Why does inaccessibility widely exist in healthcare in Ghana? Understanding the reasons from past to present
- 18 Downloads
The topic of access, or improving access, to healthcare services is a noteworthy matter, regardless of where you live. In Ghana, however, especially in rural areas, it is a critical issue worthy of investigation. Thus, we set out with the aim of exploring the specific reasons for healthcare inaccessibility in Ghana.
Subject and methods
Telephone interviews were conducted with 15 health directors in the Eastern, Central, and Ashanti regions of Ghana. A thematic analytical framework was used to analyze the data, which were then presented based on an a posteriori, inductive-reduction approach.
Six major reasons were identified: inherent inaccessibility initiated by the colonial system of administration, where essential healthcare facilities were concentrated in the capitals; economic reforms of past governments, especially the Structural Adjustment Programme which introduced the user fee system; transportation issues; urban-biased health policy implementation; the financial leakage/inefficiency/corruption that characterize interventions toward accessibility promotion; and other socio-cultural and religious beliefs that certain groups and tribes adhere to.
The authors therefore argue that there is no one main cause of healthcare inaccessibility in Ghana, but rather a confluence of issues is responsible, ranging from historical antecedents to current happenings. It is, therefore, imperative for stakeholders in the health sector to take into consideration the factors identified by the present study, in order to guide the design and implementation of policies toward improving healthcare accessibility.
KeywordsInaccessibility Accessibility Healthcare National Health Insurance Ghana
Compliance with ethical standards
Conflict of interest
The authors state that they have no conflict of interest.
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- Abukari Z, Kuyini AB, Mohammed AK (2015) Education and health care policies in Ghana: examining the prospects and challenges of recent provisions. SAGE Open 1–11Google Scholar
- ACCA (2013) Key health challenges in GhanaGoogle Scholar
- Chomitz K, Setiadi G, Azwar A (1998) What do doctors want? In developing strategies for doctors to serve in Indonesia's rural and remote areas. Policy research working paper no. 1888. World Bank, Washington, DCGoogle Scholar
- Cluett ER, Bluff R (eds) (2000) Principles and practice of research in midwifery. Baillière Tindall, EdinburghGoogle Scholar
- Drislane FW, Akpalu A, Wegdam HHJ (2014) The medical system in Ghana. Yale J Biol Med 87:321–326Google Scholar
- Durairaj V, D’Almeida S, Kirigia J (2010) Ghana’s approach to social health protection (background paper for the World Health Report 2010 no. 2). World Health Organization, GenevaGoogle Scholar
- Guba EG, Lincoln YS (1994) Competing for paradigms in qualitative research. In: Denzin NK, Lincoln YS (eds) Handbook of qualitative research. SAGE Publications, Inc., Thousand Oaks, pp 105–117Google Scholar
- Kraus J (1991) The political economy of stabilization and structural adjustment in Ghana. In: Rothchild D (ed) The political economy of recovery. Lynne Rienner, BoulderGoogle Scholar
- Lerberghe V et al (2002) When staff is underpaid: dealing with the individual coping strategies of health personnel. Bull World Health Organ 80:7581–7584Google Scholar
- Mitchell M, Williams J (2007) The role of midwife-complementary therapists: data from in-depth telephone interviews. Evid Based Midwifery 5(3):93–100Google Scholar
- Morse JM, Richards L (2002) Read me first for a users guide to qualitative methods. Sage Publications, LondonGoogle Scholar
- den Boom GJM V, Nsowah-Nuamah NNN, Overbosch GB (2004) Health care provision and self-medication in Ghana. JEL Classif I11:O5Google Scholar
- OXFAM International (2011) Achieving a shared goal: free universal health care in Ghana. https://www.oxfam.org/sites/www.oxfam.org/files/rr-achieving-shared-goal-healthcare-ghana-090311-en-sum.pdf, accessed 13 July 2017
- Sapsford R (1999) Survey research. Sage, LondonGoogle Scholar
- Schieber G, Cashin C, Saleh K, Lavado R (2012) Health financing in Ghana. World Bank, Washington, DCGoogle Scholar
- Sen A (1999) Development as freedom. Alfred Knopf, New York Google Scholar
- Shi L (1997) Health care spending, delivery, and outcome in developed countries: a cross-national comparison. Am J Med Qual 12:83–93Google Scholar
- Srivastava A, Thomson SB (2009). Framework analysis: a qualitative methodology for applied policy research. JOAAG 4(2):72–79Google Scholar
- Starfield B (1998) Primary care: balancing health needs, services, and technology. Oxford University Press, New YorkGoogle Scholar
- Sulemana A, Dinye RD (2014) Access to healthcare in rural communities in Ghana: a study of some selected communities in the Pru District. Eur J Res Soc Sci 2:2056–5429Google Scholar
- WHO (1978) Primary health care: report of the International Conference on Primary Health Care, Alma-Ata, USSR, 6–12 September 1978. WHO, GenevaGoogle Scholar
- World Health Organisation (2012) Ghana Health Profile. http://www.who.int/gho/countries/gha.pdf, accessed 7 March 2013
- Zurn P (2002) Imbalances in the health workforce: briefing paper. World Health Organization, GenevaGoogle Scholar