Cost of a Healthy Diet - FAQ

What is the Cost of a Healthy Diet?
The Cost of a Healthy Diet (CoHD) represents the daily cost of the least expensive combination of foods that meets the daily requirements for a healthy diet for an adult. It is the cheapest possible diet that meets healthy diet guidelines, given market prices of locally available foods. The CoHD is a lower bound estimate of what it costs to meet dietary guidelines. Considering preferences and convenience will add to this cost.

What is a healthy diet?
A healthy diet is a diet that meets nutritional standards established by the Ghana food based dietary guidelines to achieve adequate consumption of nutrients and prevent diet-related diseases. The nutritional standards generally include that food items must be consumed from several food groups and in specific proportions. 

Which dietary guidelines are used to calculate the CoHD for Ghana? 

The Ghana food based dietary guidelines was developed by the Ministry of Food and Agriculture, in collaboration with University of Ghana School of Public Health and published in 2023. The stated goal of the dietary guideline is to promote optimal diets, and address malnutrition and diet-related diseases. The guidelines contain seven core recommendations regarding which foods and food groups should be included in the diet, and an additional six complementary recommendations for improving nutrition and wellness. These guidelines are then quantified based on the number of food items and calories required for each recommended food group. The quantification is summarized in the table below:
Quantified food-based dietary guidelines for Ghana

What is a food group?
A food group refers to foods that are similar to each other based on nutritional composition or biological origin. The foods in a food group generally contain similar nutrients in similar amounts. The CoHD uses six (6) recommended food groups from the quantified Ghana food based dietary guidelines. These food groups are 1) starchy staples (includes starchy roots and cereal grains); 2) legumes, nuts, and seeds; 3) fruits; 4) vegetables (includes leafy and non-leafy vegetables); 5) animal source foods (includes meat, fish, eggs, and dairy); and 6) fats and oils.

Where are the food prices used to calculate the Cost of a Healthy Diet obtained from?
The retail food price data used to calculate the CoHD is collected by the Statistics, Research and Information Directorate (SRID) of the Ministry of Food and Agriculture (MoFA). The data is obtained from 190 markets from 16 regions of Ghana. The data collection is done on a weekly basis, and regional averages are aggregated at the end of each month. A total of 76 food commodities across all the recommended food groups are monitored by MoFA.

How is the Cost of a Healthy Diet calculated?
The least-cost food items and their costs depend on time and place and can vary at each time and place. The food groups and the calories required from each food item consumed from each food group remain constant, but the cheapest items in each food group vary by place and season. The CoHD represents the sum of the daily costs of the least-cost items in each food group to meet the required calories per day. This cost is calculated using the retail food prices of locally available food items, aggregated monthly, and converted from a price per unit to a price per calorie. The cost per day is calculated for each food as the price per calorie multiplied by the calories needed per food group per day. The least-expensive items are chosen at each time and place, so in any market or month a different combination of 12 items may be identified as least cost. This is the case because depending on the season, location, type of market, and other factors, the cost of a food item changes throughout the year. Thus, the same food item would not be the cheapest item in the same place throughout the year, and the cheapest item would not be the same across all locations at any time in a year. Ghana reports the CoHD every quarter, thus reporting the cost for three months at a time. A detailed description of the methods and tools for calculating the CoHD can be found here.

How can we use the CoHD indicator?
The CoHD is a useful indicator of physical and economic access to healthy diets. It is useful for identifying where and when healthy diets are more expensive, so that appropriate interventions can be developed. Interventions to lower the cost to a reasonable level could include production, distribution, or preservation interventions. When we have information on incomes, we can also assess affordability of healthy diets. Where least-cost diets are low, but households cannot afford them, social protection and earnings focused policies can be used to increase incomes. When people can afford a healthy diet, but do not consume one, policies can focus on behavior change, information, and altering preferences through marketing. It is also important to consider other costs, like meal preparation, when targeting interventions to those who can afford but do not consume healthy diets.

Are the foods selected in the CoHD calculated for a specific quarter a recommendation for the specific food items I should consume to achieve a healthy diet?
The food-based dietary guidelines are the document to look at, to understand how to consume a healthy diet. The CoHD is an indicator of economic access to diets that estimates the least expensive way of meeting dietary guidelines at each time and place. Dietary guidelines themselves recommend food groups, and a variety of food items fall into the same food group. A healthy diet refers to the food groups consumed in the right proportions to support good nutrition and health, not to specific items. The fact that the food items in CoHD are different in each time and place where it is measured is like how a person consuming a healthy diet might consume different food items every day.

What decisions can my household and I make from the CoHD bulletin?
The CoHD was developed as a tool for policymaking and planning and not a tool to prescribe individual diets. Food-based dietary guidelines serve the purpose of helping individuals identify and plan a healthy diet. Ultimately, where even the lowest cost healthy diets are too expensive or not easily accessible, improvements in food systems and social assistance are needed.

Does the CoHD take into account traditional Ghanaian diets?
Yes, the CoHD is calculated using locally available food items from selected markets in every region of the country. The food items are selected based on their consumption in the population, as determined by household consumption and expenditure surveys. Items that are commonly consumed are those selected for price monitoring by the Ministry of Food and Agriculture. Therefore, the foods monitored reflect what Ghanaians eat. Some of the frequently selected least-cost items includes local staples like maize and kokonte; fruits like fresh coconut and pawpaw; animal source foods like koobi and anchovy; and vegetables like alefu and nkontomire.

What is the relationship between food inflation and CoHD?
It is expected that the prices of all goods and services, including food, will rise over time. Inflation monitors the rate at which this happens. Food prices, and the CoHD are both expected to rise over time, and there is a positive relationship between food inflation and CoHD. However, food inflation includes a larger number of items than the CoHD, often including items that are more processed, as the least-cost items are usually relatively unprocessed foods. If the CoHD is increasing faster than food inflation, that suggests that at least some of the prices of least-cost food items are rising more quickly than food prices more generally.

Which agencies are responsible for the CoHD in Ghana?
The CoHD bulletin is produced by the Statistics, Research and Information Directorate (SRID) of the Ministry of Food and Agriculture (MoFA), with technical support from Food Prices for Nutrition project at Tufts University.

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