title: A qualitative appraisal of stakeholder reactions to a tool for burden of disease-based health system budgeting in Ghana.
abstract: BACKGROUND
  In 2010, the Ghana Health Service launched a program of cooperation with the Tanzania Ministry of Health and Social Welfare that was designed to adapt Tanzania's PLANREP budgeting and reporting tool to Ghana's primary health care program. The product of this collaboration is a system of budgeting, data visualization, and reporting that is known as the District Health Planning and Reporting Tool (DiHPART).
  
  
  OBJECTIVE
  This study was conducted to evaluate the design and implementation processes (technical, procedures, feedback, maintenance, and monitoring) of the DiHPART tool in northern Ghana.
  
  
  METHODS
  This paper reports on a qualitative appraisal of user reactions to the DiHPART system and implications of pilot experience for national scale-up. A total of 20 health officials responsible for financial planning operations were drawn from the national, regional, and district levels of the health system and interviewed in open-ended discussions about their reactions to DiHPART and suggestions for systems development.
  
  
  RESULTS
  The findings show that technical shortcomings merit correction before scale-up can proceed. The review makes note of features of the software system that could be developed, based on experience gained from the pilot. Changes in the national system of financial reporting and budgeting complicate DiHPART utilization. This attests to the importance of pursuing a software application framework that anticipates the need for automated software generation.
  
  
  CONCLUSIONS
  Despite challenges encountered in the pilot, the results lend support to the notion that evidence-based budgeting merits development and implementation in Ghana.
authors.affiliation: Regional Health Directorate, Ghana Health Service PMB, Bolgatanga, Ghana.|Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, Basel, Switzerland.|Faculty of Sciences, University of Basel, Basel, Switzerland; kawoonor@gmail.com.
authors.forename: John Koku
authors.initials: JK
authors.lastname: Awoonor-Williams
authors.affiliation: Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Schmitt
authors.affiliation: Regional Health Directorate, Ghana Health Service PMB, Bolgatanga, Ghana.
authors.forename: Janet
authors.initials: J
authors.lastname: Tiah
authors.affiliation: Regional Health Directorate, Ghana Health Service PMB, Bolgatanga, Ghana.
authors.forename: Joyce
authors.initials: J
authors.lastname: Ndago
authors.affiliation: Regional Health Directorate, Ghana Health Service PMB, Bolgatanga, Ghana.
authors.forename: Rofina
authors.initials: R
authors.lastname: Asuru
authors.affiliation: Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Ayaga A
authors.initials: AA
authors.lastname: Bawah
authors.affiliation: Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: James F
authors.initials: JF
authors.lastname: Phillips
mesh_terms: D002017:Budgets; D003141:Communicable Diseases; D005376:Financial Management / Q000379:methods*; D005869:Ghana; D006078:Government Programs; D006285:Health Planning; D006801:Humans; D012984:Software; D012985:Software Design
keywords: Ghana; budgeting; burden of disease; evidence-based planning; health systems; qualitative appraisal