Ghana

Ghana’s healthcare system is primarily financed through government tax revenues, NHIS contributions, out-of-pocket (OOP) payments, and donor support. The government allocates around 7% of GDP to health, with a portion dedicated to NCD services. To strengthen domestic financing, Ghana has implemented taxes on tobacco, alcohol, and sugar-sweetened beverages—both to raise revenue and encourage health-promoting behaviors.

Despite these measures, enforcement gaps and collection inefficiencies limit their full potential. The NHIS remains central to financial protection, though gaps persist in coverage for essential NCD medicines and advanced care. The government is exploring ways to expand NHIS benefits for NCD care, increase provider reimbursement rates, and reduce OOP costs. While external funding remains limited for NCDs, there is growing momentum toward innovative domestic financing, including public–private partnerships and dedicated budget allocations.

Established in 2003, the NHIS is Ghana’s main risk-pooling mechanism—covering about 40% of the population and financed through the 2.5% value-added tax (VAT) levies on goods and services, payroll deductions, and government subsidies. Strong presidential leadership has made NHIS a cornerstone of the national health financing system.

However, challenges remain: delayed reimbursements, limited funding for NCD care, and geographic disparities in access. Community-based health insurance (CBHI) schemes and private health insurance plans provide complementary coverage, though their reach is limited, especially among informal workers and low-income groups.

The creation of the National Medical Care Trust Fund in 2025 has strengthened the pooling landscape. It provides financial support for people living with chronic conditions, covering specialized services such as chemotherapy, dialysis, and cardiovascular care, that are not covered by the NHIS.

Strategic purchasing aims to improve efficiency and accountability in Ghana’s health spending. Centralized procurement by the Ghana Health Service and the National Health Insurance Authority has reduced costs for essential NCD medicines like insulin and antihypertensives, though supply chain issues persist.

The NHIS employs a mix of capitation and fee-for-service models, but delayed reimbursements can discourage timely care for chronic conditions. Results-based financing initiatives are being introduced to reward providers for preventive care, early detection, and treatment adherence. Partnerships with private providers are expanding specialized NCD services, such as cancer and renal care, though affordability continues to challenge equitable access.