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.
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Egg stew is a traditional dish from Ghana. It is very healthy and easy to prepare. The dish is traditionally served with rice, plantain and any other meal of one’s choice.
Ingredients
-1 litre of vegetable oil
-2 fresh salmon
-10 large tomatoes
-5 large onions
– 6 eggs
-3 tablespoonful of pepper
-1 tablespoonful of powdered garlic and ginger
-1 tin of mackerel
– I large green pepper
-3 tablespoonful of tomatoes paste
Preparation
-Wash tomatoes, onion, green pepper and blend
-Put oil on fire and add onion and powdered pepper to it
-When onions turn golden brown, add blended tomatoes and tomato paste to it. (Allow it to cook for 3 minutes.)
-Add eggs and salmon to stew and leave it for a minute before stirring.
– Add seasoning to the stew and serve.
By Linda Abrefi Wadie
Every baby deserves a healthy start. But in Ghana, too many children are being born already behind, too small, too fragile, and at far greater risk than their peers. Low birth weight, defined as weighing less than 2.5 kilograms at birth, affects an estimated one in seven newborns in this country.
That is a significant proportion of children beginning life at a disadvantage, often due to preventable causes.
Children born with low birth weight face a steeply uphill journey from their very first breath. They are more susceptible to birth asphyxia, infections, hypothermia, and respiratory complications.
They are more likely to die in their first month of life. Those who survive face higher risks of stunting, impaired cognitive development, and a greater likelihood of developing non-communicable diseases including type two diabetes, hypertension, and heart disease later in life.
Low birth weight does not just harm the child today. It shapes their health for decades.
The most powerful determinant of a baby’s birth weight is what the mother eats, and how healthy she is before and during pregnancy. Research in Ghana has consistently shown that maternal anaemia, poor dietary diversity, and inadequate antenatal care are all strongly linked to low birth weight.
A study in Cape Coast found that mothers with low dietary diversity during pregnancy were significantly more likely to deliver low birth weight babies. In Northern Ghana, maternal anaemia in both the first and third trimesters of pregnancy increased the risk of low birth weight. What a woman eats is what her baby weighs.
Education matters too. Mothers with secondary or higher education have been found to be less likely to deliver a low-birth-weight baby, a difference attributed to better nutrition knowledge, improved antenatal care attendance, and healthier health-seeking behaviour overall.
This points clearly to the need for a whole-of-society response, not just a clinical one.
Ghana has made some progress on low birth weight, but the burden remains unacceptably high and in some parts of the country, it is worsening. Other important risk factors must not be overlooked.
Adolescent pregnancy, which remains prevalent in several regions, is strongly associated with low birth weight because young mothers are often still growing and competing with the fetus for nutrients.
Malaria infection during pregnancy, particularly in endemic areas of Ghana, damages the placenta and restricts nutrient transfer, further increasing the likelihood of a low-birth-weight baby.
These risk factors compound the effects of poor maternal nutrition and limited antenatal care. Leaders in government, health facilities, and communities must prioritise maternal nutrition before, during, and after pregnancy.
Reducing low birth weight is not complicated. It requires feeding mothers well, supporting them through antenatal care, ensuring access to iron-folic acid supplementation and malaria prevention during pregnancy, and treating their health as a national priority, not an afterthought.
Feature article by Women, Media and Change under its Nourish Ghana: Advocating for Increased Leadership to Combat Malnutrition project
