Ghana’s troubled electronic medical records system has triggered a major governance test in the health sector, prompting Health Minister Kwabena Mintah Akandoh to order a full-scale forensic audit into a $100 million digitalisation contract awarded to Lightwave E-Health Solutions.
The contract, signed under the previous administration, was intended to digitalise records in more than 900 health facilities nationwide. But by the time the agreement expired on 31 December 2024, only about 450 sites could be independently verified as operational—despite approximately $77 million already paid to the contractor.
Audit Uncovers Major Gaps
According to details from the forensic audit, the discrepancies were wide-ranging:
- Out of a Year-3 milestone covering 157 facilities, only seven could be confirmed as completed, although the full milestone payment of about $10.6 million had been made—without a valid bank guarantee.
- Hardware worth an estimated $18.9 million could not be traced, including more than 6,000 desktops, 3,600 tablets, 2,200 switches and load balancers, and over 370 masts and grounding systems.
- Several devices delivered were lower-spec alternatives to those specified in the contract, with some failing shortly after installation.
- The contractor’s performance security fell below the mandatory 10 percent threshold and did not meet the requirement for a Ghanaian bank guarantee.
- Multiple facilities lacked integration with DHIMS2, undermining the promise of automated reporting into the national health database.
- The State did not possess full, independent control of its own health data at the end of the contract period.
The audit also raised concerns about the contractor allegedly switching systems on and off remotely during discussions about contract renewal and handover. The firm was also said to have claimed close personal ties with the minister—an assertion Akandoh dismissed by escalating the matter for independent investigation.
Minister Refers Case to EOCO and Attorney-General
Instead of extending the contract quietly, Akandoh referred the matter to EOCO and the Attorney-General for comprehensive criminal and civil scrutiny.
Officials familiar with the decision say the minister insisted that national systems, servers and data must return under full public control and directed relevant agencies—including the MoH, NHIA and NITA—to initiate a transition toward state-anchored platforms such as GHIMS and a national health information exchange architecture.
A Test of Accountability
The developments have sparked debate about the broader culture of public contracting in Ghana, where personal relationships often influence institutional oversight. Governance analysts note that Akandoh’s decision marks a departure from a pattern in which inherited projects are routinely extended without scrutiny.
They argue that the findings raise ethical questions about advanced payments, incomplete milestones, and the protection of national health data—issues that transcend party lines.
What Comes Next
Lightwave E-Health Solutions is expected to respond as EOCO and the Attorney-General begin their review. Recovery efforts, potential prosecutions and a restructuring of Ghana’s health digitalisation architecture are anticipated in the coming months.
For now, the minister’s decision has drawn attention to the importance of transparency and leadership in managing public resources.
Observers say the unfolding case underscores a fundamental principle: when the choice is between political convenience and protecting the national interest, public officials must choose the latter—no matter how uncomfortable it becomes.
