Audit of Grants in Ghana
02 April 2019
Although malaria remains a major cause of death in Ghana, significant progress has been registered, with reductions in prevalence, incidence and mortality: the country now ranks 13th in terms of global Malaria incidence, compared to 11th in 2015. For HIV, while overall prevalence has declined, only 33% of the estimated 316,613 people living with HIV are currently on treatment; if the 2020 national targets are to be achieved, testing, treatment, and viral load suppression challenges urgently need to be tackled. For TB, while treatment success is high at 85%, treatment coverage is only 32%; under-utilization of diagnostic machines, transportation difficulties and failing to leverage community health workers are hindering the detection of TB cases.
A revised implementation structure by the Ministry of Health and Ghana Health Service has not yet improved oversight and accountability, with duplicative roles, ambiguous reporting lines and lack of performance targets contributing to delays, poor grant absorption and weak performance.
While there have been improvements in drug storage conditions, logistics management information systems and last mile delivery, inventory management at health facilities is weak and logistics data are not yet effectively used for decision-making. And while the government has increased its funding commitments, actual investments towards HIV drug procurement, Central Management Store Fire Agreement and ACT sales refunds have been slow to materialize.
The audit did not identify any material financial irregularities or recoverable expenditures during limited, sample-based testing.
- Global Fund Grants in the Republic of Ghana (GF-OIG-19-009 - 2 April 2019)
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Dougal Thomson
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