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From donor dependence to national ownership: Ghana’s path to sustainable child nutrition

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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.

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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.

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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.

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Nutrition

The First 1,000 Days: Why Ghana’s investment in maternal and child nutrition matters for human capital development

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Children need special attention

From the start of pregnancy to a child’s second birthday, the first 1,000 days, represents the most important window for human development. Good nutrition shapes the foundation.

During this short window, the body and brain grow at a pace that will never be repeated. When nutrition is inadequate, the damage to physical growth and cognitive development is often permanent. No later investment in education or healthcare can fully reverse these losses. Ghana’s future workforce and economic progress depend on getting nutrition right during this critical period.

Science is clear. A baby’s brain develops rapidly during pregnancy and early childhood, forming the foundation for all future learning and health. Adequate nutrients during pregnancy support the formation of neural connections that underpin learning, memory, and emotional regulation. When pregnant women lack essential nutrients, their babies begin life at a disadvantage. When young children experience severe malnutrition, they miss critical growth periods that do not return.

Ghana faces serious challenges during this critical window. An estimated 68,517 children suffer from severe acute malnutrition. Between 37 and 63 percent of pregnant women are anemic, with iron deficiency particularly common in late pregnancy. These problems translate directly into diminished potential. Malnourished children perform worse in school, earn less as adults, and face higher risks of chronic diseases. The economic losses multiply across generations.

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Research worldwide shows that nutrition investments during the first 1,000 days deliver exceptional returns. Well-nourished children learn better, perform better academically, and become more productive adults. Countries that invest in early nutrition experience faster economic growth through stronger, more productive workforces.

Ghana already has effective solutions. Multiple Micronutrient Supplements for pregnant women reduce the risk of low birth weight and preterm birth, while Ready-to-Use Therapeutic Food enables high recovery rates for children with severe acute malnutrition. Both are approved in Ghana’s health guidelines. The problem is not lack of knowledge but lack of access. Coverage remains limited because financing depends heavily on donor support rather than sustainable domestic systems.

Integrating these nutrition interventions into the National Health Insurance Scheme would help close this gap. With a large proportion of mothers and young children already enrolled, NHIS provides a platform for nationwide reach. Recent reforms to health financing further strengthen the case for prioritising essential nutrition services within the scheme.

Ghana’s development agenda emphasizes industrialisation, innovation, and economic transformation. Achieving these goals requires a workforce capable of learning, problem-solving, and sustained productivity. Human capital development, however, does not begin at universities or training centers. It begins before birth.

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The first 1,000 days offer no second chances. Each year of delay means another group of children enter adulthood carrying preventable disadvantages. Investing in nutrition during this critical window is not only a health priority; it is a foundational investment in Ghana’s economic future.

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

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Nutrition

Importance of Fruits During Ramadan

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Some fruits for sale

Ramadan, the ninth month of the Islamic lunar (Hijri) calendar, is a period of fasting, reflection, and spiritual growth. A vital part of observing Ramadan is Iftar—the evening meal with which Muslims break their daily fast at sunset. Fruits play an essential role in Iftar, providing nutrition, hydration, and energy after long hours of fasting.

Here are some of the most recommended fruits to include in your Ramadan meals:

Dates

Dates are traditionally used to break the fast. They are rich in sugar, fibre, potassium, vitamins, and minerals, helping to restore energy quickly after fasting.

Watermelon

Watermelon is highly consumed for hydration, as it is composed mostly of water. It can be enjoyed in slices or blended into refreshing smoothies.

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Bananas

Bananas are an excellent source of potassium, which helps maintain fluid balance and reduce thirst. They also provide natural energy to keep you going after fasting.

Apples

Apples are fibre-rich and nutritious, promoting heart health, aiding weight management, and improving digestion.

Cucumber

Cucumber is one of the best hydrating fruits, composed of water and fibre, which aids digestion while revitalising the body.

Pawpaw (Papaya)

Pawpaw is low in calories and sugar, rich in fibre, and promotes healthy digestion, hair, and skin. It is a nutritious addition to any Iftar meal.

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Including a variety of these fruits during Ramadan not only helps replenish lost nutrients but also supports overall health, digestion, and hydration throughout the fasting period.

By Linda Abrefi Wadie

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