Bolgatanga: For communities across the Upper East Region, the Free Primary Health Care (FPHC) programme represents more than healthcare without payment at the point of service. It is an effort to bring healthcare closer to households, shift focus from treating illness to preventing it, and reduce the extent to which poverty and geography determine access to care.
According to Ghana News Agency, the FPHC programme, launched nationally on April 15, 2026, is a major component of Ghana's drive towards Universal Health Coverage (UHC). Its first phase targets 150 of the country's most deprived districts, with expansion to all districts expected by the end of 2027. The Upper East Region is prominently represented in the first phase, with all 15 municipalities and districts benefiting. Health authorities regard the region as underserved and see its implementation as both a priority and an opportunity to demonstrate what community-centred primary healthcare can achieve.
At the heart of the FPHC is a simple philosophy: healthcare should not begin only when a patient arrives at a hospital seriously ill. Health professionals must instead go into communities and households to prevent disease, detect conditions early and connect patients to appropriate care. President John Dramani Mahama underscored this approach when he launched the programme at Zuarungu in the Bolgatanga East District. He described home visits as the most important component, as such visits enable health workers to identify illnesses early and refer patients before conditions become complicated.
Community Health Nurses (CHNs) and other frontline workers will conduct household visits and community outreach, screening residents for hypertension and diabetes, assessing weight and Body Mass Index, monitoring vulnerable groups and providing health education. Pregnant women and newborns will receive particular attention. Health workers will monitor expectant mothers, encourage regular antenatal care and refer those who have not begun care. Newborns will also be monitored for healthy growth and vaccination needs.
The programme covers immunisation, antenatal and postnatal care, treatment of common illnesses such as malaria and respiratory infections, family planning, mental health support and health education. Screening for hypertension, diabetes, obesity and selected cancers will also be undertaken, with abnormal cases referred to CHPS compounds, health centres, polyclinics or hospitals.
The government also plans to establish health kiosks and health posts at busy markets, lorry stations and remote communities. According to Dr Samuel Kaba Akoriyea, the Director-General of the Ghana Health Service (GHS), the selection of districts was based on measurable indicators rather than political considerations. These include access to hospitals, maternal mortality, school enrolment and distance to healthcare.
Mr Kwabena Mintah Akandoh, the Minister for Health, has emphasised that FPHC is not a replacement for the National Health Insurance Scheme (NHIS). It is intended to complement the scheme by preventing illness, detecting conditions early and closing access gaps that remain even when people have health insurance. Importantly, beneficiaries do not need an NHIS card to access FPHC services.
The programme is supported with new logistics. In the Upper East Region, every CHPS zone is expected to have a home-visit bag. The Regional Health Directorate has also received motorbikes to improve mobility. Nationally, the government plans to provide about 7,000 motorbikes and tricycles.
Dr Braimah Baba Abubakari, the Upper East Regional Director of Health Services, has emphasised that free healthcare must not become synonymous with poor-quality healthcare. Expanded access must be accompanied by adequate staff, medicines, equipment, leadership and accountability. Success should therefore be measured not by number of visits or screenings, but by tangible improvements: mothers receiving quality care, children protected against preventable diseases, illnesses detected early, and underserved communities gaining access.
Success will depend heavily on CHNs and other frontline workers. Dr Akoriyea has urged senior health managers to support rather than take over the work of frontline personnel. The GHS has introduced patient navigators to strengthen links between communities and facilities. The navigators will help patients secure appointments, navigate referrals and ensure information is communicated back to community health workers for follow-up.
Traditional authorities have welcomed the initiative. Pe Ditundini Adiali Ayagitam III, the Chiana-Pio and President of the Upper East Regional House of Chiefs, described it as a step towards social justice and inclusion, particularly for vulnerable women and children in hard-to-reach communities. Pe Denis Aneakwoa Balinia Adda Asagpaare II, the Navro-Pio, also welcomed the programme and urged Ghanaians not to politicize it.
FPHC cannot operate in isolation. Increased screening will generate referrals, making the capacity of health centres, polyclinics and hospitals critical. Under the KOICA CHPS Plus project, construction of six CHPS compounds with accommodation has commenced in selected districts. Plans also include furnishing facilities and providing mechanized boreholes.
The FPHC faces challenges including human-resource shortages, transportation difficulties, referral gaps, infrastructure constraints and the need to maintain adequate medicines and equipment. Community participation will also be essential. Residents must be willing to receive health workers, undergo screening, follow referrals and adopt preventive practices.
The real test will be whether a nurse reaches a remote household, whether illness is detected before it becomes dangerous, whether referrals are completed and whether patients receive quality care without financial hardship. The FPHC is therefore about more than removing fees. It seeks to make healthcare closer, earlier, fairer and better.