Ghana is a small coastal country of West Africa well endowed with natural resources. The population is young and a high proportion is urban. Agriculture, which is still predominantly traditional, plays an important role in the country’s economy and remains the main sector of employment. Over the last years, Ghana has registered robust economic growth. While poverty still has a firm grip on the North, there has been a substantial decline in poverty at national level and the country is on track to achieve the first Millennium Development Goal if the current economic growth rate is sustained.
With regard to health indicators, infant and under-five mortality rates are stagnating. Low access to health services and to safe water and sanitation, high incidence of malaria and malnutrition as an underlying factor are among the main causes of mortality. Childhood immunization coverage still needs to be increased. Inadequate antenatal care coverage and unsupervised deliveries entail a high level of maternal mortality.
The Ghanaian diet largely relies on starchy roots (cassava, yams), fruit (plantain) and cereals (maize, rice). Starchy roots and cereals still supply almost three quarters of the dietary energy and diversity of the diet remains low. The dietary supply meets population energy requirements, but the share of protein and of lipids in the dietary energy supply is lower than recommendations. Rapid urbanization has modified food consumption patterns in urban areas, with an increasing demand for imported food, especially wheat and rice. Over the last decade, prevalence of undernourishment has decreased considerably. However, food insecurity persists, mainly due to unstable production, insufficient purchasing power and problems of physical access due to a lack of road infrastructure in the northern part of the country.
Breastfeeding is a common practice and, thanks to efficient promotion programmes, early initiation of breastfeeding is becoming more widely practiced. However, only half of children under 6 months are exclusively breastfed and complementary feeding practices are inadequate. These feeding practices combined with food insecurity of households and low access to health services are among the main causes of malnutrition among young children. Nearly a quarter of preschool children are stunted (i.e. affected by chronic malnutrition). Based on this prevalence rate, the severity of malnutrition is defined as “medium” at national level. However, regional disparities are marked; prevalence of chronic and acute malnutrition (i.e. stunting and wasting, respectively) is higher in the Northern and Upper East regions. Nevertheless overall prevalence of underweight is declining. Meanwhile the country is undergoing a nutrition transition. Among adult women, the prevalence of overweight and obesity is high, especially among those living in urban areas, while undernutrition persists, particularly in the Upper East region.
Undernutrition is associated with widespread micronutrient deficiencies. Although recent data are not available, iodine deficiency disorders may be still prevalent. The proportion of households using adequately iodized salt remains unacceptably low. The national programme of salt iodization needs to be evaluated. There is a lack of recent and nationally representative surveys on vitamin A deficiency (VAD) among young children. Vitamin A supplementation programmes have been implemented throughout the country but coverage needs to be extended among both children and women, and especially among women living in the Eastern and Northern regions. Anemia affects more than three quarters of young children and almost half of women of childbearing age. Food-based approaches and iron and folic supplementation programmes have been implemented to combat iron deficiency anemia but impact has not been measured.
Ghana has made steady progress towards achieving the Millennium Development Goals. However, the nutrition, health and mortality situation of young children and women, as well as persistent regional disparities need to be addressed.