FOR decades, treating severely malnourished children meant weeks or months of hospitalization. Families were forced to choose between staying with and caring for a sick child in a distant facility and keeping their farms, businesses, and households running.

Hospital wards are filled with vulnerable children who often face higher risks of hospital-acquired infections. The financial burden is overwhelming for poor households while health systems struggle with overcrowded wards and limited bed capacity. The introduction of Ready-to-Use Therapeutic Food (RUTF) fundamentally changed this reality.

RUTF is a nutrient-dense, peanut-based food that requires no water, cooking, or refrigeration. Developed in the 1990s, it made it possible for most clinically stable children with uncomplicated severe acute malnutrition to be treated at home through community-based programs after initial stabilization.

Instead of weeks or months in hospital, children could recover in their own homes with regular follow-up at nearby health facilities. This shift from inpatient to outpatient care represents one of the most important advances in child nutrition treatment.

Evidence from community-based management programs consistently shows high recovery rates, typically between 75 and 90 percent, with mortality kept below internationally accepted thresholds.

Children gain weight steadily, treatment usually lasts six to ten weeks, and outcomes meet or exceed global standards, often at far lower cost than prolonged hospitalization.

For families, the benefits are immediate and practical. Mothers no longer need to abandon other children or sources of income to remain in hospital for long periods. Weekly clinic visits replace extended admissions. Children stay in familiar environments with family care, and households avoid the costs of transport, hospital fees, and lost earnings. For many families living in poverty, this difference determines whether treatment is feasible at all.

Health systems also gain. Hospital beds are freed for children with medical complications who genuinely require inpatient care. Health workers can focus limited resources where they are most needed.

Community-based management allows significantly more children to be treated with the same resources compared to hospital admissions. As a result, this approach has been adopted across many countries facing high malnutrition burdens.

Ghana has embraced this evidence-based approach. RUTF is included in the Essential Medicines List and approved in Standard Treatment Guidelines. Healthcare workers across 20 districts have been trained in community-based management protocols. National guidelines are finalized and disseminated. The technical foundation and implementation capacity exists.

Yet access remains limited. An estimated 68,517 children in Ghana suffer from severe acute malnutrition each year, but only a small proportion receive treatment. The main barrier is not knowledge or infrastructure, it is financing.

Current reliance on donor funding creates predictable problems. Supply disruptions occur when funding cycles end. Geographic coverage depends on where donors choose to work rather than where malnutrition rates are highest. Health facilities are unable to develop effective plans without assurance of the availability of RUTF in the coming months or years.

Families in some districts access treatment while others with identical needs face empty shelves. This fragmented approach prevents Ghana from achieving the 80 to 90 percent coverage possible with adequate, sustainable financing.

Including RUTF in the National Health Insurance Scheme would address this gap. Ghana already has an established delivery platform through NHIS, with a large proportion of mothers and young children enrolled. Integrating RUTF into the benefits package would ensure that every child with severe acute malnutrition can access lifesaving treatment at home, regardless of location or household income. The move from hospital-based to community-based care proved that better approaches are possible. Sustainable, domestic financing would ensure that these better approaches reach every child who needs them.

Feature article by Women, Media and Change under its Nourish Ghana: Advocating for Increased Leadership to Combat Malnutrition project

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