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This paper aims to examine the effect of customer relationship management (CRM) on patient satisfaction and patient loyalty, controlling for other socio-demographic characteristics.

The study used a two-stage sampling process and structured questionnaires to collect data from 788 patients from three health facilities (public, quasi-public and private) in Greater Accra, Ghana. The data collected was analyzed using descriptive statistics and regression via the partial least squares-based structural equation model.

The results suggest that CRM is significantly positively correlated with patient satisfaction and patient loyalty, with patient satisfaction also significantly correlated with patient loyalty. Additionally, the results suggest that the introduction of education, health facility ownership, health insurance status and gender, neither impact significantly on the relationship between CRM and patient satisfaction/patient loyalty nor influenced patient satisfaction and patient loyalty directly.

The findings of the current paper can have substantial practice implications for operators in the health-care industry in Ghana. CRM components such as service quality, customer service, communication and the use of appropriate technology to deliver service will be fundamental if organizations operating in the health-care ecosystem in Ghana are to be able to compete effectively.

This is one of the very few papers on the relationship between CRM and patient satisfaction and patient loyalty in African health-care literature. Thus, the findings of the paper can constitute a great resource not only to academics but also to practitioners who are looking to be competitive in the health-care market.

The purpose of this paper is to examine the nature of governance structures in Ghanaian hospitals by comparing the governance systems in public and private hospitals.

This study employs a comparative case methodology. It compares the governance structures in private hospitals to that of public hospitals in Ghana to ascertain whether they exhibit different or similar governance systems. The results obtained are analyzed and discussed to ascertain the extent to which the governance structures in these hospitals conform to Taylor's principles of good governance.

The results of the study revealed numerous differences in the governance structures in private and public hospitals in Ghana. From the review of Taylor's principles of good governance and the comparative case analysis, it was observed that some of the principles are not present in the current hospital governance systems.

The findings of this paper have important implications for proper governance and management of the Ghanaian health institutions.

Purpose – The major question posed in this paper is whether public finance management (PFM) reforms undertaken by development partners (DPs) and the Ministry of Health (MOH) in Ghana were to find solutions to the many PFM challenges or it was merely a façade to pursue latent political interest?

Methodology – Study information was gathered via a desk review of major PFM policy documents, procedures, manuals, guidelines, and findings of commissioned studies covering the period under review. Information generated from the desk review was triangulated via extensive interviews with a sample of policy makers from MOH and DPs.

Findings – The findings suggest that MOH and DPs pursued reforms mostly to address the PFM challenges in the sector. Additionally, the study finds questionable the attitude and posture of the two actors and calls for further investigations to unearth what the said attitude and posture may imply in terms of intentions.

Originality/value – The findings raises fundamental question regarding public sector – DPs collaborations in executing reforms. This could open up new frontiers for further research to better understand DPs/public sector collaboration in the implementation of reforms.

Limitations – The sample used for this study may constrain generalization to other jurisdiction. This limitation does not in any case invalidate the conclusions arrived at.

This paper aims to examine links between women's access to micro‐finance and how they use maternal healthcare services in sub‐Saharan Africa (SSA).

The authors use theoretical and empirical literature to propose a framework to sustain and improve women's access to maternal healthcare services through micro‐financing.

It is found that improved access to micro‐finance by women, combined with education may enhance maternal health service uptake.

The paper does not consider empirical data in the analysis. The authors advocate empirically testing the framework proposed in other SSA countries.

It is important to empower women by facilitating their access to education and micro‐finance. This has implications for improving maternal healthcare utilization in SSA.

The paper moves beyond poor access to maternal health services in SSA and proposes a framework for providing sustainable solutions.

The purpose of this paper is to argue for a theoretical framework by which development of computer based health information systems (CHIS) can be made sustainable. Health Management and promotion thrive on well‐articulated CHIS. There are high levels of risk associated with the development of CHIS in the context of least developed countries (LDC), thereby making them unsustainable.

This paper is based largely on literature survey on health promotion and information systems.

The main factors accounting for the sustainability problem in less developed countries include poor infrastructure, inappropriate donor policies and strategies, poor infrastructure and inadequate human resource capacity. To counter these challenges and to ensure that CHIS deployment in LDCs is sustainable, it is proposed that the activities involved in the implementation of these systems be incorporated into organizational routines. This will ensure and secure the needed resources as well as the relevant support from all stakeholders of the system; on a continuous basis.

This paper sets out to look at the issue of CHIS sustainability in LDCs, theoretically explains the factors that account for the sustainability problem and develops a conceptual model based on theoretical literature and existing empirical findings.

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 purpose of this paper is to examine the association between experiences during childbirth and satisfaction with childbirth services.

A cross‐sectional analytical approach using a structured questionnaire and exit interviews was employed to gather data from 885 women who delivered vaginally in two public hospitals. Data were analysed by generating frequencies and chi‐square which was used in running a binary logistic regression using a stepwise backward elimination approach.

With a response rate of 78.75 percent the key predictor variables of satisfaction with care were: friendliness of staff (OR=15.12, p=0.00); the amount of information provided on the condition and treatment of women (OR=9.3857, p=0.007); the feeling of being treated with respect (OR=3.5581, p=0.023); and the provision of information about channels of complaint about care (OR=50.0839, p=0.000). It is therefore recommended that steps be instituted to improve client‐/health worker interpersonal relationships, to improve the amount and quality of information provided to clients, and also to establish formal structures for complaint management in hospitals.

The study sampled only women with vaginal deliveries, considering the fact that women with caesarean deliveries have different experiences. Thus views of those with caesarean deliveries are excluded.

Several studies have been conducted in Ghana on issues of health service satisfaction and quality, but this is about the first, critically looking at satisfaction with child birth services in Ghana.

This paper seeks to assess the implementation of Ghana's Patients' Charter by investigating the level of awareness and knowledge of the Charter's content, some socio‐demographic factors that may influence awareness and knowledge of the Charter and how providers have discharged their responsibilities under the Charter.

A survey research approach, sampling respondents from providers and patients in four facilities from the Greater Accra region, was used. Simple frequencies and Chi‐square test were used for analysing responses.

Study findings show that the majority of patients (53.4 per cent) are not aware of the existence of the Charter of those that know about it, a sizeable minority (33.7 per cent) are not knowledgeable about its contents. Relative to patients, providers exhibit better awareness (61.8 per cent) and content knowledge (61.8 per cent) of the Patients' Charter, but on the whole are not yet carrying out their responsibilities under it. In terms of socio‐demographic factors influencing awareness and knowledge of content, only education was found to be a positive correlate of awareness and knowledge. The relationship between providers and patients is generally cordial and could be used as a platform for improving awareness and knowledge of the charter, which could be crucial for improving service delivery.

This is an initial exploratory research with a limited sample, which was biased towards the educated. Findings are, however, instructive and essential for more extensive and representative research in this area.

Since the Charter was launched in 2002, this study is the first of its kind and therefore provides important information for policy and further research.

Traditionally, the role of technology on health services has been argued from the supply side. The purpose of this paper is to use a demand side perspective to examine the effect of Information and Communication Technologies (ICTs) on the use of maternal health services in Ghana.

Study used data from the 2008 Ghana Demographic and Health Surveys and binary response regression models to examine the effect of women's access to ICTs on maternal healthcare utilization in Ghana. Three variables on maternal healthcare utilization were employed: use of contraception, antenatal care and place of delivery.

Results from the study show that the effect of the use of technology is both positive and significant. In particular, among the other ICTs (i.e. landline phone, listening to radio, watch television, color television in household, computer in household), the coefficients of mobile phone ownership tends to be consistently significant across all four reproductive health services. Therefore, ICTs have a good capacity to influence women's demand of health information. This needs to be taken into account when designing maternal health policies and interventions.

This is one of the few papers examining the effect of ICTs on utilization of maternal health services from the demand side compared to the popular supply side argument often found in the literature.

The purpose of this paper is to examine whether organisational justice (distributive justice, procedural justice and interactional justice) predicts job satisfaction and performance of health professionals and whether the demographic characteristics of hospital employees mediate the relationship between workplace justice and job satisfaction and performance.

Questionnaires were administered to a sample of 300 respondents in seven hospitals using convenient sampling. Hypotheses were tested using multiple and hierarchical regression models.

The paper established that distributive justice, procedural justice and interactional justice predict job satisfaction and performance of health professionals. However, their demographic characteristics are shown to partially mediate the relationship between organisational justice and job satisfaction but not performance.

Granted that other studies exist, this is one of the few that focuses on hospitals and probably the first of its kind in Ghanaian hospitals. Thus the findings could be essential for policy and practice and also generate further discourse that may improve the extant literature and our understanding of the subject.