The state of primary health care (PHC) in Ghana rests in policymakers’ hands. Previous leadership has consistently failed to implement promises made during campaigns and has left Ghana to suffer through years of inadequate primary health care funding. Although the 26 African Union countries passed the Abuja Declaration in 2001 and pledged to allocate at least 15% of their annual budget to improve health care, this pledge has not been upheld by Ghanaian government and policymakers; in 2015, the health sector budget was only 9.47%. In addition, health insurance under the National Health Insurance Scheme (NHIS) has been riddled with corruption and lack of funding. According to the National Health Insurance Authority (NHIA) Annual Report in 2012, the NHIS only covers 38% of the population, leaving those without coverage to enroll in other private schemes or the “cash and carry system.” Even those who are insured under the NHIS have reported that the scheme does not cover essential drugs, preventative services such as family planning, scans or hemoglobin testing, leaving people no choice but to spend more money for these essential services.
Other issues facing PHC include: lack of quality health services, distance to the nearest health facility, overcrowding, restricted hours at facilities with long waiting times, cost, lack of information, lack of confidence in facilities and staff and sociocultural barriers. It is apparent that in addition to the corruption seen in the NHIS, PHC is facing major barriers. Though these barriers provide Ghana with many challenges, it is necessary to continue to work toward a system that promotes prosperity by giving citizens access to high-quality, affordable, comprehensive primary health care, allowing the country to make strides in achieving its ultimate goal of universal health care.
To combat issues facing the primary health care system, the Alliance for Reproductive Health Rights (ARHR) and other NGOs such as SEND Ghana, Universal Access to Health Care Campaign, Curious Minds and the Ghana News Agency have been working to increase awareness and advocacy regarding the state of the current primary health care system and the policies that new leadership must implement to uphold campaign promises. In addition, Ghana has implemented programs such as Community Based Health Planning and Services (CHPS) and decentralization to promote a strong primary health care system with a focus on equity, access and quality of services. If government upholds promises to repair the NHIS and invests 15% of the annual budget in health care, as promised by the Abuja Declaration, Ghanaians living even in remote areas will have increased access to primary health care, empowering communities, families and individuals to be active decision-makers about their health, which will ultimately increase the overall prosperity of the country.