In recent years, Ghana has taken bold steps toward strengthening its health financing framework, aligning with the broader continental call for domestic resource mobilisation (DRM) in health. Through reforms in its National Health Insurance Scheme (NHIS), uncapping of the National Health Insurance Levy (NHIL) and the creation of the Ghana Medical Trust Fund, the country is signalling strong political will to fund health systems from within.

As donor funds become increasingly unpredictable, Ghana’s approach offers critical lessons for countries seeking to future-proof their health investments, especially in the context of rising burdens such as non-communicable diseases (NCDs).

A Mixed Health Financing Model.

Ghana’s approach to achieving universal health coverage (UHC) relies on a blend of public and private insurance. The National Health Insurance Scheme (NHIS), a cornerstone of Ghana’s strategy, is funded by a 2.5% value-added tax (VAT) levy and member contributions. It currently accounts for over 70% of healthcare financing in the country. Despite progress in health service utilisation, Ghana’s health financing system still faces challenges, including low scheme enrolment, concerns over care quality, long-term sustainability, and affordability—especially for informal sector workers and vulnerable groups.

Meanwhile, private health insurance schemes (PHIS) complement the NHIS, providing flexibility, broader benefit packages, and quicker service delivery, especially for high urban populations. As of 2025, twelve PHIS were licensed in Ghana, offering both inpatient and outpatient care options. These schemes are also helping close service delivery gaps, especially where NHIS access is limited.

Fiscal Innovation in the Face of Declining Aid.

In May 2025, Ghana’s Deputy Finance Minister, Hon. Thomas Nyarko Ampem, highlighted the country’s pivot toward domestic solutions to balance declining external health support. Speaking at the World Health Assembly, he confirmed Ghana had increased the NHIS allocation in the national budget from GH¢ 5.9 billion (approx. $567 million) in 2024 to GH¢ 9.8 billion (approx. $941 million) in 2025, an increase of over 66%.

Additionally, the government removed the statutory cap on the NHIL, unlocking new funding opportunities for health services, including NCDs. This follows years of civil society advocacy led by the Ghana NCD Alliance (GhNCDA), which also launched a manifesto for the 2024 elections demanding dedicated funding and stronger accountability for NCD care.

New Institutions for Long-Term Impact.

To bridge service gaps in areas not currently covered by NHIS, particularly for NCD treatment, H.E. President John Mahama launched the Ghana Medical Trust Fund (“Mahama Cares”) in April 2025. The fund will cover NCD care and aims to crowd in private and philanthropic capital. A bill is expected to be tabled in Parliament to formalise the fund’s mandate and oversight.

Looking forward, the Ghana NCD Alliance is developing an accountability tracker and advocating for the formation of a Parliamentary NCD Caucus to monitor the flow of NHIL resources and ensure NCD priorities are not overlooked.

What This Means for the Continent?

Ghana’s story reinforces a broader truth: external support can catalyse but not sustain health systems. With Sub-Saharan Africa’s tax-to-GDP ratio still at 13%, there is room and responsibility for countries to finance their own futures. Ghana’s mix of fiscal discipline, political courage, and civil society engagement offers a replicable model for the continent.

As Deputy Minister Hon. Ampem put it:

“External aid is no longer a reliable solution… We must prioritise prevention, repurpose budgets, and unlock new investment through good governance and innovation.”