Previous Article in Journal
Testing Realist Programme Theories on the Contribution of Lean Six Sigma to Person-Centred Cultures: A Comparative Study in Public and Private Acute Hospitals
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
Hospitals
Volume 2
Issue 3
10.3390/hospitals2030024
hospitals-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Perspective

Improving Accountability for Quality and Safe Healthcare: Lessons from Ghana

by
Elom Hillary Otchi
1,2,3,* and
David Greenfield
4
1
Africa Institute of Healthcare Quality Safety & Accreditation (AfIHQSA), Accra P.O. Box KB 755, Ghana
2
Department of Health Law & Ethics, University of Ghana School of Law, Accra P.O. Box LG 70, Ghana
3
Department of Community Health, Accra College of Medicine (ACM), Accra P.O. Box CT 9828, Ghana
4
School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
*
Author to whom correspondence should be addressed.
Hospitals 2025, 2(3), 24; https://doi.org/10.3390/hospitals2030024
Submission received: 28 May 2025 / Revised: 4 September 2025 / Accepted: 8 September 2025 / Published: 11 September 2025
(This article belongs to the Topic Health Services Optimization, Improvement, and Management: Worldwide Experiences)
Browse Figure
Review Reports Versions Notes

Abstract

Health systems function optimally when accountability principles, legal frameworks, and governance processes are clearly defined, understood, and implemented. Together these elements set norms, standards, and systems for the practice of health professionals, facilities, products, and the provision of quality and safe care. Ghana, like other countries, has these elements in place but could be more effective. When the system fails, the consequences of a lack of accountability are widespread, significant, and impact the poor and vulnerable the hardest. Achieving accountability for the legal and social expectation of high-quality, safe healthcare is an ongoing challenge, for every country, not just Ghana. Hence, a key dual question arises: within Ghana, how can health system accountability be enhanced through examining legal frameworks and their implementation? The following six key elements are identified to promote accountability in health systems: establish and implement effective healthcare governance arrangements; capacity development, understanding, and delineation of stakeholder roles and responsibilities; appropriate financing and resourcing; establishing and maintaining effective management of required infrastructure; undertaking measurement for accountability; and focusing on people-centered care. A clear focus on these six elements enables the delivery of equitable, high-quality, safe care for the population and a better future for all.

1. Introduction

Legal frameworks are fundamental to how health systems are managed and organized by policymakers. In many ways, they affect health determinants. They are an important tool in accelerating our efforts towards the provision of quality healthcare for populations [1,2]. The core areas of public health require appropriate legal frameworks to advance their implementation [3]. This includes the protection of rights, access to quality and safe healthcare, prevention, and management of public health risks, and the promotion of the required action on the social determinants of health [3].
Legal frameworks have the potential to facilitate the provision of quality healthcare once accountability mechanisms can be embedded [1]. Accountability is the combination of structures, processes, and practice norms. Together they hold the community, professionals, and politicians legally responsible for their actions and impose sanctions if they violate the law [4,5,6]. Additionally, answerability, enforcement, and responsiveness are three core components of accountability [6]. The application of these into practice is becoming increasingly fraught in many contexts.
In Ghana, like many countries around the world, there is a comprehensive set of legal frameworks, supported by practice norms, that governs the provision of high-quality, safe healthcare. However, there is an ongoing challenge of the successful implementation of the laws, guidelines, and practice norms with variability in healthcare quality, safety, outcomes, and equity across the population. For instance, there is inequitable distribution of health infrastructure and human resources, with rural and hard-to-reach areas often disadvantaged [7]. Across the 16 regions with 11,079 public health facilities, 3367 (30%) are shared between just two—the Greater Accra and Ashanti regions. Similarly, these two regions have the highest levels of health insurance—40% of the total insured population in the country in 2021 [7].
Like many other countries, Ghana lacks a common legislative, regulatory, and institutional framework that harmonizes the functions of all the 12 existing regulatory bodies; the impact is the duplication of efforts and inefficiency in regulatory function [8]. Accountability for the provision of high-quality, safe healthcare remains a wicked problem [9], that is, problems that can have complex interconnections, changing standards and practices, and disparate goals of stakeholders. Wicked problems are never finalized, merely solved for a period until they reemerge, shaped by the behaviors of people and context. Achieving accountability for the legal and social expectation of high-quality, safe healthcare is an ongoing issue for every country, not just Ghana. The challenge, however, remains an ongoing one, necessary to be addressed each day, week, and month. Hence, a key dual question is the following: within Ghana, how can health system accountability be enhanced through examining legal frameworks and their implementation?

2. What Legal Frameworks Exists in Ghana?

Ghana has a comprehensive set of legal frameworks that governs the provision of quality and safe healthcare (Table 1). The legal structure, including the constitution, operations of the parliament, and laws it has established, provides the regulatory framework. Together these components set the expectations and standards for the operation and practices of health facilities, professions, and individuals, including training and ongoing development, funding, products, and the provision of quality and safe care within a pluralistic healthcare system. Together, with the revised National Health Policy (2020), they seek to define and structure healthcare accountability and governance. Governance is how an organization is led, structured, directed, controlled, held accountable, and safeguarding with high standards [2,10]. Policies, such as the National Health Policy (2020), and legal regulations, such as those listed in Table 1, together comprise a framework to influence behavior and norms in the health system.
Though Ghana has sufficient laws to facilitate accountability within its health system to advance the provision of quality healthcare, agents face many challenges that make this ethos difficult to realize. For instance, there is a failure to appropriately plan, resource, and finance the administration and implementation of these legal frameworks for accountability. Unfortunately, the challenges in the implementation of these legal frameworks in many instances have led to a number of evidenced consequences of a lack of accountability within the health system, such as the following: human rights violations, especially of mental health patients [11], contrary to the Mental Health Act, 2012 (Act 846); poor quality of healthcare across all of its dimensions [12,13]; inequitable distribution of resources [12,13]; healthcare fraud [14,15] and increased medicolegal cases [16].
Table 1. Summary of Ghanian laws to facilitate health sector accountability.
Table 1. Summary of Ghanian laws to facilitate health sector accountability.
Legal FrameworkSummary Explanation
Ghana Constitution (1992)Provides the overarching framework for the provision of quality and safe healthcare, including guaranteeing the right to health as provided for in the “Directive Principles of State Policy” in Chapter 6. This enjoins the President to report annually to Parliament on what efforts it was undertaking to ensure the attainment of the objectives of “basic human rights, a healthy economy, the right to work, the right to good healthcare and the right to education” [17].
Parliament of GhanaProvides legal oversight over the activities of the health sector by reviewing, monitoring, and supervising the relevant health sector policies through its committee system, parliamentary visits, statutory audits, and other tools available to it [17].
The Public Health Act 2012 (Act 851)Seeks to facilitate the provision of comprehensive legislation on public health with a focus on keeping people healthy and improving their health. The objectives of the Act, among others, include the promotion of public health and well-being, providing essential public health services and functions, and responding effectively to public health emergencies [18]. Schedule Six of this Act also contains the Patients Charter that seeks to protect the rights of the patient in the health service.
Health Institutions and Facilities Act, 2011 (Act 829)This is the main legislation responsible for regulation of health facilities (i.e., public and private), including their licensing, registration, inspection, and monitoring. The Act also establishes the mortuaries and funeral facilities with the exclusive responsibility of controlling and regulating the storage and disposal of human remains and the Ambulance Council, responsible for regulating the operations of the ambulance service [19].
National Health Insurance Act, 2003 (Act 650) as amended in 2012 (Act 852)This Act completes the efforts of the government to facilitate financial access to quality and safe universal healthcare through the establishment of the National Health Insurance Scheme (NHIS). It also establishes the National Health Insurance Fund, which ensures that the healthcare costs of members of the scheme are paid for. The Act further establishes and acknowledges the role of private health insurance operators as well [20].
Ghana Health Service and Teaching Hospitals Act 1996 (Act 525)This piece of legislation separated health service delivery and regulatory functions from the Ministry of Health (MoH) such that it could concentrate on its key role of policy, resource mobilization, and monitoring and evaluation. Service delivery and regulatory functions have been devolved to its 24 agencies.
Mental Health Act, 2012 (Act 846)This legislation seeks to ensure that persons with mental health disorders are provided quality healthcare and their rights are respected. It has also introduced changes to the way mental health services are organized, provided, and funded.
Health Professions Regulatory Bodies Act, 2013 (Act 857)This piece of legislation established professional regulatory bodies such as the Allied Health Professions Council, the Medical and Dental Council, the Nursing and Midwifery Council, Pharmacy Council, and the Psychology Council. Each of these is responsible for ensuring the highest standards in the practice of the respective professions [21].
Corporate Governance Manual for Governing Boards/Councils of the Ghana Public ServiceThis document seeks to provide guidance to governing boards/councils of public services, including the health service, to ensure accountability, transparency, and appropriate governance practices to enhance productivity.
Other legal frameworksNurses Regulation, 1971 (LI 683); Pharmacy Act, 1994 (Act 489); Public Procurement Act, 2003 (Act 663) as Amended (Act 914) in 2016; Traditional Medicine Practice Act, 2000 (Act 575); Mental Health Act, 2012 (Act 846); Public Financial Management Act, 2016 (Act 921); and the Financial Administration Act, 2003 (Act 654).

3. How to Implement Health System Accountability?

To achieve health system accountability in Ghana and possibly elsewhere, the implementation of the legal framework requires the following six key elements: establishing and implementing effective healthcare governance arrangements; capacity development; understanding, and delineation of stakeholder roles and responsibilities; appropriate financing and resourcing; establishing and maintaining effective management of required infrastructure; undertaking measurement for accountability; and focusing on people-centered care. The framework is summarized in Figure 1. One can start his/her implementation from anywhere and only needs to be consistent and conscientious.

3.1. Establish and Implement Effective Healthcare Governance Arrangements

First, in Ghana the task is to ensure the adherence to defined healthcare governance arrangements. That is, the MoH needs to oversee the establishment and implementation of clinical governance practices to facilitate an effective management of the resources of the healthcare organization for the desired outcomes [2,22]. The establishment and implementation of clinical governance is a key step to ensuring stakeholders—frontline care providers, policymakers, managers, executives, and governing boards—are accountable for continuously improving the quality and safety of care to the patient and community. Accountability is a shared responsibility in any well-governed healthcare institution [2,15,22]. It is not sufficient to know what is required but necessary to act responsibly. Though every stakeholder group has a role to play, members of governing boards have the ultimate responsibility of establishing effective clinical governance systems that are accountable for the outcomes of care and performance of the organization [23]. The main principles that are proposed to guide effective implementation include succinct accountability, leadership, just culture, personal responsibility, defined authority, and people-centered care [2,10,24]. Further, an effective clinical governance program requires the following integrated elements: performance management, risk management, effective communication, ownership, continuous quality improvement, and systems and organizational awareness [2,10,15,24].

3.2. Capacity Development, Understanding and Delineation of Stakeholder Roles and Responsibilities

Second, within the Ghana health system capacity development, understanding and delineation of stakeholder roles and responsibilities is critical. Attention to the capacity development of stakeholders will more successfully achieve the implementation of laws for accountability [3]. Capacity development means the extent to which the knowledge, skills, competencies, dedication, leadership, structures, and systems are built through facilitated continuous education and training sessions and action learning across the levels of the health system to ensure accountability, adherence to the existing legal frameworks, and safe and high-quality care [25]. One strategy for clearer role engagement is for the MoH to increase its oversight role across its agencies and enforce the legal frameworks to ensure health system accountability. This can include, for example, ensuring the Health Facilities Regulatory Agency sees that public and private health facilities are appropriately licensed and accredited; promoting the effective corporate governance of boards/councils of public services; and, at an individual level, ensuring the professional regulatory bodies ensure the highest standards in the practice of their respective professions.
Further responsibility across the Ghana health system can be improved if appointments of the heads of the agencies and board chairs are made by the Minister of Health, rather than directly from the presidency. Appropriate governance practices require the positions are declared vacant, qualified and competent persons apply and are interviewed by impartial panels, and subsequently appointed by the Minister of Health. Amendments to legislation to support this approach will be necessary, with the benefit being this will make the positions apolitical and the appointees more accountable. This action corresponds to the option of the president to nominate community members to the governing boards of health facilities and agencies and, thus, adding another layer of representativeness and accountability. For instance, the Ghana Health Service/Teaching Hospitals Act, 1996, provides for the appointment of a member of the trade union, Christian and Islamic faiths, a member of the regional house of chiefs, and two other residents of the region [where the facility is situated], one of whom must be a woman. There is the need to invest in capacity building of the key agents of accountability and demand generation to ensure improved care outcomes.

3.3. Appropriate and Adequate Financing and Resourcing

Third, the Ghana parliament, through attending to the constitutional requirements, can ensure that financing and resourcing meet the responsibilities outlined in the various pieces of legislation necessary to drive improvements. Providing appropriate and adequate financing attends to a critical challenge confronting the sector and is a major step to enable implementation of the legislation and accountability [26]. This requirement is further endorsed by the fact that Ghana is a signatory to the Abuja Declaration for African countries to spend 15% of GDP on healthcare [27,28]. The decision by the government to uncap the NHIS in its 2025 budget and, thus, making an excess of GHS 9.9 billion Ghana cedis (USD 622 million) in funds available, is a step in the right direction and commendable [29]. Effective and targeted allocation of funding to the earmarked areas of claims reimbursement, essential medicines and vaccines, and free primary healthcare is necessary. Doing so will contribute to bridging the overall funding gap in the health sector and ensure sustainability of the gains.

3.4. Establish and Maintain Effective Management of Required Infrastructure

Fourth, the MoH can promote the knowledge that establishing and maintaining effective management of required infrastructure and equipment contributes positively to safe and high-quality care. It is important that health facility managers develop and implement an effective maintenance culture to ensure that the equipment and infrastructure are fit for purpose. This culture can be reinforced by the Health Facilities Regulatory Agency (HeFRA) through implementing and monitoring innovative standards that make health facility maintenance a requirement for licensing and renewal. Again, this is an important transition from knowing to effective action. This action will work towards ensuring that providers and patients alike are safe in any health facility in line with existing legislation [19,30].

3.5. Undertake Measurement for Accountability

Fifth, the MoH needs to integrate robust measurement to facilitate the monitoring of the performance of the health system for quality. Performance indicators and outcomes along the dimensions of quality (i.e., safety, timeliness, efficiency, equity, effectiveness, people-centeredness, integration, and integrity) will have to be developed and implemented.

3.6. Focusing on People-Centered Care

Finally, the MoH, boards, and professional bodies need to focus on implementing people-centered care. This can be achieved by ensuring that the needs and expectations of patients are the main value that guides the provision of care and are fundamental. In addition, there should be MoH policies guiding implementation of the rights-based approach to care where the rights of the patient to the highest quality of accessible, equitable, safe, and comprehensive healthcare are ensured. Health systems will benefit greatly if the concept of social accountability, where the voices of the users of health services are integrated and implemented to improve care outcomes and the overall performance of the health system [31]. Further, providers should ensure that they are always guided by the ethical principles of autonomy, beneficence, non-maleficence, and justice [18,32]. To ensure the confidence of the community, there needs to be transparency demonstrating how they are implemented. Finally, it is important that the appropriate accountability frameworks, such as one that ensures that accountability is defined, are in place. Additionally, accountability zones and strategies, when effectively implemented in healthcare settings, will go a long way to improve the wicked problems facing Ghana. Doing so will significantly enhance people-centered care, reduce waste and inordinate delays safety, and improve mortality and morbidity [33].

4. Conclusions

The challenges and lessons from Ghana are unique and universal at the same time; they are potentially relevant to countries in Africa and globally. Accountability for the provision of high-quality, safe healthcare remains a great problem. Health systems require continuous attention to ensure structures, processes, and practice norms are understood, managed, and supported by stakeholders. To improve the desired outcomes of care and accelerate efforts by countries to attain the targets of the Sustainable Development Goals, urgent action must be taken. Attention is to be directed at ensuring the effective implementation of the following six health system accountability elements: establishing and implementing effective healthcare governance arrangements; capacity development, understanding and delineation of stakeholder roles and responsibilities; appropriate financing and resourcing; establishing and maintaining effective management of required infrastructure; undertaking measurement for accountability; and focusing on people-centered care. Therefore, with a clear focus on these key elements that comprise the ‘health system’ positive change can be achieved and maintained. Policy makers, practitioners, and managers owe it to current and future generations to take action. We must hold one another accountable, establish sustainable systems, and deal with the challenges of our time. Doing so enables the delivery of equitable, high-quality, safe care for the population and a better future for all.

Author Contributions

Conceptualization and writing by E.H.O. and D.G. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

No new data were created or analyzed in this study. Data sharing is not applicable to this article.

Conflicts of Interest

The authors declare no conflicts of interest.

References

  1. Gostin, L.O.; Monahan, J.T.; Kaldor, J.; DeBartolo, M.; Friedman, E.A.; Gottschalk, K.; Kim, S.C.; Alwan, A.; Binagwaho, A.; Burci, G.L.; et al. The legal determinants of health: Harnessing the power of law for global health and sustainable development. Lancet 2019, 393, 1857–1910. [Google Scholar] [CrossRef] [PubMed]
  2. Ghavamabad, L.; Vosoogh-Moghaddam, A.; Zaboli, R.; Aarabi, M. Establishing clinical governance model in primary health care: A systematic review. J. Educ. Health Promot. 2021, 10, 338. [Google Scholar] [CrossRef] [PubMed]
  3. World Health Organisation Regional Committee- Regional Office for the Western Pacific. Strengthening Legal Frameworks for Health in the Sustainable Development Goals; World Health Organisation Regional Committee: Manila, Philippines, 2018. [Google Scholar]
  4. Aston, T.; Faria, G.; Santos, Z. Social Accountability and Service Delivery Effectiveness: What is the Evidence for the Role of Sanctions? 2022. Available online: https://documents1.worldbank.org/curated/en/099534209302293819/pdf/IDU0aff7666c06b8804bc00a9170ce2d26867056.pdf (accessed on 1 June 2025).
  5. Kgobe, F.; Mamokhere, J. Interrogating the Effectiveness of Public Accountability Mechanisms in South Africa: Can Good Governance be Realized? Int. J. Entrep. 2023, 25, 1–12. Available online: https://www.researchgate.net/publication/373013719 (accessed on 31 May 2025).
  6. Birdayanthi, B.; Yusriadi, Y.; Ikmal, I. Accountability and Transparency in Public Administration for Improved Service Delivery. J. Social Civilecial 2025, 3, 34–47. [Google Scholar] [CrossRef]
  7. Ghana Investment Promotion Council. Ghana’s Healthcare Sector Report; Ghana Investment Promotion Council: Accra, Ghana, 2022. Available online: https://www.gipc.gov.gh/wp-content/uploads/2023/03/Ghanas-Healthcare-Sector-Report.pdf (accessed on 29 May 2025).
  8. Ministry of Health (MoH). 2021 Holistic Assessment Report; MoH: Accra, Ghana, 2021. Available online: https://www.moh.gov.gh/wp-content/uploads/2022/08/2021-Holistic-Assessment-Report_v1.7.3.pdf (accessed on 29 May 2025).
  9. Lönngren, J.; van Poeck, K. Wicked problems: A mapping review of the literature. Int. J. Sustain. Dev. World Ecol. 2021, 28, 481–502. [Google Scholar] [CrossRef]
  10. Aguilera, R.V.; Castillo, M.R. Toward an updated corporate governance framework: Fundamentals, disruptions, and future research. BRQ Business Research Quarterly 2025, 28, 336–348. [Google Scholar] [CrossRef]
  11. Human Rights Watch. Ghana: Chaining People with Mental Health Conditions Persists. Available online: https://www.hrw.org/news/2022/12/01/ghana-chaining-people-mental-health-conditions-persists (accessed on 1 June 2025).
  12. Ghana Ministry of Health. National Health Policy: Ensuring Healthy Lives for All. Revised Edition; 2020. Available online: https://www.moh.gov.gh/wp-content/uploads/2021/08/NHP_January-2020.pdf (accessed on 5 July 2025).
  13. Yawson, A.E.; Owusu-Boatemaa, A.; Otchi, E.H. End-Term Assessment of Ghana’s National Healthcare Quality Strategy (2017–2021); MoH: Accra, Ghana, 2023. [Google Scholar]
  14. Nyonator, J. Doctor Jailed 10 Years for Defrauding NHIS. Available online: https://citinewsroom.com/2018/06/doctor-jailed-10-years-for-defrauding-nhis/ (accessed on 19 May 2025).
  15. Eugster, N.; Kowalewski, O.; Śpiewanowski, P. Internal governance mechanisms and corporate misconduct. Int. Rev. Financ. Anal. 2024, 92, 103109. [Google Scholar] [CrossRef]
  16. Bayuo, J.; Koduah, A.O. Pattern and outcomes of medical malpractice cases in Ghana: A systematic content analysis. Ghana Med. J. 2022, 56, 322–330. [Google Scholar] [CrossRef] [PubMed]
  17. The Republic of Ghana. The Constitution of the Republic of Ghana. 1992. Available online: https://judicial.gov.gh/index.php/the-laws-of-ghana (accessed on 25 April 2025).
  18. Public Health Act, 2012 (Act 851). Available online: https://www.moh.gov.gh/wp-content/uploads/2016/02/Public-Health-Act-851.pdf (accessed on 8 June 2025).
  19. Health Institutions and Facilities Act, 2011 (Act 829). Available online: http://hefra.gov.gh/wp-content/uploads/2018/03/Act-829-Health-Institutions-and-Facilities-Act2cl-2011.pdf (accessed on 10 July 2025).
  20. National Health Insurance (Amendment) Act, 2018 (Act 971) of 2018. Available online: https://ghalii.org/akn/gh/act/2018/971/eng@2018-08-01 (accessed on 19 April 2025).
  21. Health Professions Regulatory Bodies Act, 2013 (Act 857). 2013. Available online: https://www.brr.gov.gh/reg_details?id=NDE0 (accessed on 28 November 2024).
  22. Bhati, D.; Deogade, M.S.; Kanyal, D. Improving Patient Outcomes Through Effective Hospital Administration: A Comprehensive Review. Cureus 2023, 15, e47731. [Google Scholar] [CrossRef] [PubMed]
  23. Australian Commission on Safety and Quality in Health Care. National Model Clinical Governance Framework; Australian Commission on Safety and Quality in Health Care: Sydney, Australia, 2017. [Google Scholar]
  24. Jerab, D.A. The Effect of Organizational Structure on Corporate Governance. SSRN Electron. J. 2023. [Google Scholar] [CrossRef]
  25. Bergeron, K.; Abdi, S.; Decorby, K.; Mensah, G.; Rempel, B.; Manson, H. Theories, models and frameworks used in capacity building interventions relevant to public health: A systematic review. BMC Public Health 2017, 17, 914. [Google Scholar] [CrossRef] [PubMed]
  26. Hanson, K.; Brikci, N.; Erlangga, D.; Alebachew, A.; De Allegri, M.; Balabanova, D.; Blecher, M.; Cashin, C.; Esperato, A.; Hipgrave, D.; et al. The Lancet Global Health Commission on financing primary health care: Putting people at the centre. Lancet Glob. Health 2022, 10, e715–e772. [Google Scholar] [CrossRef] [PubMed]
  27. World Health Organization (WHO). The Abuja Declaration: Ten Years On 2001 Promises of Commitment and Solidarity. 2010. Available online: https://apps.who.int/iris/bitstream/handle/10665/341162/WHO-HSS-HSF-2010.01-eng.pdf (accessed on 11 June 2025).
  28. Republic of Ghana; UNICEF. Health Budget Brief 2023. Available online: https://www.unicef.org/ghana/media/5001/file/2023%20Health%20Budget%20Brief.pdf (accessed on 1 April 2024).
  29. Ghana Ministry of Finance. 2025 Budget Speech; Ghana Ministry of Finance: Accra, Ghana, 2025. Available online: https://mofep.gov.gh/sites/default/files/budget-statements/2025-Budget-Speech.pdf (accessed on 19 April 2025).
  30. HeFRA. Health Facilities Regulatory Agency: 2018 Annual Report; Ministry of Health (MoH): Accra, Ghana, 2019. Available online: http://www.moh.gov.gh/wp-content/uploads/2016/02/MAF-strategic-plan.pdf (accessed on 5 March 2025).
  31. Nejatian, A.; Arab, M.; Takian, A.; Ashtarian, K. Social Accountability in Health System Governance: A Scoping Review. Iran. J. Public Health 2024, 53, 35. [Google Scholar] [CrossRef] [PubMed]
  32. World Health Organization. Patient Safety Rights Charter. Geneva. 2024. Available online: https://www.who.int/publications/i/item/9789240093249 (accessed on 28 April 2025).
  33. Atkinson, P.; Innes, G. Patient care accountability frameworks: The key to success for our healthcare system. CJEM 2021, 23, 274–276. [Google Scholar] [CrossRef] [PubMed]
Hospitals 02 00024 g001
Figure 1. Accountability framework for improving quality and patient safety in healthcare.
Figure 1. Accountability framework for improving quality and patient safety in healthcare.
Hospitals 02 00024 g001
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

MDPI and ACS Style

Otchi, E.H.; Greenfield, D. Improving Accountability for Quality and Safe Healthcare: Lessons from Ghana. Hospitals 2025, 2, 24. https://doi.org/10.3390/hospitals2030024

AMA Style

Otchi EH, Greenfield D. Improving Accountability for Quality and Safe Healthcare: Lessons from Ghana. Hospitals. 2025; 2(3):24. https://doi.org/10.3390/hospitals2030024

Chicago/Turabian Style

Otchi, Elom Hillary, and David Greenfield. 2025. "Improving Accountability for Quality and Safe Healthcare: Lessons from Ghana" Hospitals 2, no. 3: 24. https://doi.org/10.3390/hospitals2030024

APA Style

Otchi, E. H., & Greenfield, D. (2025). Improving Accountability for Quality and Safe Healthcare: Lessons from Ghana. Hospitals, 2(3), 24. https://doi.org/10.3390/hospitals2030024

Article Metrics

Back to TopTop