Ghana has been widely acknowledged as one of sub-Saharan Africa’s ‘rising stars’ during the era of the Millennium Development Goals, and has made substantial progress in improving access to health care and education over the past two decades. However, a step change is now needed to ‘reach the furthest behind first’, as committed in Agenda 2030, if Ghana is to leave no one behind in its progress towards the Sustainable Development Goals. This report contributes to that debate by addressing the questions of who is being left behind, and why – integrating analysis of data, policy, financing and service delivery, and offering concrete recommendations for change.