Ghana’s Health Minister Kwabena Mintah Akandoh has said Cabinet has approved government investment in 35 district hospitals under the Agenda 111 project, with the facilities to be completed in phases, as the government moves to concentrate scarce resources on a select number of near-finished projects rather than spreading funding thinly across all sites.
Speaking in an interview with Bernard Avle on Channel One TV’s The Point of View on Monday, October 19, Akandoh said the decision reflected the government’s long-held position that attempting to complete all of the original programme’s hospitals simultaneously would leave none operational. “Cabinet has approved to invest in 35 of the district hospitals under Agenda 111. So we are phasing them out. That was our position when we were in opposition. We thought that you can’t spread yourself too thin, and at the end of the day, you don’t do anything,” he said .
The minister disclosed that approximately GH¢4.5 billion had already been spent on the projects, arguing that the amount could have completed roughly 20 hospitals had resources been concentrated on fewer facilities from the outset. “You have spent about GH¢4.5 billion. This GH¢4.5 billion could have finished about 20 of them. So we think that we can go gradually. So we are investing in about 35. Some of these hospitals, the contractors are on site,” he added .
Background: A Programme Under Strain
Launched in 2021 by the previous New Patriotic Party administration under then-President Nana Addo Dankwa Akufo-Addo, Agenda 111 was designed to bridge Ghana’s healthcare infrastructure gap by constructing 111 district and regional hospitals across the country . The programme, however, has been dogged by delays, cost overruns, and accountability concerns. A government audit revealed that 35 contractors received US$7.9 million in mobilisation funds but either failed to mobilise to site or performed work not commensurate with the amounts paid .
The financial scale of the unfinished programme is substantial. Akandoh told Parliament in July that more than GH¢20 billion would be required to complete all remaining Agenda 111 projects, describing the GH¢4.8 billion already invested as “just a tip of the iceberg” . President John Dramani Mahama said in August that the 35 prioritised hospitals were those at least 70 percent complete, with another 20 facilities at 50 percent completion or above to be selected next year .
Selection Criteria and Faith-Based Partnerships
Akandoh explained that the selection of the initial 35 hospitals was guided by two principal considerations: the level of completion and equitable distribution across Ghana’s 16 regions. “Two main factors: level of completion and fair distribution. For example, we have about 16 regions, so at least every region must have one or two,” he said. He noted that a hospital with a lower completion rate in one region could be selected ahead of a more advanced facility elsewhere if necessary to ensure fair regional distribution .
Beyond direct state investment, the government is engaging faith-based healthcare providers to complete, equip, and operate some of the remaining facilities. Akandoh said the Christian Health Association of Ghana (CHAG) and the Ahmadiyya Muslim Mission have been approached to identify hospitals they could take over. “Government will give them those facilities to finish, equip and then run, because after all, government pays their compensation for them. We have that kind of relationship,” he said . A further batch of between 30 and 35 Agenda 111 hospitals is being prepared for completion through such partnerships, with the government open to considering additional phases of direct investment after assessing progress on the initial 35 .
Sewua Hospital Resumes Construction
The minister also disclosed that construction work had resumed on the Sewua Government Hospital in the Ashanti Region after longstanding challenges involving road access, electricity supply, water provision, and equipment installation were addressed. “We had issues about the road, we had issues about electricity, we had issues about water, we had issues about installation of some equipment. Now water solved, electricity is solved, road is solved. So the contractor is on site as I speak to you now,” Akandoh said .
The Sewua facility had been commissioned by the previous administration in 2025 but remained non-operational due to unresolved infrastructure connections. Ashanti Regional Minister Dr Frank Amoakohene had said in June that a dedicated task force was working to operationalise the hospital alongside the Oforikrom Municipal Hospital and the Trede District Hospital before the end of 2026 .
The phased approach has drawn qualified support from policy analysts. IMANI Centre for Policy and Education research associate Ransford Brobbey described the consolidation as “a necessary exercise in public expenditure prioritisation,” noting that the original rollout spread roughly GH¢4.8 billion across dozens of sites without delivering a single working facility . Brobbey recommended that partnerships with CHAG and other non-profit providers be formalised through gazetted concession and management contracts with defined service-level agreements and state-backed payroll coverage, giving operators confidence to take on facilities the state cannot finish alone .
