Challenges in accessing patient-centered care and patient empowerment in selected Ghanaian hospitals.

Background: Patient-centred care (PCC) and patient empowerment (PE) are crucial for better healthcare outcomes, in lower-middle-income countries like Ghana, which continues to encounter many challenges. Aim: The study sought to determine the factors affecting the implementation of PCC and PE in Ghana through the voices of patients and healthcare providers. Setting: The study is based in Ghana, West Africa, and includes three healthcare facilities representing primary, secondary and tertiary care. Methods: A qualitative exploratory descriptive research design was employed to investigate the study's objective by engaging healthcare workers and patients in selected facilities through purposive sampling. While 33 healthcare service providers participated in in-depth interviews, focus group discussions were held with four patient groups. The collected data were analysed thematically to identify key themes and insights. Results: The analysis revealed three overarching themes: organisational-, individual-, and environmental-level factors influencing PCC and PE. Findings presented under 10 sub-themes show that resource constraints and staff shortages hinder PCC, while patient agency and communication impact PE. In addition, the ability to pay and geographical barriers further hinder access to patient-centred services, affecting overall healthcare delivery. Conclusion: The findings from this study emphasise that without system-wide interventions to address these issues - including improving resource allocation, enhancing communication, and reducing geographical and financial barriers - achieving Universal Health Coverage (UHC) by 2030 remains highly aspirational. Contribution: The contribution of the study is inherent in the relevance of contextual findings towards improving health service delivery.