Economic Development and Nutrition Transition in Ghana Taking Stock of Food Consumption Patterns and Trends (ReSAKSS ATOR, Ch. 4) Olivier Ecker (IFPRI)

Background Ghana’s high economic growth in the 1990s and 2000s contributed to rapid reduction of extreme poverty and hunger. Economic growth and transformation usually entail a “nutrition transition” (i.e. changing dietary patterns and nutritional outcomes), giving rise to new nutritional problems such as overweight/obesity and related NCDs. As overnutrition increases faster than declines in undernutrition (incl. micronutrient deficiencies), many middle-income countries have experienced a “double-burden of malnutrition.” These new nutritional realities constitute challenges to national policies (incl. public health, social protection, agriculture).

What is the current state of the nutrition transition in Ghana?

Analysis Three steps: Long-term, national trends in development and food supply indicators Regional household food consumption patterns and changes in recent years Estimation of Engel curves Focus on the consumption of protein-rich foods, because: Animal-source food consumption is a good indicator of the nutrition transition, Consumption of foods rich in high-quality protein (of vegetal and animal origins) is associated with improved nutritional outcomes, Overconsumption of animal-source foods is linked to overweight/obesity and higher risk of NCDs.

Economic Growth, Consumption & Child Nutrition GDP Total protein Calories Economic reforms Source: Own representation based on data from FAOSTAT and WDI data (accessed Sept. 2016).

Household Food Consumption Patterns Composition of average food consumption and average changes   Southern Ghana Northern Ghana Urban Rural 2012-13 (%) Change from 2005-06 (pp) Mean share of food in total consumption 39.2 -1.8 53.7 -2.9 46.2 -2.8 59.7 -5.0 Mean share of … in food consumption  Animal-source foods 30.0 0.2 29.8 -0.4 23.5 17.5 1.8 Pulses & nuts 1.6 0.0 1.4 -0.1 3.4 0.6 6.8 1.2 Cereals 19.5 -1.2 19.2 1.1 25.1 -3.3 29.2 -3.1 Roots & tubers 12.3 -0.7 20.7 -2.3 11.6 -0.9 12.7 Vegetables & fruits 17.2 14.3 0.7 16.1 15.4 Urban-rural & South-North wealth gaps Engel’s Law & dietary shifts Protein-rich foods Staples 31.6 31.3 26.9 24.3 31.8 39.9 36.7 41.9 Note: Percentage point (pp) changes in gray indicate changes that are statistically insignificant at the 5% level (acc. to a t-test for unequal variance). Consumption is measured in monetary value terms and converted to a per adult equivalent basis. Source: Own calculation based on GLSS 5 and 6 data.

Engel Curves & Food Consumption Elasticities Findings from estimation results: In Southern Ghana (urban & rural), income growth is associated with diversification of food consumption toward more high-quality protein foods of both animal and vegetal origins and more vegetables and fruits, and less staple foods. In Northern Ghana (urban & rural), income growth is associated with shifts toward more animal-source food (ASF) consumption, with little diversification toward other nutritious food groups. Consumption levels of ASFs tend to increase linearly with rising incomes and at much higher rates than those of other food groups in Southern Ghana (urban & rural), while the consumption levels of ASFs and cereals tend to increase at similarly high rates similar in Northern Ghana (urban & rural).

Conclusions There is no evidence for a nutrition transition over the past decades. Ghana is rather about to face a rapid nutrition transition and increasing double burden of malnutrition. There are marked regional differences within Ghana. It is timely to review existing food security and social protection policies and to reform those that have become ineffective and may have adverse nutritional effects in the near future. More rigorous research is needed that helps to design policies and large-scale programs that effectively reduce undernutrition and the risk of overnutrition at the same time.