Every year, roughly 27,000 Ghanaians hear the word “cancer” attached to their own diagnosis for the first time. According to the World Health Organisation’s GLOBOCAN 2022 report, Ghana recorded 27,385 new cancer cases and 17,944 cancer deaths that year, with breast cancer, liver cancer and cervical cancer leading the toll. Nearly 64,000 people are living with a cancer diagnosed within the past five years.
Behind every one of those numbers is a family now facing a question the health system has never adequately answered: how do you pay for this?
A Diagnosis That Doubles as a Financial Sentence
For most Ghanaian families, a cancer diagnosis triggers two crises at once a medical one and a financial one. Research from Korle Bu Teaching Hospital’s surgical unit found that breast cancer treatment alone costs the average household close to USD 990, with direct medical costs making up the bulk of that figure. In a country where the minimum daily wage sits at roughly two dollars, that is not a bill most families can absorb; it is a bill that reorganize their entire economic life forcing sale of assets, loans from family or moneylenders, and in many cases, abandonment of treatment altogether.
The uncomfortable truth is that Ghana’s National Health Insurance Scheme (NHIS), for all its real achievements, was never built to carry this weight. The NHIS formally covers only breast and cervical cancer, and even there, coverage is partial: diagnostic imaging, some essential medicines, and newer therapies like immunotherapy fall outside the benefits package entirely.
A recent qualitative study involving stakeholders across Ghana’s cancer-care system found that even where treatment is technically listed under NHIS, patients routinely face out-of-pocket demands due to delayed reimbursements, incomplete coverage of diagnostics, and providers passing cash-flow gaps onto patients as “top-up” fees. For every other cancer liver, prostate, stomach, colorectal, the very cancers that top Ghana’s own incidence charts patients are left almost entirely to the “cash and carry” system that NHIS was designed to replace.
The Numbers Don’t Add Up Literally
This is not simply a design flaw; it is a resourcing gap that Ghanaian health economists have already quantified. A cost-effectiveness analysis of the NHIS benefits package found that fully funding evidence-based interventions for everyone who needed them would cost roughly GH¢4.3 billion (about USD 994 million) a year while the NHIS budget available was only around GH¢970 million (about USD 223 million). That is a fourfold gap between what comprehensive coverage would cost and what the scheme can actually spend.
Cancer care, which is resource-intensive by nature chemotherapy, radiotherapy, surgery, ongoing scans will always be squeezed hardest by that shortfall.
The government’s 2026 decision to raise NHIS tariffs paid to providers by an average of 120%, and to remove the scheme’s fixed budget cap, is a meaningful step, and NHIS enrolment has grown to cover roughly 60% of the population. But raising what NHIS pays providers for the services it already covers does nothing to close the more fundamental gap: the list of cancers and treatments the scheme covers at all remains dangerously short.
What Families Actually Do
Faced with these gaps, Ghanaian families cope the way families across much of the region cope by underinsuring themselves against catastrophe. Surveys of cancer patients have found that the vast majority who manage treatment lean on their NHIS card for whatever portion it covers, then fill the rest through informal, high-cost strategies: selling land, borrowing from relatives, taking loans from moneylenders at punishing rates.
A smaller but telling share of patients, delayed or priced out of formal treatment, turn instead to herbalists and spiritual healers not necessarily out of belief, but because it is what remains affordable, even as it costs precious time that cancer does not forgive. Late-stage presentation, one of the most consistent findings across Ghanaian cancer research, is as much a symptom of cost as it is of awareness.
Beyond Breast and Cervix: The Coverage Gap Hiding in Plain Sight
It is worth stating plainly what Ghana’s own cancer statistics make obvious: the two cancers NHIS actually covers are not the two cancers killing the most Ghanaians.
Liver cancer is the single leading cause of cancer death among Ghanaian men and a major killer of women too, yet it sits entirely outside NHIS’s cancer benefit. Prostate cancer, the second most common cancer among men, is in the same position.
A insurance architecture built around two conditions, however important, cannot claim to answer Ghana’s cancer burden as a whole.
What Coping Would Actually Require
If Ghana is serious about the question this article is asking, the answer cannot simply be “make NHIS cards easier to renew.” It requires:
Expanding the NHIS cancer benefits list beyond breast and cervical cancer to include the liver, prostate and colorectal cancers that dominate Ghana’s actual disease burden.
Closing the reimbursement gap that pushes facilities to demand out-of-pocket “top-ups” even from insured patients a problem of implementation, not just policy design.
Investing in early detection and screening infrastructure, since the cost of treating cancer early is a fraction of the cost of treating it late, and late presentation remains the norm precisely because families delay seeking care they cannot afford.
Building dedicated catastrophic-illness financing separate from the general NHIS pool so that a cancer diagnosis does not have to compete for the same limited GH¢970 million meant to cover the entire country’s health needs.
The Honest Answer
For now, the honest answer is: only by selling what they own, borrowing what they can, and hoping the diagnosis came early enough. That is not coping it is enduring. A country whose own health authorities acknowledge that cost is a primary driver of late diagnosis and death owes its citizens a health insurance architecture built for the cancers Ghanaians actually get, not just the two the current package happens to cover.
Mustapha Bature Sallama
Medical/ Science Communicator,
Private Investigator, Criminal Investigation and Intelligence Analysis,
International Conflict Management and Peacebuilding. ( USIP)
[email protected]
+233555275880
Sources
GLOBOCAN 2022 Ghana Fact Sheet, Global Cancer Observatory (IARC/WHO): https://gco.iarc.who.int/media/globocan/factsheets/populations/288-ghana-fact-sheet.pdf
Ghanaian Times, “Ghana records 27,385 cancer-related diseases annually – GLOBOCAN”: https://ghanaiantimes.com.gh/ghana-records-27385-cancer-related-diseases-annually-globocan/
GhanaFact, “Cervical cancer the third-killing cancer disease in Ghana in 2022”: https://ghanafact.com/cervical-cancer-the-third-killing-cancer-disease-in-ghana-in-2022/
“Household treatment cost of breast cancer and cost coping strategies from a tertiary facility in Ghana,” PLOS Global Public Health: https://journals.plos.org/globalpublichealth/article?id=10.1371%2Fjournal.pgph.0000268
“Breast and cervical cancer care in Ghana: a qualitative exploratory study of stakeholder perspectives on NHIS coverage,” BMJ Open, Jan 2026: https://pubmed.ncbi.nlm.nih.gov/41535087/
“A comprehensive survey of cancer medicines prices, availability and affordability in Ghana,” PLOS ONE: https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0279817
City Cancer Challenge (C/Can), “The hidden costs for breast and cervical cancer patients in Ghana”: https://citycancerchallenge.org/the-hidden-costs-for-breast-and-cervical-cancer-patients-in-ghana/
“Cost Effectiveness and Resource Allocation” (NHIS benefits package cost-effectiveness study), DOAJ: https://doaj.org/article/519b65d1b84f4789980301617bbfff4d
Accra Street Journal, “Most Affordable Health Insurance Options In Ghana” (2026 NHIS tariff/coverage figures): https://accrastreetjournal.com/2026/08/18/the-most-affordable-health-insurance-options-in-ghana/
Accra Street Journal, “NHIS In Ghana 2026 – Benefits, Registration, Renewal & Coverage Explained”:
