{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T06:03:40Z","timestamp":1784268220287,"version":"3.55.0"},"reference-count":52,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Public Health Challenges"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Achieving universal health coverage (UHC) remains a key priority for many low\u2010 and middle\u2010income countries, yet equity in access continues to be a significant challenge. This study examines the level and distribution of health service coverage in Ghana and Liberia, with a particular focus on wealth\u2010 and residence\u2010based disparities, to assess progress toward UHC and Sustainable Development Goal (SDG) 3.8.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional analysis was conducted using the most recent Demographic and Health Survey (DHS) data from Ghana and Liberia. Key indicators related to maternal health, health promotion, environmental health and infectious disease treatment were assessed. Composite indices for protection and treatment coverage were computed. Inequality was measured using the slope index of inequality (SII), relative index of inequality (RII), absolute difference index (ADI) and the urban\u2013rural coverage ratio.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, Ghana demonstrated higher coverage in preventive services such as antenatal care (90.6%) and improved drinking water (91.8%), whereas Liberia showed slightly higher treatment coverage for malaria and respiratory infections. However, both countries exhibited substantial pro\u2010rich inequities in skilled birth attendance and insecticide\u2010treated net (ITN) use. In Ghana, a rural advantage was observed in some indicators, likely due to targeted outreach through the Community\u2010Based Health Planning and Services (CHPS) initiative, whereas Liberia displayed mixed urban\u2013rural disparities. The composite coverage index (CCI) was higher in Liberia (77.9%) than in Ghana (63.3%), reflecting recent donor\u2010supported health system investments in Liberia post\u2010Ebola.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite moderate national coverage levels, significant socio\u2010economic and geographic disparities persist in both countries. Although targeted policies, such as Ghana's National Health Insurance Scheme (NHIS) maternal exemption and Liberia's post\u2010crisis recovery programs, have contributed to localized improvements, inequities in access to essential health services remain. Addressing these disparities is critical for both countries to make meaningful progress toward equitable UHC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/puh2.70280","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T08:04:41Z","timestamp":1779869081000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Universal Health Coverage and Health Equity in West Africa: Tracking Progress Toward SDG 3.8 in Ghana and Liberia"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3050-6277","authenticated-orcid":false,"given":"Samuel","family":"Asamoah","sequence":"first","affiliation":[{"name":"Kumasi Centre for Collaborative Research in Tropical Medicine  Kumasi Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7380-1608","authenticated-orcid":false,"given":"Michael","family":"Sarfo","sequence":"additional","affiliation":[{"name":"School of Human and Health Sciences University of Huddersfield  Huddersfield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0863-216X","authenticated-orcid":false,"given":"Olanrewaju","family":"Lawal","sequence":"additional","affiliation":[{"name":"School of Human and Health Sciences University of Huddersfield  Huddersfield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1286-627X","authenticated-orcid":false,"given":"Sandra Konadu","family":"Bonnah","sequence":"additional","affiliation":[{"name":"Department of Health Promotion and Disease Prevention University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1218-7434","authenticated-orcid":false,"given":"Michael","family":"Snowden","sequence":"additional","affiliation":[{"name":"School of Human and Health Sciences University of Huddersfield  Huddersfield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4555-7470","authenticated-orcid":false,"given":"Jamie P.","family":"Halsall","sequence":"additional","affiliation":[{"name":"School of Human and Health Sciences University of Huddersfield  Huddersfield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4860-3869","authenticated-orcid":false,"given":"Godness Kye","family":"Biney","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology School of Public Health and Health Sciences University of Massachusetts Amherst  Amherst Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1398-6889","authenticated-orcid":false,"given":"Angwach Abrham","family":"Asnake","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics School of Public Health College of Health Sciences and Medicine Wolaita Sodo University  Wolaita Sodo Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Achieving Universal Health Coverage: Developing Financing System","author":"World Health Organization","year":"2005"},{"key":"e_1_2_11_3_1","volume-title":"The World Health Report 2008: Primary Health Care: Now More Than Ever","author":"World Health Organization","year":"2008"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.12.113985"},{"key":"e_1_2_11_5_1","unstructured":"World Health Organization.Making Fair Choices on the Path to Universal Health Coverage: Final Report of the WHO Consultative Group on Equity and Universal Health Coverage(World Health Organization 2014) http:\/\/www.who.int\/choice\/documents\/making_fair_choices\/en\/."},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60955-1"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.15171\/ijhpm.2015.184"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.9745\/GHSP-D-16-00286"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/inthealth\/ihx046"},{"key":"e_1_2_11_10_1","unstructured":"World Health Organization World Health Statistics2023:Monitoring Health for the SDGs Sustainable Development Goals(World Health Organization 2023)."},{"key":"e_1_2_11_11_1","unstructured":"United Nations. 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