Background. Ghana has made major strides in improving access to health services. Despite these improvements,
Ghana did not meet the Millennium Development Goals 4 and 5. Quality of care is a major factor that could explain
this shortfall.
Objective. To understand current practice and to identify needs in the area of quality of care in Ghana for improving
health outcomes and to guide the National Institute for Health and Care Excellence (NICE) in supporting the care
quality improvement efforts in Ghana.
Methods. The directory of existing standards, guidelines and protocols of the Ghana Health Service was reviewed
and sixteen in-depth interviews were conducted to identify interventions that addressed quality of care. Additional
information was obtained during a NICE scoping visit to Accra followed by a study tour of Ghanaian stakeholders
to NICE and to the National Health Service.
Results. Since 1988, 489 policy interventions have been identified that address quality of care. Among them, the
development of health protocols and guidelines were the most frequent interventions (n=150), followed by health
policies and strategies (n=106); interventions related to health information (n=77); development of training manuals
and staff training (n=69); development of regulations (n=38) and interventions related to organisation of services
(n=15).
Conclusions. Ghana has made significant efforts in developing guidelines, policies and conducting in-service training.
Supervision, monitoring and evaluation have also received attention. However, less effort has been made in
developing processes and systems and involving communities and service users. Some recommendations were made
to guide the future work on quality of care.