Thanks to the data collected by the Ghana Ministry of Food and Agriculture (MoFA) in collaboration with IANDA, the impact of the food list on the estimated cost of a nutritious diet has been highlighted. Expanding the food list from 38 to 56 commodities, especially by adding more vegetables, fruits and legumes (out of 18 added foods, 6 are vegetables, 4 are fruits and legumes/seeds, 5 are fish and meat and 3 others), decreased the cost of the nutritious diet (SNUT) by 30%. This supports the decision of having a minimum list of close to 60 foods from diverse food groups for conducting Cost of the Diet analyses as one of the Fill the Nutrient Gap standards.
Also, the relatively high cost of a nutritious diet for adolescent girls and women, especially while pregnant or lactating, was highlighted. During pregnancy and lactation, some of the nutrient requirements are higher, which results in higher costs. For the child (6-23 months) provision of locally produced Kidifeed (voucher) and SQ-LNS (Grownut) (voucher) were the most effective in reducing the cost of a nutritious diet, respectively by an average of 84% and 60% in both regions, indicating that they are very good sources of essential nutrients. For the adolescent girl, the fresh food voucher for eggs and green leafy vegetables was the most cost-effective (average of 30% cost reduction in both regions), which is explained by their relatively high content of calcium, iron and B12, which are limiting nutrients. For PLW, SC interventions (SC, SC+ and SC with fortified oil) were the most cost-effective and even more so when SC was modelled by adding it to a daily diet that included one serving of staple food, rather than two. On average, provision of SuperCereal for free (using a voucher) reduced the cost of a nutritious diet for PLW by 50% in both regions.
For the Obaasima products, the analysis found them to be less cost-effective to meet nutrient requirements compared to other options, which is due to the fact that their content of specific nutrients, including panthotenic acid, iron and vitamin B12, was lower than that of the other fortified options included in the model. Among the three products, the Lola Milk Biscuit performed better, indicating that it was a more cost-effective source of essential nutrients. Besides nutrient content and cost, acceptability and actual amount consumed by the intended targeted group are also important determinants of whether a specific food will be able to make a good contribution to improving nutrient intake. Consumption of Obaasima products is likely to make a meaningful contribution to meeting nutrient intake requirements even when it has a lower content of certain micronutrients than other foods that consumers may or may not prefer over those products. Nevertheless, it would be good to consider increasing the content of the specific micronutrients for which content is relatively low.
Overall, the previous CotD analyses and those shared in this report have shown that the costs of a nutritious diet are relatively high, compared to a diet that only meets energy needs, and that a substantial proportion of the population cannot afford these costs (about one third in the previous analysis, ranging from 12% to 78% across regions). Any strategy or intervention that increases the availability and lowers the costs of nutritious foods (i.e. those that have a high content of essential nutrients relative to energy content), whether from natural foods or processed fortified foods, and whether by making them available for free, at subsidized price or regular price, and/or increases income can improve affordability and hence likelihood of increased consumption of nutrient-rich foods and hence better meeting nutrient requirements among different target groups.
The examples analysed in this report compare the extent to which different foods and distribution modalities reduce the cost of a nutritious diet for specific target group and can be used to select (combinations of) approaches and distribution channels for improving nutrition among specific groups or the population in general. Apart from selecting cost-effective options for improving nutrient intake, the acceptability and demand for the different foods by the target population should also be ensured.