Access to psychotropic medicines in Ghana

Key messages:

• Over 90% of people with mental illness in Ghana do not receive the treatment they need.
• Psychotropic medicine supply in Ghana is erratic with frequent shortages, limiting access to care even where healthcare providers are trained.
• Treatment of mental illness is not reimbursed by the National Health Insurance Scheme (NHIS). Instead, psychotropic medicines are financed directly by the Ministry of Health (MOH). However, budgetary allocation is inadequate for the quantities of medicines required to meet demand.
• To make up the deficit in medicine supply, facilities purchase medicines themselves from wholesalers, with costs recouped by selling the medicines to service users, and use donations from organisations such as Direct Relief, which are passed free of charge onto the user.
• To maximise coverage within the MOH budget, enable consistent supply and treatment across Ghana, and simplify procurement processes, a list of medicines for regular procurement has been established.
• Strengthened relationships between the Mental Health Authority, the Procurement Directorate in the MOH, and pharmaceutical suppliers are recommended, to ensure sustainable procurement and reliable supply.
• Systemic improvement, with integration of psychotropic medicines into the general health system monitoring, evaluation, forecasting, and quantification tools is needed. At facility level, psychotropic medicines must be integrated into the pharmacy stock and management systems.
• The annual budget should be informed by forecasting and quantification.
• Advocacy and policy amendments are needed to ensure coverage of mental illness by the NHIS and universal access to care.