By: Abulsalam Mohammed Daaru: CEO- Oxygen Health 

The launch of the Ghana Medical Care Trust Fund, popularly known as Mahama Cares, represents a major stride in Ghana’s healthcare reform efforts. The fund aims to cover the costs of chronic illnesses such as kidney failure, cancer, diabetes, and cardiovascular diseases—conditions that impose high out-of-pocket expenses on thousands of Ghanaians. While the initiative holds great promise, its long-term success hinges on how sustainably and transparently it is managed. Ensuring sustainability involves more than securing funding. It requires a strong legal framework, sound institutional arrangements, operational efficiency,  and mechanisms for transparency and accountability. Ghana can learn from global experiences that offer valuable insights into building durable and inclusive health financing systems.

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1. Establishing a Strong Legal and Institutional Framework: A foundational step is to enact a robust legal and institutional structure. The announcement that a draft bill is ready for parliamentary submission is encouraging. The law should define clear operational guidelines, establish an independent governing board, and ensure administrative autonomy. Countries such as Rwanda and Chile have demonstrated that legal backing and institutional independence are vital to insulating health funds from political interference and enabling long-term success. Rwanda’s CBHI and Chile’s FONASA both operate under legal mandates that reinforce transparency and continuity.

2. Diversifying Sources of Funding: Health funds often fail when overly reliant on government budgets. To remain resilient, Mahama Cares should be financed through a balanced mix of public funding, private sector contributions, donor support, and voluntary donations—including from the diaspora. Examples from Thailand and South Korea show how general taxation, payroll deductions, and employer contributions can be combined to create a stable funding base. Broadening the revenue base also distributes the financial burden across different sectors and stakeholders.

3. Building Transparency and Public Trust: Public trust is critical for the credibility of any national health fund. Transparency in how funds are collected, allocated, and used can enhance legitimacy. Real-time reporting systems and open-access dashboards can provide the public with regular updates. In Estonia, for instance, digital tools enable citizens to track public expenditure. Ghana could introduce quarterly reports and annual public audits for Mahama Cares. Moreover, civil society organizations and professional associations should be granted oversight roles—similar to citizen councils in Germany and Brazil—which would promote checks and balances.

4. Enhancing Operational Efficiency: Bureaucratic delays and administrative inefficiencies often undermine public health schemes. To avoid such pitfalls, Ghana should invest in digital infrastructure that allows efficient application, verification, and fund disbursement. Fast-tracking processes not only ensures timely access to medical services but also minimizes leakages and delays. Countries like the Philippines have digitized their health fund systems, leading to better service delivery and reduced opportunities for corruption.

5. Establishing Strong Monitoring and Evaluation Systems: Sustainable health financing also requires robust systems for monitoring and evaluation (M&E). Tracking fund utilization, beneficiary reach, and overall impact helps to measure success and guide adjustments. Brazil’s Bolsa Família program provides a useful model, where routine evaluations influence program improvements. Similarly, Mahama Cares should include annual impact assessments, with findings submitted to Parliament and made available to the public. This fosters accountability and ensures that the fund remains responsive to Ghana’s changing health needs.

Conclusion: From Vision to Long-Term Impact:  The Mahama Cares Fund is a bold response to Ghana’s rising burden of chronic illness and the financial strain it imposes. Yet its success will ultimately depend on the systems and structures behind it. By embedding principles of legal accountability, funding diversity, transparency, efficiency, and continuous learning, Ghana can transform Mahama Cares into a sustainable, inclusive, and trusted national health financing model. Rather than being a symbolic launch, Mahama Cares can become a lasting legacy—if Ghana commits to managing it with the rigor, foresight, and discipline seen in the most successful global health systems