Despite the significant attention paid to inequities in national development, they persist
in Ghana. Social services such as health,
education, water and sanitation exhibit differentials depending on where citizens live.
Decentralisation has often been proposed
as a means of making these services more
equitable. Examining the case of the health
sector, this paper contends that the nature of
health sector decentralisation coupled with
funding inequities among districts sustains
health inequities in Ghana’s decentralised
units. In-depth interviews are conducted in
four districts in the Northern and Greater
Accra regions in Ghana, alongside national
level officers within the decentralised and
health system. As part of the analysis, tapes
were transcribed and coded, and data generated were analysed for themes and patterns.
Findings reveal that funding inequalities, as
well as the concurrent existence of multiple
strands of decentralisation in the health
sector, result in persistence of inequities. If
decentralisation is to positively impact on
inequities in the health system, there must be
clarity and a streamlining of the cooperation
and coordination between and at all levels
of the health sector and the districts
