No Blood, No Beds, No Light: How Ghana’s Broken Hospitals Are Failing Mothers

She arrived at the Cape Coast Teaching Hospital in a taxi.

The 39-year-old woman had been referred from a hospital in Tarkwa after a caesarean section went wrong and she began to bleed. By the time she reached Cape Coast on the morning of July 3, 2024, what she needed was simple and specific: blood. Type B-positive.

There were none at Cape Coast. Staff called the University of Cape Coast Hospital and arranged for five units of blood and two units of plasma. There was none there either. At 4:18pm that afternoon, she was declared dead.

Her death is recorded in a single, clinical paragraph inside a new report by Ghana’s Auditor-General, one of thousands of Ghanaian women who die each year from causes doctors describe as preventable. But the report argues that her case is not an accident of bad luck. It is what happens, repeatedly, when a country makes a solemn promise to save mothers’ lives and then fails to deliver the water, electricity, the blood, the beds and the doctors that keeping that promise requires.

A promise that keeps breaking at the delivery bed

In a performance audit Auditor-General examined how well the government of Ghana is working toward Sustainable Development Goal 3.1 - the global commitment to reduce maternal deaths. Ghana pledged to cut its maternal mortality ratio from 377 deaths per 100,000 live births in 2010 to 125 by 2030.

More than a decade on, the country is not closed. The audit found that Ghana’s maternal mortality ratio has remained stuck above 200 deaths per 100,000 live births for the past 15 years. Between 2019 and 2023 it drifted between 234 and 264, rising in some years even as officials announced new interventions. At this pace, the auditors concluded bluntly, Ghana is unlikely to hit its 2030 target.

This is not a story of a government that did nothing. Ghana signed the global goals, wrote the policies and spent real money. Between 2019 and 2023, the government, together with UNICEF and the World Health Organization, put roughly GH¢159 million into a single community health programme. In 2024, Japan’s development agency donated equipment worth $150,000, and the United States committed $45 million to maternal, newborn and child health.

The problem the auditors uncovered is what happens to those good intentions on the ground; in the maternity wards of Bolgatanga, the corridors of Bongo, the stalled construction site in Kumasi and the CHPS compounds of the Upper East, where the promise dissolves at the exact moment a woman is most vulnerable.

To find out, the audit team visited 30 health facilities across six regions - Greater Accra, Upper East, Northern, Ashanti, Central and Volta between January 2019 and December 2024. They reviewed documents, inspected equipment and interviewed officials, obstetricians, midwives, traditional leaders and pregnant women themselves.

Delivering babies by the light of a phone

What they saw at the facility level was often grim.

At the Bolgatanga Regional and Bongo District hospitals, maternity wards were so crowded that patients were lying on floors and in corridors to receive treatment. Hospital officials told the auditors that this overcrowding was itself contributing to infections, a leading cause of maternal death.

In Kumasi, the audit found a maternity block whose construction began in the year 2000. At the time of the audit in September 2025 - a quarter of a century later - it still stood unfinished, a stalled concrete shell. Because it was never completed, the Kumasi South Hospital has to turn some expectant mothers away and refer them to Komfo Anokye Teaching Hospital. At the nearby South Suntreso Hospital, women in labour had to be wheeled more than 300 metres to a shared general theatre and queue with other patients for caesarean sections; a nursing officer told auditors this led to delays, discomfort and the risk of losing mothers during emergencies. A new theatre meant to fix the problem had also stalled.

The most striking failures were the most basic. In the Bongo District, the audit found 58 community health zones and not a single generator among them to serve as backup when the national grid went down. Midwives, the report says, were reduced to using their phones for light while delivering babies.

At Tamale Teaching Hospital and several CHPS compounds, there was no reliable water supply. Pregnant women were told to bring their own water for delivery, and some had to go home to wash after giving birth before returning to the facility. Nurses said these conditions bred the infections that turn into complications and, sometimes, death.

Equipment told the same story. Across the facilities, auditors found shortages or broken units of the basic tools of safe childbirth foetal dopplers, Cardiotocography (CTG) machines, blood pressure monitors, ultrasound scanners, and delivery beds. At the Ho Teaching Hospital, there were five CTG machines where 13 were needed. And essential drugs to stop bleeding and prevent seizures were frequently out of stock. Of 130 pregnant women interviewed, 58 said they had to buy medicines that were supposed to be free under the National Health Insurance Scheme; 46 turned instead to traditional birth attendants, whose medications doctors warned could not be verified as safe.

Blood, the very thing the woman from Tarkwa needed, was chronically short. In a review of 30 maternal death audit reports from teaching and regional hospitals, the auditors found that 18 women had died because blood and blood products were not available.

Three specialists for nearly three million people

Behind the missing equipment sits an even deeper shortage: Human resources.

In the Upper East Region and its neighbours, the audit found just three obstetrician-gynaecologists serving a combined population of about 2.86 million - a ratio of roughly one specialist to every 953,875 people, against a WHO standard of one to 100,000. Bongo District, with a population of about 130,000, had no obstetrician at all; two general doctors handled maternal emergencies without specialist support.

This is not because Ghana has no trained health workers. The audit found the opposite. Citing the country’s own nursing strategy, it reported a backlog of 60,000 trained nurses and midwives who had not been employed because the Finance Ministry had not granted financial clearance to hire them. The Ghana Medical Association told auditors that more than 800 doctors including obstetricians and gynaecologists remained unposted as of October 2025, even as their overworked colleagues in the regions struggled to cope.

The country cannot fully count its own dead

If the government is to fix any of this, it needs to know the true scale of the problem. The audit suggests it does not.

Ghana runs two systems for tracking maternal deaths, and they do not agree. In 2019, one system recorded 2,850 maternal deaths while the other recorded 2,650 for the same year. That gap of 200 to 250 deaths persisted every year through 2024. A regional health director explained that facility staff sometimes entered figures wrongly recording “200 deaths” instead of “20.” Many rural facilities lacked the internet, computers or trained staff to record data properly; a national assessment cited in the report found that only 28 per cent of health facilities had computers with stable internet.

The data also failed the very people the effort was meant to protect. The system did not break down maternal health figures by disability or by adolescent motherhood, meaning the government could not tell whether its interventions were reaching disabled women and teenage mothers at all.

“Leave No One Behind”
Ghana’s stated commitment under the global goals is to “Leave No One Behind.” Yet across the report, the people falling through the gaps are consistently the same: the rural poor, women in hard-to-reach communities, teenagers and women with disabilities.

Facilities in the Central, Upper East and Northern regions lacked ramps, rails and accessible washrooms, leaving pregnant women with disabilities at greater risk. The planning that shaped these programmes, meanwhile, had left out several institutions whose absence the women on the floors would recognise instantly the Ministry of Energy, the Ministry of Roads and Highways, the Ghana Water Company and the drivers’ unions who ferry labouring women to hospital. There was, the audit added, no dedicated budget line for maternal health at all.

What happens now
The Auditor-General recommended that the Ministry of Health establish sustainable, ring-fenced funding for maternal health; bring the missing stakeholders into planning; strengthen supply chains for drugs, equipment and blood with priority for rural facilities; recruit and deploy skilled staff to underserved areas; and harmonies the two clashing data systems.

The Ministry’s response, recorded in the report, was brief. On several of the central findings, management simply “took note.” It acknowledged that overcrowding remained a major challenge and that procuring equipment was capital-intensive and needed sustained government support. The Ghana Health Service said it was working toward a fairer redistribution of skilled personnel and that its information management center routinely checks the data for errors.

For the woman who arrived in Cape Coast in a taxi, none of that came in time. Her death was preventable; the kind of death Ghana promised the world it would stop. The audit’s quiet, damning conclusion is that the promise was real, the effort was real, and it still was not enough.

By
Seraphina Quaicoe

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