Process and lessons learned in the development of food-based dietary guidelines in Ghana

Food-based dietary guidelines (FBDGs) are used, globally, as a tool for promoting awareness of healthy diets and, thereby, to improve dietary behaviour. It is also used as a policy framework for creating a health-promoting food environment. In sub-Saharan Africa, only a few countries have developed FBDGs. In 2016, Ghana commenced the process for developing a national FBDG. Four years down the line, significant progress has been achieved towards developing dietary guidelines for persons living in Ghana. The process for developing Ghana's FBDGs has, generally, follow the plan proposed by the 1998 FAO/WO consultative meeting on development of FBDGs, but with minor deviations. These deviations have been occasioned by the need to adapt the process to accommodate context-relevant circumstances relating to local capacity and financial resources constraints. The first step in developing Ghana’s FBDGs was to set up a national Multisectoral Technical Task Team (MTTT) under the policy direction of the Ministry of Food and Agriculture. Thereafter, an evidence review exercise was carried out, involving systematic review of existing literature, complemented by primary data collection, all aimed at understanding the priority foods, nutrition and health issues to be addressed by recommendations in the FBDGs. The key issues identified in the evidence review were validated by the MTTT and subsequently prioritized using an online survey, as well as a prioritization workshop that convened key stakeholders in nutrition and health in Ghana. Subsequently, the priority issues served as the basis for the crafting of technical recommendations. The aim of this paper is to describe the processes, people, data, and resources that have facilitated progress towards development of Ghana’s FBDGs. The challenges, and limitations of the process, as well as the solutions that have been employed to overcome them, have also been highlighted here. For the benefit of future FBDGs development in Ghana and elsewhere, the key lessons that have been learned in the development of Ghana’s FBDGs have been presented, including lessons on political will, planning and time management, resources, capacity development, and multi-sectoral action. Key words: Food-based dietary guidelines, Ghana, diet, food system, evidence review