Ghana’s newly introduced Free Primary Healthcare Policy could significantly expand access to basic health services, but questions remain about how it will be sustainably financed, a policy analysis has warned.

The concerns were raised by the Centre for Health Policy and Development–Africa, led by its Executive Director, Emmanuel Opuni.

The policy, launched on 15 April 2026, aims to provide free access to essential primary healthcare services and shift the country’s health system from a treatment-focused model to one centred on prevention and community care.

It is being implemented by the Ghana Health Service under the Ministry of Health, with an initial rollout covering 150 districts.

Access and prevention

The scheme includes treatment for common illnesses such as malaria and respiratory infections, maternal and child health services, immunisation, and screening for conditions including hypertension, diabetes and cancer.

Analysts say the policy could improve access to healthcare, particularly for people not covered by the National Health Insurance Scheme (NHIS), which currently reaches just over half of the population.

By removing upfront costs, the programme is also expected to improve health equity, especially among low-income and rural communities.

Funding uncertainty

However, the report warns that the absence of a dedicated funding source could threaten the policy’s long-term viability.

Although the 2026 budget allocates funding for the initiative within a broader GH¢9bn health financing envelope, the programme relies heavily on revenue from Value Added Tax (VAT), which has declined as a share of total tax income in recent years.

Emmanuel Opuni said this dependence could create uncertainty.

“The financing of the policy is largely dependent on VAT, which has shown declining trends over the years,” he said. “This raises significant sustainability concerns.”

Delays in revenue collection and disbursement could also disrupt service delivery, the analysis noted.

Impact on household spending

The government hopes the policy will reduce out-of-pocket healthcare spending from around 35% to 20% by 2030.

But the report cautions that shortages of medicines, diagnostics and personnel could force patients to seek care from private providers, limiting the expected savings.

Operational challenges

The analysis also highlights longstanding challenges within the health system, including workforce shortages in rural areas, weak supply chains and gaps in infrastructure.

In some parts of the country, access to healthcare facilities remains limited, particularly in rural communities where distances to the nearest clinic can be significant.

“What is the use of free healthcare if there are no professionals or facilities available to deliver the services?” Mr Opuni asked.

Call for reforms

The Center for Health Policy and Development–Africa is calling for measures to strengthen the policy, including dedicated funding for primary healthcare, expanded infrastructure in underserved areas, and improved logistics and workforce planning.

While the Free Primary Healthcare Policy has been widely seen as a step towards universal health coverage, the report concludes that its success will depend on how effectively these financial and operational challenges are addressed.