Malnutrition among women and children is an underlying cause of high morbidity and
mortality in the developing world. Ghana is one of 36 countries with a high
prevalence (> 20%) of chronic stunting in childhood. Although proven and
inexpensive technologies and interventions exist to address maternal and child
malnutrition, their implementation remains at a low scale in many developing
countries, including Ghana. In Ghana, barriers to scaling up nutrition actions have
been identified at the national level, yet little is known about the situation at the
district and sub-district levels where nutrition interventions are directly delivered. The
current study assessed district-level capacity and commitment for accelerating
implementation of effective nutrition interventions to address the high burden of
maternal and child malnutrition. In June 2010, key informant interviews involving
technical officers, clinicians, nurses, and administrative staff, and a desk review of
program and administrative reports were conducted in the Omanye District
(pseudonym). Using the framework from the WHO landscape analysis of readiness to
scale up nutrition actions, interviews explored questions of commitment (financial,
planning, collaborations) and capacity (human resources, job aids, skills) to
implement nutrition actions in the district. Most key nutrition interventions were
being implemented in the Omanye District including growth promotion, micronutrient
supplementation, behavior change communication on infant and young child feeding,
and a pilot project for community management of severe acute malnutrition.
Interventions are challenged, however, by barriers including inadequate financial
commitment, low prioritization of nutrition, inadequate personnel, and insufficient job
aids. Because nutrition was relatively underfunded in the district, nutrition technical
officers had been shifted to perform other or additional tasks. Insufficient investment
and inadequate capacity prevents delivery of quality nutrition services in the Omanye
District. Interventions that prioritize and improve investment in nutrition actions are
needed to optimize nutrition services at the district level in Ghana.