{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:28:22Z","timestamp":1790706502588,"version":"4.1.0"},"reference-count":12,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2007,1,22]],"date-time":"2007-01-22T00:00:00Z","timestamp":1169424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Health Planning &amp; Management"],"published-print":{"date-parts":[[2007,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This article looks at the issue of sustaining funding for a public programme through the case study of the delivery exemptions policy in Ghana. The Government of Ghana introduced the policy of exempting users from delivery fees in September 2003 in the four most deprived regions of the country, and in April 2005 it was extended to the remaining six regions in Ghana. The aim of the policy of free delivery care was to reduce financial barriers to using maternity services. Using materials from key informant interviews at national and local levels in 2005, the article examines how the policy has been implemented and what the main constraints have been, as perceived by different actors in the health system. The interviews show that despite being a high\u2010profile public policy and achieving positive results, the delivery exemptions policy quickly ran into implementation problems caused by inadequate funding. They suggest that facility and district managers bear the brunt of the damage that is caused when benefits that have been promised to the public cannot be delivered. There can be knock\u2010on effects on other public programmes too.<\/jats:p>\n                  <jats:p>Despite these problems, start\u2010stop funding and under\u2010funding of public programmes is more the norm than the exception. Some of the factors causing erratic funding\u2014such as party politics and intersectoral haggling over resources\u2014are unavoidable, but others, such as communication and management failures can and should be addressed. Copyright \u00a9 2007 John Wiley &amp; Sons, Ltd.<\/jats:p>","DOI":"10.1002\/hpm.867","type":"journal-article","created":{"date-parts":[[2007,1,22]],"date-time":"2007-01-22T05:59:46Z","timestamp":1169445586000},"page":"133-143","source":"Crossref","is-referenced-by-count":52,"title":["Start\u2010stop funding, its causes and consequences: a case study of the delivery exemptions policy in Ghana"],"prefix":"10.1002","volume":"22","author":[{"given":"Sophie","family":"Witter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Adjei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,1,22]]},"reference":[{"key":"e_1_2_1_2_1","volume-title":"Sector\u2010Wide Approaches for Health Development: A Review of Experience. Recommendations on Implementing Sector\u2010Wide Policies in the Health Sector","author":"Foster M","year":"2000"},{"key":"e_1_2_1_3_1","volume-title":"\u2018We are Still Paying\u2019: A Study on Factors Affecting the Implementation of the Exemptions Policy in Ghana","author":"Garshong B","year":"2001"},{"key":"e_1_2_1_4_1","unstructured":"GrahamW.2004.Poverty and maternal mortality: what's the link?Keynote address delivered at Annual Research Meeting NMIMR University of Ghana Legon."},{"key":"e_1_2_1_5_1","volume-title":"Sustaining Primary Health Care","author":"LaFond A","year":"1995"},{"key":"e_1_2_1_6_1","volume-title":"Guidelines for Implementing the Exemption Policy on Maternal Deliveries","author":"Ministry of Health","year":"2004"},{"key":"e_1_2_1_7_1","volume-title":"National Health Insurance Policy Framework for Ghana (revised version)","author":"Ministry of Health","year":"2004"},{"key":"e_1_2_1_8_1","volume-title":"An Evaluation of the Policy of Universal Fee Exemption for Delivery Care: Ghana Operational Protocol","author":"Noguchi Institute and IMMPACT","year":"2005"},{"key":"e_1_2_1_9_1","unstructured":"PHS work programme.2005.I. Policy Brief: Implementation of the Free Delivery Programme in Ghana. Aberdeen Noguchi Institute and IMMPACT. Ref Type: Pamphlet."},{"key":"e_1_2_1_10_1","volume-title":"Ghana health sector five year programme of work (2002\u20132006)\u2014an in\u2010depth review of the health sector response to maternal mortality in Ghana by 2003","author":"UNFPA, Ministry of Health","year":"2004"},{"key":"e_1_2_1_11_1","unstructured":"WaddingtonC.1992.Health Economics in an Irrational World: The View From a Regional Health Administration in Ghana Doctor in Philosophy Liverpool School of Tropical Medicine."},{"key":"e_1_2_1_12_1","volume-title":"Evaluation of the Free Delivery Policy in Ghana: Findings From Key Informant Interviews","author":"Witter S","year":"2005"},{"key":"e_1_2_1_13_1","volume-title":"Health Financing Revisited: A Practitioner's Guide","author":"World Bank","year":"2006"}],"container-title":["The International Journal of Health Planning and Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhpm.867","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hpm.867","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T23:36:55Z","timestamp":1700005015000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hpm.867"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,1,22]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2007,4]]}},"alternative-id":["10.1002\/hpm.867"],"URL":"https:\/\/doi.org\/10.1002\/hpm.867","archive":["Portico"],"relation":{},"ISSN":["0749-6753","1099-1751"],"issn-type":[{"value":"0749-6753","type":"print"},{"value":"1099-1751","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,1,22]]}}}