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EPMA J. 2017 Aug 18;8(3):197-206. doi: 10.1007/s13167-017-0109-3. eCollection 2017 Sep.

Emerging issues in public health: a perspective on Ghana's healthcare expenditure, policies and outcomes.

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School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Perth, WA 6027 Australia.
School of Natural Sciences, Edith Cowan University, Perth, WA 6027 Australia.
Department of Mathematics and Statistics, La Trobe University, Melbourne, Victoria 3083 Australia.
Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, 100069 China.
School of Public Health, Taishan Medical University, Taian, Shandong 271000 China.


Ghana's healthcare expenditure has increased over the past two decades. Increased healthcare expenditures are required to enhance the acquisition of better hospital resources that may improve healthcare. This study presents an overview of healthcare expenditures and health outcomes (i.e. infant mortality, under-5 mortality and life expectancy) from 1995 to 2014 in Ghana. Infant and under-5 mortalities have declined by 50 and 25%, respectively, as of 2014, while life expectancy has increased from 60.7 to 64.8 years. Private spending on health, especially out-of-pocket payments, declined but is higher than the World Health Organization's recommended financial threshold. Non-communicable diseases (NCDs) are rising with healthcare costs leading to catastrophically high healthcare expenditures in the future. While government's investments on healthcare have yielded positive results, the improvement in the health outcomes cannot be attributed to increased health expenditure alone. Therefore, this paper outlines policies on maternal health, national health insurance and healthcare reforms that have influenced health outcomes. In parallel, the paper highlights challenges of the Ghana health system of which the major ones are (1) inadequate financial investments in health and (2) limited health workforce and facilities. These challenges can be ameliorated by (1) establishing new health institutions and expanding existed ones; (2) providing incentives to discourage the exodus of health workers; (3) introduction of the concept of predictive, preventive and personalized medicine (PPPM) for treating NCDs; and (4) alternative insurance schemes for vulnerable groups. This, coupled with the will of the government to curb misappropriation of funds, will be important to achieving better health outcomes.


Health policy; Healthcare expenditure; Infant mortality; Life expectancy; Predictive preventive personalized medicine; Under-5 mortality

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