Patient safety—defined by the World Health Organization as the “absence of preventable harm to a patient during the process of health care and the reduction of risk of unnecessary harm associated with health care to an acceptable minimum”—has emerged as a foundational principle for modern health systems worldwide. In Ghana, recent policy reforms and the government’s commitment to Universal Health Coverage have heightened attention on safeguarding patients from avoidable errors and adverse events. Yet, as Augustine Kumah observes, translating this commitment into safer everyday care requires confronting deeply entrenched challenges across infrastructure, workforce, and governance domains.
Ghana’s mixed delivery model comprises public, private, and faith-based providers coordinated through the Ministry of Health and implemented by the Ghana Health Service. Anchored by a three-tiered network; ranging from community-based CHPS compounds to district hospitals and teaching hospitals, the system has achieved notable gains in expanding access. Nevertheless, uneven resource distribution and capacity gaps between urban and rural facilities continue to undermine care quality. The NHIS, launched in 2003 to eliminate point-of-service payments, has boosted utilization, but persistent inequities in service readiness and quality remain a barrier to safe care delivery.
One of the most urgent patient safety concerns in Ghana is hospital-acquired infection (HAI). A multicenter point-prevalence study conducted in 2016 found that 8.2 percent of inpatients across ten hospitals suffered HAIs, with surgical site infections accounting for 32.6 percent, bloodstream infections 19.5 percent, and urinary tract infections 18.5 percent of cases.
By 2024, the economic toll of these infections was estimated at USD 1.57 billion annually—nearly 2 percent of Ghana’s GDP—while 45 percent of healthcare facilities reported inadequate access to clean water, a basic necessity for effective infection prevention and control (IPC). Medication errors and diagnostic failures further compound patient harm. Home-based studies among pediatric caregivers revealed that 68.4 percent of children experienced at least one medication error, principally involving incorrect timing or dosing frequency.
In hospital settings, error rates ranging from 18.2 percent to 27.2 percent have been documented, with many resulting in adverse outcomes due to gaps in training, standardization, and oversight. Misdiagnoses and laboratory mistakes such as incompatible blood transfusions underscore the need for systematic mortality audits and root-cause analyses to prevent recurrence.
Beyond clinical lapses, systemic constraints pose formidable obstacles to safer care. Ghana’s doctor-to-patient ratio remains an estimated 1:8,000, well below the WHO’s recommended 1:1,000, while overburdened nurses report high burnout and fatigue levels that elevate the risk of errors.
Only 5 percent of primary-level facilities possess complete basic examination tools, hampering early detection of critical conditions. Financially, health received just 6.9 percent of the 2024 national budget; far short of the Abuja Declaration target, with 71 percent of that allocation consumed by salaries, leaving scant resources for equipment, maintenance, and quality initiatives.
“ Improving patient safety in Ghana requires a multi-stakeholder approach, integrating policy reform, technology, workforce development, and public awareness campaigns ”
A robust culture of reporting and continuous improvement remains more aspiration than reality. Adverse event reporting systems are underdeveloped, and fear of punitive responses discourages frontline workers from disclosing near-misses or errors. Public awareness of patient rights and safety protocols is low, and regulatory enforcement mechanisms lack the teeth to drive accountability. These deficiencies perpetuate cycles of preventable harm and inhibit data-driven policymaking and facility-level learning.
Yet Ghana stands at a threshold of opportunity. Digital health solutions—from nationwide electronic health records to telemedicine platforms—offer pathways to streamline communication, standardize clinical workflows, and bolster surveillance of safety incidents. Investment in simulation-based training and continuous professional development can equip healthcare workers with up-to-date IPC and medication-safety competencies.
Strengthening regulatory frameworks and accreditation standards will incentivize facilities to adopt international best practices, while community engagement campaigns can empower patients to participate actively in their own safety. Realizing this vision will demand sustained political will, smart investments, and a commitment to transparency, Ghana can transform its healthcare landscape by aligning ambitious policy goals with pragmatic facility-level actions, rooted in data, grounded in local context, and guided by global best practices. In doing so, it will not only protect patients from preventable harm but also lay a resilient foundation for universal, high-quality care that leaves no citizen behind.
Source: Frontiers | The future of patient safety in Ghana: challenges and opportunities
