The health of a nation is the bedrock of its development. No country can prosper without a well-functioning, accessible, and equitable health system.
Yet in Ghana, despite pockets of progress and significant efforts by health professionals, our health system is under severe strain.
The challenges we face today demand not just attention but urgent, coordinated action from policymakers, practitioners, and the public alike.
State of the Health System: A Mixed Diagnosis
Over the years, Ghana has taken important strides to improve health delivery. The National Health Insurance Scheme (NHIS), launched in 2003, was a bold move to ensure financial access to healthcare.
Expanded immunisation programmes and maternal health interventions have helped reduce child mortality and improve overall life expectancy. Infrastructure improvements, such as the establishment of regional and district hospitals, have brought healthcare closer to communities.
Yet, these efforts are being undermined by a mix of systemic problems:
- Underfunding: Ghana spends less than 5% of its GDP on health, far below the 15% Abuja Declaration benchmark. This limits our ability to equip hospitals, retain skilled personnel, and expand critical services.
- Human Resource Shortages: The country faces a brain drain of medical professionals. Trained doctors, nurses, and specialists continue to migrate in search of better conditions, leaving huge gaps especially in rural and underserved areas.
- Inequities in Access: Rural and remote communities remain marginalised. While urban areas boast better-equipped hospitals, many rural clinics lack even basic medications or qualified staff.
- Poor Infrastructure and Maintenance: Many facilities are deteriorating due to neglect, poor maintenance culture, and delayed funding. Patients are often forced to travel long distances to access specialist care or essential diagnostics.
- Bureaucracy and Weak Governance: Inefficiencies in procurement, project execution, and health governance have led to waste, corruption, and duplication of efforts. Political interference continues to weaken institutional integrity.
The Consequences: Lives at Risk
These systemic failures have real consequences. Delays in treatment, inadequate emergency services, and shortages of drugs and equipment often lead to preventable deaths.
Chronic diseases like hypertension, diabetes, and cancer are on the rise, but our health system remains ill-equipped to manage these non-communicable diseases (NCDs) effectively.
Mental health remains woefully neglected, despite the increasing incidence of depression, anxiety, and substance abuse, particularly among the youth. The few psychiatric hospitals we have are under-resourced, and mental illness is still heavily stigmatised.
The COVID-19 pandemic briefly exposed both the resilience and fragility of Ghana’s health system. While frontliners rose heroically to the occasion, the pandemic also highlighted shortages in personal protective equipment (PPE), testing capacity, and intensive care infrastructure.
A Vision for Transformation: What Must Be Done
To reverse these trends and create a health system worthy of our aspirations as a middle-income country, we must adopt a radical but realistic approach.
Increase Public Investment in Health
Health must be prioritised in national budgeting. The government should aim to meet or exceed the 15% Abuja target, while ensuring funds are used transparently and efficiently. Innovative financing mechanisms—such as health bonds or diaspora health funds—should be explored.
Strengthen the NHIS
While the NHIS remains a critical pillar of our health strategy, it is plagued by delays in claims payment, limited coverage, and rising dissatisfaction among service providers. The scheme needs urgent reform to expand coverage, eliminate inefficiencies, and ensure financial sustainability.
Develop and Retain Health Workers
We must invest in the training, motivation, and retention of health professionals. This includes improving pay and working conditions, expanding postgraduate training opportunities, and creating clear career progression pathways. Rural posting incentives must be real and attractive.
Invest in Infrastructure and Technology
Modern healthcare requires modern tools. We need to complete stalled hospital projects, equip existing facilities with essential technology, and adopt electronic health records to improve data management and continuity of care.
Decentralise and Empower Local Health Systems
Greater autonomy should be given to regional and district health directorates to manage resources, recruit staff, and address local health challenges. A “one-size-fits-all” approach from Accra will never be sufficient to meet diverse community needs.
Address Preventive Health and Health Education
We must shift from a cure-oriented to a prevention-focused system. Community-based health promotion, especially through schools, churches, and media, can raise awareness about hygiene, nutrition, physical activity, and the dangers of self-medication. Traditional healers should also be engaged in community health education.
Mental Health Must Not Be an Afterthought
We need to destigmatise mental illness and integrate mental health services into primary healthcare. The Mental Health Authority must be adequately funded and empowered to carry out its mandate. School-based counselors and community mental health officers must be trained and deployed nationwide.
Engage Civil Society and the Private Sector
Improving health is a national effort. Faith-based organizations, NGOs, and private providers should be involved in decision-making, service delivery, and accountability. Public-private partnerships (PPPs) can bring innovation and efficiency, particularly in areas like diagnostics, pharmaceuticals, and logistics.
Conclusion: Let Us Not Wait for a Crisis
Healthcare is not a privilege—it is a right. Ghana has the talent, the policy frameworks, and the social capital to build a health system that works for all. What we need now is the political will, strategic vision, and collective commitment to act.
We cannot afford to wait for another pandemic or a tragedy to jolt us into action. Every Ghanaian deserves quality healthcare—from the newborn in Bolgatanga to the elderly woman in Apam. Let us rise to the occasion and give life to the promise of a healthy, resilient, and inclusive Ghana.
Call to Action
As citizens, let us hold our leaders accountable. Let us support our health workers, report corruption, and participate in health advocacy. For the sake of our children, our communities, and our future, we must build a health system that we can all be proud of.
