Inter-Sectoral Collaboration for Health - a Case Study of Sekyere West District

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This study was carried out in the Sekyere West District of Ashanti Region of Ghana to assess the nature of inter-sectoral collaboration for health in the district using questionnaire interviews, in-depth interviews, review of existing records and case studies. The study revealed that the level of inter-sectoral collaboration for health in the district was 52%, which is low. Out of the eleven sectors sampled .for the study, five had high levels of collaboration for health whilst six had low levels of collaboration for health. Also, of the five variables on which these were assessed, three achieved high levels of collaboration by the sectors as against two which achieved low levels by the sectors. The strength of inter-sectoral collaboration for health in the District were found in the planning, implementation and information, education and communication (IEC) of health related programmes. The weaknesses in inter-sectoral collaboration for health in the district were also found in research and monitoring and evaluation of health related programmes. Almost all the sectors in the study were represented on the District Management Health Team (DMHT) and the District National Immunisation Programme Committee (DNIPC) with the exception of one sector. Information on health issues were considerably shared among the sectors and resources were also shared for the implementation of health related programmes. Joint planning for health related programmes were carried out by some of the sectors. However, most of the sectors did not have policies on inter-sectoral collaboration and did not understand the concept of inter-sectoral collaboration. Many sectors always looked on to the District Health Administration (DHA) to initiate activities on inter-sectoral collaboration for health. Bureaucratic tendencies within most of the decentralised departments prevented them from taking decisions at the district level including those for promoting inter-sectoral collaboration for health and lack of horizontal relationships among the sectors, impeded effective inter-sectoral collaboration for health in the district. Since most of the sectors planned their health related programmes in isolation of the other sectors, collaboration in other programmes that followed these plans were weak. Also most of the sectors did not make the effort to request for assistance from the other sectors nor offer them to other sectors for health related programmes. It is therefore recommended that policies on inter-sectoral collaboration for health should be made available to all the sectors at the district level. This however demands an absolute decentralization whereby the top hierarchy of the various sectors would have to devolve some decision making powers to the district level, It is envisaged that these measures would pave the way for improvement in inter-sectoral collaboration for health so that the sectors can play their respective roles in promoting inter-sectoral collaboration among themselves.
A thesis submitted to the Board of Postgraduate Studies, Kwame Nkrumah University of Science and Technology, Kumasi, in partial fulfilment of the requirement for the award of Master of Science Degree in Health Services Planning and Management, 1999