Ethan Rhodes
Ghana's healthcare system is comprised of both public and private facilities, with approximately 60% of hospitals being publicly-owned and 40% being private. The public healthcare system is largely funded and administered by the government through the Ministry of Health and the Ghana Health Services. The private sector complements the public system, with private clinics and hospitals often having more sophisticated equipment. Ghana's healthcare system has faced challenges, particularly in rural areas where access to healthcare is limited, and traditional healers remain important health providers.
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What You'll Learn
Ghana's healthcare system is 60% public and 40% private
Ghana's healthcare system is comprised of about 60% public facilities and 40% private facilities. The public healthcare system is largely administered by the Ministry of Health and the Ghana Health Services, with the government running 1,625 of these facilities. The Ghana Health Service consists of government (including university) hospitals and clinics, hospitals and clinics within the Christian Health Association of Ghana, and hospitals and clinics run by missions and quasi-government organisations. The Ashanti region has the most health facilities in Ghana, with 530 health facilities, 170 of which are operated by the Ghana Health Service, 71 by missions, 281 by private institutions, and 8 by the Ashanti quasi-government. The Ashanti monarchy operates about 32% of all health facilities in the Ashanti Region.
Healthcare in Ghana is mostly provided by the national government, and less than 5% of GDP is spent on healthcare. Ghana spends on average about 6% of its GDP on healthcare infrastructure. The COVID-19 pandemic exposed large gaps in the health sector, particularly regarding the need for more district-level hospitals. Ghana has very limited local production of pharmaceuticals and medical equipment, relying on imports for approximately 85% of its total healthcare consumption. Private health facilities complement the public sector, and private clinics with sophisticated equipment are springing up in cities with the development of a small but growing middle class.
Ghana's healthcare system has gone through several major periods, pre- and post-colonial. In the pre-colonial period, traditional priests, clerics, and herbalists were the primary caregivers, and the use of traditional healers persists mostly in rural regions of Ghana. After independence in 1957, Kwame Nkrumah pushed health and education policies that aimed to make these services more available and accessible. However, these policies were mainly targeted at urban populations, with 76% of doctors practicing in urban areas while only 23% of the population lived there. Health programs were financed entirely through general taxation, so anyone could receive medical care in any government hospital at no cost.
The post-colonial period marks the beginning of government intervention in healthcare through various policies. These interventions were plagued with inadequate performance and rising costs for consumers, culminating in the implementation of the National Health Insurance Scheme (NHIS). The NHIS currently serves people in both the formal and informal employment sectors and seeks to increase access to healthcare for all Ghanaians. Ghana's 2021 census results report that 68.6% of the population is covered by either the NHIS or private health insurance schemes. There is a higher rate of health insurance coverage for females (72.6%) than males (64.5%).
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The Ghana Health Service runs many public facilities
Ghana's healthcare system is organised into five levels of providers: health posts, health centres and clinics, district hospitals, regional hospitals, and tertiary hospitals. The Ghana Health Service (GHS) is a government body that administers many of these public facilities. In the Ashanti Region, for example, 170 out of 530 health facilities are operated by the GHS, while 71 are run by missions, 281 are private, and 8 are run by the Ashanti quasi-government.
The GHS has made significant advances in healthcare delivery, but there are still challenges and considerations when utilising its system. The COVID-19 pandemic, for instance, exposed gaps in the health sector, particularly regarding the need for more district hospitals and local production of pharmaceuticals and medical equipment. Ghana's healthcare system is also complemented by private facilities, such as the Nyaho Medical Centre, which is one of the leading private healthcare providers in the country.
The smallest unit of healthcare in Ghana's public system is the Community-based Health Planning and Service Compounds (CHPS), which provide basic healthcare. These CHPS compounds are present in most communities, but the nearest health centre or district hospital may be far away, especially in the country's northern regions. This issue is exacerbated by the poor transportation network and high transport costs in rural areas.
To address healthcare accessibility, Ghana introduced the National Health Insurance Scheme (NHIS) in 2003, which provides free access to a range of healthcare services for its members. As of 2021, about 68.6% of Ghana's population is covered by either the NHIS or private health insurance schemes, with a higher rate of coverage among females (72.6%) than males (64.5%). The NHIS primarily covers treatment for prevalent diseases like malaria.
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Private health facilities complement the public sector
Ghana has a universal healthcare system that is largely administered by the Ministry of Health and the Ghana Health Services. The healthcare system is organised at three levels: national, regional, and district. The country spends about 6% of its GDP on healthcare infrastructure. However, the COVID-19 pandemic exposed large gaps in the health sector, including a lack of district-level hospitals and limited local production of pharmaceuticals and medical equipment.
Most healthcare in Ghana is provided by the government, with public hospitals funded by government agencies. However, private health facilities play a significant role in complementing the public sector. Ghana has sought to increase private-sector participation in healthcare, particularly in privately funded hospitals, clinics, and the pharmaceutical sector. This move towards privatisation is driven by a growing middle class that prefers and can afford private health facilities.
In the Ashanti Region, for example, 281 out of 530 health facilities are operated by private institutions, while 170 are run by the Ghana Health Service. Private providers argue that they can improve health equity by serving underserved communities and offering a wider range of services. They also enhance patient choice, promptness in receiving care, and overall satisfaction.
However, there are concerns about the quality of private healthcare in Ghana. Some members have reported poor experiences with private providers, and there are challenges with accreditation, claims, payment delays, and equity in service delivery. Additionally, the private sector's profit motivation can lead to concerns about crowding out cash-paying and insurance-paying clients.
Despite these challenges, private health facilities continue to play a complementary role to the public sector in Ghana, helping to decongest public facilities and increase member choices. The inclusion of private providers in the National Health Insurance Scheme (NHIS) requires critical reflections on strategic purchasing and how private providers will complement public services.
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The Ashanti region has the most health facilities
Ghana has a multi-layered healthcare system, with services provided by the government, private institutions, and non-profits. The country's healthcare system is organised at three levels: national, regional, and district. Ghana spends around 6% of its GDP on healthcare infrastructure. However, the COVID-19 pandemic exposed gaps in the health sector, highlighting the need for more district hospitals and local production of pharmaceuticals and medical equipment.
The Ashanti Region in Ghana has the most health facilities, with around 530 health facilities. Of these, 170 are operated by the Ghana Health Service, 71 by missions, 281 by private institutions, and 8 by the Ashanti quasi-government. The Ashanti monarchy operates approximately 32% of all health facilities in the region. The Ashanti capital, Kumasi, has the highest concentration of health facilities in the region, at 38%. The Komfo Anokye Teaching Hospital in Kumasi is the largest hospital in the Ashanti Region.
The Ashanti Region is the most populous region in Ghana, with around one-sixth of the country's total population, according to the 2021 census. The region has a population of about 5.4 million people, with the majority belonging to the Akan ethnic group. Healthcare in the region is managed by the Ashanti Regional Health Directorate (RHD), which oversees 43 smaller district health directorates. There are approximately 1,654 health facilities in the Ashanti Region, including CHPS facilities and health centres.
The National Health Insurance Scheme (NHIS) provides coverage for a limited scope of health issues, primarily insuring treatment for prevalent diseases such as malaria. In 2021, 68.6% of Ghana's population was covered by either the NHIS or private health insurance schemes, with a higher rate of coverage among females (72.6%) than males (64.5%). The Ashanti Region's high number of health facilities contributes significantly to the accessibility of healthcare services in the country.
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Ghana's healthcare spending is less than 5% of GDP
Ghana's healthcare system is a mix of public and private institutions. The government provides most healthcare services, which are administered by the Ministry of Health and the Ghana Health Services. The system is organised at three levels: national, regional, and district. It consists of five types of providers: health posts, health centres and clinics, district hospitals, regional hospitals, and tertiary hospitals. The Ashanti Region, for example, has 530 health facilities, 170 of which are operated by the Ghana Health Service, 71 by missions, 281 by private institutions, and 8 by the Ashanti quasi-government.
Ghana's healthcare spending per capita has fluctuated over the years. In 2018, it was $82.99, which increased by 11.29% to $93.19 in 2019. However, in 2020, it decreased by 6.16% to $87.44. On average, Ghana spends about 6% of its GDP on healthcare infrastructure. This percentage is higher than the less than 5% figure you provided, but it's important to note that the specific numbers may vary based on different calculations and data sources.
The COVID-19 pandemic revealed significant gaps in Ghana's healthcare sector, highlighting the need for more district-level hospitals and increased local production of pharmaceuticals and medical equipment. Ghana relies heavily on imports for its healthcare consumption, with approximately 85% of its healthcare products being imported.
To address the challenges and improve healthcare access and quality, Ghana has implemented the National Health Insurance Scheme (NHIS). According to the 2021 census, 68.6% of the population is covered by either the NHIS or private health insurance schemes. The NHIS primarily covers treatment for prevalent diseases such as malaria. However, there are regional variations in insurance coverage, with the Oti Region having the lowest at 51.9% and the Upper East Region the highest at 86.2%.
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Frequently asked questions
Ghana's healthcare system is comprised of about 60% public facilities and 40% private facilities. The government provides most healthcare, which is administered by the Ministry of Health and the Ghana Health Services. The Ghana Health Service consists of government (including university) hospitals and clinics, hospitals and clinics within the Christian Health Association of Ghana, and hospitals operated by missions.
Healthcare is more accessible in urban areas, where most health resources are concentrated. In rural areas, patients either rely on traditional African medicine or travel great distances for healthcare. The COVID-19 pandemic exposed large gaps in the health sector, particularly regarding the need for more district-level hospitals.
Ghana spends about 6% of its GDP on healthcare infrastructure, with less than 5% spent on healthcare overall. Ghana's healthcare has historically been funded by general taxation, with anyone able to receive medical care in any government hospital at no cost. However, this proved unsustainable for the economy, and by the 1980s, healthcare services were inadequate. The National Health Insurance Scheme (NHIS) was implemented to increase access to healthcare for all Ghanaians. In 2021, 68.6% of the population was covered by either the NHIS or private health insurance schemes.
Ghana faces a scarcity of health resources, including hospitals, doctors, nurses, and other health professionals. Specialist physicians are relatively few, as most acquire their specialty training abroad and remain there. However, the development of a small but growing middle class has led to the emergence of some private clinics with sophisticated equipment.
