Why does inaccessibility widely exist in healthcare in Ghana? Understanding the reasons from past to present

  • Prince PeprahEmail author
  • Hayford Isaac Budu
  • Williams Agyemang-Duah
  • Emmanuel Mawuli Abalo
  • Akwasi Adjei Gyimah
Original Article



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.


Inaccessibility Accessibility Healthcare National Health Insurance Ghana 


Compliance with ethical standards

Conflict of interest

The authors state that they have no conflict of interest.

Ethical approval

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

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Prince Peprah
    • 1
    Email author
  • Hayford Isaac Budu
    • 2
  • Williams Agyemang-Duah
    • 1
  • Emmanuel Mawuli Abalo
    • 1
  • Akwasi Adjei Gyimah
    • 3
  1. 1.Department of Geography and Rural DevelopmentKwame Nkrumah University of Science and TechnologyKumasiGhana
  2. 2.Department of NursingKwame Nkrumah University of Science and TechnologyKumasiGhana
  3. 3.Department of Community HealthKwame Nkrumah University of Science and TechnologyKumasiGhana

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