Overview

Improving Primary Health Care Efficiency in Ghana

From 2000 to 2018, Ghana improved coverage of key primary health care services nationwide and lowered many of the barriers that prevented Ghanaians from accessing care. The investments Ghana made in its health system increased equity by reducing coverage gaps between Ghana’s poorest and richest population groups. This equitable improvement in service coverage is associated with improvements in population health outcomes.

Authors

Beatrice Amboko Genevieve Cecelia Aryeetey Adjeiwa Akosua Afram Augustina Koduah Jacob Nonvignon Mamothena Mothupi Rose Muthuri Lizah Nyawira Fiammetta Bozzani Dina Balabanova Anna Vassall Edwine Barasa

UHC effective coverage relative to total health expenditure

By improving the availability of funds at the national level and funds flow throughout the system, productivity and planning at the district level, and financial risk protection and the delivery of health services at the community level, Ghana increased the efficiency of its PHC system and boosted population health outcomes.

Primary health care is a whole-of-society approach to effectively organize and strengthen national health systems to bring services for health and wellbeing closer to communities.¹

Researchers estimate that high-quality care via PHC could prevent more than half of excess deaths in low- and middle-income countries each year and could avert as many as 60 million deaths by 2030. Effective PHC can also reduce health care costs by lowering hospital admissions and rates of emergency department use.

Finally, experts believe strengthening PHC is essential to achieving universal health coverage worldwide.¹

Despite the complexity of improving PHC in resource-constrained settings, Exemplar countries like Ghana have implemented a range of complementary health system reforms focused on financing, governance, access to care, and performance and accountability. As a result, they have performed better than their peers during the past 20 years relative to their total health spending.

Exemplars research distinguished two broad ways, or pathways, in which Ghana’s reforms improved PHC performance and efficiency:

Placeholder — Ghana district health directorate decision space

Sources: Exemplars subnational primary data collection, 2023

Reforms working through this pathway prioritized increased resources for the health system; established decentralized, data-driven processes for planning and decision making; and ensured coordination with development partners on the management and use of funds.

Pathway 1: How did Ghana change its approach to health system administration?

Reforms in this pathway made PHC services more affordable, delivered PHC services to people in the communities where they live, and engaged communities themselves in health service delivery and oversight.

Pathway 2: How did Ghana improve access to primary health care?

1
World Health Organization. Primary health care. Published November 15, 2023. Accessed September 24, 2024. https://www.who.int/news-room/fact-sheets/detail/primary-health-care

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Improving Primary Health Care Efficiency in Ghana

UHC effective coverage relative to total health expenditure

Contents

Exemplars research distinguished two broad ways, or pathways, in which Ghana’s reforms improved PHC performance and efficiency:

Pathway 1

Ghana enabled health system efficiency through increased resources for health and administrative reform at the national, regional, and local levels.

Pathway 2

Ghana increased equitable access to quality PHC services by focusing on making PHC services more affordable and prioritizing community-driven and community-led care.