A national primary health care initiative
Free Primary Health Care
The Free Primary Health Care initiative is the next strategic step in Ghana's primary health care reform journey, building on CHPS, the National Health Insurance Scheme, the Essential Health Services Package and Primary Care Networks in pursuit of 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. Installed from Google Play, so it keeps itself up to date.
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- 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 does not start from nothing. It builds on reforms Ghana has already made, each of which solved part of the problem of getting quality care to everyone.
- CHPS
Community-based Health Planning and Services
Took health services into communities and established the zoning that population-based planning now runs on.
- 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
Organised facilities into networks, so a population is served by a connected system rather than isolated points of care.
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
The initiative is steered by three objectives that have to advance together: reaching more people, treating them better, and being able to keep doing both.
Expanding access and equity
Bring the essential package within reach of every population, starting with the communities that have been hardest to serve.
Improving quality of care
Raise and standardise the care delivered at primary level, so that free care is also safe, effective and consistent.
Enhancing efficiency and sustainability
Direct resources where they achieve the most, and keep the initiative affordable to run beyond its first years.
How it is implemented
Guiding principles
These principles decide the order in which populations are reached, how facilities plan, and how the system is held to account.
- 01
Equity-first expansion
Underserved populations are reached first, rather than last, as the initiative scales.
- 02
Population-based planning on CHPS zoning
Facilities plan for a defined population in a defined zone, not only for those who happen to attend.
- 03
Strong referral systems and gatekeeping
Primary care is the first point of contact, and higher levels receive the cases that genuinely need them.
- 04
Data-driven decision-making
Planning, monitoring and correction rest on routine data from the facilities delivering the care.
- 05
Community engagement and accountability
Communities take part in how services are shaped, and hold the system to what it has promised.
Points of care
Where care is delivered
Services are delivered through the primary level of the health system — 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 in order 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. When a condition needs more than the primary level can give, the referral structure carries the client onward 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 it keeps your own care connected: 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, so that staff everywhere are prepared the same way.
Population-Based Payment funds have been released to the Regions and the comprehensive rollout has commenced. Regions are now to proceed with the Training of Trainers.
- 1
Regional level
Regional Health DirectoratesRegions run the Training of Trainers, carrying the capacity-building responsibility the Guidelines assign them.
- 2
District level
District Health Management TeamsRegionally trained trainers cascade the same content and delivery approach to district teams.
- 3
Facility level
Implementing health facilitiesDistrict teams train the staff who deliver the package day to day 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 treated as essential to the success of 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 policy's vision is universal access to free, quality primary health care, and expansion is guided by an equity-first principle that reaches underserved populations first.
What is covered without charge?
A defined essential package delivered at the primary level: 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?
To your nearest CHPS compound, health centre, clinic or polyclinic. These are the first point of contact, and they refer you onward when a condition needs care beyond the primary level.
Why is there a referral and gatekeeping system?
So that primary care handles what it is equipped to handle, and hospitals receive the cases that genuinely need them. The referral structure links primary, secondary and tertiary care, so a client moves through the system rather than starting again at each level.
Who is being trained, and by whom?
Following the release of Population-Based Payment funds to the Regions, Regional Health Directorates run the Training of Trainers and cascade it through districts to implementing facilities. Consistent content and delivery across all Regions is treated as essential to the rollout.
The content of this page summarises the National Implementation Guidelines for Free Primary Health Care. Where this page and the Guidelines differ, the Guidelines are the authority.
Where to go next
Free primary health care starts at the facility closest to you. Health staff working on the initiative 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