Nutrition
From donor dependence to national ownership: Ghana’s path to sustainable child nutrition
An estimated 68,517 children in Ghana currently suffer from Severe Acute Malnutrition, yet only about 15 percent receive treatment. This gap is not due to a lack of effective solutions, but to limited and unstable access driven by fragmented, donor-dependent financing. As Ghana advances toward universal health coverage and economic self-reliance, ensuring sustainable and equitable child nutrition services requires urgent policy action.
Ready-to-Use Therapeutic Food (RUTF) and Multiple Micronutrient Supplements (MMS) are proven, cost-effective interventions. RUTF achieves recovery rates of 75–90 percent among children with severe acute malnutrition, while MMS reduces low birth weight and preterm birth. Both interventions are included in Ghana’s Essential Medicines List and Standard Treatment Guidelines. National protocols are finalised and disseminated, and over 600 health workers have been trained. In short, Ghana has laid the policy and technical groundwork.
Despite this readiness, access remains constrained by reliance on donor funding. Time-bound financing leads to supply disruptions, uneven geographic coverage, and weak long-term planning. Service availability often reflects donor priorities rather than population need.
Most critically, national ownership is undermined when lifesaving child nutrition interventions depend on external support. Donor dependence also limits system integration. Nutrition services delivered through projects remain peripheral to routine care. Health facilities cannot fully integrate RUTF and MMS into standard maternal and child health services without predictable supply. Data systems, quality assurance, and accountability mechanisms remain fragmented, preventing these interventions from reaching scale and impact.
Integrating RUTF and MMS into the National Health Insurance Scheme (NHIS) offers a clear pathway to sustainable national ownership. With 84 percent of mothers of children under five already enrolled, NHIS provides an existing platform for rapid and equitable scale-up. The 2025 uncapping of the National Health Insurance Levy further strengthens the financing base. NHIS inclusion would remove out-of-pocket costs for vulnerable families, standardise service delivery nationwide, and embed nutrition care within routine health services.
The cost implications are manageable. MMS costs approximately USD 2.50 per pregnancy for a full course, representing a small fraction of current undernutrition spending. Timely community-based RUTF treatment also reduces costly hospital admissions for complicated and severe malnutrition. Ongoing Health Technology Assessments will provide Ghana-specific evidence to guide reimbursement decisions.
Domestic financing brings broader benefits. It ensures stronger government accountability, improved data reporting, better quality assurance, and long-term planning beyond donor cycles. Most importantly, it affirms that the survival and wellbeing of Ghanaian children are national responsibilities.
The policy decision before Ghana’s leadership is clear. The clinical evidence supports RUTF and MMS. The regulatory framework is established. The implementation capacity exists through trained health workers and operational guidelines. The financing mechanism is available through NHIS with its recently expanded revenue base. What remains is the political committment to prioritise sustainable nutrition financing as part of Ghana’s Universal Health Coverage roadmap and broader development agenda.
Donor support has been valuable in establishing these interventions and building implementation capacity. The transition to domestic financing should be viewed not as disengagement but as graduating to full national ownership. Development partners can continue supporting technical assistance, capacity building, and innovation while Ghana secures sustaining coverage at scale.
The gap between 15 percent coverage and the 80 to 90 percent achievable with adequate financing represents thousands of preventable child deaths and compromised maternal health outcomes annually. Closing this gap through NHIS integration of RUTF and MMS is not merely a technical health financing decision. It is a statement of national values and priorities, affirming that every Ghanaian child deserves access to lifesaving nutrition treatment regardless of circumstance. It is a foundation for sustainable human capital development.
Feature article by Women, Media and Change under its Nourish Ghana: Advocating for Increased Leadership to Combat Malnutrition project.
Join our WhatsApp Channel now!
https://whatsapp.com/channel/0029VbBElzjInlqHhl1aTU27
Reliable data is the foundation of effective health systems. Governments need accurate information to track progress, identify gaps, and ensure that services reach the people who need them most. In Ghana, however, data on nutrition services often remains fragmented.
For example, it is possible to estimate how many children received Ready-to-Use Therapeutic Food (RUTF) treatment in some districts during the past quarter. But these numbers often come from separate reporting systems maintained by different implementing partners.
Each project may collect and report data in its own format. When donor-funded programmes end, the systems used to track service delivery may also disappear. As a result, national health planners cannot always see a complete, real-time picture of nutrition service coverage across the country.
This challenge is common in areas where services depend heavily on project-based funding. When nutrition interventions operate primarily through donor programmes, coverage data often comes from periodic surveys or partner reports rather than routine health system data.
Comparing outcomes across facilities or districts requires compiling information from multiple sources, which can be time-consuming and sometimes inconsistent. The result is that decision-makers may be working with incomplete or outdated information when planning nutrition services.
Integrating nutrition interventions into the National Health Insurance Scheme (NHIS) could help change this. When services such as RUTF treatment for severe acute malnutrition and Multiple Micronutrient Supplements (MMS) for pregnant women become part of the NHIS benefits package, their delivery would automatically generate data through existing national health information systems.
Each child receiving RUTF would generate a reimbursement claim recorded within NHIS systems. Each pregnant woman receiving MMS during antenatal care would leave a record linked to her NHIS enrollment.
In practical terms, this means nutrition coverage could be tracked continuously rather than estimated periodically. If facilities in districts with known malnutrition burdens are not submitting claims for RUTF, the gap becomes visible much sooner.
If recovery rates at specific facilities fall below expected standards, health managers can investigate and provide support. If supply chains break down, the absence of claims may signal a problem before it becomes widespread.
Data integration also strengthens accountability. NHIS reimbursement systems require documentation that services were delivered. Facilities must maintain records to support their claims, and routine audits help verify the accuracy of reporting.
These processes reduce the risk of inflated numbers or reporting errors that sometimes occur in fragmented project systems. At the same time, integrated data systems create opportunities for better learning and programme improvement.
When nutrition services are captured within broader health system data, analysts can begin to answer important questions. For example, do children who complete RUTF treatment experience better growth outcomes later? Do pregnant women who receive MMS have fewer complications during delivery?
These kinds of insights become easier to generate when nutrition services are fully embedded within national health information systems.
Integrated data also strengthens public accountability. When nutrition interventions operate through NHIS, policymakers and parliamentarians can review their performance through the same dashboards used to monitor other health services.
Coverage rates, budget use, and service quality become visible through a single national system rather than scattered across multiple donor reports.
Ultimately, improving data systems is about more than administrative efficiency. It reflects a shift in how nutrition is viewed.
When nutrition services depend mainly on external projects, they are often treated as temporary initiatives. When they are integrated into national systems such as NHIS, they become core health services deserving the same attention and monitoring as other essential treatments.
Knowing in real time how many children receive treatment for severe malnutrition or how many pregnant women access comprehensive micronutrient support allows Ghana to move from periodic assessments to continuous accountability.
That is the difference between hoping nutrition programmes are working and knowing whether they are delivering results.
Feature article by Women, Media and Change (WOMEC) under its Nourish Ghana: Advocating for Increased Leadership to Combat Malnutrition project.
– 2 cups of fresh spinach
-1 cup of almond milk
-1 cup of coconut water
-2 slice of banana or pineapple
– 1/2 cup of greek yogurt
Ice (optional, if not using frozen fruit)
Preparation
- Blend almond milk and spinach
- Continue to blend until no large pieces remain.(This ensures a smooth, non-gritty texture
– Add frozen fruit, yogurt to the mixture
- Blend on high speed until completely smooth
-Add ice cubes and serve.
