While rural-urban disparities are still significant, there are signs that Ghana’s cities are facing considerable challenges with land use, infrastructure and services provision (particularly with regard to housing, sanitation and transportation), and the absence of gainful and productive employment opportunities, especially for the youth. The critical policy challenge has been to ensure orderly and sustainable spatial development, co-ordination and planning, and measures to enable metropolitan and municipal authorities to secure adequate financing for infrastructure and services. The culprit was the Ebola epidemic that struck the sub-region, especially Guinea, Sierra Leone and Liberia, between December 2013 and December 2015. Other contributing factors included a wait-and-see approach to governance in the run-up to the 11 October 2015 presidential election, and the adverse international economic outlook, which hurt the prices of export goods.