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To what extent do you agree or disagree with that statement and how can 21st century health systems leadership be shaped to improve health outcomes in LCMICs?

November 26, 2021
Christopher R. Teeple

QUESTION 1
Poor leadership has been identified as one of the key challenges hindering the development of health systems in
low and middle income countries.(LCMICs -Daire et al.2014;Galaviz et al 2016)
To what extent do you agree or disagree with that statement and how can 21st century health systems leadership
be shaped to improve health outcomes in LCMICs? (50marks)
QUESTION 2
Procurement has been cited as one of the key sources of corruption in the health sector of many developing
countries. Though some countries have procurement laws, the implementation of these laws meet several
challenges, impeding efforts at ensuring good governance in health and throwing countries off meeting health
goals.
Discuss the principles of good governance in health, and propose ways of dealing with procurement challenges,
thereby reducing corruption in health sector of developing countries.(50marks)
QUESTION 3
Primary Health Care (PHC) has long been identified as critical in achieving universal coverage of health care
service. However, its implementation in many countries has faced practical challenges.
To what extent can health Systems leadership (from national to decentralized levels ) facilitate the use of closeto- client concepts (such as the Community- based Health Planning Services -CHPS approach in Ghana) to
promote PHC in Africa (50marks)
QUESTION 4
The outbreak of Ebola virus disease in West Africa in 2014 highlighted the weakness in the health systems of
many developing countries. Outline and discuss the key lessons for health systems management, using specific
examples.
QUESTION 5
During the 2016 general elections in Ghana, the health care system dominated debates among political parties
contesting to lead the country. As a special advisor to the new Minister for Health, identify five key challenges
the sector faces that should serve as priority issues for the Minister, proposing pragmatic solutions to the
challenges identified.
QUESTION 6
The year 2015 saw major changes in global political landscape, which have been seen posing critical challenges
to the funding health in many developing countries. Discuss four of such challenges that developing countries
face as a result of the withdrawal of Britain from European Union and a possible reduction of global health
funding from the United States government due to the promises made by the current U.S. President.
QUESTION 7
Globally, health financing has been acknowledged as a tool to achieving universal health coverage and the
global health community is using every available opportunity to promote increasing health expenditures through
various financing mechanisms. One concrete tool to enhancing financing is health insurance, which has been
embraced by many developing countries as a way to ensuring financial risk protection for, especially the poor
and vulnerable, but also to the entire population. Ghana’s National Health insurance scheme, which became
operational in 2004 currently covers about 30% of the country’s population. However, the scheme is faced with
a number of challenges which, if unresolved could undermine the objectives and sustainability of the scheme.
Discuss four of these challenges and propose practical solutions ( 50 marks)
As a health manager propose innovative ways of mobilizing local resources to improve health financing in
Ghana. In particular, how can the private sector and the health system itself (operating efficiently) help mobilize
such resources?
QUESTION 8
Discussions are ongoing in Ghana’s health sector to transfer decentralized health structures (from the district
level downwards) to the Local Government authority( Metropolitan, Municipal, and District Assemblies). This
will imply local government structures having full control over health activities and decisions at these lower
levels of health system, including the power of recruit health staff at these levels.
Discuss the advantages and challenges that such a move could pose to operation and efficiency of the health
systems components. (50marks)
QUESTION 9
Primary Health care( PHC ) has long been identified as critical in achieving universal coverage of health care
service. However, its implementation in many countries has faced practical challenges. To what extent can
health systems leaderships (from national to decentralized levels) facilitate the use of close- to- client concepts
(such as the Community based Health Planning and Services- CHPS approach in Ghana) to promote PHC in
Africa?
QUESTION 10
In recent times, there have been calls from various actors on the global health landscape for donors in national
governments in low and low- middle income countries ( L MICs) to significantly increase investment in health,
if significant improvements in health are to be observed in these countries. For example, the lancet commission
on investing in Health’s Global Health 2035 report calls for investments of up to U.S. dollars 70 billion
annually over the next 20 years, which could propel reduction of mortality levels (from infectious, maternal and
child diseases) to levels currently seen in the best performing middle income countries (China Chile, Costa
Rica and Cuba), a phenomenon they prefer to as the grand convergence. The Lancet Commission and the school
of Public Health, UG recent estimates show that Ghana and kenya require about US dollar 566 million and US
dollar 932 million (respectively) investments annually (equivalent to doubling current spending on health) to
attain the convergence. With the transition of some countries ( Ghana ,Kenya, Nigeria) to lower- middle income
status, evidence shows that donor support for health in these countries has significantly reduced, mainly due to
the transition. This phenomenon implies that governments will have to mobilize mainly local resources for
financing health.
As a health manager, propose innovative ways of mobilizing local resources to improve health financing in
Ghana. In particular, how can private sector and health system itself (operating efficiently) help mobilize such
resources. (50marks)
QUESTION 11
Discussions are ongoing in Ghana’s health sector to transfer the decentralized health structures (from the district
level downwards) to the local government authority(Metropolitan, Municipal and District Assemblies). This
will imply local government structures having full control over health activities and decisions at these lower
levels of the health system, including the power to recruit health staff at these levels.
Discuss the advantages and challenges that such a move could pose to operation and efficiency of the health
systems components (50marks)
QUESTION 12
Primary Health Care (PHC) has long been identified as critical in achieving universal coverage of health care
service. However, its implementation in many countries has faced practical challenges. To what extent can
Health system leadership (from national to decentralized levels) facilitate the use of close- to- client concepts
(such as the Community-based Health Planning and Services- CHPS approach in Ghana) to promote PHC in
Africa.
QUESTION 13
According to Akinwumi Adesina, President of African Development Bank, poor governance and lack of public
accountability have always been among the main causes hindering Africa’s structural transformation.
To what extent do you agree or disagree with the above statement, as it relates to the health sector of countries
in Africa. (50marks)
QUESTION 14
From 6-12th September, 1978, the United Nations convened an International conference on the Primary Health
Care Alma-Ata, which resulted in Alma-Ata declaration on Primary Health care. Among many things, the
declaration provided that;
“Primary Health care is essential health care based on practical, scientifically sound and socially acceptable
methods and technology made universally accessible to individuals and families in the community through their
full participation and at a cost that the community and the country can afford to maintain at every stage of their
development in the spirit of self-reliance and self-determination. It forms an integral part both of the country’s
health system, of which it is the central function and main focus, and of the overall social and economic
development of the community. It is the first level of contact of individuals, the family, and community with
National Health system bringing health care as close as possible to where people live and work and constitutes
the first element of continuing health care process.
After 40 years of the Alma-Ata Declaration, to what extent are the characteristics of the primary health care
mentioned above still relevant for achieving universal health coverage, especially in developing countries?
(50marks)
QUESTION 15
There have been calls from various actors on global health landscape for donors and national governments in
low and lower-middle income countries (LMICs) to significantly increase investments in health, if significant
improvements in health outcomes are to be observed in these countries. As a health manager propose innovative
ways of mobilizing local resources to improve health financing in Ghana. (50marks)
QUESTION 16
Ghana’s population is youthful with about 1/3 being young people. The government is concerned about this
population dynamics and has been contemplating whether this is a “risk” or an “opportunity” for the country’s
development. As an adolescent health experts, you have been consulted by the National Development Planning
to make inputs into its 25-year development plan. Discuss four critical issues you will consider in relation to
investment in adolescent health. (40 Marks)
QUESTION 17
Why should a trainee public health professionals take a course in demography (30 Marks)
QUESTION 18
With the aid of the relevant illustrative examples, show why and how innovative interventions are currently
needed to improve maternal health outcomes in Ghana. (30marks)
QUESTION 19
UNAIDS estimates of Ghana in 2017 shows that there are 28,000 children between 0-14 years living with
HIV.As the Directorate-General of the Ghana Health service, what will you do to eliminate mother to child
transmission of HIV in Ghana by 2023. (30marks)
QUESTION 20
From an ecological perspective, discuss the common determinants of micronutrient deficiency among women in
reproductive age in developing countries settings.(30marks)
QUESTION 21
Universal Health Coverage (UHC) has been endorsed by major players in global health and national
governments as a major approach to ensure that all people have much needed access to essential health care
services. Identify any three leadership styles and discuss the leadership style that is much needed to facilitate the
transition to you UHC in the Ghanaian health sector, discussing the advantages of this style and how it towers
above the others in facilitating UHC (100marks)
QUESTION 22
Life Time Risk (LTR) of Maternal mortality is an important and a better indicator of risk of maternal mortality
than the most commonly used indicators. Explain why this is the case and why LTR is not commonly
estimated? (100marks)
QUESTION 23
With the Millennium Development Goal endline fast approaching, the sustainable Development Goals (SDGs)
are being developed as the next set of goals to guide major decisions. Global Health leaders are discussing
health goals which should be included to guide global health decisions. What roles exist for good governance,
accountability and transparency in national health system to facilitate the achievement of those goals when they
are made? (100marks)
QUESTION 24
Ghana’s health system is generally regarded as weak, hindering the achievement of positive outcomes despite
the fact that huge investments have been made in the health sector. Discuss essential managerial skills be that
are required to facilitate the be delivery of health services in order to improve population health (100marks)
QUESTION 25
According to Akinwumi Adesina, President of the African Development Bank, “ poor governance and lack of
public accountability have always been among the main causes hindering Africa’s structural transformation”.
To what extent do you agree or disagree with the above statement, as it relates to the health sector of countries
in Africa. (50marks)
QUESTION 26
From 6-12th September, 1978, the United Nations convened an International conference on the Primary Health
Care Alma-Ata, which resulted in Alma-Ata declaration on Primary Health care. Among many things, the
declaration provided that;
“Primary Health care is essential health care based on practical, scientifically sound and socially acceptable
methods and technology made universally accessible to individuals and families in the community through their
full participation and at a cost that the community and the country can afford to maintain at every stage of their
development in the spirit of self-reliance and self-determination. It forms an integral part both of the country’s
health system, of which it is the central function and main focus, and of the overall social and economic
development of the community. It is the first level of contact of individuals, the family, and community with
National Health system bringing health care as close as possible to where people live and work and constitutes
the first element of continuing health care process”.
After 40 years of the Alma-Ata Declaration, to what extent are the characteristics of the primary health care
mentioned above still relevant for achieving universal health coverage, especially in developing countries?
(50marks)
QUESTION 27
There have been calls from various actors on global health landscape for donors and national governments in
low and lower-middle income countries (LMICs) to significantly increase investments in health, if significant
improvements in health outcomes are to be observed in these countries. As a health manager propose innovative
ways of mobilizing local resources to improve health financing in Ghana. (50marks)
QUESTION 28
The outbreak of Ebola virus disease in West Africa in 2014 highlighted the weakness in the health systems of
many developing countries. Outline and discuss the key lessons for health systems management, using specific
examples.
QUESTION 29.
During the 2016 general elections in Ghana, the health care system dominated debates among political parties
contesting to lead the country. As a special advisor to the new Minister for Health, identify five key challenges
the sector faces that should serve as priority issues for the Minister, proposing pragmatic solutions to the
challenges identified.
QUESTION 30
The year 2015 saw major changes in global political landscape, which have been seen posing critical challenges
to the funding health in many developing countries. Discuss four of such challenges that developing countries
face as a result of the withdrawal of Britain from European Union and a possible reduction of global health
funding from the United States government due to the promises made by the current U.S. President.
QUESTIONS: Leadership in Healthcare
31. Innovative financing opportunities that the government in South Africa can leverage on to close the
financing gap resulting from the pressures of the COVID-19 pandemic
32. Innovative solutions to the agitations of remuneration, recruitment and posting of health workers upon
completion in Ghana and other Sub-Saharan African countries.
33. How governance can assist in curbing challenges in procurement among the government sector of
developing countries.
34. What suggestions would you give for South Africa to better prepare for handling pandemics of the COVID19 magnitude?

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