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This book draws on a framework for assessing poverty and access health care services to analyse the feasibility of implementing universal health coverage in Ghana. The analyses show that increased enrolment in the National Health Insurance (NHIS) and its associated increase in utilisation of health care was highest among the poor. It suggests however, that the urban-oriented structure of Ghana's health system which is characterised by limited availability and unequal urban-rural distribution of health resources may have a negative consequence on the scheme's expansion and smooth transition to universal health coverage. Such analyses offer a more nuance understanding of the structural and operational challenges and reforms needed both within the NHIS and in the Ghana Health care delivery system in order to sustain the scheme and to move towards achieving universal coverage.