Nutrition
The NHIS Opportunity: Leveraging Ghana’s uncapped health levy for nutrition services
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.
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.
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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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.
– 2 cups of fresh spinach
-1 cup of almond milk
-1 cup of coconut water
-2 slice of banana or pineapple
– 1/2 cup of greek yogurt
Ice (optional, if not using frozen fruit)
Preparation
- Blend almond milk and spinach
- Continue to blend until no large pieces remain.(This ensures a smooth, non-gritty texture
– Add frozen fruit, yogurt to the mixture
- Blend on high speed until completely smooth
-Add ice cubes and serve.
