For most of the last two decades, Ghana’s economy has been on a high growth path, which has been accompanied by significant reduction in poverty. Despite this progress, large macroeconomic imbalances threaten growth and continued poverty reduction. Rapid economic growth and poverty reduction has been accompanied by growing inequality in terms of income and geographical areas. The Government of Ghana (GoG) has a comprehensive national social protection strategy (NSPS) in place and is finalizing the national social protection policy. Given existing macroeconomic challenges, resources allocated to social protection programs should be used in the most cost-effective and pro-poor manner. This assessment aims to contribute to the rationalization of social protection public expenditures, building on recent work by the GoG. This report updates the analysis on core social assistance programs, active labor market programs, social insurance schemes including the national health insurance scheme, and general fuel and electricity subsidies. To establish a more effective and sustainable social protection system, the report recommends addressing the following four challenges: consolidating the substantial gains achieved to date and building a stronger program portfolio; strengthening expenditure management; expanding well-targeted programs and rationalizing poorly targeted programs; and ensuring the sustainability of key programs.