Philanthropic and corporate models of hospital governance in Ghana: A comparative study

Private hospitals are a key component of the healthcare delivery system of many countries, and hospital boards play an important role in the governance of these hospitals. In Ghana, the main healthcare providers in the private sector are the mission-based providers, which consist of the Christian and Muslim hospitals and the private medical and dental practitioners. This study examined the healthcare governance of private hospitals in Ghana by the use of questionnaire and interviews with top management of the hospitals. Specifically, we compared the governance structures of not-for-profit (mission-based) and private-for-profit hospitals. The ownership type of the hospital has implications for the form of governance system adopted by the hospital. The results indicate that, all the not-for-profit or mission-based hospitals sampled have a board and majority of the for-profit or private hospitals have a hospital board in place. Also, mission-based hospitals have a significantly higher proportion of non-executive directors represented on the board than private hospitals. Private hospitals were seen to have a higher percentage of medical staff on the board than not-for-profit or mission hospitals. However, both forms of hospital have medical staff represented on their boards. With respect to board leadership structure, the results indicate that less than half of all mission hospitals have the CEO also doubling as the board chair. In the case of for-profit or private hospitals, however, the majority of them have their CEO also serving as the board chair. Interestingly, even though the results indicates that both forms of hospital have female representation on their board, board diversity or percentage of females on the hospital board is less than half. Also, the results indicate that while the boards of private-for-profit hospitals meet more frequently, the boards of not-for-profit hospitals fall short of the required number of meetings. The findings of this study have implications for the efficient governance of hospitals in Ghana.