Prof Ama Pokuaa Fenny

Dr. Ama Pokuaa Fenny
Associate Professor and Head, Economics Division

Prof. Ama Pokuaa Fenny is an associate professor with the Institute of Statistical, Social and Economics Research (ISSER) at the University of Ghana. She is a health economist whose research focuses on the evaluation of health and development programs in low- and middle-income country settings. In these settings, she studies the role of health financing strategies in offering social protection to vulnerable groups, targeted health system strategies to improve health seeking behavior and costing and cost-effectiveness methods that address efficiency of health programmes. Her current research focuses on the evaluation of child and adolescent health interventions and the integration of governmental policies into service delivery systems in Africa. At ISSER, Dr. Fenny provides leadership and oversight to projects involving research, project implementation, technical assistance and policy advocacy across a range of subjects.

She has several years of practical experience; lending her technical expertise to the Ministry of Health in Ghana and several other national and international agencies. She has also carried out a number of costing, expenditure tracking surveys and health expenditure reviews with country experience across West and East Africa (Gambia, Liberia, Eriteria, Mozambique among others). In 2016, she was accepted as a West Africa Global Health Leaders Fellow, with the Centre on Global Health Security, Chatham House. Her research with the centre focused on how the poor could be integrated into social health insurance programs in Sub Saharan African countries. Subsequently, she has been engaged actively in the development of strategies to improve health systems performance and governance to achieve Universal Health Coverage (UHC) in Ghana. In 2020, she served as a member of the Africa Health Agenda International Conference (AHAIC) Commission which was responsible for creating a comprehensive report on the State of UHC in Africa. She has a PhD in Health Economics from the Department of Public Health, Aarhus University, Denmark and an MSc in Health, Population & Society from the London School of Economics & Political Science (UK).

apfenny@ug.edu.gh
  • Health systems and policy research
  • Health financing and expenditures
  • Quality of care assessments 
  1. Otieku, E., Lindholm Kurtzhals, J. A., Fenny, A. P., Ofori, A. O., Labi, A.-K., & Enemark, U. (2024). Healthcare provider cost of antimicrobial resistance in two teaching hospitals in Ghana. Health Policy and Planning, 39(2), 178–187. https://doi.org/10.1093/heapol/czad114
  2. Otieku, E., Fenny, A.P., Labi, AK. Ofori A.O., Kurtzhals J.A.L., & Enemark U. (2023) Attributable Patient Cost of Antimicrobial Resistance: A Prospective Parallel Cohort Study in Two Public Teaching Hospitals in Ghana. PharmacoEconomics Open. https://doi.org/10.1007/s41669-022-00385-9
  3. Otieku E, Fenny AP, Labi A, Ofori A.O., Kurtzhals J.A.L., & Enemark U.(2023) Knowledge, attitudes and practices regarding antimicrobial use and resistance among healthcare seekers in two tertiary hospitals in Ghana: a quasi-experimental study BMJ Open 2023;13:e065233. doi: 10.1136/bmjopen-2022-065233
  4. Hollingworth, S.A., Leaupepe, G.A., Nonvignon, J., Fenny A.P., Odame E.A., Ruiz F.(2023) Economic evaluations of non-communicable diseases conducted in Sub-Saharan Africa: a critical review of data sources. Cost Effectiveness and Resource Allocation 21, 57.  https://doi.org/10.1186/s12962-023-00471
  5. Appiah-Korang Labi, Noah Obeng-Nkrumah, Nicholas T K D Dayie, Ben Molai Addo, Mary-Magdalene Osei, Ama Fenny, Beverly Egyir, James Edward Mensah (2022), Occurrence and significance of fluoroquinolone-resistant and ESBL-producing Escherichia coli and Klebsiella pneumoniae complex of the rectal flora in Ghanaian patients undergoing prostate biopsy, JAC-Antimicrobial Resistance, Volume 4, Issue 6, dlac113, https://doi.org/10.1093/jacamr/dlac113
  6. Omenako, K.A.; Enimil, A.; Marfo, A.F.A.; Timire, C.; Chinnakali, P.; Fenny, A.P.; Jeyashree, K.; Buabeng, K.O. (2022) Pattern of Antimicrobial Susceptibility and Antimicrobial Treatment of Neonates Admitted with Suspected Sepsis in a Teaching Hospital in Ghana, 2021. Int. J. Environ. Res. Public Health, 19, 12968. https://doi.org/10.3390/ ijerph191912968
  7. Osei MM, Dayie NTKD, Azaglo GSK, Tettey EY, Nartey ET, Fenny AP, Manzi M, Kumar AMV, Labi AK, Opintan JA, Sampane-Donkor E. (2022)  Alarming Levels of Multidrug Resistance in Aerobic Gram-Negative Bacilli Isolated from the Nasopharynx of Healthy Under-Five Children in Accra, Ghana. Int J Environ Res Public Health. 19(17):10927. doi: 10.3390/ijerph191710927. PMID: 36078645.
  8. Tetteh FKM, Fatchu R, Ackah K, Philips TJ, Shewade HD, Fenny AP, Timire C, Edwards JK, Parbie EA. (2022) Sepsis among Neonates in a Ghanaian Tertiary Military Hospital: Culture Results and Turnaround Times. International Journal of Environmental Research and Public Health. 19(18):11659. https://doi.org/10.3390/ijerph191811659
  9. Fenny AP, Otieku E, Labi KA, Asante FA, Enemark U. (2022) Cost-Effectiveness Analysis of Alcohol Handrub for The Prevention of Neonatal Bloodstream Infections: Evidence from HAI-Ghana Study PLOS One 17(3): e0264905. https://doi.org/10.1371/journal.pone.0264905
  10. Otieku, E., Fenny, A. P., Asante, F. A., Bediako-Bowan, A., & Enemark, U. (2022). Cost-effectiveness analysis of an active 30-day surgical site infection surveillance at a tertiary hospital in Ghana: evidence from HAI-Ghana study. BMJ Open, 12(1), e057468. https://doi.org/10.1136/bmjopen-2021-057468
  11. Hollingworth, S., Fenny, A.P., Yu, SY. et al. Health technology assessment in sub-Saharan Africa: a descriptive analysis and narrative synthesis. Cost Eff Resour Alloc 19, 39 (2021). http://sci-hub.tw/10.1186/s12962-021-00293-5
  12. E Otieku, A P Fenny, A-K Labi, U Enemark Incidence of preterm births in a referral teaching hospital in Ghana: What is the role of maternal age, parity, gravidity, and stress during pregnancy? South African Journal of Child Health 2021;15(3):155-158. doi:10.7196/SAJCH. 2021.v15i3.01777
  13. Asuman D., Fenny A.P, Odame D.N.A, (2021) Trends and antecedents of inequalities in maternal healthcare coverage in four African countries, Journal of International Development, DOI: 10.1002/jid.3534
  14. Ama P. Fenny, Robert Yates & Rachel Thompson (2021) Strategies for financing social health insurance schemes for providing universal health care: a comparative analysis of five countries, Global Health Action, 14:1, DOI: 10.1080/16549716.2020.1868054
  15. Fenny, A.P., Otieku, E., Labi, K.A. et al. (2021) Costs and Extra Length of Stay because of Neonatal Bloodstream Infection at a Teaching Hospital in Ghana. PharmacoEconomics - Open, 5(1), 111-120. Available from: URL: https://doi.org /10.1007/s41669-020-00230-x
  16. Fenny AP, Otieku E, Akufo C, Obeng-Nkrumah N, Asante FA, Enemark U. (2020) The Financial Impact of Puerperal Infections On Patients, Carers and Public Hospitals in Two Regions in Ghana. International Journal of Gynecology & Obstetrics (IF 2.216) Pub Date: 2020-12-04, DOI: 10.1002/ijgo.13509
  17. Jimah, T., A. P. Fenny, and O.A. Ogunseitan. (2020) Antibiotics stewardship in Ghana: a cross-sectional study of public knowledge, attitudes, and practices among communities. One Health Outlook. In Press.
  18. Fenny A.P., Asante FA, Otieku E, Bediako-Bowan A, Enemark U (2020), Attributable Cost and Extra Length of Stay of Surgical Site Infection at a Ghanaian Teaching Hospital, Infection Prevention in Practice, https://doi.org/10.1016/j.infpip.2020.100045
  19. Crentsil A.O., Asuman D., Fenny A.P, (2019) " Assessing the determinants and drivers of multidimensional energy poverty in Ghana", Energy Policy, Volume 133, October 2019, 110884, https://doi.org/10.1016/j.enpol.2019.110884
  20. Asuman D., Ackah, C.G., Fenny, A.P. F. Agyire-Tettey (2019) “Assessing socioeconomic inequalities in the reduction of child stunting in sub-Saharan Africa”.  Journal of Public Health (Berl.) https://doi.org/ 10.1007/s10389-019-01068-2.
  21. Alvarado G, Fenny A. P, Dakey S, Mueller J. L, O'Brien-Milne L, Crentsil O. A, Duvvury N, Scriver S, Schwenke C, (2018) "The health-related impacts and costs of violence against women and girls on survivors, households and communities in Ghana”. Journal of Public Health in Africa. 9(860), https://doi.org/10.4081/jphia.2018.860
  22. Fenny A.P, Asuman D., Crentsil A.O., Odame D.N.A, (2018) "Trends and causes of socioeconomic inequalities in maternal healthcare in Ghana, 2003–2014", International Journal of Social Economics, https://doi.org/10.1108/IJSE-03-2018-0148
  23. Kusi A., Fenny A.P., Arhinful D.K., Asante A.F., Parmar D., (2018) "Determinants of enrolment in the NHIS for women in Ghana – a cross sectional study", International Journal of Social Economics, Vol. 45 Issue: 9, pp.1318-1334, https://doi.org/10.1108/IJSE-10-2016-0291
  24. Fenny, A. P., Yates, R., & Thompson, R. (2018). Social health insurance schemes in Africa leave out the poor. International Health. doi:10.1093/inthealth/ihx046
  25. Fenny, A., Crentsil, A., & Ackah, C. (2017). The health MDGs in Ghana: lessons and implications for the implementation of the sustainable development goals. Journal of Public Health, 26(2), 225-234. http://dx.doi.org/10.1007/s10389-017-0854-8
  26. Fenny, A. P., Crentsil A.O., & Asuman D. (2017). Determinants and Distribution of Comprehensive HIV/AIDS Knowledge in Ghana. Global Journal of Health Science, 9(12). doi.org/10.5539/gjhs. v9n12p32
  27. Dushie D., Fenny, A.P. & Crentsil, A.O. (2017) Vehicular Emissions and Its Implications on the Health of Traders: A Case Study of Traders in La Nkwantanang Municipality in Ghana. Journal of Sustainable Development; 10(6) doi.org/ 1913-9063
  28. Fenny, A. P. (2017). Ghana’s Path to an Industrial–Led Growth: The Role of Decentralisation Policies. International Journal of Economics and Finance, 9(11). doi.org/10.5539/ijef. v9n11p22
  29. Fenny, A.P., 2017, ‘Live to 70 Years and Over or Suffer in Silence: Understanding Health Insurance Status Among the Elderly Under the NHIS in Ghana’, Journal of Aging & Social Policy Vol. 29, Iss. 4, 352-370 DOI: 10.1080/08959420.2017.1328919
  30. Fenny, A.P., Kusi, A, Arhinful, D.K & Asante, F.A. 2016, ‘Factors contributing to low uptake and renewal of health insurance: a qualitative study in Ghana’, Global Health Research and Policy, 2016, DOI: 10.1186/s41256-016-0018-3 F
  31. Fenny, A.P., Asante, F.A., Arhinful, D.K., Kusi, A., Parmar, and Williams, G. 2016, ‘Who uses outpatient healthcare services under Ghana’s health protection scheme and why?’ BMC Health Services Research, 16: 174 DOI: 10.1186/s12913-016-1429-z
  32. Fenny, AP, Asante, FA, Enemark, U & Hansen, KS 2015, ‘Malaria care seeking behavior of individuals in Ghana under the NHIS: Are we back to the use of informal care?’ BMC Public Health 2015, 15:370 
  33. Fenny, AP, Asante, FA, Enemark, U & Hansen, KS  2015, Treatment-seeking Behaviour and Social Health Insurance in Africa: The Case of Ghana under the National Health Insurance Scheme' Global Journal of Health Science, Vol 7 (1)
  34. Fenny, AP, Hansen, KS, Enemark, U & Asante, FA  2014, ‘Quality of Uncomplicated Malaria Case Management in Ghana among Insured and Uninsured’ International Journal for Equity in Health, 13:63
  35. Fenny, AP, Hansen, KS, Asante, FA & Enemark, U 2014, 'Patient Satisfaction with Primary Health Care – A Comparison between the insured and non-insured under the National Health Insurance Policy in Ghana' Global Journal of Health Science, Vol 6(4)

 

 

 

 

 

 

 

 

Adolescent Mental, Sexual and Reproductive Health and Wellbeing Policy, Program and Primary Care Implementation Priorities in West Africa

Aim: The general objective of this study is to describe the what and analyze the how and why of adolescent wellbeing policy and program priorities in countries in West Africa, mental, sexual and reproductive health services availability at primary health care level; the mechanisms by which these services are funded and assess the effectiveness, and technical efficiencies of available primary health centers (public and or private) in providing adolescents’ mental, sexual and reproductive health services.   The countries selected are Ghana, Niger and Burkina Faso with the research consortium spanning across country teams and Universities in the UK and Canada.

Position: Co-Principal Investigator

Duration: (2021 - 2024)

Funding Agency: Medical Research Council (MRC), UK

Implementing smartphone app technology for screening jaundiced newborns at the Korle-Bu Teaching Hospital

About 60% of all newborn infants will develop neonatal jaundice in the first week after birth. In most newborns, jaundice is physiological and clears spontaneously over the first few days, but a significant proportion will require treatment to avoid a persistently high level of bilirubin (hyperbilirubinaemia). Severe hyperbiliribinaemia may lead to brain damage (kernicterus), death and lifelong impairment. It is the most significant and preventable risk factor for cerebral palsy in Ghana. These complications of hyperbiliribinaemia are largely preventable with effective screening to achieve timely diagnosis and treatment. Subjective visual inspection of the eye and skin is the standard screening process in low-resource countries, but it is confounded by skin pigmentation and ambient light, and is particularly difficult for untrained individuals such as community health workers and parents. High-income countries recommend against relying solely on visual identification for diagnosis of neonatal jaundice. Available screening methods are expensive, invasive, and not usually accessible at the point of care in low-resource settings. Affordable, portable and reliable tools for screening newborns for jaundice are needed to tackle the burden of death and disability from neonatal jaundice.

The overall aim of the project is to develop a smartphone app for screening jaundiced newborns. The specific objectives of this study are to systematically assess the implementation of the smartphone app into routine clinical practice at the postnatal ward of Korle Bu Teaching Hospital and to evaluate the cost-effectiveness of the smartphone app screening tool in clinical practice.

Duration: (2020 - 2021)

Position: Co-Principal Investigator

Fiscal and Public Health Impact of a Change in Tobacco Excise Taxes in Ghana

In Ghana, more than 5,000 people are killed by tobacco-caused diseases every year (Tobacco Atlas, 2018). Currently, the country’s tax administration approach is unitary with a uniform ad valorem tax structure on all excisable products including tobacco. However, the ECOWAS directive on tobacco control in line with the WHO Framework Convention on Tobacco Control (WHO FCTC), recommends a simple tax structure using a mixed excise system with a minimum specific tax floor, to overcome the large limitations of the ad valorem system on tobacco products especially cigarettes. The study therefore simulates mixed tax policy interventions and assesses its effect on government revenue and public health relative to the current ad valorem tax system. The study provided evidence-based analysis of tobacco taxation in Ghana. The main research theme addressed best practices in tobacco taxation centering on the impact of tobacco tax increases on the retail price of tobacco products, tobacco consumption and government tax revenue.

Duration: (2019-2020)

Position: Principal Investigator

Costing of Healthcare Associated Infections (HCAI) and Cost-Effectiveness of HCAI Control Interventions in Ghana

Healthcare associated infections (HCAIs) pose a constant threat not only to patients, their families and healthcare systems but also to society as a whole. Apart from contributing to increased mortality they add substantially to hospital costs. Very few studies estimate the excess cost of HCAI in developing countries with the majority of these studies found in Latin America. To date, there has been no costing of HCAIs in Ghana. The costing study which is part of larger HCAI study will be conducted in three phases with two stages of data collection within each phase. Phase 1 will involve the costing of Surgical Site Infections (SSI) and interventions. Phase 2 will involve the costing of neonatal sepsis and interventions, while Phase 3 will involve the costing of puerperal sepsis and interventions. In each of these phases, two sets of data collection exercises will be undertaken; one at the baseline and then an endline survey after the intervention has taken place. The aim of this study is to measure the direct, indirect and opportunity costs associated with HCAIs and HCAI control interventions in Ghana. These infections include Surgical site infections, neonatal and puerperal sepsis.

Duration: (2016 - 2021)

Position: Principal Investigator