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In this study, the authors document the political pathway to the implementation of the NHIS in Ghana as well as the continuous political will supporting  the scheme. The political structure as well as advocacy strength play a critical role in setting budgets for health which can influence a country’s ability to attain UHC. The authors used qualitative data from interviews with key stakeholders. These include stakeholders instrumental in the design and establishment of the NHIS. Party manifestoes from the two main political parties in the country were also reviewed. The findings show that the establishment of the NHIS was down to political commitment and effective engagement with relevant stakeholders. It was considered a solution to the political promise to remove user fees and make healthcare accessible to all. A review of the manifestos shows that in almost every election year after the NHIS was established, there has been some promise related to improving the scheme. There were several policy propositions repeated in different election years. The findings imply that advocacy to get health financing on the political agenda is crucial.
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