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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

Palava sauce and plantain

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Plantain with palava sauce

Ingredients

-Cocoyam leaves (Nkontomire)

-Palm oil

-Ripped Plantain

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-2 Large smoked salmon

-1 cowhide (wele)

-1 cup of Egusi

– Momoni

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-3 fresh eggs

-2 large onions

-2 large tomatoes

-Pepper

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-Ginger

-Garlic

Method

-Wash cocoyam leaves thoroughly under running water

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-Cut cocoyam leaves into stripes and wash for the second time

-Blend tomatoes, onion, pepper, ginger, and garlic together

-Put sauce pan on fire and heat palm oil

-Add blended ingredients and allow to cook for about 5 minutes

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– Wash salmon, wele and cut into cubes and add to stew

-Add salt

-Add eggs to egusi in a bowl to form paste and add it to stew

-Add to stew and allow to simmer for seven minutes

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-Add cocoyam leaves to stew and allow it to cook for sometime

-Wash, peel plantain and cut into shapes

-Cook for some time (Pour water out and serve with stew)

By Linda Abrefi Wadie

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Nutrition

Food waste is a nutrition problem too

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Every year, Ghana produces thousands of tonnes of nutritious food but a significant share of it never reaches a plate. Fruit spoils before it’s sold. Vegetables rot in transit. Grains are ruined by poor storage. Conversations about nutrition often focus on growing more food but reducing what’s lost or wasted after harvest may be one of the fastest ways to improve food security and nutrition, without farming a single extra acre.

The cost of losing nutritious food

Fresh fruit and vegetables spoil the fastest, and without adequate storage, cooling, or transport, farmers are often forced to sell at rock-bottom prices or watch their harvest go to waste. That squeezes farmers’ incomes and shrinks the supply of nutritious food reaching local markets. As supply falls, prices rise, pushing healthy food further out of reach for the low-income households that need it most.

Nutrition begins beyond the farm gate

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Cutting post-harvest losses means more nutritious food reaches families without needing more farmland or higher yields. When tomatoes, mangoes, and leafy greens are preserved through better storage, drying, or processing, they stay available and affordable for longer. Better handling also protects nutritional quality itself, so the vitamins and minerals in food aren’t lost before it ever reaches a consumer.

Supporting farmers supports nutrition

Many farmers still lack access to storage facilities, cold chains, processing equipment, and reliable transport. Strengthening these systems is a win on both ends: farmers earn more from what they grow, and households gain more affordable access to nutritious food. Local processing, such as turning surplus fruit into juices, dried fruit, or purees, can extend shelf life and cut waste even further.

What needs to change?

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Reducing food loss takes coordinated action:

•         Government: invest in rural roads, storage infrastructure, irrigation, and agricultural extension services.

•         Private sector: expand cold storage, food processing, and distribution networks.

•         Research institutions: keep developing better post-harvest preservation technology.

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•         Consumers: plan meals, store food properly, and make safe use of leftovers.

Looking ahead

As Ghana works to tackle malnutrition in all its forms, cutting food loss deserves a place at the top of the agenda. Growing more food matters, but making sure the food already grown actually reaches families, safely and affordably, matters just as much.

Every basket of tomatoes saved, every crate of mangoes preserved, and every bag of grain protected from spoilage adds up to better nutrition, stronger livelihoods, and a more resilient food system for the future.

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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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