What are the Stories
Change in Nutrition in Ghana?
Richmond Aryeetey, Afua Atuobi-Yeboah
and Mara Van Den Bold

Ghana

Ghana- Nutrition situation
Covic and Hendriks, 2016

www.westafrica.transformnutrition.org
1) generate knowledge to improve
nutrition
2) mobilize knowledge for policy and
programming

Stories of Change in Ghana
nutrition-relevant changes and
challenges between 2008 and
2018
Anticipate future nutrition
relevant changes and challenges
To drive political commitment,
policy, and program coherence in
nutrition

Planned activities
 Initial Stakeholder consultations
 Trend and Decomposition analysis
 Key Informant Interviews
 Stakeholder Net Map
 National and sub-national interviews
 Nutrition policy and programme
timelines

Objective
We describe initial findings of the initiative’s efforts to
understand what the nutrition priorities are in Ghana with
respect to outcomes, processes, and opportunities

Decomposition analysis
35%
27%
19%14%
10%
5%
2003 2008 2014
Stunting
Severe Stunting
0
.1.2.3.4
Density
-5 -4 -3 -2 -1 0 1 2 3 4 5
HAZ score
2003 2014
Distribution of HAZ scores 2003 and 2014Prevalence of stunting (2003 and 2014)

Decomposition analysis
Characteristic 2003 2008 2014
Change (2003-
2014)
% of Change
Asset Index, 1-10 2.61 3.15 4.13 1.52 58%
Maternal education (years) 4.18 4.53 5.02 0.85 20%
Paternal education (years) 6.47 6.86 6.98 0.51 8%
4 prenatal visits or more (%) 70 79 87 17 24%
Born in medical facility (%) 41 54 69 28 67%
Open defecation (%) 32 29 26 -6 -17%
Improved water source (%) 40 76 79 39 96%
Number of children 4.57 4.31 4.25 -0.32 -7%
Birth interval (years) 3.76 3.84 3.98 0.22 6%
Maternal height (cm) 158.92 158.78 158.91 -0.01 0%
Presence of bednet in household (%) 25 73 81 57 231%

Estimated contributions of selected factors
to change in HAZ (0-59 mo)

Policy
Timeline -
2008-2018 2008 2009 2010 2011 2012 2013 2015 20162014 2017 2018
National Environmental Sanitation Strategy and Action Plan
Environmental Sanitation Policy
Strategic Environmental Sanitation Investment Plan
Medium Term Agriculture Sector Investment Plan
The Savanna Accelerated Development Authority-Synopsis of
Development Strategy
Medium Term National Development Policy Framework: Ghana Vol I&II
The Coordinated Programme of Economic and Social Development
Policies
National Ageing Policy
Agona West Municipal Assembly-District Environmental Sanitation
Strategy and Action Plan
Education Strategic Plan: Strategies and Work Programme
MOH Health Matrix
National Pension Act( Act 766)
Child and Family Welfare Policy
National Social Protection Policy
National Gender Policy
Justice for Children Policy
National School Feeding Policy
Youth Employment Agency Act, Act 887
National Food Safety Policy
Private Health Sector Development Policy
Draft Inclusive Education Policy
Health Professions Regulatory Bodies Act, Act 857
Environmental Assessment Guidelines for Oil and Gas Development in Ghana
Pre-Tertiary Teacher Professional Development and Management Policy?
Health Sector Gender
Policy
Anti-Malaria Drug
Policy
National E-Health
Strategy
Medium Term Agric
Sector Investment
Plan
Fisheries Regulations
Trees Crops Policy
National Environmental Policy
National Urban Policy: Framework and Action Plan
Strategy for the Management, Prevention and Control of Chronic Communicable Disease in Ghana
National Policy for the Prevention and Control of Chronic Non-communicable Disease in Ghana
Occupational Health and Safety Policy and Guidelines for Health Sector
National Public Health Law
Mental Health Act, Act 846
National Health Insurance Act, Act 852
Public Health Act, Act 851
Ministry of Health Referral Policy Guidelines
Policy on Antimicrobial Use and Resistance
National Nutrition Policy
Ghana National Healthcare Quality Strategy
National Community-Based Health Planning
Services (CHPS) Policy
Ghana National Alcohol Policy
Local Government Act, 2016
Health Sector Medium
Term Development
Plan
National Employment
Policy
Fisheries Amendment
Act, Act 880
National Pensions
Amendment Act, Act
883

Nutrition-relevant policies in Ghana: 2008-2018
27
9
7
9
5
3
3
63
0 10 20 30 40 50 60 70
Health and Nutrition
Economic and Social
Agriculture/Fisheries
Environment- Water & Sanitation
Gender
Education
Others
Total
Sectors

Policies and links with WHA Indicators
July 3, 2018; Swiss Spirit and Suits Alisa Hotel, Accra
Polices WHA Targets
& Indicators
WHA Indicators
National Nutrition Policy,
2016
6 U5 stunting, U5 wasting, U5 Overweight, Women,
Women of Reproductive Age who are anaemic, EBF,
LBW
Under Five's Child Health
Policy 2007-2015 (2007)
5 U5 stunting, U5 wasting, Women, Women of
Reproductive Age who are anaemic, EBF, LBW
Under Five's Child Health
Strategy 2007-2015 (2007)
5 U5 stunting, U5 wasting, Women, Women of
Reproductive Age who are anaemic, EBF, LBW
National Health Policy:
Creating Wealth Through
Health
4 U5 stunting, U5 wasting, U5 Overweight, Women,
Women of Reproductive Age who are anaemic
Health Sector Medium
Term Development Plan
2014-2017 (2014)
3 U5 stunting, U5 wasting, Women, Women of
Reproductive Age who are anaemic,

NUTRITION ACTORS
GOVERNMENT
Health
Agriculture
MOH
GHS MOFA
WIAD
SUN
UN
NDPC
WHOWFP
UNICEF
Key Informant Interviews

Stakeholder perception
Nutrition/Health situation
Reduced stunting, anemia
Reduced maternal/child deaths
Increased overweight, obesity
Policy Processes
National nutrition policy
Increased opportunities for
nutrition coordination
(National SUN MSP)
Social Protection
interventions
School feeding program
Cash transfer program (LEAP)
Capitation Grant
Fo Food System
Reduced
undernourishment
Increased access to energy-
dense, nutrient poor foods
Western dietary practices
Transition to Lower Middle-Income Country
Expanded infrastructure (electricity, ICT, road network, health facilities
(CHPS), health insurance scheme
Macro economic Development

Conclusions and Lessons
Dynamic changes in nutrition
landscape linked with
nutrition-sensitive changes
Value of stakeholder
engagement

Many Thanks For Your Attention
www.westafrica.transformnutrition.org