Nutrition
Beyond Pilot Projects: Why Ghana needs sustainable financing for nutrition at scale
Ghana has made important progress in testing effective nutrition interventions. Multiple Micronutrient Supplements (MMS) have been piloted in selected health facilities across several districts, reaching thousands of pregnant women.
Ready-to-Use Therapeutic Food (RUTF) has been delivered through community programs in high-burden districts, supported by trained health workers. These initiatives demonstrate that proven nutrition interventions can be implemented successfully within Ghana’s health system.
However, pilot projects are designed to test feasibility, not to meet national needs.
Despite their success, current pilots reach only a small fraction of the women and children who require these services. Meanwhile, anemia affects a large proportion of pregnant women, and tens of thousands of children suffer from severe acute malnutrition each year. The gap between pilot coverage and population need highlights the limits of project-based approaches.
Nutrition projects funded through time-bound grants face predictable constraints. Coverage depends on donor priorities rather than national burden. Programs end when funding cycles close, even if needs persist. Financing uncertainty makes long-term planning difficult, and supply chains often remain fragmented instead of being integrated into national systems. Data collection and accountability focus on project requirements rather than strengthening national monitoring.
Most critically, project-based approaches perpetuate inequity. Women and children in pilot districts receive evidence-based interventions while those in non-pilot areas with identical needs receive outdated or no care. Access becomes a matter of geography rather than health policy. This creates a two-tier system where donor program placement, not health policy, determines who receives lifesaving treatment.
Systems-based financing through the National Health Insurance Scheme offers a fundamentally different approach. NHIS integration ensures nationwide coverage based on enrollment rather than project geography. With 84 per cent of mothers with children under five already enrolled, the delivery infrastructure exists.
Financing becomes predictable through established NHIS revenue streams. Supply chains integrate with national pharmaceutical procurement systems. Quality standards and accountability mechanisms operate across all facilities, not just pilot sites.
Transitioning from pilot to scale requires policy decisions that projects alone cannot deliver. RUTF and MMS must be formally included in NHIS benefits and medicines lists. Reimbursement rates must be established to cover procurement and distribution. Budget allocations must be protected within medium-term expenditure frameworks. Supply chains must be strengthened at national level rather than replicated across multiple projects.
Ongoing Health Technology Assessments will deliver crucial evidence about cost-effectiveness to guide future decisions. Available data already suggests that MMS is highly affordable within public-sector financing, while community-based treatment of severe malnutrition reduces reliance on costly hospital care. These interventions are not only effective, but they are also fiscally realistic.
Pilots have served their purpose. Continuing to operate at pilot scale when national implementation is feasible means accepting preventable illness and loss of human potential. Ghana has the policy frameworks, trained workforce, and financing mechanisms required to move forward. What remains is the decision to shift from demonstration to delivery, and to ensure that effective nutrition interventions reach everyone 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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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.
