A national primary health care initiative
Free Primary Health Care
Free Primary Health Care is the next step in Ghana's primary health care reform. It builds on CHPS, the National Health Insurance Scheme, the Essential Health Services Package and Primary Care Networks, working towards Universal Health Coverage.
Universal access to free, quality primary health care for all Ghanaians.
The vision of the initiative
Free at the point of use
Primary care, close to home
Start at any of these
- CHPS compounds
- Health centres
- Clinics
- Polyclinics
Referred onward to district and regional hospitals when you need it
Download the Android app
Record visits in the field and upload them when you have signal. It installs from Google Play and updates itself.
Download the Android app- 3
- Strategic objectives
- 5
- Guiding principles
- 4
- Types of primary facility
- 8
- Service areas covered
Where it comes from
The next step in a longer reform journey
Free Primary Health Care builds on reforms Ghana has already made. Each one solved part of getting quality care to everyone.
- CHPS
Community-based Health Planning and Services
Took health services into communities. Its zoning is what population-based planning runs on today.
- NHIS
National Health Insurance Scheme
Introduced pooled financing and the first broad protection against the cost of care.
- EHSP
Essential Health Services Package
Defined the services every Ghanaian should be able to receive, and at which level of care.
- PCNs
Primary Care Networks
Grouped facilities into networks, so each population is served by one connected system.
What it is for
Vision and goal
Both statements are taken from the policy itself.
- Vision
- Universal access to free, quality primary health care for all Ghanaians.
- Goal
- To strengthen primary health care as the foundation of the health system while guaranteeing financial protection by removing cost as a barrier to essential primary care.
What it is trying to achieve
Three strategic objectives
Three objectives guide the initiative and must advance together. Reach more people, treat them better, and keep doing both.
Expanding access and equity
Bring the essential package within reach of every population. Start with the communities that have been hardest to serve.
Improving quality of care
Raise and standardise care at the primary level. Free care must also be safe, effective and consistent.
Enhancing efficiency and sustainability
Put resources where they do the most good. Keep the initiative affordable to run beyond its first years.
How it is implemented
Guiding principles
These principles set who is reached first, how facilities plan, and how the system is held to account.
- 01
Equity-first expansion
Underserved populations are reached first as the initiative expands.
- 02
Population-based planning on CHPS zoning
Facilities plan for everyone in their zone, not only for those who attend.
- 03
Strong referral systems and gatekeeping
Primary care is the first point of contact. Higher levels receive only the cases that need them.
- 04
Data-driven decision-making
Planning, monitoring and correction use routine data from the facilities delivering care.
- 05
Community engagement and accountability
Communities help shape services and hold the system to what it has promised.
Points of care
Where care is delivered
Care is given at the primary level, in the facilities closest to where people live.
CHPS compounds
The closest point of care, serving a defined community zone.
Health centres
Sub-district facilities offering the fuller outpatient package.
Clinics
Outpatient care for common conditions within the primary level.
Polyclinics
Larger primary facilities with a broader range of services on one site.
What is covered
The essential service package
A defined package of primary care services, delivered without cost at the point of use.
Covered at no cost at the point of use
8 service areas · every primary facility
Health promotion and education
Helping people and communities stay well before illness starts.
Disease prevention
Immunisation and other measures that stop preventable illness.
Maternal, newborn and child health
Care through pregnancy, delivery and the early years of life.
Family planning
Counselling and services that let people plan their families.
Basic outpatient care
Consultation and treatment for common conditions.
Screening and early detection
Finding priority diseases early, while they are still manageable.
Basic diagnostics
The tests a primary facility needs to decide on care.
Initial management and referral
Starting treatment, and moving the client onward when more is needed.
Continuity of care
An organised referral structure
Primary care is the entry point. If a condition needs more, the referral structure moves the client on to secondary and, where necessary, tertiary care.
- Level 1
Primary
CHPS compounds, health centres, clinics and polyclinics
First point of contact. Delivers the essential package and decides what needs to move up.
- Level 2
Secondary
District and regional hospitals
Receives referred clients who need specialist assessment, admission or procedures.
- Level 3
Tertiary
Teaching and specialist hospitals
Handles the most complex care, referred on from the secondary level.
Gatekeeping means starting at the primary level. It keeps hospital capacity for the people who need it, and the facility that refers you stays part of your care.
Implementation
Rollout and Training of Trainers
Training cascades from Regional level through Districts to the facilities that deliver the package. Staff everywhere are prepared the same way.
Population-Based Payment funds have been released to the Regions and the comprehensive rollout has started. Regions are now to run the Training of Trainers.
- 1
Regional level
Regional Health DirectoratesRegions run the Training of Trainers. The Guidelines give them the capacity-building responsibility.
- 2
District level
District Health Management TeamsRegional trainers pass the same content and delivery approach to district teams.
- 3
Facility level
Implementing health facilitiesDistrict teams train the staff who deliver the package at the primary level.
Who leads it. The Guidelines assign capacity-building and training responsibilities to Regional Health Directorates.
Why consistency matters. The same content, delivered the same way in every Region, is essential to the rollout.
Questions
Common questions
Short answers drawn from the policy. For anything specific to your district or facility, contact your Regional Health Directorate.
Who is the initiative for?
All Ghanaians. The vision is universal access to free, quality primary health care. Expansion follows an equity-first principle, so underserved populations are reached first.
What is covered without charge?
A defined essential package at the primary level. It covers health promotion and education, disease prevention, maternal, newborn and child health, family planning, basic outpatient care for common conditions, screening and early detection of priority diseases, basic diagnostics, and initial management and referral.
Where do I go for care?
Go to your nearest CHPS compound, health centre, clinic or polyclinic. They are the first point of contact. They refer you onward if you need care beyond the primary level.
Why is there a referral and gatekeeping system?
So primary care handles what it is equipped to handle, and hospitals receive the cases that need them. The referral structure links primary, secondary and tertiary care, so a client moves through the system instead of starting again at each level.
Who is being trained, and by whom?
Population-Based Payment funds have been released to the Regions. Regional Health Directorates now run the Training of Trainers and cascade it through districts to implementing facilities. The same content and delivery in every Region is essential to the rollout.
This page summarises the National Implementation Guidelines for Free Primary Health Care. Where the two differ, the Guidelines are the authority.
Where to go next
Free primary health care starts at the facility closest to you. Staff use PNCCS to keep client records, referrals and follow-up connected across facilities.
No card, no payment and no appointment is needed at the primary level.
If you need care
Go to your nearest CHPS compound, health centre, clinic or polyclinic. They will treat you or refer you onward.
If you are GHS staff
Sign in to the Patient Navigation and Care Continuity System to work your caseload.
Staff sign in