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Nutrition

The NHIS Opportunity: Leveraging Ghana’s uncapped health levy for nutrition services

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Ghana’s decision to uncap the National Health Insurance Levy in 2025 marks an important shift in health financing. By removing limits on how much revenue the National Health Insurance Scheme (NHIS) can receive, government has created room to strengthen and expand essential health services.

This change comes at a crucial time for maternal and child nutrition, where effective solutions already exist but are yet to reach everyone who needs them.

Two such interventions are Ready-to-Use Therapeutic Food (RUTF) for children with severe acute malnutrition and Multiple Micronutrient Supplements (MMS) for pregnant women. Both are included in Ghana’s Essential Medicines List and Standard Treatment Guidelines, confirming their safety and effectiveness. Yet neither is currently covered under NHIS, leaving access dependent largely on donor-supported programmes.

The consequences are visible. An estimated 68,517 children in Ghana need treatment for severe acute malnutrition, but only about 15 per cent receive RUTF. For pregnant women, iron–folic acid supplements remain the standard, even though they address only two of the 15 essential micronutrients required during pregnancy. As a result, maternal anaemia remains widespread, affecting between 37 and 63 per cent of pregnant women depending on the trimester.

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What makes this moment different is that Ghana already has the systems needed to deliver these services at scale. NHIS enrollment among mothers of children under five stands at about 84 per cent. National guidelines for the use of RUTF and MMS are finalised and in use, and more than 600 health workers have been trained on updated protocols. Supply chain structures are in place. The missing link has been sustainable, predictable financing.

Cost should not be a barrier. A full course of MMS costs about USD 2.50 per pregnancy and has been shown to reduce low birth weight by 12 per cent and preterm births by 11 per cent. This represents a small share of current spending on undernutrition. RUTF, while more resource-intensive, reduces the need for expensive hospital admissions by enabling effective community-based care, with recovery rates of 75 to 90 per cent. Ongoing Health Technology Assessments will provide Ghana-specific evidence to guide NHIS reimbursement decisions.

Including RUTF and MMS in the NHIS benefits package would change how nutrition services are delivered. Coverage would no longer depend on where donor programmes operate. Families would be protected from out-of-pocket costs, and services would be delivered as part of routine maternal and child healthcare. Importantly, data on coverage and outcomes would flow through national systems, strengthening monitoring, accountability, and planning.

Ghana has committed to achieving 80 per cent coverage of essential health services by 2030 under its Universal Health Coverage agenda. Nutrition is central to this goal, as it underpins child survival, maternal health, and long-term human development. The uncapping of the National Health Insurance Levy offers a rare chance to close long-standing nutrition financing gaps using domestic resources.

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The opportunity is clear. The systems are ready. The evidence is established. What remains is a deliberate policy choice to use this expanded fiscal space to ensure that lifesaving nutrition services reach mothers and children across the country, consistently, equitably, and sustainably. The levy uncapping opens the door; leadership must walk through it.

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

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Nutrition

Benefits of chocolate

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Chocolate is made from tropical Theobroma cacao tree seeds. It has since become a popular food product that millions enjoy every day. It has a unique, rich, and sweet taste.

-Cholesterol
A researcher revealed that chocolate consumption help to reduce low density lipoprotein.

Regular consumption of chocolate bars with low-fat diet supports cardiovascular health by lowering cholesterol and improves blood pressure.

  • Keeps brain healthy
    Researchers have suggested that drinking two cups of hot chocolate a day could keep the brain healthy and reduce memory decline in older people.

The researchers found that hot chocolate helped improve blood flow to parts of the brain where it was needed.

  • Heart disease
    Consuming chocolate could help lower the risk of developing heart disease and also lower risk of cardiometabolic disorders.

-Stroke
Canadian scientists, in a study involving 44,489 individuals, found that people who ate one chocolate were 22 per cent less likely to experience a stroke than those who did not.

Also, those who had about two ounces of chocolate a week were 46 per cent less likely to die from a stroke.

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-Fetal growth and development
Eating chocolate every day during pregnancy might benefit fetal growth and development, according to a study presented at the 2016 Pregnancy Meeting of the Society for Maternal-Fetal Medicine in Atlanta, GA.

The flavonoids in dark chocolate can stimulate the endothelium (lining of arteries) to produce nitric oxide (NO).

One of the functions of nitric oxide is to send signals to the arteries to relax, which lowers the resistance to blood flow and therefore reduces blood pressure.

Dark chocolate may also improve the function of your brain.

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Studies show that eating high flavanol cocoa could help improve blood flow to the brain in young adults.

Cocoa flavonoids may also help maintain brain health and the ability to think in older adults with mild cognitive impairment and reduce the chance of progressing to dementia. But more research is needed.

-medicalnewstoday.com

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Nutrition

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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