Nutrition
The Data Imperative: How NHIS integration can strengthen nutrition monitoring
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 The result is that decision-makers may be working with incomplete or outdated information when planning nutrition services.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.
Kaklo is the common street snack that turns overripe plantain into pure gold.
Kaklo is best eaten fresh off the fire. Crispy outside, soft and sweet inside, with a kick of ginger and pepper.
Mostly, found at bus stop from Accra.
Ingredients
– 4 ripped plantain
– 1 onion finely grated
– 1/2 tablespoonful of grated fresh ginger
– 1 tablespoonful dried powdered pepper
– ½ tablespoonful of fresh scotch bonnet, finely chopped
– Salt to taste
– ¼ cup corn flour
– Oil for deep frying
Preparation
-Peel the overripe plantains and place in a bowl.
– Mash thoroughly with a fork or your fingers until smooth.
– Add grated onion, ginger, pepper, and salt to the mashed plantain. Mix well.
-Sprinkle in the corn flour and stir until the batter holds together (It should be thick and scoopable, not watery. If too soft, add a little more flour).
-Pour oil into a deep pan or skillet to about 2 inches deep. Heat on medium until a small drop of batter sizzles and rises immediately. If using palm oil, don’t let it smoke.
– Using a tablespoon, scoop batter and gently drop into the hot oil. Don’t crowd the pan.
-Fry 2–3 minutes per side until deep golden brown and crisp.
– Remove with a slotted spoon and drain on paper or in a colander. Serve hot.
Cook’s Notes
– Plantain test: If it’s not sweet and soft enough, your kaklo will taste bland. The skin must be black and the flesh very soft.
– No blender: Traditionally, kaklo is mashed by hand. Blending makes it too smooth and it absorbs more oil.
– Serve with: Fresh ground pepper, shito, or a handful of roasted groundnuts. Perfect with a chilled bottle of sobolo or ice water.
By Theresa Tsetse
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
