Ghana has made strong commitments to protecting the health and wellbeing of its citizens. The Constitution affirms the state’s responsibility to safeguard public health, and the country has endorsed international agreements recognizing the right to adequate food and nutrition.

 National policies also acknowledge malnutrition as a major challenge and outline interventions designed to address it. Yet for many vulnerable families, the reality remains very different. An estimated 68,517 children with severe acute malnutrition face a mortality risk nine times higher than that of well-nourished children, while only 15 per cent receive the treatment their government has approved as essential medicine. The gap between rights on paper and access in practice defines the challenge facing vulnerable families.

When rights are effectively implemented, systems exist to ensure access regardless of income or location. Ghana’s immunisation program is a good example. Children receive vaccines through routine services across the country because financing mechanisms guarantee supply and remove cost barriers. Similarly, many pregnant women

access antenatal services through the National Health Insurance Scheme. Nutrition interventions, however, do not yet benefit from the same level of system support.

For a mother in a rural community whose child develops severe malnutrition, the availability of treatment often depends on factors beyond her control. Does a donor-supported program operate in her district? Are supplies currently available at the health facility, or have funding gaps caused stockouts? Even though national policy recognises the treatment, the health system may not consistently provide it.

The same challenge affects maternal nutrition. Multiple Micronutrient Supplements are recognised in policy and supported by convincing evidence. Studies show they can reduce low birth weight and preterm birth while addressing a broader range of micronutrient deficiencies. Yet pilot programs currently reach only a small proportion of pregnant women nationwide.

When access depends on project locations rather than national systems, inequities deepen. Wealthier households may find ways to obtain supplements or travel to better-resourced facilities. Poor families, particularly in rural areas, rely entirely on public services. When those services operate on a limited scale, poverty becomes a determining factor in who receives care.

Closing this gap requires strengthening the mechanisms that translate policy commitments into real services. Integrating nutrition interventions such as RUTF and Multiple Micronutrient Supplements into the National Health Insurance Scheme could provide that mechanism. With a large share of mothers and children already enrolled, NHIS offers an existing platform capable of expanding access nationwide.

This is fundamentally a question of equity and justice. Ghana has demonstrated the capacity to deliver universal coverage for some health interventions. The right to vaccination does not depend on household income because financing systems ensure supply and remove cost barriers. The right to antenatal consultation is similarly protected through NHIS. There is no technical or ethical justification for treating nutrition rights differently. If severe malnutrition treatment and comprehensive maternal supplementation are essential for health, they deserve the same financing commitment as other essential services.

Rights become meaningful when they guarantee access. Ensuring that every child and every pregnant woman can obtain proven nutrition interventions is not only a health priority, but also a step toward making Ghana’s policy commitments a reality.

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