Part $1$: Case Study Summary

The case study explores the interplay between global health agendas $$ Universal Health Coverage $($UHC$),$ Health Security $($HS$),$ and Health Promotion $($HP$)$ within Ghana and Sierra Leone. It investigates how these agendas influence national policy setting, formulation, and implementation, highlighting potential synergies and fragmentation. Key insights include the role of political leadership, agency of local actors, resource allocation, and the impact of global pressure. While synergistic approaches can improve health outcomes, fragmentation persists due to resource scarcity, limited stakeholder engagement, and competing institutional interests.

Contextual Background:

Both Ghana and Sierra Leone have experienced unique challenges. Ghana has had a period of political stability and gradual economic growth, while Sierra Leone faced civil war and an Ebola outbreak. These factors have influenced their health systems$$ stability and integration.

Key Challenges:

Global influences, including donor$-$driven priorities, often lead to fragmented health initiatives. A lack of coordination among multiple actors within each country's health sector exacerbates this fragmentation, as different agencies and stakeholders pursue varied goals.

Health System Structure and Leadership:

Effective leadership is crucial for promoting synergies within health policies. However, political turnover and competition among professional groups often lead to fragmented implementation.

Lessons Learned:

The importance of building strong, cohesive health policies that align with national priorities rather than solely with global agendas. Developing trust and accountability mechanisms is essential to foster cooperation among health sector stakeholders. Building capacity for cross$-$sectoral collaboration can address broader health determinants, thereby reducing fragmentation and enhancing health security and promotion.

Part $2$: Formal Presentation on Case Study

Response to a question outlined below. This case study examines the link between national$-$level policy development and the challenges of implementing these policies in the context of Universal Health Coverage $($UHC$).$ Respond to this question:

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From the case study, what key lessons from the experiences of Sierra Leone and Ghana can South African health systems planners consider with our on$-$going efforts to implement the NHI as a mechanism for ensuring Universal Health Coverage $($UHC$)?$

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Discuss up to three important lessons that Sierra Leone and Ghana can teach South Africa. To answer this question, you will have to draw on your understanding of different content areas in HSS $2($e$.$g$.,$ health financing, human resources for health, primary health care, health information, population health etc.$).$