Assessment of the Governance and Leadership Structures of the Healthcare System in Ghana and its Implications for the Implementation of Networks of Practice: The Case of a Newly Created Region

Introduction The realization of the Sustainable Development Goals (SDGs) on health and the achievement of Universal Health Coverage (UHC) hinges on good health system leadership and governance and the effective and resilient health system structures, processes, and resources are among the key elements that can work toward the achievement of these milestones. Objective The study aimed to assess three main governance and leadership components (structures, processes, and resources) to identify the challenges of leadership and governance and offer suggestions for mitigation before implementing NoP. Methods The study adopted a survey relational design with a mixed method (quantitative and qualitative) and utilized a survey approach with probability and non-probability sampling. The study population was healthcare professionals in one of the newly created regions. Target respondents are senior managers at the regional and district level. Both quantitative and qualitative data analyses were conducted. SPSS v.21 and NVIVO statistical software were used to process and analyze data. Thematic and narrative descriptions and descriptive and inferential statistics were used to analyze data Results The study’s findings include strong associations and direct relationships between HSLG structures, processes, and resources and NoP implementation. The study further revealed that the current levels of health system structures, processes, and resources are inadequate for implementing NoP. Conclusion The current health system leadership and governance structures can only achieve 54.5% success in the NoP implementation, processes 54%, and resources 59%. Improving the structures and processes alone can increase the success of NoP implementation by 71% while investing in the resources to support the structures and processes can achieve an overall success of 83%. Recommendations The study recommended a holistic approach to improving all the components of health system leadership and governance to facilitate the successful implementation of the Networks of Practice (NoP)must be pursued. Originality/value The study comes as a deviation from previous studies that have tended to use only quantitative methods. Focusing on health system leadership and governance components in a newly created region with a myriad of challenges provides an important point of reflection for policymakers ahead of the full implementation of the NoP in all regions across the country.