Healthcare, Utilities, and Schools: The public institutions Ghanaians rely on — and where informal payments still flow

Public service delivery is at the heart of Ghana’s governance experience, and according to the Ghana Statistical Service’s Governance Series Wave 2 report, more citizens are engaging with public institutions than ever before.Ghana travel guide

The proportion of adults who contacted at least one public official surged from 55.7% in Wave 1 to 74.2% in Wave 2, a remarkable increase that highlights both growing accessibility and growing demand for public services.

The institutions with the highest citizen contact are the everyday pillars of national development:

Healthcare officials: 37.9%, Public utility staff (water, electricity): 26.5%, Public school teachers (basic to SHS): 24.8%.

These touchpoints are where most Ghanaians go when they need help, whether it’s renewing a health insurance card, resolving a water billing issue, or seeking school-related support. They are the places where governance becomes real and personal.Buy vitamins and supplements

Yet these everyday institutions are not the ones most associated with bribery and informal payments. Instead, the most bribery-prone sectors remain those where public officials control approvals, movement, or documentation. All areas where discretion is high and delays can be costly.

The Motor Traffic and Transport Division (MTTD) still records the highest number of bribery encounters, followed by police general duties, the Passport Office, the Births and Deaths Registry, and the DVLA. These institutions wield the kinds of administrative power that can either unlock progress or create bottlenecks, and it is within these spaces that citizens often feel compelled to “facilitate” their service.

Still, recent developments show that the pressures of informal payments are spreading into sectors that citizens interact with most frequently.

In 2025, a series of arrests revealed bribery and manipulation within the school placement system. Officials at the Free SHS Secretariat and the Ministry of Education uncovered cases where individuals attempted to alter placement outcomes in exchange for money, with some parents allegedly paying as much as GH₵30,000 to secure their preferred schools.

A separate viral claim suggested that admission into Aburi Girls’ Senior High School could be bought for GH₵15,000, prompting a formal investigation.

These revelations suggest growing attempts to monetise a system designed to guarantee fairness, and they heighten public anxiety about the integrity of school placements, especially for highly competitive institutions.

Corruption-related pressures have surfaced in other service areas as well. In early 2025, the National Intelligence Bureau arrested individuals accused of taking money from prospective national service personnel with the promise of securing preferred postings, including placements in major hospitals.

While not a direct case of bribery-for-medical-care, these incidents point to the ways in which access to crucial public institutions, including healthcare facilities, can be shaped by informal exchanges behind the scenes.

Broader corruption analyses also indicate that although bribery in hospitals does not dominate headlines, the heavy demand on subsidised healthcare and long waiting times create fertile ground for small, quiet exchanges intended to accelerate treatment or secure attention.

The GSS report further shows that informal payments are becoming more habitual for some citizens. Nearly one in four people who gave gifts or money to public officials did so five or more times, a sharp rise from Wave 1. Yet the majority of these payments remain small: most are GH₵100 or less, and amounts above GH₵1,000 are increasingly rare.

Taken together, the findings portray a public service system that is simultaneously expanding in reach and struggling with long-standing weaknesses. Citizens are interacting more frequently with government institutions, signalling trust in public systems and a growing reliance on them.

But the persistence of informal payments—whether at the point of documentation, school placement, or basic service delivery—shows that access and fairness remain uneven.

For many, small payments feel like shortcuts through slow systems; for others, they are viewed as necessary gestures in an environment where personal discretion still shapes outcomes.

As the government deepens its digitalisation agenda, from automating service processes to decentralising approvals, the hope is that opportunities for informal payments will diminish. Transparent timelines, digital queues, and reduced human discretion could help level the playing field.

But the Wave 2 report and recent service-related scandals make one thing clear: while Ghana’s public service system is becoming more accessible, certain institutions continue to act as pressure points.

 

By: Sheba Araba Bennin/Channel One Research Desk