Nutrition
Integrating RUTF Into NHIS: Strengthening Health Systems and Protecting Ghana’s Future
Malnutrition remains one of the most significant barriers to Ghana’s long-term development. While its effects are most visible in childhood illness and mortality, its consequences extend far beyond the health sector, affecting education outcomes, labor productivity, and economic growth.
Severe Acute Malnutrition (SAM), in particular, demands urgent policy attention due to its direct link to preventable child deaths. At the center of the solution lies Ready-to-Use Therapeutic Food (RUTF) and the need for its inclusion in the National Health Insurance Scheme (NHIS).
NHIS has played a critical role in expanding access to healthcare by reducing out-of-pocket expenditures and improving utilization of services. However, the exclusion of RUTF exposes a structural weakness in the system.
When families cannot access treatment for SAM through NHIS, the burden of care shifts back to households already struggling with poverty and food insecurity.
RUTF is not a luxury commodity; it is an essential medicine for malnutrition. Its formulation allows children to be treated at home, reducing hospitalization costs and improving adherence. Evidence from Ghana and other countries shows that community-based management of acute malnutrition is both effective and scalable when adequately financed.
Failure to integrate RUTF into NHIS creates inefficiencies across the health system. Facilities cannot plan effectively, health workers face ethical dilemmas, and monitoring of outcomes becomes fragmented. By contrast, NHIS coverage would allow for standardized protocols, better data collection, and improved quality of care.
Importantly, integrating RUTF into NHIS would reduce Ghana’s dependence on donor funding for a core child survival intervention.
While development partners play a valuable role, reliance on external funding for essential services poses sustainability risks. National ownership through NHIS financing would ensure continuity of care and long-term impact.
The economic case is equally compelling. Studies consistently show that investments in nutrition yield some of the highest returns in development, often exceeding returns from infrastructure projects. Children who receive timely treatment for malnutrition are more likely to complete school, earn higher incomes, and contribute to national growth.
As Ghana advances its Universal Health Coverage agenda, it is imperative that nutrition interventions are fully integrated into health financing decisions.
Leaving RUTF outside NHIS sends the message that malnutrition is a peripheral issue rather than a core determinant of health and development.
Policymakers have the opportunity to correct this imbalance. Integrating RUTF into NHIS would strengthen the health system, protect vulnerable children, and safeguard Ghana’s future workforce. It is a policy decision grounded in evidence, equity, and national interest.
Key Policy Recommendations: The Ministry of Health and NHIA should immediately commission a costing study to integrate RUTF into the NHIS benefits package by 2027. Parliament’s Health Committee should prioritize oversight of this integration, with quarterly progress reports.
The National Health Insurance Authority must allocate 2-3% of its annual budget to nutrition interventions, including RUTF coverage for all diagnosed SAM cases. District health directorates should establish standardized RUTF distribution protocols, with digital tracking systems to monitor utilization and outcomes.
Finally, the Ghana Health Service should launch a nationwide training programme for health workers on community-based management of acute malnutrition, ensuring quality service delivery from hospital to household level.
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
