Stakeholders’ power sources and influence over the design and implementation of medicine pricing policies in Ghana
| Policy/stage | HCSCMP | Framework contracting | VAT exemption for essential medicines | VAT exemption for local manufacturing | ||||||||
| Policy design | ||||||||||||
| Power/level of influence | Bureaucratic (approval) | Political | Technical | Bureaucratic (approval) | Political | Technical | Bureaucratic (approval) | Political | Technical | Bureaucratic (approval) | Political | Technical |
| Minister for Health | +++ | +++ | +++ | +++ | ||||||||
| MOH-Procurement and Supplies Directorate | +++ | +++ | +++ | +++ | +++ | +++ | ||||||
| MOH-Office of Chief Pharmacist | ++ | +++ | +++ | |||||||||
| MOH-Pharmacy Department | +++ | +++ | +++ | +++ | ||||||||
| GHS-Stores, supplies and drug management | +++ | +++ | ++ | ++ | ||||||||
| GHS-Expanded Programme on Immunisation | ++ | |||||||||||
| GHS-Institutional Care Division | ++ | ++ | ||||||||||
| NHIA-Provider Payment Directorate | +++ | +++ | +++ | +++ | ||||||||
| Food and Drugs Authority | ++ | +++ | ++ | ++ | ||||||||
| Ministry of Finance | +++ | +++ | +++ | |||||||||
| Ghana Revenue Authority | +++ | +++ | +++ | |||||||||
| Ministry of Trade and Industry | +++ | |||||||||||
| Pharmaceutical Manufacturers Association of Ghana (PMAG) | ++ | +++ | ||||||||||
| WHO | +++ | +++ | ++ | |||||||||
| United Nations Industrial Development Organisation (UNIDO) | +++ | +++ | ||||||||||
| USAID|DELIVER | +++ | |||||||||||
| USAID|Global Health Supply Chain-Procurement and Supply Management | +++ | ++ | ||||||||||
| Private Health Sector Alliance | ++ | |||||||||||
| Christian Health Association of Ghana72 | + | ++ | ++ | |||||||||
| Pharmaceutical Society of Ghana | +++ | ++ | ||||||||||
| Ghana National Chamber of Pharmacy | +++ | ++ | ||||||||||
| Community Pharmacy Practice Association (CPPA) | ++ | ++ | ||||||||||
| MOH Ghana National Drugs Programme | ++ | ++ | ++ | ++ | ||||||||
| MOH Central Medical Stores | ++ | |||||||||||
| MOH-National Drug Information Resources Centre | +++ | +++ | ||||||||||
| GHS-Regional Health Administrations | ++ | +++ | ++ | + | ||||||||
| GHS Regional Medical Stores | ++ | ++ | ||||||||||
| GHS National TB Control Programme | + | |||||||||||
| GHS National AIDS Control Programme | + | |||||||||||
| Teaching hospital Pharmacy Department | ++ | +++ | ||||||||||
| GHS National Malaria Control Programme | + | |||||||||||
| GHS Health facilities | + | ++ | ||||||||||
| Pharmaceutical Importer and Wholesalers Association (PIWA) | ++ | |||||||||||
| Association of Representatives of Ethical Pharmaceutical Institutions (AREPI) | ++ | + | ||||||||||
| Ghana Medical Association (GMA) | + | + | ||||||||||
| Nurses and Midwives Council (NMC) | + | + | ||||||||||
| Pharmacy Council | ++ | ++ | ||||||||||
| Parliament Select Committee on Health/Parliamentarians | +++ | +++ | ||||||||||
| Attorney General Department | +++ | +++ | ||||||||||
| Society of Private Medical and Dental Practitioners | ||||||||||||
| Public Procurement Authority | +++ | |||||||||||
| Cancer Connect Ghana | + | |||||||||||
| National Diabetes Association | + | |||||||||||
| Policy implementation | ||||||||||||
| Power/level of influence | Financial | Authority to implement | Authority to enforce, monitor and evaluate | Financial | Authority to implement | Authority to enforce, monitor and evaluate | Financial | Authority to implement | Authority to enforce, monitor and evaluate | Financial | Authority to implement | Authority to enforce, monitor and evaluate |
| Minister for Health | +++ | + | +++ | +++ | + | +++ | +++ | + | +++ | +++ | + | +++ |
| MOH-Procurement and Supplies Directorate | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | +++ | ++ | ||
| MOH-Office of Chief Pharmacist | ++ | ++ | ||||||||||
| MOH-Pharmacy Department | ++ | +++ | ++ | +++ | +++ | +++ | +++ | +++ | ||||
| GHS- Stores, supplies and drug management | ++ | ++ | ++ | ++ | ||||||||
| GHS-Expanded Programme on Immunisation | ++ | |||||||||||
| GHS-Institutional Care Division | ||||||||||||
| NHIA-Provider Payment Directorate | ++ | +++ | +++ | +++ | +++ | +++ | +++ | |||||
| Food and Drugs Authority | + | + | + | + | ||||||||
| Ministry of Finance | +++ | +++ | +++ | +++ | +++ | +++ | ||||||
| Ghana Revenue Authority | +++ | +++ | +++ | +++ | ||||||||
| Ministry of Trade and Industry | +++ | +++ | ||||||||||
| Pharmaceutical Manufacturers Association of Ghana (PMAG) | +++ | +++ | +++ | |||||||||
| WHO | + | ++ | +++ | |||||||||
| United Nations Industrial Development Organisation (UNIDO) | ||||||||||||
| USAID |DELIVER | ++ | ++ | +++ | |||||||||
| USAID|Global Health Supply Chain-Procurement and Supply Management | +++ | ++ | +++ | |||||||||
| Private Health Sector Alliance | + | |||||||||||
| Christian Health Association of Ghana72 | ||||||||||||
| Pharmaceutical Society of Ghana | ++ | |||||||||||
| Ghana National Chamber of Pharmacy | ++ | ++ | +++ | +++ | +++ | ++ | + | ++ | ||||
| Community Pharmacy Practice Association (CPPA) | ++ | |||||||||||
| MOH Ghana National Drugs Programme | + | + | + | |||||||||
| MOH Central Medical Stores | ++ | + | +++ | + | ||||||||
| MOH- National Drug Information Resources Centre | + | + | ||||||||||
| GHS-Regional Health Administrations | +++ | +++ | +++ | ++ | ||||||||
| GHS Regional Medical Stores | ++ | + | +++ | + | ||||||||
| GHS National TB Control Programme | ||||||||||||
| GHS National AIDS Control Programme | ||||||||||||
| Teaching hospital Pharmacy Department | +++ | + | +++ | ++ | ||||||||
| GHS National Malaria Control Programme | ||||||||||||
| GHS Health facilities | +++ | + | +++ | + | ||||||||
| Pharmaceutical Importer and Wholesalers Association (PIWA) | +++ | +++ | ||||||||||
| Association of Representatives of Ethical Pharmaceutical Institutions (AREPI) | +++ | +++ | ||||||||||
| Ghana Medical Association (GMA) | ||||||||||||
| Nurses and Midwives Council (NMC) | ||||||||||||
| Pharmacy Council | ||||||||||||
| Parliament Select Committee on Health/ Parliamentarians | ||||||||||||
| Pharmaceutical Suppliers | +++ | + | +++ | ++ | ||||||||
| Attorney General Department | ||||||||||||
| Society of Private Medical and Dental Practitioners | ||||||||||||
| Public Procurement Authority | +++ | + | ||||||||||
| Cancer Connect Ghana | ||||||||||||
| National Diabetes Association | ||||||||||||
Notes:+++, high influence; ++, medium influence; +, low influence; empty cells—no influence identified.
HCSCMP, Health Commodity Supply Chain Master Plan; VAT, Value Added Tax.