Three decades of trends and socioeconomic inequalities in household access to electricity and clean cooking fuels in Ghana from 2003 to 2022

Access to modern energy is central to Sustainable Development Goals (SDGs) 7 and 10. While Ghana has progressed in expanding electricity access, evidence on long-term trends and social inequalities in clean cooking fuel access remains limited. This study examined trends and inequalities in household access to electricity and clean cooking fuels in Ghana using nationally representative data spanning nearly three decades. A repeated cross-sectional analysis was conducted using WHO Health Equity Assessment Toolkit (HEAT) data from Ghana Demographic and Health Surveys (DHS) and Malaria Indicator Surveys (MIS) (2003–2022 for both indicators). Inequalities were assessed across wealth quintiles, residence, and subnational region using difference, ratio, population attributable risk and fraction, concentration indices, and Theil Index. Inequality measures are presented alongside 95% confidence intervals to support inferential interpretation. Household electricity access increased substantially from 60.5% in 2008 to 85.1% in 2022, with significant reductions in wealth-related inequality (Absolute Concentration Index [ACI]: 19.6 to 11.4) and regional inequality (Theil Index: 203.5 to 7.0). Clean cooking fuel use rose slowly from 13.6% in 2003 to 28.7% in 2022. Wealth-related inequalities widened considerably, with the richest–poorest gap increasing from 55.0 to 82.0 percentage points and ACI rising from 6.1 to 16.6. Persistent urban–rural and regional disparities remained, with northern households consistently disadvantaged. The Gini coefficient for clean cooking fuel access increased from 0.59 in 2003 to 0.61 in 2022 (quintile-based estimates), further confirming the trend of widening wealth-related inequality. While electricity expansion has been relatively inclusive, progress in clean cooking fuels has been slow with widening inequalities. Accelerated, equity-focused clean cooking policies are urgently needed to ensure no population group is left behind.