Ghana
Hepatitis
MedCOI

July 2024

Manuscript completed in July 2024
Neither the European Union Agency for Asylum (EUAA) nor any person acting on behalf of the
EUAA is responsible for the use that might be made of the information contained within thispublication.
Luxembourg: Publications Office of the European Union, 2024
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doi: 10.2847/377911

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GHANA TOPICAL MEDCOI REPORT: HEPATITIS

Acknowledgements
The EUAA acknowledges International SOS as the drafter of this report.
The report has been reviewed by International SOS and EUAA.

3

EUROPEAN UNION AGENCY FOR ASYLUMContents
Acknowledgements........................................................................................................................ 3
Disclaimer ........................................................................................................................................ 5
Glossary and abbreviations ........................................................................................................... 6
Introduction ..................................................................................................................................... 8
Methodology ......................................................................................................................................... 8
Terms of reference .......................................................................................................... 8
Collecting information ..................................................................................................... 8
Quality control ................................................................................................................... 8
Sources ................................................................................................................................................... 91.

Prevalence of hepatitis B and hepatitis C ..................................................................... 10

2.

Access to treatment .......................................................................................................... 11
2.1. Insurance and national programmes .................................................................................... 112.2. Non-governmental organisations (NGOs)........................................................................... 12

3.

Cost of treatment ..............................................................................................................12

4.

Cost of medication ............................................................................................................15

Annex 1: Bibliography ...................................................................................................................18
Annex 2: Terms of Reference (ToR) ............................................................................................ 20

4

GHANA TOPICAL MEDCOI REPORT: HEPATITIS

Disclaimer
This report was written according to the EUAA COI Report Methodology (2023). The report isbased on publicly available sources of information, as well as oral anonymised sources whoare based in Ghana. All sources used are referenced.
The information contained in this report has been researched, evaluated and analysed withutmost care. However, this document does not claim to be exhaustive. If a particular event,person or organisation is not mentioned in the report, this does not mean that the event has
not taken place or that the person or organisation does not exist.
Furthermore, this report is not conclusive as to the determination or merit of any particularapplication for international protection. Terminology used should not be regarded asindicative of a particular legal position.
‘Refugee’, ‘risk’ and similar terminology are used as generic terminology and not in the legal
sense as applied in the EU Asylum Acquis, the 1951 Refugee Convention and the 1967
Protocol relating to the Status of Refugees.
Neither the EUAA, nor any person acting on its behalf, may be held responsible for the use
which may be made of the information contained in this report.
On 19 January 2022 the European Asylum Support Office (EASO) became the European Union
Agency for Asylum (EUAA). All references to EASO, EASO products and bodies should beunderstood as references to the EUAA.
The drafting of this report was finalised on 27 March 2024. Any event taking place after thisdate is not included in this report. More information on the reference period for this report canbe found in the methodology section of the Introduction.

5

EUROPEAN UNION AGENCY FOR ASYLUMGlossary and abbreviations
Term

Definition

AFP

Alpha-Fetoprotein

AIDS

Acquired Immunodeficiency Syndrome

ALAT

Alanine Transaminase

ASAT

Aspartate Aminotransferase

CHPS

Community-Based Health and Planning Services

CT

Computed Tomoghraphy

DNA

Deoxyribonucleic Acid

HBeAb

Hepatitis B e Antibody

HBcAb

Hepatitis B core Antibody

HBsAb

Hepatitis B Surface Antibody

HBsAg

Hepatitis B Surface Antigen

HBV

Hepatitis B Virus

HCV

Hepatitis C VirusHIV

Human Immunodeficiency Virus

FDA

Food and Drugs Authority

6

GHANA TOPICAL MEDCOI REPORT: HEPATITIS

TermDefinition

MRI

Magnetic Resonance Imaging

NGO

Non-Governmental Organisation

NHIS

National Health Insurance Scheme

PET

Positron-Emission Tomography

PHC

Primary Healthcare

PTC / PTHC

Percutaneous Transhepatic Cholangiography

RNA

Ribonucleic Acid

SGOT

Serum Glutamic Oxaloacetic Transaminase

SGPT

Serum Glutamic Pyruvic Transaminase

TIPS

Transjugular Intrahepatic Portosystemic Shunt

WHO

World Health Organisation

7

EUROPEAN UNION AGENCY FOR ASYLUM

Introduction
Methodology
The purpose of the report is to provide information on access to hepatitis treatment in Ghana.
This information is relevant to the application of international protection status determination(refugee status and subsidiary protection) and migration legislation in EU+ countries.

Terms of reference
The terms of reference for this Medical Country of Origin Information Report were developedby EUAA.
The terms of reference for this Medical Country of Origin Information Report can be found in
Annex 2: Terms of Reference (ToR). The initial drafting period was finalised on 9 November
2023, peer review occurred between 10 November – 22 December 2023, and additional
information was added to the report as a result of the quality review process during the review
implementation up until 27 March 2024. The report was internally reviewed subsequently.

Collecting information
EUAA contracted International SOS (Intl.SOS) to manage the report delivery including datacollection. Intl.SOS recruited and managed a local consultant to write the report and a publichealth expert to edit the report. These were selected from Intl.SOS’ existing pool ofconsultants. The consultant was selected based on their experience in leading comparable
projects and their experience of working on public health issues in Ghana.
This report is based on publicly available information in electronic and paper-based sources
gathered through desk-based research. This report also contains information from multiple
oral sources with ground-level knowledge of the healthcare situation in Ghana who wereinterviewed specifically for this report. For security reasons, all oral sources are anonymised.

Quality control
This report was written by Intl.SOS in line with the European Union Agency for Asylum (EUAA)
COI Report Methodology (2023), 1 the EUAA Country of Origin Information (COI) Reports
Writing and Referencing Guide (2023) 2 and the EUAA Writing Guide (2022). 3 Quality control of
the report was carried out both on content and form. Form and content were reviewed by
Intl.SOS and EUAA.
The accuracy of information included in the report was reviewed, to the extent possible,
based on the quality of the sources and citations provided by the consultants. All the
EUAA, Country of Origin Information (COI) Report Methodology, February 2023, url
EUAA, Country of Origin Information (COI) Reports Writing and Referencing Guide, February 2023, url
3
EUAA, The EUAA Writing Guide, April 2022, url
12

8

GHANA TOPICAL MEDCOI REPORT: HEPATITIS

comments from reviewers were reviewed and were implemented to the extent possible, undertime constraints.

Sources
In accordance with EUAA COI methodology, a range of different published sources have been
consulted on relevant topics for this report. These include governmental publications,academic publications, reports by non-governmental organisations and internationalorganisations. All sources that are used in this report are outlined in Annex 1: Bibliography.
Key informant interviews were carried out in September 2023. Interviews were conducted
mainly with officers who work within organisations of Ghana’s healthcare system. A complete
anonymised list of interviewees can be found in the Annex 1: Bibliography.

9EUROPEAN UNION AGENCY FOR ASYLUM

1. Prevalence of hepatitis B and hepatitis C
Hepatology is a medical speciality that focuses on the study, prevention, diagnosis andmanagement of diseases that affect the liver, gallbladder, biliary tree and pancreas. This
report focuses on the situation in Ghana with respect to hepatitis B and hepatitis C.
In Ghana, viral hepatitis is a major health concern for health authorities. Hepatitis B is
hyperendemic, with an estimated chronic hepatitis B surface antigen (HBsAg) prevalence inthe population of 8.36 % and chronic hepatitis C viral (HCV) estimated prevalence of 3 %. 4
Chronic hepatitis B viral (HBV) infection is a major public health problem in Ghana. 5 Looking at
the data from 2015 to 2019, across all the regions in Ghana, HBV prevalence was estimatedfor sub-populations as follows: 8.36 % in the adult population, 14.30 % in the adolescentpopulation and 0.55 % in children under five years (pre-schoolers). Among adults, HBV
prevalence was the highest in the special occupation (barbers and long-distance drivers)
group (14.40 %) and the lowest prevalence rate of 7.17 % was recorded among blood donors.
Prevalence was lower in the north than in the southern part of the country. The Ashanti region
had the most studies at 6/21 (29 %), while no study was identified for the Upper West Region.
Across the country, the highest HBV infection prevalence rates were recorded in the agegroup of 20 to 40 years. 6
The burden of hepatitis B is enormous and remains an important public health issue in
Ghana. 7 Hepatitis B and hepatitis C are serious public health threats in Ghana with theprevalence of HCV estimated to be at 3 % nationally in 2016. 8 At the time of writing, Ghana
does not have a national hepatitis B or hepatitis C elimination plan in place. 9

Coalition for Global Hepatitis Elimination, Ghana Can Eliminate Hepatitis, National Hepatitis Elimination Profile,
December 2021, December 2021, url, p. 1
5
Abesig, J., et al., Prevalence of viral hepatitis B in Ghana between 2015 and 2019: A systematic review and metaanalysis, June 2020, url, p. 1
6
Abesig, J., et al., Prevalence of viral hepatitis B in Ghana between 2015 and 2019: A systematic review and metaanalysis, June 2020, url, p. 1
7
Abesig, J., et al., Prevalence of viral hepatitis B in Ghana between 2015 and 2019: A systematic review and metaanalysis, June 2020, url, p. 1
8
WHO, Renewed hope for all people living with viral hepatitis in Ghana, July 2023, url
9
Coalition for Global Hepatitis Elimination, Ghana National Hepatitis Elimination Profile: Key Takeaways, January2022, url
410

GHANA TOPICAL MEDCOI REPORT: HEPATITIS

2. Access to treatment
Ghana has a pluralistic health sector in terms of ownership (public and private) and in terms ofhealthcare models (orthodox, traditional and alternative medicine). 10 Healthcare services areprovided by the public sector, as well as by private sector service providers made up of forprofit providers and non-profit faith-based health facilities. 11 The health system is organised inthree levels: the primary level, with a focus on primary healthcare (PHC) services, with thecommunity-based health and planning services (CHPS) compound, the sub-district healthcentre/clinic and the district hospital. The secondary and tertiary levels have regional andteaching hospitals, respectively. 12
Public and private facilities, at all levels of the health system, can provide care within limits set
by the Standard Treatment Guidelines 2017. 13 The primary level of care has the capacity toidentify and make differential diagnosis of some of the conditions. This capacity is mostly at
the district hospital level where they can make more definitive diagnosis, commence basiccare and refer the client to the appropriate secondary or tertiary facility for definitive casemanagement. All patients can access care at the nearest point of service to them at any levelof the health system. Based on the severity of the condition and the capacity of the point ofservice to manage the condition, care will be continued, or the patient will be referred to thenext higher level of care for further appropriate case management. Patients can however walk
into any emergency room in any secondary or tertiary facility and will be attended to. 14
Ghana has a 99 % coverage of HBV vaccination through the infant routine vaccination
programme. 15

2.1. Insurance and national programmes
The public National Health Insurance Scheme (NHIS) and private health insurance schemes
cover both inpatient and outpatient cost of care to different degrees, with the private schemes
generally providing more cover than the NHIS. 16 The NHIS covers the consultation fees for all
general and specialist clinic attendances, as well as hospital admission (bed and feeding) arecovered. Hepatitis B birth dose and adult vaccinations are not covered by NHIS and must be
financed out of pocket. 17

Ghana, MOH, National Health Policy: Ensuring healthy lives for all (Revised Edition), January 2020, url, p. 23
Ghana, MOH, Health Sector Medium Term Development Plan 2022-2025, December 2021, url, p. 11
12
Ghana, MOH, Health Sector Medium Term Development Plan 2022-2025, December 2021, url, p. 11
13
Ghana, MOH (Ministry of Health), GNDP (Ghana National Drugs Programme), Standard Treatment Guidelines,
Seventh Edition, 2017, url, pp. 37-42
14
CHpKII101, Consultant Hepatologist, Interview, September 2023, Accra
15
WHO, Renewed hope for all people living with viral hepatitis in Ghana, July 2023, url
16
CHpKII101, Consultant Hepatologist, Interview, September 2023, Accra
17
Coalition for Global Hepatitis Elimination, Ghana Can Eliminate Hepatitis, National Hepatitis Elimination Profile,
December 2021, url, p. 6
10
11

11

EUROPEAN UNION AGENCY FOR ASYLUMAs of 2019, the NHIS had a membership of over 12 million Ghanaian. 18 The NHIS is available
for registration to all individuals living in Ghana. 19
The government of Ghana has taken some steps to address the hepatitis B and hepatitis C
epidemic in the country. The government (Ministry of Health and the Ghana Health Services)with support from the World Health Organisation (WHO) has launched a person-centredintervention that responds directly to the needs of people living with hepatitis C. This project
has provided treatment to many Ghanaians living with hepatitis C. 20 Ghana has also partneredwith Egypt and initiated The Stop Hepatitis C Ghana Project to eliminate hepatitis C in the
country. 21 Egypt has pledged to supply Ghana with medicine to treat 50 000 Ghanaians with
hepatitis C, and patients will receive the drugs free of charge. 22

2.2.

Non-governmental organisations (NGOs)

There are a few organisations in Ghana that provide free or low-cost treatment for hepatitis B
and hepatitis C, but mostly they provide private health education, screening and advocacy.
Some of these organisations include: the Hepatitis Foundation of Ghana, a patient's
organisation and non-profit, non-governmental organisation (NGO) registered in Ghana. It
seeks to promote awareness of viral hepatitis and provide support to those living with thedisease; 23 the Cedaku Foundation of Ghana, an organisation created to educate, assist withthe treatment, and prevent the spread of HIV/AIDS and hepatitis B in Africa and worldwide;24
and the Falcons Health Foundation of Accra, Ghana, which creates public awareness about
viral hepatitis B and hepatitis C, advocates for those with hepatitis, and provides treatment. 25
Services provided by all these organisations are free with no restriction to beneficiaries. 26

3. Cost of treatment
While HCV antibody and HBsAg point-of-care tests are meant to be covered under the NHIS,in practice many patients still pay out of pocket. Moreover, all persons have to pay out of
pocket for confirmatory HBV and HCV testing. Treatment accessibility is similarly a concern
because HBV and HCV treatments are only available in teaching hospitals and must be fully
financed by the patient.27

NHIS, NHIS active membership soars, July 2020, url
CHpKII101, Consultant Hepatologist, Interview, September 2023
20
WHO, Renewed hope for all people living with viral hepatitis in Ghana, July 2023, url
21
WHO, Renewed hope for all people living with viral hepatitis in Ghana, July 2023, url
22
The Task Force for Global Health, Egypt and Ghana Team Up To Eliminate Hepatitis C, June 2023, url
23
Hepatitis Foundation of Ghana, The National Voice for Hepatitis Patients, n.d., url
24
Cedaku Foundation of Ghana, 2023, url
25
Hepatitis B Foundation, CHIPO Partner Highlight: Falcons Health Foundation of Accra, Ghana, July 2023, url
26
CHpKII101, Consultant Hepatologist, Interview, September 2023, Accra
27
Coalition for Global Hepatitis Elimination, Ghana Can Eliminate Hepatitis, National Hepatitis Elimination Profile,
December 2021, url, p. 6
18

19

12

GHANA TOPICAL MEDCOI REPORT: HEPATITISIn Table 1 and Table 2, public facilities’ prices are based on NHIS medicines’ list 28 and the
NHIS tariffs.29 Information for the private sector, as well as reimbursement and insurance
information are provided by Interviewee CHpKII102. 30
Concerning the coverage and reimbursement of the treatment prices in the tables 1 and 2
below, the following principles apply to all listed treatments:
1.

Public and some private sector facility treatment prices are covered by NHIS andsometimes private insurance.

2. If insured, on presentation of one’s insurance card, whether NHIS or private, nopayment is made by the patient, as the insurance company re-imburses the facility at alater date on submission of claims.
3. In public facilities, any price difference between the listed NHIS tariffs and the priceasked by the facility is borne by the patient (some facilities obtain parliamentary
approval to increase their prices). In private facilities where NHIS coverage is
accepted, the price difference between the NHIS tariffs and the private price is borneby the patient.
4. Uninsured patients pay out of pocket for all services at public and private facilities.

Table 1. Cost of hepatology specialist consultations in public tertiary and private health facilities
Specialist

Publicoutpatient
treatment
price in GHS

Internist

147

Infectiologist

Public inpatient
treatment price in GHS

Privateoutpatient
treatment
price in GHS

Private inpatient
treatment pricein GHS

128 (cost of admission,
not including
consultation fee)

280 to 500

600 to 1 000

147

128 (cost of admission,
not including
consultation fee)

280 to 500

600 to 1 000

Gastroenterologist

147

128 (cost of admission,
not including
consultation fee)

280 to 500

600 to 1 000

Hepatologist

147

128 (cost of admission,
not including
consultation fee)

280 to 500

600 to 1 000

NHIS, Medicine List, February 2023, url
Ghana, NHIS, Tariffs for Tertiary Hospitals, February 2023
30
CHpKII102, Administrator of a Private Hospital, Interview, July 2023
28

29

13

EUROPEAN UNION AGENCY FOR ASYLUMTable 2. Cost of hepatology laboratory, diagnostic imaging and specialist treatment interventions inpublic tertiary and private health facilities.
Public treatment price in
GHS

Private treatment price in
GHS

Laboratory test: Hepatitis B antibodies:
HBsAg, HBeAb, HBcAb

155

500 to 600

Laboratory test: Hepatitis B antigens:
HBsAg,

31

70 to 90

Laboratory test: HBV DNA testing incase of Hepatitis B

Not found

2 900 to 2 700

Laboratory test: HCV RNA test [hepatitisC]

Not found

1 920 to 2 000

Laboratory test: liver function (PT,albumin, bilirubin, transaminases:
ASAT(=SGOT), ALAT(=SGPT) etc.)

95

150 to 180

Laboratory test: Fibrotest; incl. 6 serum
markers: alpha-2-macroglobulin,
haptoglobin, apolipoprotein A1, gamma
GT, total bilirubin, ALAT

Apolipoprotein A1 – 63

Alpha 2 – 4 000-4 500

Total bilirubin – 19

Apoliprotein A1 – 200 to
250

Laboratory test: HCV antibody in caseof Hepatitis C

155

70 to 90

Laboratory test: alpha-fetoprotein (AFP)

78

70 to 90

Laboratory test: HCV genotype(hepatitis C)

Not found

1 600 to 1 800

Laboratory test: viremia of hepatitis D +HBsAg

HBsAg – 70 to 80
Not found

14

Hepatitis D RNA – 1 620 to
1 800

GHANA TOPICAL MEDCOI REPORT: HEPATITIS

Public treatment price in
GHS

Private treatment price in
GHS
Hepatitis Ab – 460 to 510

Laboratory test: alkaline phosphatase34

60 to 80

Diagnostic imaging by means ofultrasound (of the liver)75

200 to 300

Diagnostic test: liver biopsy

320

Not found

Diagnostic imaging: MRI scan

1 065

995 to 1 100

Diagnostic imaging: computed
tomography (CT scan)

590

600 to 700

Diagnostic imaging: computed
tomography (CT) scan with contrast

790

1 000 to 1 200

Clinical admittance on internal/
infectious disease department (daily
rate)

127

300 to 450

4. Cost of medication
The cost of medication in the public sector is regulated by the NHIS medicines list. 31 The NHIS
medicines’ list is expected to include the official charges for medicines in public facilities. This
is often not adhered to because the prices of NHIS’ medicines are below market prices.
Facilities, mainly the teaching hospitals, will go on to secure parliamentary approval for higher
fees and charges to ensure they are able to recover the cost of services and medicines that
the NHIS may not fully cover. These additional fees and charges are paid out of pocket bypatients. 32
The cost of medicines in the private sector is not regulated, and different service providers set
different fees and charges that enable them to, at least, fully recover their costs. These fees

31
32

NHIS, Medicine List, February 2023, url
CHpKII101, Consultant Hepatologist, Interview, September 2023, Accra
15

EUROPEAN UNION AGENCY FOR ASYLUM

and charges may be revised at any time and the revisions are primarily influenced by foreignexchange rates. 33
The cost of medication is generally higher in private as compared to public facilities, and also
increases from primary to tertiary level of care. 34 Most medicines are available in the wholecountry. The private sector pharmacies maintain a more complete stock of medicines thanpublic facilities and medicines are more readily available in urban as against ruralcommunities. 35
As far as possible, medicines found in the country are registered by the Food and Drugs
Authority (FDA) for use. The implication of this is that the quality of the medicines can beassured, to a large extent. For a product to be registered, it means that it has gone through andpassed the rigorous testing and product source verification processes carried out by the FDAof Ghana. However, non-registered, as well as fake, medicines are also found in the country.
Some of the medicines are on the Essential Medicines List and the National Health Insurance
Medicines List. Their inclusion on the list encourages pharmacies and health facilities to stock
them, reducing situations when stocks run out. 36
In situations where needed medicines are not available in the country, citizens may makearrangements for friends and family living abroad to purchase and send to them these
medicines, or they may seek the support of pharmacies to order the medicines for them.
These scarce medicines may or may not be registered by the FDA. These medications areoften prescription-only medications and often need to be accompanied by the prescription. 37
In the table below, ‘Pharmacy’ refers to the private sector and ‘Hospital’ refers to the public
sector.
Public facilities prices are as listed in the NHIS medicines’ list. 38 No brand names are covered
under the medicines’ list. 39 Prices in private facilities and information on insurance andreimbursement are provided by interviewee CHpKII103. 40
Concerning the coverage and reimbursement of the medication prices in the table below, thefollowing principles apply:
1.

Both public and private sector prices can be covered by NHIS or/and private
insurance.

2. If insured, on presentation of one’s insurance card, whether NHIS or private, nopayment is made by the patient, as the insurance company re-imburses the facility at alater date on submission of claims.

CHpKII103, Pharmacist of a Private Hospital, Interview, September 2023, Accra
CHpKII101, Consultant Hepatologist, Interview, September 2023, Accra
35
CHpKII101, Consultant Hepatologist, Interview, September 2023, Accra
36
CHpKII103, Pharmacist of a Private Hospital, Interview, September 2023, Accra
37
CHpKII103, Pharmacist of a Private Hospital, Interview, September 2023, Accra
38
Ghana, NHIS, Medicine List, February 2023, url
39
CHpKII103, Pharmacist of a Private Hospital, Interview, September 2023, Accra
40
CHpKII103, Pharmacist of a Private Hospital, Interview, September 2023, Accra
33

34

16

GHANA TOPICAL MEDCOI REPORT: HEPATITIS

3. In private facilities, where NHIS coverage is accepted, the price difference between the
NHIS tariffs and the private price is borne by the patient.
4. Uninsured patients pay out-of-pocket for all medications at public and private facilities.

Table 3. Cost of medicines in public and private facilities
Generic Name

Brand nameStrengthof unit

Form

Numberof unitsin thecontainer

Price perbox inGHS

Place(pharmacy,
hospital,…)Tenofovir
alafenamide

Tenofovir
alafenamide

25 mgtablet30

187.7

Pharmacy

Tenofovir
disoproxil

Tenofovir
disoproxil

300 mgtablet30

196.3

Pharmacy

Ledipasvir +sofosbuvir(combination)

Ledipasvir +sofosbuvir

90 mg+40 mg

tablet28

74.5

Pharmacy

Peginterferon
alfa-2aPegasys®

180 mcg/
0.5 mlinjection

1

696.3

Pharmacy

17

EUROPEAN UNION AGENCY FOR ASYLUM

Annex 1: Bibliography
Oral sources, including anonymous sources
CHpKII101, A Consultant Hepatologist Interview, Accra, September 2023. The person wishes
to remain anonymous.
CHpKII102, An Administrator of a Private Hospital, Interview, Accra, September 2023. The
person wishes to remain anonymous.
CHpKII103, A Pharmacist of a Private Hospital, Interview, Accra September 2023. The person
wishes to remain anonymous.

Public sources
Abesig, J., Chen, Y., Wang, H., Mwekele Sompo, F. and Wu, I. X. Y., Prevalence of viral
hepatitis B in Ghana between 2015 and 2019: A systematic review and meta-analysis, in: PLoS
ONE, Vo. 15, Issue 6, Article No. e0234348 [no pagination], June 2020,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292378/pdf/pone.0234348.pdf, accessed 5
December 2023
Cedaku Foundation of Ghana, 2023, https://hepfree.nyc/hepfree-partner/cedaku-foundationghana/, accessed 5 December 2023
Coalition for Global Hepatitis Elimination, Ghana Can Eliminate Hepatitis, National Hepatitis
Elimination Profile, December 2021,
https://www.globalhep.org/sites/default/files/content/page/files/2021-12/Ghana National
Hepatitis Elimination Profile - December 2_1.pdf, accessed 5 December 2023
Coalition for Global Hepatitis Elimination, Ghana National Hepatitis Elimination Profile: Key
Takeaways, January 2022, https://www.globalhep.org/news/ghana-national-hepatitiselimination-profile-key-takeaways, accessed 5 December 2023
Ghana, MOH (Ministry of Health), GNDP (Ghana National Drugs Programme), Standard
Treatment Guidelines, Seventh Edition, 2017, https://www.moh.gov.gh/wpcontent/uploads/2020/07/GHANA-STG-2017-1.pdf, accessed 5 October 2023
Ghana, MOH (Ministry of Health), Health Sector Medium Term Development Plan 2022-2025,
December 2021, https://www.globalfinancingfacility.org/sites/gff_new/files/Ghana-GFFInvestment-Case.pdf, accessed 5 December 2023
Ghana, NHIS (National Health Insurance Scheme), Medicine List, February 2023,
https://nhis.gov.gh/medlist, accessed 5 December 2023

18

GHANA TOPICAL MEDCOI REPORT: HEPATOLOGY

Ghana, NHIS (National Health Insurance Scheme), NHIS active membership soars, July 2020,
https://www.nhis.gov.gh/News/nhis-active-membership-soars5282#:~:text=Ghana's%20National%20Health%20Insurance%20Scheme,Accra%20region%20
with%201.7%20million, accessed 5 December 2023
Ghana, NHIS (National Health Insurance Authority), Tariffs for Tertiary Hospitals, February
2023, accessed 5 December 2023, not available online
Ghana, MOH (Ministry of Health), National Health Policy: Ensuring healthy lives for all (Revised
Edition), January 2020, https://www.moh.gov.gh/wpcontent/uploads/2020/07/NHP_12.07.2020.pdf-13072020-FINAL.pdf, accessed 5 December
2023
Hepatitis B Foundation, CHIPO Partner Highlight: Falcons Health Foundation of Accra, Ghana,July 2023, https://www.hepb.org/blog/chipo-partner-highlight-falcons-health-foundation-accraghana/, accessed 5 December 2023
Hepatitis Foundation of Ghana, The National Voice for Hepatitis Patients, n.d.,
https://www.hepatitisghana.org/about/, accessed 5 December 2023
The Task Force for Global Health, Egypt and Ghana Team Up To Eliminate Hepatitis C, June
2023, https://www.taskforce.org/egypt-and-ghana-team-up-to-eliminate-hepatitis-c/, accessed
5 December 2023
WHO (World Health Organization), Renewed hope for all people living with viral hepatitis in
Ghana, July 2023, https://www.who.int/news-room/feature-stories/detail/renewed-hope-for-allpeople-living-with-viral-hepatitis-in-ghana, accessed 5 December 2023

19

EUROPEAN UNION AGENCY FOR ASYLUM

Annex 2: Terms of Reference (ToR)
Hepatitis
Note for drafters: These are guidelines on the information to be included. If one aspect is
not relevant, e.g., there is no national institute to treat this disease or no international
donor programme, there is no need to mention it. Keep the focus on treating medicine –General information
•
•
•
•

•
•
•
•

Briefly describe prevalence and incidence of hepatitis / types of this disease(epidemiologic data).
How is the health care organized for hepatic diseases?
How is hepatitis treated – at specific centres, in primary health care centres, secondary
care / hospitals, tertiary care etc.?
Which kinds of facilities can treat hepatic diseases [public, private not for profit (e.g.,
hospitals run by the church), private for-profit sector]? Include links to facilities’
websites if possible.
How are the resources organized in general to treat patients with hepatic diseases?
Are there sufficient resources available to treat all patients?
Is there a particular type of this disease for which no (or only partial) treatment exists inthe country?
Is there a (national) institute specialised in treating hepatic diseases?
Are there any national or international plans or (donor) programmes for certain
diseases; if yes, could you elaborate on such programme(s) and what it entails?

Access to treatment
•
•
•

•
•

Are there specific treatment programmes for hepatitis? If so, what are the eligibility
criteria to gain access to it and what they contain?
Are there specific government (e.g., insurance or tax) covered programmes for hepaticdiseases? If so, what are the eligibility criteria to gain access to it?
Are there any factors limiting the access to healthcare for patients? If so, are theyeconomic, cultural, geographical, etc.? Are there any policies to improve access tohealthcare and/or to reduce the cost of treatments and/or medication? What is thenumber of people having access to treatment? Keep focus on e.g., waiting times rather
than the exact number of specialists in the field.
If different from information provided in the general section; is the treatment
geographically accessible in all regions?
What is the ‘typical route’ for a patient with this disease (after being diagnosed with thedisease)? In other words: for any necessary treatment, where can the patient find help

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•
•
•

•

and/or specific information? Where can s/he receive follow-up treatment? Are there
waiting times for treatments (e.g., liver transplantation, etc)?
What must the patient pay and when?
Is it the same scenario for a citizen returning to the country after having spent a
number of years abroad?
What financial support can a patient expect from the government, social security or apublic or private institution? Is treatment covered by social protection or an additional /communal health insurance? If not, how can the patient gain access to a treatment?
Any occurrences of healthcare discrimination for people with hepatic diseases?

Insurance and national programmes•••

National coverage (state insurance).
Programmes funded by international donor programmes.
Include any insurance information that is specific for patients with hepatic diseases.

Cost of treatment
Guidance / methodology on how to complete the tables related to treatments:
•
•
•

•
•
•
•

Do not delete any treatments from the tables. Instead state that they are not available
or information could not be found if that is the case.
In the table, indicate the price for inpatient and outpatient treatments in public andprivate facilities and if the treatments are covered by any insurance or by the state.
For inpatient, indicate what is included in the cost (bed / daily rate for admittance,
investigations, consultations…). For outpatient treatment, indicate follow up or
consultation cost.
Is there a difference in respect to prices between the private and public facilities?
Are there any geographical disparities?
Are the official prices adhered to in practice?
Include links to online resources used, if applicable (e.g., hospital websites).

Note: a standardised list of treatments was also included in the original ToR, as can beviewed in the report. Any treatment without a found price was removed at the editorial
stage.

Cost of medication
Guidance / methodology on how to complete the tables related to medications:•

Do not delete any medicines from the tables. Instead, state that they are not available
or information could not be found if that is the case.

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•
•
•
•

•
•

Are the available medicines in general accessible in the whole country or are there
limitations?
Are the medicines registered in the country? If yes, what are the implications of it
being registered?
Indicate in the tables: generic name, brand name, dosage, form, pills per package,
official prices, source, insurance coverage.
Are (some of the) medicines mentioned on any drug lists like national lists, insurance
lists, essential drug lists, hospital lists, pharmacy lists etc.? If so, what does such a list
mean specifically in relation to coverage?
Are there other kinds of coverage, e.g., from national donor programmes or otheractors?
Include links to online resources used, if applicable (e.g., online pharmacies).

Note: a standardised list of medication was also included in the original ToR, as can beviewed in the report. Any medication without a found price was removed at the editorial
stage.

NGOs••

Are any NGOs or international organisations active for patients with hepatic diseases?
What are the conditions to obtain help from these organisations? What help or support
can they offer?
Which services are free of charge and which ones are at a cost? Is access provided to
all patients or access is restricted for some (e.g., in case of faith-based institutions or incase of NGOs providing care only to children for instance).

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