Decentralising health: A promise whose time has come

The renewed push to devolve Ghana’s health sector is both timely and necessary.

For far too long, the conversation around decentralisation, particularly in health, has lingered between promise and partial progress.

The recent engagement between the Inter-Ministerial Coordinating Committee (IMCC) on Decentralisation and the Ministry of Health signals a welcome return to an agenda that should never have stalled.

At its core, decentralisation is about one simple but powerful idea, decisions must be made as close as possible to the people they affect.

Nowhere is this more important than in healthcare. From staffing gaps in district hospitals to delays in essential services, the consequences of over-centralisation are felt daily across communities.

When authority is concentrated at the centre, responsiveness suffers at the periphery.

The Ghanaian Times welcomes the meeting as a strong indication that both institutions are revisiting earlier efforts and aligning them with the National Decentralisation Policy and Strategy (2026–2030).

The acknowledgment that previous attempts, particularly those between 2015 and 2016 did not reach full implementation is not a weakness; it is an opportunity to correct course with the benefit of hindsight.

The Minister for Health’s indication that recruitment is already being decentralised offers a glimpse of what is possible.

Allowing districts to play a greater role in hiring health professionals is not only practical but strategic.

It improves the likelihood that personnel will accept and remain in postings, while fostering a sense of local ownership and accountability.

Yet, piecemeal reforms will not be enough. What is required is a coherent, legally grounded framework that clearly defines roles, responsibilities and resources at every level.

Ghana already has a solid foundation in the Local Governance Act, 2016 (Act 936). The task now is to align sector-specific laws, particularly those governing health with this broader decentralisation vision.

Without this legal clarity, implementation will remain uneven and uncertain.

The formation of a 12-member technical committee to draft the necessary legislation is, therefore, a critical step. But timelines must be treated as commitments, not mere aspirations.

The target to submit a draft bill to Cabinet by December 2026 must be pursued with urgency and discipline. Delays have cost the country enough.

Equally important is ensuring that decentralisation does not become a transfer of responsibility without resources. Metropolitan, Municipal and District Assemblies (MMDAs) must be adequately equipped financially, technically and administratively to manage their expanded roles.

Devolution without capacity will only shift inefficiencies from the centre to the local level.

There is also a need for transparency and sustained public engagement. Citizens must understand what decentralisation means for them: shorter waiting times, better-staffed facilities, and services that reflect local needs.

When people see tangible improvements, confidence in governance deepens.

The constitutional backing for decentralisation is clear. The policy direction is established. What remains is the political will to follow through consistently and decisively.

This is a moment Ghana cannot afford to squander. The health of the nation quite literally depends on how effectively care is delivered at the local level.

Bringing decision-making closer to communities is not just an administrative reform; it is a moral imperative.

The government, the Ministry of Health, and all relevant stakeholders must move beyond dialogue to decisive action. Ghanaians have waited long enough.

It is time to finish what we started and build a health system that truly serves every community, not just from the centre, but from the ground up.