Published in PLOS One on 2026-04-02, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Mary Yeboah, Richard Abeiku Bonney, Loretta Adu-Boahemaa Antwi, Pius Amponsah Anane, Obed Kwabena Offe Amponsah, Peter Agyei-Baffour
Source: PLOS One • DOI 10.1371/journal.pone.0346140
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Non-communicable diseases (NCDs) cause 74% of global deaths, disproportionately affecting LMICs like Ghana. Chronic treatment remains hindered by medicine shortages and high costs, consuming over 50% of the minimum wage incomes. Despite Ghana’s NCD policies, supply chain gaps and price inflation persist. This study assesses access to medicine, operationally defined as availability and affordability, in three municipalities to inform reforms for Universal Health Coverage and achieve SDG 3.4 targets.
This cross-sectional mixed study assessed the availability and affordability of NCD medicines in three municipalities in Ghana using WHO/HAI methods. Data on 62 medicines were collected from nine health facilities, supplemented by interviews with pharmacy managers.
This study assessed access to NCD medicines across three municipalities in Ghana, revealing stark disparities. Availability varied significantly by location (Oforikrom 70% vs. Juaben 48.6%, p < 0.001) and facility type (government 67.2% vs. private 54.6%, p = 0.042). Insulin was least affordable (3.94–8.74 days’ wages), with 10-fold metformin price differences between municipalities. Private facilities charged 2–5 × more than the government for chronic medications. Logistic regression analysis showed that patients in private facilities were significantly more likely to encounter unaffordable NCD medicines compared to those in public facilities (AOR = 3.85, p = 0.001). Supply chain delays (2–3 weeks) and National Health Insurance Scheme (NHIS) reimbursement delays exacerbated gaps.
This study highlights inequities in access to NCD medicines in Ghana, with stark gaps in availability and affordability, especially in underserved areas. Findings reveal high costs, stock-outs, and geographic disparities as key factors, underscoring the need for supply chain reforms, price regulation, and municipal oversight to advance equitable, sustainable, universal health coverage.
Background
Non-communicable diseases (NCDs) represent a global public health challenge, accounting for 74% of all deaths worldwide [1], with 73% of these deaths occurring in low- and middle-income countries (LMICs) [2]. Unlike communicable diseases, NCDs are characterized by their chronicity, multifactorial etiology, and strong association with modifiable behavioral and metabolic risk factors, including physical inactivity, unhealthy diets, tobacco use, harmful alcohol consumption, and air pollution [3,4].
Non-communicable diseases are a growing public health concern in Sub-Saharan Africa (SSA), with wide variation in prevalence across the region. Reported rates range from 0.07–0.3% for stroke, 0–16% for diabetes, 6–48% for hypertension, 0.4–43% for obesity, and 0.4–71% for smoking [5]. Globally, NCDs account for 71% of all deaths, primarily due to cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes [6]. In SSA, NCDs such as hypertension and diabetes contribute substantially to morbidity and mortality and affect younger populations compared to high-income countries, placing additional strain on already burdened health systems [7].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider financing & policy desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Mary Yeboah, Richard Abeiku Bonney, Loretta Adu-Boahemaa Antwi, Pius Amponsah Anane, Obed Kwabena Offe Amponsah, Peter Agyei-Baffour. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Out-of-pocket payments and associated factors among hypertensive patients insured under the National Health Insurance Scheme in a referral hospital, Ghana
- Evidence brief: The effect of recall period on reported out-of-pocket health expenditure in Ghana
- Evidence brief: Factors associated with individuals’ preferences for Primary Health Care facility type: A case of Bolgatanga Municipality in the Upper East Region of Ghana
