How poor coordination and weak capacity undermine progress and what needs to change.
The puzzle at the heart of Ghana’s food system
Ghana has plans, policies and pockets of technical excellence on nutrition. What it lacks is a functioning system that turns those plans into sustained action on the ground. Professor Richmond Aryeetey, in his GAAS inaugural lecture, described the problem plainly: good ideas exist, but the bridges that should unite them are missing. The result is a fragmented landscape in which ministries, agencies and donors run parallel efforts that rarely cohere into a national programme capable of reaching every district and household.
“Systems don’t fail by accident; they fail because we fail to align them.” — Prof. Richmond Aryeetey
Fixing the system, Aryeetey argued, requires confronting three structural weaknesses at once: coordination failures, capacity deficits and weak accountability and doing so across national, regional and district levels.
NDPC vs GHS: who leads and who delivers?
At the centre of Ghana’s coordination dilemma are two institutions with legitimate but overlapping roles: the National Development Planning Commission (NDPC) and the Ghana Health Service (GHS). The NDPC is charged with multisectoral planning and development frameworks; the GHS carries technical responsibility for health and direct service delivery. When nutrition sits between planning and implementation, neither body consistently exercises full authority.
The consequence is predictable: NDPC-led plans that lack operational buy-in, and GHS-led programmes that lack the multi-sectoral resources they need. Prof. Aryeetey’s message is clear, “alignment matters”. Without a defined role matrix and operational pathways linking NDPC strategy to GHS execution (and to agriculture, education, and local government), efforts either duplicate or fall through the cracks.
Horizontal and vertical coordination: two broken axes
Coordination failures play out along two axes:
Horizontal coordination: cooperation across ministries and agencies at the same level is often ad hoc. Inter-ministerial committees and technical working groups exist, but meet without long-term funding lines or enforcement mechanisms. Parties convene, draft recommendations, then return to sectoral silos.
Vertical coordination: the flow from national policy to regional and district implementation is even weaker. District assemblies and regional coordinating councils are expected to translate national nutrition priorities into local action, yet many lack formal mandates, budget allocations, or trained personnel to do so. Plans created in Accra rarely map onto the logistical and fiscal realities of districts, producing plans that are unfunded or unimplemented.
Regional and district-level gaps: where policy hits the ground
Ghana’s decentralisation was supposed to deliver local ownership. In practice, it delivered local responsibility without corresponding authority or resources. District nutrition officers routinely prepare annual plans which includes health promotion campaigns, growth monitoring, kitchen garden support, school feeding coordination but then lack the funds to turn plans into programmes. Some districts rely on short-term donor projects; others cobble together activities by piggybacking on unrelated health campaigns.
This fragmentation deepens inequity: a district with strong NGO presence or donor support will make measurable gains; a neighbouring district without such support will stagnate. The uneven patchwork undermines national goals and erodes public trust.
Data silos: the information problem
A modern food system cannot be governed blind. Yet Ghana’s data remains fractured. The Ministry of Health collects anthropometric and anemia data; Agriculture collects production and post-harvest loss figures; Education tracks school feeding and enrolment. Each dataset has value but because they are stored and reported separately, policymakers lack an integrated view of how production, markets, diet quality and health interact.
Without a unified data platform, interventions are planned on partial evidence and monitoring is cumbersome. Time lags in national surveys further weaken responsiveness. Aryeetey called for harmonised indicators and a live dashboard that links agriculture, health, education and social protection data tools that would enable local managers to make faster, smarter decisions.
Capacity shortages: the human resource crisis
Policy and data are useless without people to run them. Ghana’s nutrition workforce shortage is stark: roughly 54 trained dietitians are estimated to serve a health system with more than 3,000 facilities. That shortfall bleeds into prevention, clinical care, programme design and monitoring. Districts often lack nutrition officers with the technical skills to manage multi-sectoral initiatives; universities produce research, but graduates are thinly distributed and often leave for better-paid roles abroad or in urban centres.
Capacity gaps are not only clinical. District planners, agricultural extension officers, school administrators and local assembly members need training in nutrition-sensitive planning, budget tagging, and the use of integrated data systems. Building these competences is as essential as hiring more dietitians.
Research funding and local evidence: the missing engine
Research and local evidence are the engines of adaptation and accountability. Yet Ghana’s research funding for locally driven nutrition science is inconsistent and heavily donor-dependent. That dependency shapes research agendas and creates gaps between national priorities and the evidence produced. Prof. Aryeetey urged the government to invest in national research funds that prioritize applied, policy-relevant studies and capacity building within Ghanaian institutions. Local evidence matters: it is what turns global ‘best buys’ into contextually appropriate, scalable programmes.
Pockets of success: NANUPAC and the SUN movement
There are proof points that multi-sectoral collaboration can work. The National Nutrition Partners Coordinating Committee (NANUPAC), an instrument of the Ghana Health Service and Ghana’s participation in the Scaling Up Nutrition (SUN) movement have helped align partners, reduce duplication and create joint accountability mechanisms. Where these platforms have been used to focus financing and harmonise reporting, they produced tangible gains. The challenge is institutionalising these gains beyond project cycles.
A roadmap for a Whole-of-Government food system
Fixing the system requires a compact of reforms, sequenced and politically backed:
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Define clear leadership and mandates. Clarify roles between NDPC, GHS and sector ministries; consider an elevated national coordination body with presidential oversight to ensure cross-sector accountability.
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Institutionalise district capacity. Fund and professionalise district nutrition units — with dedicated staff, recurrent budgets, and training pathways.
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Build a unified data platform. Integrate health, agriculture, education and social protection indicators into a real-time dashboard accessible to national and district planners.
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Invest in people and research. Scale training for dietitians and community nutrition cadres; create a national research fund for applied nutrition studies.
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Finance coordination. Embed nutrition budget lines across ministries and create mechanisms for pooled funding for cross-cutting interventions.
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Measure and hold to account. Set clear, measurable indicators and tie them to performance frameworks for ministries and district assemblies.
From fragmentation to coherence
Ghana’s gains in nutrition to date show the country can achieve progress when interventions are coordinated and funded. The remaining barrier is not technical imagination but institutional alignment. As Prof. Aryeetey emphasised: systems succeed when people, money and data move together toward a shared goal. A Whole-of-Government approach backed by unified data, funded local capacity and clear political accountability will be the only reliable path from plans on paper to healthier plates across Ghana.
