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Thanks Cheryl for your comments which I agree. Indeed, the important element to highlight is that the system-wide process in Ghana is country owned and led by the NHIS/MOH team with full participation and active discussion involving different stakeholders. Donor agencies play a supportive role but the decision making and the management of implementation is in the hands of the national team. At the end of the day, ownership is key to ensure the sustainability of the reform process over the medium term.