From Donor Dependence to National Ownership: Ghana’s Path to Sustainable Child Nutrition

An estimated 68,517 children in Ghana currently suffer from Severe Acute Malnutrition, yet only about 15 percent receive treatment. This gap is not due to a lack of effective solutions, but to limited and unstable access driven by fragmented, donor-dependent financing. As Ghana advances toward universal health coverage and economic self-reliance, ensuring sustainable and equitable child nutrition services requires urgent policy action.

Ready-to-Use Therapeutic Food (RUTF) and Multiple Micronutrient Supplements (MMS) are proven, cost-effective interventions. RUTF achieves recovery rates of 75–90 percent among children with severe acute malnutrition, while MMS reduces low birth weight and preterm birth. Both interventions are included in Ghana’s Essential Medicines List and Standard Treatment Guidelines. National protocols are finalized and disseminated, and over 600 health workers have been trained. In short, Ghana has laid the policy and technical groundwork.

Despite this readiness, access remains constrained by reliance on donor funding. Time-bound financing leads to supply disruptions, uneven geographic coverage, and weak long-term planning. Service availability often reflects donor priorities rather than population need. Most critically, national ownership is undermined when lifesaving child nutrition interventions depend on external support. Donor dependence also limits system integration. Nutrition services delivered through projects remain peripheral to routine care. Health facilities cannot fully integrate RUTF and MMS into standard maternal and child health services without predictable supply. Data systems, quality assurance, and accountability mechanisms remain fragmented, preventing these interventions from reaching scale and impact.

Integrating RUTF and MMS into the National Health Insurance Scheme (NHIS) offers a clear pathway to sustainable national ownership. With 84 percent of mothers of children under five already enrolled, NHIS provides an existing platform for rapid and equitable scale-up. The 2025 uncapping of the National Health Insurance Levy further strengthens the financing base. NHIS inclusion would remove out-of-pocket costs for vulnerable families, standardize service delivery nationwide, and embed nutrition care within routine health services.

The cost implications are manageable. MMS costs approximately USD 2.50 per pregnancy for a full course, representing a small fraction of current undernutrition spending. Timely community-based RUTF treatment also reduces costly hospital admissions for complicated and severe malnutrition. Ongoing Health Technology Assessments will provide Ghana-specific evidence to guide reimbursement decisions.

Domestic financing brings broader benefits. It ensures stronger government accountability, improved data reporting, better quality assurance, and long-term planning beyond donor cycles. Most importantly, it affirms that the survival and wellbeing of Ghanaian children are national responsibilities.

The policy decision before Ghana’s leadership is clear. The clinical evidence supports RUTF and MMS. The regulatory framework is established. The implementation capacity exists through trained health workers and operational guidelines. The financing mechanism is available through NHIS with its recently expanded revenue base. What remains is the political committment to prioritize sustainable nutrition financing as part of Ghana’s Universal Health Coverage roadmap and broader development agenda.

Donor support has been valuable in establishing these interventions and building implementation capacity. The transition to domestic financing should be viewed not as disengagement but as graduating to full national ownership. Development partners can continue supporting technical assistance, capacity building, and innovation while Ghana secures sustaining coverage at scale.

The gap between 15 percent coverage and the 80 to 90 percent achievable with adequate financing represents thousands of preventable child deaths and compromised maternal health outcomes annually. Closing this gap through NHIS integration of RUTF and MMS is not merely a technical health financing decision. It is a statement of national values and priorities, affirming that every Ghanaian child deserves access to lifesaving nutrition treatment regardless of circumstance. It is a foundation for sustainable human capital development.

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