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Health Care, Citizenship, and Policy Intervention in Ghana: An Agenda for Change

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Title: Health Care, Citizenship, and Policy Intervention in Ghana: An Agenda for Change
Author: Agyei, Ebenezer Bossman
Department: Department of Political Science
Program: Political Science
Advisor: Johnson, Candace
Abstract: Recent research shows a growing interest in young people’s health. Yet there is relatively little empirical research on programs and health interventions for young people, particularly in developing countries. The present study contributes to filling this knowledge gap. Specifically, this dissertation comparatively examines Ghana’s prior Adolescent Health and Development Programme (ADHD), and a more recent health initiative – the Ghana Adolescent Reproductive Health Programme (GHARH). Situating the study within the broader context of new global paradigms – that is, the Sustainable Development Goals (SDGs), the Global Strategy, and the Global Accelerated Action for the Health of Adolescents (AA-HA!) – this research examines the impact of policy framing on citizenship and development outcomes for young people. In light of the research objectives, this dissertation contributes broadly to the literature on health, citizenship, youth studies, globalization, and development studies. The study employs a qualitative case study method, which involves extensive document analysis, elite interviews, and focus group discussions. The study involved sixty participants, and was conducted over a period of six months in Ghana in 2017. Overall, three key findings emerge from the study. First, policy frames might or might not hold any potential for inclusive citizenship and change in health outcomes; contextual and institutional factors must be taken into careful account. Importantly, the analysis highlights how initiatives for young people’s health are shaped by the complex and dynamic interaction of the micro and macro political environment. In line with this understanding, the study establishes five key factors that shape adolescent and youth health outcomes: policy frames, political structure, economic framework, cultural discourse, and policy framework. Second, adolescent health programming must be understood within the broader context of participatory governance. As the analysis suggests, engaging young people in program interventions could potentially foster better policy outcomes. Third, health, as a social right of citizenship, is not a policy domain of state monopoly. Through collective action strategies, young people can reconfigure state-society relationship in ways that position them to better make claims on the state regarding their citizenship entitlements. As such, the substance of citizenship will likely be a function of both contestation and state-activated access.
Date: 2019-01-15
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