Public Health and Development Briefs Ghana’s health-insurance coverage: an 8.1-point sex gap in the 2021 census IDER Research Desk | 2026-09-12 Reference period: 2021 census The 2021 census reported health-insurance coverage of 72.6% among females and 64.5% among males. Comparing the complements shows that the proportion without reported coverage was about 30% higher among males. This identifies a descriptive coverage gap, without explaining its causes. The shares without reported insurance were 35.5% for males and 27.4% for females in 2021, an 8.1-percentage-point difference. Current-data companion — 19 September 2026 The latest GSS headline multidimensional-poverty rate is 21.9% for Q3 2025. It is a different outcome from health-insurance coverage and cannot update the 2021 insurance-gap estimate. A current insurance decision requires newer enrolment, active-membership and benefit-access evidence. https://iderafrica.com/insights/ghana-current-data-business-decisions-september-2026 What the comparison adds The source presents insured shares. Looking at their complements changes the operational question to the proportion remaining outside reported coverage. The ratio 35.5/27.4 is approximately 1.30. That relative comparison can help prioritise an investigation into enrolment and retention, but it should always appear alongside the absolute difference. A relative gap alone can obscure its scale. Neither comparison establishes that sex causes the difference, and neither identifies which people currently require assistance or what form that assistance should take. Coverage needs an access assessment Our interpretation is that insurance coverage is one stage in a longer path to receiving care. An assessment should distinguish reported coverage, valid entitlement, successful use of services and financial protection. A covered person may still encounter barriers, while someone without reported coverage may obtain particular services through another arrangement. These are possibilities to investigate, not prevalence estimates from this brief. The census percentages should therefore not be relabelled as the share receiving appropriate care, the share protected from all health costs, or a measure of clinical outcomes. Questions for programme research An enrolment study should first check how coverage is recorded and whether renewal and inactive membership are handled consistently. Compare relevant age groups and locations before interpreting an overall difference between females and males. Interview people about their recent attempts to enrol, renew and use services, recording the reasons for unsuccessful steps. Connect that evidence with service availability and the programme’s actual rules. Follow-up evaluation can then track whether a change reduces the identified barrier, rather than equating additional registrations with improved access. No intervention effect is estimated here. Method This secondary analysis uses the female and male insurance percentages in Ghana Statistical Service’s 18 November 2021 release. Complement shares are 100 − 64.5 = 35.5% and 100 − 72.6 = 27.4%. The difference is 8.1 percentage points; their ratio is about 1.30. These calculations preserve the source’s sex categories and do not create an estimate for unreported categories. Limitations The published aggregate cannot explain the gap or separate the effects of age, income, location and programme eligibility. It is a 2021 observation, not a current membership audit. No measure of service quality, expenditure or health outcomes is derived. The brief supports research design and programme monitoring; it provides no clinical advice. Sources 2021 PHC — General Report Volumes 3A, 3B and 3C: release highlights Ghana Statistical Service https://census2021.statsghana.gov.gh/presspage.php?Pr=&readmorenews=MTY4OTA1MDkwNC4wOTY%3D Original editorial desk analysis prepared with AI assistance. No named human signoff or peer review is asserted.