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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

When floodwaters rise, nutrition and food safety should not be ignored

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Disacard food with of contamination

The recent floods across parts of Ghana have disrupted lives, displaced families, and damaged homes and livelihoods. While rescue efforts and rebuilding understandably take centre stage, another urgent issue deserves equal attention, nutrition and food safety, both during the flood and long after the water recedes.

Floods contaminate water sources, destroy crops, interrupt food supplies, and increase the spread of foodborne disease. These challenges place young children, pregnant and breastfeeding women, older adults, and people living with chronic illness at far greater risk of malnutrition. The scale of this threat is not hypothetical: in June 2025 alone, floods displaced nearly 90,000 people across seven regions, according to Ghana’s National Disaster Management Organisation (NADMO). Past flood-drought cycles show why displacement of this kind matters for nutrition following a similar disaster in Ghana’s three northern regions, the World Food Programme documented chronic malnutrition among children ranging from 34 to 48 per cent, alongside acute malnutrition of 8 to 12 percent, in the hardest-hit areas. As Ghana faces more frequent extreme weather events, protecting nutrition must become a core part of disaster preparedness, not an afterthought.

Floods affect more than food availability

Floodwaters wash away farms, destroy stored food, and make it difficult for farmers and traders to move produce to market. As supplies shrink, prices of nutritious foods such as fruits, vegetables, fish, and eggs increase. For households already stretched by the rising cost of living, that often means choosing cheaper, less nutritious food just to feel full. Over time, diets narrow, and the risk of vitamin and mineral deficiencies grows.

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The hidden danger: unsafe food

Floodwater is rarely clean. It carries sewage, chemicals, animal waste, and other contaminants into homes, farms, and food stores. Eating food that has touched floodwater, or drinking unsafe water, can trigger diarrhoea, cholera, typhoid, and other infections, illnesses that block nutrient absorption and cause rapid weight loss, especially in children. The danger doesn’t end when the water goes down; improperly stored or damaged food can still make people sick weeks later.

What every household can do

  • Drink only safe or treated water where supplies have been affected.
  • Wash fruits and vegetables thoroughly with clean water.
  • Discard any food that has been exposed to floodwater, even if it looks fine.
  • Cook food thoroughly and never eat spoiled food.
  • Keep breastfeeding infants: breast milk remains the safest source of nutrition in an emergency.
  • Seek medical care promptly if a child develops persistent diarrhoea or shows signs of dehydration.

Recovery needs more than a full stomach

Emergency food aid tends to focus on energy-dense staples like rice and maize. Important, yes but not enough on their own. Recovering families also need protein, healthy fats, vitamins, and minerals, especially the most vulnerable groups. A nutrition-smart response includes fortified foods, beans and other legumes, safe drinking water and fresh produce where possible.

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Recovery shouldn’t stop at food distribution, either. Communities need help rebuilding farms, markets, and livelihoods so families can go back to sourcing diverse, nutritious food on their own, not depending indefinitely on aid.

A call for leadership

Floods will keep testing Ghana’s resilience. The first call is to find innovative ways to reduce the impact of the floods. The response, however, has to go beyond emergency relief to actively protect nutrition and food safety through safe water provision, food safety education, trained health workers who can spot malnutrition early, and recovery programmes that help farmers get growing again quickly.

When communities are protected from hunger, disease, and poor nutrition at every stage of a disaster, they don’t just survive floods, they recover from them faster and stronger.

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

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Nutrition

How to prepare sausage rolls

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Sausage rolls

Ingredients  

-2 onion sliced

– One pack of sausage

– 2 tablespoonful of salt

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-1 tablespoonful of nutmeg

-One tin of milk

– 2 large eggs

– 2 kilograms of flour

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Method

-Pre-heat oven to keep it warm

-Put saucepan on the fire and heat oil

-Add onions and cook until soft and golden brown and spread out on a plate to cool

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-Add onions, nutmeg and sausage and mix together

– Roll the pastry out into a big rectangle as thick as a pound coin and cut it length ways into two long, even rectangles

-Roll mixture into sausage shapes with your hands and lay along the centre of each rectangle

-Mix the egg and milk and brush the pastry with the mixture, then fold one side of the pastry over, wrapping the filling inside. Press down with your fingers or the edge of a spoon to seal the joint

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Cut the long rolls into the sizes you want and space them out on a baking tray. Brush with the rest of the egg wash and bake in the pre-heated oven for 25 minutes or until puffed, golden and cooked through

By Linda Abrefi Wadie

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