Ghana's Health Workforce Policy Evolution from 1996 to 2020: A document analysis

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Abstract Background Ghana has, over the past decades, undergone distinct health workforce policy evolutions, as part of reforms of its public health sector organisation and procedures, to improve the quality of health services, increase access to care, and achieve better health outcomes. Despite the age-old implementation of the health workforce policies arising from the policy evolutions, there is paucity of evidence on the interaction between the policies, their intended strategic objectives, and health workforce indices to aid the understanding of past policy failures and successes and to plan for future health workforce policy implementation. Methods Using the READ approach of document analysis, we explored the health workforce policy environment of the public health sector of Ghana to gauge the impact major health workforce policies have had in determining the production of and demand for essential health workforce. Findings Ghana was found to have undergone three distinct phases of health workforce policy evolutions, following its health sectors reforms in the 1990s – an expansionary production and recruitment policy drive between the late 1990s and 2011, a seeming policy vacuum between 2012 and 2018, and a phase of policy streamlining from 2020 where fiscal realities began shaping issues of health workforce production and demand. Conclusion The distinct phases of the health workforce policy evolution had differing impacts on the production of and demand for essential health workforce, with instances of misalignment between policy objectives and implementation.

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