Measuring access to health facilities in Ghana: Implications for implementation of health interventions and the Sustainable Development Goal 3

Spatial access to health is important for Sustainable Development Goal 3, yet most existing studies have largely focused on the primary health care level without considering other hierarchies of health facilities. This study analyzed spatial accessibility to primary, secondary, and tertiary health facilities in Ghana. Accumulated distance and network analysis were used in measuring accessibility by drawing insights from Ghana's Upper West region. The results show that 61% of the population have access to primary health care facilities within recommended standards. Also, 81% have access to secondary health care facilities, but the degree of access varies with mode of transportation (i.e., motorcycle or car) and other barriers such as speed and road conditions. On the contrary, only 48% of the population can reach tertiary medical centres in the recommended 30-min journey time. Considering other demographic and socioeconomic factors, the results of overall access show that the highest spatial concentration of healthcare facilities does not translate into high overall healthcare access among the inhabitants. The results imply a varied degree of spatial accessibility across different hierarchies of health facilities, with transportation, socioeconomic, and demographic factors playing critical roles in determining overall access. The findings suggest that for progress towards Sustainable Development Goal 3, it is imperative to focus on addressing rural transport infrastructure, inadequacy of doctors, and national health insurance subscriptions to scale up access towards universal primary health care for all and also improve secondary and tertiary access.