Nutrition
The true cost of free healthcare: Why NHIS must cover essential nutrition services
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Ghana’s National Health Insurance Scheme (NHIS) has transformed healthcare access for millions of people. Since its establishment, the scheme has reduced out-of-pocket health spending and increased the use of healthcare services. For many families, an NHIS card means the difference between seeking treatment and delaying care. Yet this promise of accessible healthcare encounters significant limitations when families face nutrition emergencies.
Consider a mother whose child develops severe acute malnutrition (SAM). This life-threatening condition affects an estimated 68,000 children in Ghana and carries a mortality risk up to nine times higherthan that of well-nourished children. The good news is that SAM can be treated effectively. Ready-to-Use Therapeutic Food (RUTF), a peanut-based therapeutic food that allows children with uncomplicated malnutrition to recover through community-based treatment. Recovery rates typically range between 75 and 90 per cent, with very low mortality when treatment is delivered early. RUTF is not an experimental intervention. It is included in Ghana’s Essential Medicines List and the Standard Treatment Guidelines, and health workers across the country are trained to use it.
Yet RUTF is not covered under the NHIS benefits package.
This means that even when a mother holds a valid NHIS card, the scheme may cover consultation fees and routine medicines but not the one treatment that could save her child’s life. Access often depends on whether a donor-funded program happens to be operating in her district. If supplies run out, or if her district is not part of a project, treatment may simply not be available. This is the hidden cost of healthcare that appears free on paper but remains inaccessible in practice.
The pattern repeats with maternal nutrition. An estimated 37 to 63 per cent of pregnant women in Ghana experience anemia, depending on the stage of pregnancy. While iron and folic acid supplements help address two nutrients, pregnancy increases the body’s demand for many more vitamins and minerals. Multiple Micronutrient Supplements (MMS) provide 15 essential vitamins and minerals in a single daily tablet. Evidence shows that MMS can reduce low birth weight by about 12 per cent, preterm birth by about 11 per cent, and small-for-gestational-age births by around 8 percent.
Despite these benefits, access remains limited. A full course of MMS during pregnancy costs about $2.50 in public-sector procurement, yet current pilot programs reach only a small fraction of pregnancies. Most pregnant women enrolled in NHIS receive antenatal consultations and iron-folic acid tablets, but comprehensive micronutrient supplementation is not yet routinely available through the system. As a result, women who can afford supplements from private pharmacies may receive more comprehensive care, while others rely on more limited options. These gaps create what economists call “false savings”.
When children with severe malnutrition cannot access RUTF early, their condition may worsen, requiring costly hospitalisation and medical care. When pregnant women lack adequate micronutrient support, complications during pregnancy and childbirth can generate healthcare costs far greater than the cost of prevention.
In other words, excluding essential nutrition interventions from NHIS may appear to save money in the short term, but it often raises healthcare costs later while worsening health outcomes. The encouraging news is that the infrastructure to address this gap already exists. A large majority of mothers with young children in Ghana are already enrolled in NHIS. Health facilities have trained staff, established antenatal care systems, and experience delivering nutrition services.
What remains is a policy decision. Integrating RUTF and MMS into the NHIS benefits package would ensure that families enrolled in the scheme can access these essential services when they need them most.
Healthcare that appears free but excludes life-saving nutrition services is healthcare that fails at critical moments. Including these interventions under NHIS would not simply expand the benefits package. It would complete the promise of universal health coverage, ensuring that Ghanaian mothers and children receive the care they need to survive and thrive.
Feature article by Women, Media and Change under its Nourish Ghana: Advocating for Increased Leadership to Combat Malnutrition project
Nutrition
When floodwaters rise, nutrition and food safety should not be ignored

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.
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.
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.
Feature article by Women, Media and Change under its Nourish Ghana: Advocating for Increased Leadership to Combat Malnutrition project
Nutrition
How to prepare sausage rolls

Ingredients
-2 onion sliced
– One pack of sausage
– 2 tablespoonful of salt
-1 tablespoonful of nutmeg
-One tin of milk
– 2 large eggs
– 2 kilograms of flour
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
-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
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




