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Introduction
My broad research area is applied microeconomics. Specific research interests include inequalities in health care utilization and outcomes, health financing, efficiency of health systems, poverty and vulnerability analysis, impact evaluation of interventions/programmes, among others. My current research activities are on (1) understanding financial incentives for socioeconomic related inequalities in health care utilization in Ghana, (2) Heterogeneous impact of health insurance and health shocks on economic outcomes (3) Impact of agricultural input subsidies and child nutritional outcomes (4) Youth unemployment in Africa.
Additional affiliations
Education
January 2012 - November 2015
August 2008 - August 2010
August 2003 - May 2007
Publications
Publications (85)
Background
Globally, adolescent health remains a public health priority given that adolescents often face unique vulnerabilities to health issues like mental disorders, substance abuse, and sexual health risks. In developing countries like Ghana, primary healthcare facilities (PHCs) are often the first point of contact for addressing these issues....
This study sought to unpack the impact of mobile money adoption and credit constraints on product innovation and performance of Micro, Small, and Medium‐scale Enterprises in Sierra Leone. We used the most recent Sierra Leone Enterprise survey data conducted by the World Bank to monitor enterprises. To achieve the objectives of the study, we used Or...
Background
Adolescent mental health (AMH) is a critical issue worldwide, particularly in West Africa, where it is intensified by socio-economic, cultural, and security challenges. Insecurity and the presence of mining sites expose adolescents to hazardous environments, substance abuse, and adulterated alcohol, further aggravating their mental healt...
This volume is the first ever publication to try to assess the performance of the Malawi economy since independence in 1964, by examining how the underpinning political and economic history and the associated policies and strategies have affected the country’s long-term socio-economic development. Part I deals with the political economy of Malawi’s...
Countries all over the world are seeking to enhance the general well-being of their populations by instituting a prepayment health system in which people can access healthcare at any time without financial risks. In Ghana, the National Health Insurance Scheme (NHIS) seeks to achieve this objective while leaving no one behind. To accelerate the coun...
Tracers of health system equity, neglected tropical diseases (NTDs) disproportionately affect marginalized populations. NTDs that manifest on the skin – “skin NTDs” – are associated with scarring, disfigurement, physical disability, social exclusion, psychological distress, and economic hardship. To support development and evaluation of appropriate...
Objectives
A quarter of West Africa's population are adolescents 10–19 years. Their mental, sexual, and reproductive health is inter-related. We therefore aimed to examine published evidence on effectiveness of interventions for adolescent mental, sexual and reproductive health in the Economic Community of West African States (ECOWAS) to inform dev...
Integrated approaches to managing co-endemic neglected tropical diseases (NTDs) of the skin within primary healthcare services are complex and require tailoring to local contexts. We describe formative research in Atwima Mponua District in Ghana’s Ashanti Region designed to inform the development of a sustainable intervention to improve access to s...
Background
Globally, adolescent health remains a public health priority given that adolescents often face unique vulnerabilities to health issues like mental disorders, substance abuse, and sexual health risks. In developing countries like Ghana, primary healthcare facilities (PHCs) are often the first point of contact for addressing these issues....
This research estimated the impact of credit uptake (formal, informal, and family) on youth entrepreneurship performance in Benin using panel data from a World Bank survey on enterprise formalization. To address potential endogeneity and ensure the robustness of results, we employed multiple models and estimation techniques (fixed-effects and Lewbe...
Integrated strategies are recommended to tackle neglected tropical diseases of the skin (skin NTDs), which pose a substantial health and economic burden in many countries, including Ghana. We describe the development of an integrated and decentralised skin health strategy designed to improve experiences of skin NTDs in Atwima Mponua district in Ash...
Since the outbreak of the Covid-19 crisis, there is growing interest to understand how social inequalities, discrimination, and inclusion are related to the pandemic. Sub-Saharan Africa has been comparatively resilient regarding the number of reported cases and fatalities per capita. At the same time, the region has high rates of multiple types of...
In many developing countries, financial risk protection for health is underdeveloped and negative health outcomes can be impoverishing. In this study, we sought to investigate the impact of negative health outcomes on household welfare and the role of public health insurance in mitigating this impact. We used data from the seventh round of the Ghan...
Primary health care (PHC) is a universally accepted key strategy to achieve universal health coverage (UHC) and Sustainable Development Goal 3 (SDG 3) due to its potential to produce a range of economic benefits through improved health outcomes, health quality, and health system efficiency. However, little evidence exists about the cost efficiency...
Background
Global aid for reproductive, maternal, newborn, and child health has stagnated in recent years, and aid mentioning newborns or stillbirths has previously represented a very small proportion of aid for reproductive, maternal, newborn, and child health. Neonatal survival targets have been set by 78 countries, and stillbirth prevention targ...
Background
Evidence shows high levels of catastrophic and impoverishing healthcare expenditure among households in sub-Saharan Africa (SSA). The way healthcare is financed has an impact on how well a health system performs its functions and achieves its objectives. This study aims to examine the effect of healthcare financing policy tools on health...
Background
Community Based Surveillance Volunteers (CBSVs) have been instrumental in the management of Neglected Tropical Diseases (NTDs) but a concern that their services in scale up programmes may be affected due to high attrition rates has been widely acknowledged. We explored the roles and capacity needs of existing CBSVs to inform for a succes...
Background
Birthweight is an important indicator of maternal and fetal health globally. The multifactorial origins of birthweight suggest holistic programs that target biological and social risk factors have great potential to improve birthweight. In this study, we examine the dose-response association of exposure to an unconditional cash transfer...
Background
Malaria remains a common course of morbidity in many sub-Saharan African countries. While treatment options have improved in recent times, inappropriate prescription seems conventional among providers, increasing the burden on patients and society. This study examined the cost of inappropriate prescriptions for uncomplicated malaria trea...
Objective
Universal health coverage (UHC) is a major pathway to save many people from catastrophic and impoverishing healthcare spending and address the inequality in health and healthcare. The objective of this paper is to assess the efficiency with which health systems in sub-Saharan Africa (SSA) are utilizing healthcare resources to progress tow...
Background : Buruli ulcer (BU) can lead to disfiguring ulcers and permanent disability. The 2030 World Health Organization (WHO) road map for Neglected Tropical Diseases (NTDs) calls for major scaling up in diagnosis and management to eliminate disability due to the disease. Current treatment for BU is with daily oral rifampicin (10mg/kg dose) and...
Objectives: Low birthweight (LBW) prevalence remains high in African countries and evidence of cash transfer impacts on birthweight, particularly by season of infant birth, is limited. This study examines overall and seasonal cash transfer impacts on LBW in rural Ghana.
Methods: Data come from a longitudinal, quasi-experimental impact evaluation of...
Background
The Ghana National Health Insurance Scheme was introduced in 2003 to provide financial protection to the population. While the Scheme has made strides in improving access to healthcare there have been a few challenges including out of pocket charges to insured patients with weak client power. The study investigated the catastrophic natur...
Background : Buruli ulcer (BU) can lead to disfiguring ulcers and permanent disability. The 2030 World Health Organization (WHO) road map for Neglected Tropical Diseases (NTDs) calls for major scaling up in diagnosis and management to eliminate disability due to the disease. Current treatment for BU is with daily oral rifampicin (10mg/kg dose) and...
Background
Malaria remains a common course of morbidity in many sub-Saharan African countries. While treatment options have improved in recent times, inappropriate prescription seems conventional among providers, increasing the burden on patients and society. This study examined the cost of inappropriate prescriptions for uncomplicated malaria trea...
While micro, small and medium-sized enterprises (MSMEs) have been identified as major economic drivers, they continue to face substantial financial constraints that limit their performance. The Impact Financing Envelope (IFE) of the European Investment Bank (EIB) seeks to improve credit access across developing countries through institutions such a...
Expanding access to clean cooking fuels is an important driver of sustainable development goal (SDG) 7,which is
to ensure universal access to affordable and clean energy. Ghana is among 20 countries that account for more
than 80% of the global deficit in access to clean cooking fuel, despite efforts to improve uptake of clean cooking
fuel over the...
Background:
Expanding health insurance coverage is a priority under Sustainable Development Goal 3. To address the intersection between poverty and health and remove cost barriers, the government of Ghana established the National Health Insurance Scheme (NHIS). Government further linked NHIS with the Livelihood Empowerment Against Poverty (LEAP) 1...
Background: Cutaneous leishmaniasis and leprosy are stigmatizing skin diseases often resulting in substantial morbidity and disability. The economic burden of these skin diseases has not been well documented. The aim of this qualitative study was to explore the household economic impact of cutaneous leishmaniasis and leprosy in rural Ethiopia and t...
The COVID-19 pandemic has exposed health system funding challenges across many developing countries. The needed infrastructure to effectively respond to the pandemic was absent in many developing countries. This has resulted in policymakers resorting to various strategies to mobilise sufficient resources in response to the pandemic, especially in t...
Ghana is a lower-middle-income economy that has made significant efforts to improve its health system, in order to achieve universal health coverage. Ghana has adopted strategic health purchasing as an important tool for efficient utilization of resources. This paper focuses on Ghana’s National Health Insurance Scheme (NHIS) analyzing its governanc...
Unconditional cash transfers have demonstrated widespread, positive impacts on consumption, food security, productive activities, and schooling. However, the evidence to date on cash transfers and health seeking behaviours and morbidity is not only mixed, but the evidence base is biased towards conditional programmes from Latin America and is more...
Malaria remains an important public health concern. Sub-Saharan African countries carry over 95% of the global burden. Unfortunately, there are also major resource constraints that have limited efforts to reduce the burden. Our study sought to estimate efficiency in the use of malaria resources and to identify potential determinants. We used primar...
The informal sector forms a significant proportion of the private sector of many developing economies. Despite challenges in the exact measurement of its size, the informal sector is noted for its role in employment creation as well as economic output in sub-Saharan Africa. However, access to formal credit is a major challenge for informal firms du...
The road to universal health coverage depends on resources committed to the health sector. In many cases, the political structure and strength of advocacy play an important role in setting budgets for health. However, this has, until recently, not been of interest to health system researchers and policymakers. In this study, we document the politic...
Background
Malaria remains a global public health challenge despite efforts that have significantly reduced its burden. In addition to prevention, effective treatment using the recommended medicines and approaches is essential to further minimize the burden., Yet, inappropriate prescription of anti-malarial medicines remains a challenge. Malaria pr...
In many developing countries, financial risk protection for health is underdeveloped and negative health outcomes can be impoverishing. In this study, we sought to investigate the impact of negative health outcomes on household welfare and the role of public health insurance in mitigating this impact. We used Ghana’s public-funded National Health I...
This deep-dive research (DDR) focuses on understanding how credit activities of the Development Bank of Jamaica (DBJ) affect the performance of microfinance institutions (MFIs) as well as micro, small and medium-sized enterprises (MSMEs) in Jamaica. The DBJ received support from the European Investment Bank (EIB) under the Impact Financing Envelope...
High fertility rates can hamper economic growth and development. Access to
contraception is a key strategic lever for development – to empower women and
adolescents, increase investments in children and ultimately contribute to poverty
reduction. The interventions analyzed here treat both adult women (married and
unmarried), offering sensitization/...
Out-of-pocket payments for health are considered a major limitation to universal health coverage (UHC). Policymakers across the globe are committed to achieving UHC through the removal of financial barriers to health care. In Ghana, a national health insurance scheme was established for this purpose. A unique feature of the scheme is its premium ex...
Efficiency has historically been considered a key mechanism to increase the amount of available revenues to the health sector, enabling countries to expand services and benefits to progress towards universal health coverage (UHC). Country experience indicates, however, that efficiency gains do not automatically translate into greater budget for hea...
Background
Socioeconomic inequality in maternity care is well-evident in many developing countries including Bangladesh, but there is a paucity of research to examine the determinants of inequality and the changes in the factors of inequality over time. This study examines the factors accounting for the levels of and changes in wealth-related inequ...
Background:
Out of pocket payments for health is considered a major limitation to universal health coverage. Policymakers across the globe are committed to achieving UHC through the removal of financial barriers to health care. In Ghana, a national and public-funded health insurance scheme was established for this purpose. A unique feature of the...
With the onset of the COVID-19 pandemic, many developing countries faced a twin-challenge; the coronavirus and a health system that is grossly underfunded. The needed infrastructure to effectively respond to the pandemic was absent in many developing countries. This has resulted in policy makers resorting to various strategies to mobilize sufficien...
In Ghana, the ageing population is growing at a fast pace amidst challenging socioeconomic environment. As such, the health of elderly persons in Ghana is of emerging concern and of high priority to the Government. In this study, we seek to measure health inequality among elderly persons in Ghana to determine its existence and explore the factors d...
High-performing primary health care (PHC) is essential for achieving universal health coverage. However, in many countries, PHC is weak and unable to deliver on its potential. Improvement is often limited by a lack of actionable data to inform policies and set priorities. To address this gap, the Primary Health Care Performance Initiative (PHCPI) w...
Background
Reproductive, maternal, neonatal and child health (RMNCH) remains an important public health objective. In sub-Saharan Africa (SSA), inadequate financial commitment continues to pose a major challenge to improving RMNCH outcomes. Understanding financing gains and potential fiscal space for RMNCH can therefore not be overemphasized.
Obje...
Background:
Continuing population growth could be detrimental for social and economic wellbeing. Understanding the factors that influence family planning decisions will be important for policy. This paper examines the effect of childhood mortality and women's bargaining power on family planning decisions.
Methods:
Data was from the 2014 Ghana De...
Background:
Improving maternal and child health remains a public health priority in Ghana. Despite efforts made towards universal coverage, there are still challenges with access to and utilization of maternal health care. This study examined socioeconomic inequalities in maternal health care utilization related to pregnancy and identified factors...
The linkages between international trade integration and economic performance has received significant attention from both policy makers and researchers. There seem to be consensus in the literature to suggest that improved trade openness corresponds to improved economic growth. A missing link in the literature is how trade openness affects specifi...
Smallholder farmers in sub-Sahara Africa and other developing regions face a number of constraints that include low and uncertain prices, nonavailability of markets for their produce, which make them highly vulnerable. Using data from the Ghana World Food Programme's Purchase for Progress (P4P) Farmer Livelihoods and Agriculture Production surveys,...
Purpose
Understanding the linkages between poverty and inequality is vital to any sustainable development and poverty reduction strategies. In Ghana, while poverty has reduced significantly over the years, inequality has increased. The purpose of this paper is to examine the linkages between inequality in household expenditure components and overa...
In recent years, economic development discourse has moved beyond increasing economic growth to ensuring that growth also leads to reduction in poverty and inequality. This motivates the current study to examine the relationship between economic growth and poverty in Benin. We used data from the 2006 and 2011 Benin Demographic and Health Surveys and...
Purpose
The purpose of this paper is to decompose income inequality across various household income components and to estimate the marginal effects of changes in each of the income components on overall income inequality in Ghana.
Design/methodology/approach
Data were collected from the fifth and sixth rounds of the Ghana Living Standards Survey...
Background
Health centers in Ghana play an important role in health care delivery especially in deprived communities. They usually serve as the first line of service and meet basic health care needs. Unfortunately, these facilities are faced with inadequate resources. While health policy makers seek to increase resources committed to primary health...
The study argues that potential savings from efficiency could be effective alternative to increasing health system financing in SSA. Health system efficiency estimates were derived from the Data Envelopment Analysis (DEA) and Stochastic Frontier Analysis (SFA) and used to compute potential gains from efficiency. Data was sourced from the World Bank...
Background:
Malnutrition is a prevalent public health concern in Ghana. While studies have identified factors that influence child malnutrition and related inequalities in Ghana, very little efforts have been made to decompose these inequalities across various household characteristics. This study examined the influence of socioeconomic factors on...
The study sought to decompose income inequality across various household income components and to estimate the marginal effects of changes in income components on overall income inequality in Ghana. A Gini decomposition procedure was applied to the fifth and sixth rounds of the Ghana Living Standards Surveys. The results suggest that, in general, i...
The study examined the linkages between inequality in household expenditure components and total inequality and poverty in Ghana. Using micro data from the sixth round of the Ghana Living Standards Survey conducted in 2012/2013, marginal effects and elasticities were computed for both within-and between-component analysis. The results suggest that,...
Sub-Saharan African countries face significant health challenges, with several countries still far from reaching the health-related targets of the Millennium Development Goals (MDGs). The implication of this on economic growth and individual welfare is daunting. An important channel through which population health affects economic performance is la...
The purpose of the current study was to estimate efficiency of health systems in sub-Sahara Africa (SSA) and to compare efficiency estimates from various time-varying frontier models. The study used data for 45 countries in SSA from 2005 to 2011 sourced from the Word Bank World Development Indicators. Parametric time-varying stochastic frontier mod...