply chain (HSC) workers capacity and competency to perform supply chain (SC) functions and the lessons for workforce development.

A mixed-method study was conducted across the Northern Region of Ghana. Qualitative data were collected from in-depth interviews with 34 key SC managers at the regional, district and facility levels. A semi-structured questionnaire was administered through the RedCap mobile app to 233 core HSC workers and non-core workers (clinicians with additional responsibilities in SC). Data were managed and analysed inductively and deductively for themes.

Weak knowledge and competency in SC functions attributed to poor training exposure and organisational support for capacity building, undermined the capacity to perform basic SC functions, especially by the non-core category. The policy and regulatory environment of the HSC marketplace were described as fluid and with complexity of demands. Both worker categories, therefore, requested functional, technical, managerial and customer care competencies to anticipate and manage complexities. Structural characteristics of the health system giving narrow decision space to HSC workers cascaded the capacity for innovation and initiative and promoted frustrations among mid-level managers. Infrastructural deficits and shortfalls in operational resources scaled back the capacity to efficiently manage inventory and ensure that commodities reach clients in good quality.

Finding suggest that capacity building of HSC workers, strengthening of health institutions structural and resource capacity, and leveraging on technology will enable optimal performance of HSC functions.