📄 Download the full Ghana case study. (Also in this series: Thailand and the Netherlands.)
Health leaders in all health systems must make critical decisions about which products―including diagnostics, medical devices, medicines, and vaccines―and services to provide within the constraints of their health budget. Between the global pipeline that brings technologies to market and the national systems that must deliver them at scale lies a critical inflection point: health innovation introduction. Prioritization―which often includes health technology assessment (HTA) processes―is an essential function of innovation introduction, as are the coordinated set of national and subnational processes through which innovations are prepared for sustained, scaled access (e.g., regulatory review, procurement, supply chain planning, etc).
Every health system faces difficult choices about which innovations to fund and how to make the best use of limited resources. For Ghana, these questions became increasingly urgent as pressures on the National Health Insurance Scheme (NHIS) grew. In response, the country embarked on a deliberate effort to institutionalize Health Technology Assessment (HTA), establishing a structured pathway for reviewing evidence on new health innovations and ensuring that coverage decisions support both population health and the long-term sustainability of the insurance scheme.
This case study is one in a series of decision-making deep dives produced by the ALIGN Consortium as part of our shared learning agenda. Each examines how a particular country has navigated the persistent challenge of introducing new health innovations—how it evaluates, prioritizes, finances, and sustains them within real fiscal and political constraints. Our aim is not to rank systems or prescribe a single model, but to understand how reform actually unfolds: what enables it, what constrains it, and what does and does not transfer across contexts. These cases inform ALIGN’s work alongside national partners and are offered in the spirit of mutual learning. We welcome reactions, corrections, and counter-examples from colleagues who know these systems first-hand.