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

Abstract

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. 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.