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Boosting demand for orange-fleshed sweetpotato through nutrition counseling at Ghana health service facilities

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Fig. 1 Training on OFSP utilization for expecting and
lactating mothers at the Ghana Health Service facility
(credit E. Dery)
Boosting demand for orange-eshed
sweetpotato through nutrition counseling
at Ghana health service facilities
We introduced the pro-vitamin A-rich orange eshed sweetpotato (OFSP) to
the nutrition counselling program of the Ghana Health Service in the Northern
and Upper East Regions of Ghana. In 2015 and 2016, over 8,000 pregnant or
lactating women received counselling (Fig. 1), including cooking and feeding
demonstrations, and were encouraged to grow or buy OFSP. In 2016, over
4,000 women received vouchers to get free samples of planting material and
roots from local producers and were encouraged to buy more. At the end of
the season, more than 90% indicated a willingness-to-pay for OFSP planting
material and roots, and 15-16% had actually done so.
September 2017
Implementing partners:
• Association of Church-Based
Development Projects
National programs
• CSIR – Savanna Agricultural
Research Institute (SARI)
• Ghana Health Service (GHS)
• Ministry of Food
and Agriculture
What was the problem?
Undernutrition, including micronutrient
deficiency, is a widespread public health
problem in Ghana, and is particularly severe
in two northern regions, where over 30% of
children under five are underweight or stunted.
Sustainable solutions to solving this problem are
needed, and improving nutritional knowledge
and access to healthy foods complement efforts
such as industrial fortification of foods and
vitamin A supplementation and are particularly
relevant for rural dwellers. The provitamin
A-rich orange fleshed sweetpotato (OFSP)
is a biofortified crop that can be effective in
combating vitamin A deficiency at the community
level, but for sustainable impact, it needs to be
present on farms, in gardens, and in markets, and
sought after by consumers. In northern Ghana,
OFSP was unknown when we started this effort.
What did we want to achieve?
We wanted to introduce OFSP to pregnant and
lactating women to benefit them (Fig. 2) and their
families, particularly their children under two
years of age, who are the most at risk for vitamin
A deficiency. We wanted to do this in a way that
would have sustainable impact, by encouraging
consumption and production at the household
garden level, while also encouraging the broad
popularization and commercialization of OFSP
as a nutritious, climate-resilient crop suitable for
rain-fed and irrigated production in northern
Ghana. We wanted to evaluate whether we could
use the antenatal nutrition counselling and infant
and young child feeding (IYCF) efforts of the
Ghana Health Service (GHS) as entry points to
help to achieve the sustainable inclusion of OFSP
in household diets.
Where did we work?
We conducted our work at pilot sites in the
Northern Region (NR) and Upper East Region
(UER) of Ghana. We worked with Ghana Health
Service staff through the Community Health
Planning Services (CHPS) compounds, 7 in 2
districts of NR and 25 in 7 districts of UER. We
chose locations for this intervention where we
were working with agricultural extension and
NGO partners to introduce OFSP to farmer groups
as a commercial crop.
CONTACTS: Erna Abidin (CIP-Ghana), • Joseph Nchor (ACDEP), • Esi Amoaful
(GHS), • Gloria Kobati (GHS – Upper East Region), • Abdulai A. Rauf
(GHS – Northern Region),
How did we make it happen?
In 2014, we developed information, education and
communication (IEC) materials following the essential
nutrition actions guidelines of the global Scaling Up
Nutrition (SUN) movement. These included counselling
cards to be used by health workers, a facilitator’s guide,
a training of trainers’ manual on OFSP utilization and
processing, a “Golden Sweetpotato” recipe-book, a poster
showing 15 different ways to prepare local dishes using
OFSP, and a brochure about the program, with contact
information for OFSP planting material suppliers.
In 2015, we worked with GHS nutrition department staff
to train and organize volunteer health workers (VHW)
to work with mother-to-mother and IYCF groups at
the community level. Over 7,000 pregnant or lactating
women received counselling, or participated in cooking or
feeding demonstrations through 33 CHPS compounds in
9 districts where we were working to establish OFSP as a
commercial crop.
In 2016, we continued counselling activities and used
the VHW network to distribute vouchers to enable
beneficiaries of counselling to access small quantities of
planting material (100 cuttings) and roots (2 kg), with the
encouragement that they should buy more. In all, over
5,000 women received vouchers for vines and over 4,000
received vouchers for roots.
What did we achieve?
The IEC materials were distributed to GHS District
Nutrition officers and GHS staff through 33 CHPS in nine
target districts.
332 CHPS workers comprising 221 health service staff
and 111 volunteers were trained on nutrition counseling,
including information on OFSP and its cultivation and
Through individual counselling (Fig. 3), cooking,
and feeding demonstrations (Fig. 4), 8,437 pregnant
or lactating women received information on OFSP
cultivation and use as part of a healthy diet for their
young children and families.
Using subsidized vouchers, 5,060 of the counseled woman
obtained OFSP planting material during the planting season,
and 4,110 received OFSP storage roots during the harvest
season in 2016, with encouragement to purchase more.
Vine producers received $6,313 and the root producers
$2,055, giving a boost to their businesses.
A survey of 419 of the voucher recipients conducted in
early 2017, showed that:
over 95% knew about vitamin A
100% ate OFSP at least once a week, when available,
with most eating 3 to 4 times a week;
almost 100% indicated a willingness to pay for OFSP
planting material and roots at reasonable prices, and 16%
actually reported having done so. Similar results were
found in both regions.
What are the next steps?
This integrated approach, with or without the use of
subsidized vouchers, appears to have considerable potential
for continuing at the locations where it was implemented and
for upscaling to other Districts in Ghana. As awareness of the
nutritional value and uses of OFSP and market demand for it
develop, it will be increasingly easy and reasonable to include
in the counselling efforts of the GHS and the extension
programs of District Departments of Agriculture.
Fig. 4. GHS sta demonstrate how to incorporate OFSP into local
dishes (credit E. Dery)
Fig. 2 An expecting mother is eating a complete OFSP meal
comprising leaf stew and mpotompoto (mashed OFSP prepared
with sh and Ghanaian spices) (credit E. Abidin)
Fig. 3. Counseling at ante-natal care services at GHS facility in
Nyankpala (credit E. Abidin)
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