Folate and B12 deficiency in Ghanaian Women: The hidden nutrition crisis

When nutrition challenges among Ghanaian women are discussed, anaemia and obesity often dominate the conversation.

 These are real and serious concerns. But there are two other deficiencies, folate and vitamin B12, quietly causing harm to women and their unborn children. They are less visible, less talked about, and yet their impact begins early, often before a woman even knows she is pregnant.

Some studies suggest that about 68 per cent of women may have low vitamin B12 levels, folate deficiency affects a significant share of women of childbearing age, and many women do not meet recommended dietary intake levels for these nutrients.

Diet plays a major role. In many households, meals are largely carbohydrate-based, with limited intake of animal-source foods and micronutrient-rich options. Over time, this can lead to multiple nutrient deficiencies including iron, folate, and vitamin B12, occurring together. Low intake of iron, vitamin B12, and folate together puts women at heightened risk of giving birth to low birth weight babies or, in the worst cases, stillbirths.

These gaps often go unnoticed because they do not always show immediate symptoms, but their consequences can be serious.

Folate is essential for the healthy formation of a baby’s neural tube, the structure that develops into the brain and spinal cord, in the very first weeks of pregnancy, often before a woman even knows she is pregnant. When folate levels are insufficient during this critical window, the risk of neural tube defects rises significantly. These are severe birth conditions, many of which are fatal or cause lifelong disability. Vitamin B12 deficiency compounds this risk further, as the two nutrients work together in the body’s most fundamental cell processes.

Despite their importance, folate and vitamin B12 deficiencies receive limited attention in public health messaging and programmes.

 Women need to know about these nutrients before they become pregnant, not after. This requires preconception nutrition counselling, targeted supplementation programmes, fortification of staple foods, and education campaigns that reach women in communities, markets, and health facilities.

 Ghana has had a mandatory wheat flour fortification policy with iron and folic acid since 2007, but enforcement and coverage remain inconsistent, and the policy does not address vitamin B12. Expanding fortification to include B12 and strengthening compliance monitoring would be important steps forward.

Leaders across health, education, and agriculture must place these ‘hidden’ deficiencies on the national nutrition agenda, because the damage they cause is anything but hidden to the families who experience it.

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