世界银行-加纳社会保护计划支出和家庭福利（英）-2023.4-152页_6mb

Summary of "Social Protection Program Spending and Household Welfare in Ghana" by Raju, Younger, and Dadzie (April 2023)

Introduction

The study evaluates Ghana's main social protection programs, including social assistance (Livelihood Empowerment Against Poverty - LEAP program, Labor-Intensive Public Works - LIPW program, Ghana School Feeding Programme - GSFP) and social insurance (Social Security and National Insurance Trust - SSNIT pensions, National Health Insurance Scheme - NHIS). The aim is to analyze spending patterns, program effectiveness, coverage rates, and incidence.

1. Government Spending

• Social protection programs receive low government funding.
• Social assistance spending is particularly low, averaging about 0.2% of GDP (equivalent to approximately 1.4% of overall government spending), significantly below international averages.
• Social insurance programs receive higher funding, accounting for around 1.3-1.5% of GDP in total spending.
• The total social protection budget has grown steadily, but it remains insufficient relative to GDP and public expenditure.

2. Program Effectiveness

• Despite strong targeting in many cases, the overall effects of social assistance programs on poverty and inequality are modest due to limited funding and benefit levels.
• Effective targeting is noted for most programs, with the LEAP program demonstrating high concentration among the poor.
• Benefit levels are low compared to consumption and poverty lines. In 2017, the average benefit represented around 15% of total household consumption for LEAP beneficiaries.
• The NHIS is less effective due to low coverage and slow reimbursement to providers, undermining its universal health insurance objectives.

3. Challenges and Limitations

• Funding and Benefici : Benefit values have declined significantly due to inflation, and frequent adjustment cycles are irregular.
• Targeting Geographical Expansion : Programs lose effectiveness when expanding nationally due to dilution of targeted areas.
• High Arrears Issue : The government frequently fails to pay for services and benefits due to fiscal constraints, causing delays that impact program effectiveness.
• Limited Universal Coverage : Programs like NHIS do not achieve their target coverage due to enrollment barriers, although targeting is strong for social assistance programs.

4. Recommendations

• Increase budget allocation to social assistance programs to expand coverage and raise benefit levels.
• Resolve arrears problems to ensure timely delivery of social protection benefits.
• Prioritize preserving cash transfer program effectiveness through regular adjustments for inflation.
• Address climate-related vulnerabilities in program design through better geographical targeting.

Conclusion

While Ghana has made commendable efforts in social protection design and implementation, fiscal constraints and management challenges limit the effectiveness and reach of these programs. Income transfers have limited impact against poverty due to scale, benefit value, and delivery challenges. A balanced approach addressing both program design and fiscal sustainability is necessary to strengthen social protection systems.