Extending Universal Health Coverage to Disadvantaged Populations in Ghana : Analytical Report

Overview & Synopsis

Ghana adopted the Universal Health Coverage Roadmap (2020 to 2030) with the objective of ensuring equitable access to quality health services for all citizens, regardless of ability to pay. While Ghana has made notable progress over the past two decades, reflected in the doubling of its UHC service coverage index between 2000 and 2021, significant inequities in access to health care persist, particularly among disadvantaged populations. This analytical report examines pathways to advance UHC for three underrepresented groups: people with disabilities, people with mental health conditions, and survivors of gender-based violence, selected due to their limited inclusion in health policy dialogue and service delivery. The study employed a mixed methods approach, combining a systematic scoping review of health system strengthening strategies in lower middle-income countries with three qualitative case studies conducted in Greater Accra, Ashanti, and Northern Regions of Ghana. Findings highlight persistent gaps between policy intent and implementation at subnational levels, compounded by stigma, poverty, and unmet need. Promising practices emphasize community based, condition specific screening and case management, alongside adaptations of the WHO Mental Health Gap Action Programme. The study underscores the importance of engaging individuals with lived experience as active contributors to health system governance. Achieving UHC for disadvantaged populations requires both foundational system reforms and targeted, context responsive strategies that move beyond one size fits all approaches.