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KOKO Plus Foundation, The Ajinomoto Foundation, and Ghana Health Service Sign New Memorandum of Cooperation to Combat Child Malnutrition through Innovative Public-Private Partnership
KOKO Plus Foundation (KPF), The Ajinomoto Foundation (TAF), and Ghana Health Service (GHS) have officially signed a renewed Memorandum of Cooperation (MOC) to expand and strengthen their partnership aimed at combating child malnutrition in Ghana. The collaboration is based on a sustainable, market-based model with Social and Behavior Change (SBC) and takes effect from April 1, 2025. This new agreement builds on over a decade of joint efforts and aligns with Ghana’s commitments under the Africa Health and Wellbeing Initiative (AfHWIN)—a framework launched at TICAD7—and the global Nutrition for Growth (N4G) Summit agenda.
Sustainable Partnerships: Over a Decade of Advancing Child Nutrition
The partnership traces its roots back to 2011, when Ajinomoto Co., Inc. (AJICO), in collaboration with the University of Ghana and the Nevin Scrimshaw International Nutrition Foundation (INF), developed the Protein and Micronutrient Powder known as KOKO Plus®. Initially launched as a pilot program and nutritional research initiative, the collaboration was formalized through a Memorandum of Understanding signed on April 5, 2011. In 2017, TAF, a public-interest foundation, took over responsibility from AJICO to lead the initiative.
In 2018, the partnership was further strengthened through the signing of an initial MOC between TAF and GHS, which promoted appropriate nutrition education to mothers and caregivers, facilitated access to locally available nutritious foods including Protein and Micronutrient Powder, and provided training to ensure proper use.
To reinforce project management and prepare for expansion, KPF was established as a local Ghanaian non-governmental organization and serves as TAF’s official in-country partner.
The President of The Ajinomoto Foundation, Mr. Kaoru Kurashima (right) and the Country Director of the KOKO Plus Foundation, Mr. Yusuke Takahashi (left) display the renewed Memorandum of Cooperation, reinforcing the long-standing partnership of the stakeholders and their commitment to advancing child nutrition.
Advancing Evidence-Based Research and Strengthening Frontline Health Capacity Through Innovative Collaboration
As of 2025, the initiative has gained international recognition as a successful model of public-private partnership in nutrition. Building on this success, the partnership now includes efforts to support the nutritional needs of school-age children, alongside infants, through the introduction of Protein and Micronutrient Powder and other locally sourced nutritious foods.
The renewed MOC outlines several key goals and joint initiatives:
· Improve child nutrition, reduce stunting and anemia among children aged 6 months to 10 years, and eventually expand to other life stages and generations in Ghana.
· Train health workers in best practices for maternal and child nutrition.
· Strengthen distribution systems for nutritious foods and supplements, such as Protein and Micronutrient Powder.
· Promote dietary diversity and develop stronger, more resilient food systems.
The partners will also drive collaboration across sectors by embracing innovation—especially digital tools and diagnostic technology—as part of a broader strategy to achieve Universal “Nutrition” and Health Coverage in a sustainable manner.
For example, while the project initially focused on improving maternal and child nutrition, it has since expanded to collaborate with innovative tools such as an automated hematology analyzer by Sysmex Corporation, which can detect anaemia and malaria-infection in patients simultaneously in one minute, and mobile apps by NEC Corporation for health workers supporting health checkups and nutrition instructions. This multi-faceted approach has been internationally recognized as a successful model of technology-driven, multisectoral collaboration for nutrition improvement in Africa. With the new MOC, the project is expected to expand even further as a benchmark for transformative public-private partnerships.
The renewed MOC also supports Ghana’s national N4G targets—reducing wasting to 3%, increasing exclusive breastfeeding to 70%, and significantly reducing anemia to 50% among women and children by 2030. This Ghana–Japan partnership underscores a shared commitment to evidence-based, sustainable interventions that enhance maternal and child health, and positions Ghana as a leading innovator in nutrition and cross-sector collaboration.
Through this ongoing partnership, KOKO Plus Foundation, The Ajinomoto Foundation, and the Ghana Health Service continue to show their commitment to the fight against child malnutrition!
The President of The Ajinomoto Foundation (middle), the Country Director of the KOKO Plus Foundation (left), and the Director-General of the Ghana Health Service, Prof. Kaba Akoriyea (right), affirm their commitment to advancing evidence-based research and strengthening frontline health capacity through innovative collaboration.
KOKO Plus Foundation Strengthens Partnership with the Ghana Health Service
In a strategic meeting that highlights the commitment to improve infants and young child nutrition in Ghana, Mr. Yusuke Takahashi, Country Director of the KOKO Plus Foundation, recently met with Professor. Samuel Kaba Akoriyea, Acting Director-General of Ghana Health Service, to discuss the expansion of the Ghana Nutrition Improvement Project.
The meeting was marked by substantive discussions focused on key areas of collaboration and centered on deepening the existing partnership between the KOKO Plus Foundation and the Ghana Health Service. By aligning institutional goals and resources, both organizations aimed to create a better framework for delivering nutrition interventions, using KOKO Plus®️ and nutrition education to improve nutrition and health outcomes in Ghanaian children.
Another objective was to develop a comprehensive strategy for scaling the Ghana Nutrition Improvement Project across all districts in Ghana, ensuring that no child is left behind. Recognizing that successful partnerships require continuous adaptation, both parties reviewed and updated the existing Memorandum of Cooperation and explored the different facets of nutrition interventions.
The economic implication of this partnership is significant. According to the Global Nutrition Report, malnutrition represents losses of 11 percent of gross domestic product annually in Africa and Asia. Each dollar invested in preventing malnutrition delivers an impressive $16 in return, highlighting the importance of such targeted interventions.
Still in the meeting, the two heads delved into various avenues to share the success stories from the project at international platforms like the Nutrition for Growth Summit and the Tokyo International Conference on African Development (TICAD), to inspire global support and potential replication of the ‘Ghana model’. Lastly, there were further discussions on strengthening the African Health and Wellbeing Initiative (AfHWIN), a collaborative effort between Japanese and the Ghanaian government dedicated to achieving sustainable Universal Health Coverage (UHC).
This partnership approach goes beyond traditional nutrition interventions. By implementing a Social and Behaviour Change strategy coupled with a market-based model, the KOKO Plus Foundation demonstrates how innovative, collaborative approaches can push improvements in public health nutrition.
The Foundation remains steadfast in its mission to combat child malnutrition, believing that every child deserves the opportunity to grow, learn, and thrive. Through strategic partnerships, innovative solutions, and a deep commitment to community welfare, we continue to work towards a future where no child suffers from nutritional deficiencies.
KOKO PLUS AT THE JUST ENDED 9TH AFRICA NUTRITION CONFERENCE (ANC2024)
The Africa Nutrition Conference is an educational event, jointly organized by the African Nutrition Society (ANS) and the Ghana Academy of Nutrition and Dietetics (GAND).
The 9th Africa Nutrition Conference (ANC2024) took place this year, from October 7th to 11th 2024, at the University of Cape Coast in Ghana.
The theme of the conference, “Food and Nutrition in a Changing World: Implications for Nutrition Security and Health” seeks to address key critical global issues which impact food and nutrition security and the food supply chain. The theme was chosen to highlight and reflect the succession of global and regional crises and issues currently impacting on nutrition and health, and their implications for research, practice, advocacy and the training of nutrition and health professionals in Africa.
The conference brought together students, academics, trainers, and practitioners, as well as government and non-government actors within Africa. The aim was to bring together experts in the field of nutrition to share knowledge, experiences, and best practices.
As Koko plus foundation is a nutrition focus organization, it was important for us to join associate our brand with this event.
Koko plus Foundation had the opportunity to introduce our project and our progress during one of the symposiums at the conference. We also shared the strides we have made by combining Social behavior Change with a market base approach as part of efforts to sustain the project.
Along side the conference, an exhibition was held for all 5 days that provided a platform to showcase products and services to a diverse audience of dietitians, healthcare professionals, and nutrition enthusiasts.
As Koko plus foundation is a nutrition focus organization, it was important for us to showcase our protein micronutrient powder, Koko plus. Throughout the 5 days, complimentary sampling and interactive engagements were undertaken by the Koko plus team at the exhibition. Participants has the opportunity to tasting Koko plus with either millet porridge or mashed kenkey infused with ground nut, apples and bananas to promote 4-star diet whiles demonstrating the appropriate use of Koko Plus. Through this initiative, this activity aimed at
– Enhancing brand recognition and credibility
– Building and strengthening relationships with healthcare professionals and stakeholders
– Showcasing/promoting Koko Plus’s nutritional benefits
– Gathering feedback and insights from participants”
The engagement was a success with the team interacting with at least 400 participants that attended the conference with some making a repeated visits to the Koko plus booth. Some participants from other African countries were also intrigued and requested for product samples to be taken back home.
Securing sustainable good nutrition in the first 1000 days: The synergy of localization, social behaviour change communication and markets. Presenter: Kennedy Bomfeh
In the spotlight: Forgotten Foods / Opportunity Crops and Nutrition in the First 1000 Days
7 – 11 October 2024. University of Cape Coast – North Campus, Cape Coast, Ghana. The African Nutrition Society (ANS) and the Ghana Academy of Nutrition and Dietetics (GAND) are organizing the 9th edition of the Africa Nutrition Conference (ANC2024 / ANEC IX).
Tuesday 8th October,2024. TRACK 1A: Food Systems and Nutrition in Africa
Securing sustainable good nutrition in the first 1000 days: The synergy of localization, social behaviour change communication and markets. Presenter: Kennedy Bomfeh PhD
Background: Nutrition in the First 1000 Days
The First 1,000 days – the time between conception to 24 months of life – has been considered a critical phase in a child’s development. Scientific evidence suggests that this period records the most rapid body development. For example, the brain records its highest growth rate and plasticity during this period, with tremendous implications for overall well-being, cognitive development and behavioral expression in later life. Nutrition plays a central role in the health outcomes realized at this point in life and beyond. Accordingly, nutrition in the First 1000 days is considered a unique window of opportunity during which gains in general and cognitive development can be made, or irreversibly lost.
One of the critical irreversible adverse health effects of malnutrition in the First 1000 days is stunting. It is a condition in which a child experiences growth faltering, becoming too short for their age compared with WHO child growth standards, with corresponding lower cognitive development. Stunting stems from chronic or recurrent undernutrition, both of which, with concerted efforts, are preventable.
In Ghana, considerable government, private sector and development partners’ efforts have been centered on addressing stunting. Through these endeavours, stunting has declined from 33% in 1993 to 18% in 2022, according to the latest Ghana Demographic and Health Survey report. Though a commendable achievement, the number remains above the national target of 14% by 2025. More work is therefore needed to drive the rates further down. For more than a decade, the Ghana Nutrition Improvement Project (GNIP) of The Ajinomoto Foundation (TAF) has been a significant contributor to that drive.
GNIP and the fight against malnutrition in Ghana
Started in 2009, GNIP is focused on preventing malnutrition among infants and young children. Itundertook product development of a protein and micronutrient nutrient powder (called KOKO Plus®) based on WHO guidelines for infant and young child nutrition (IYCN), conducted scientific efficacy studies that verified that KOKO Plus® is effective against stunting, and distribution model studies that evaluated delivery channel options for reaching the target population (children from 6 months old).
In the product development, to ensure sustainable production, due regard was given to the local food culture and local supply chains. This “localization” commitment emphasized the use of local raw materials for the manufacture of the product, the use of a local production facility and labour, and respect for the local food culture by making a sprinkle-type point-of-use supplement for traditional complementary foods. KOKO Plus® is a 15g powder supplement containing soybean flour, added lysine, and a mixture of vitamins and minerals. The product formulation has been published in the scientific literature. In 2018, the UN World Food Programme (WFP) registered KOKO Plus® as a “Nutritious Powder” in its food basket for Ghana.
Reaching the nutritionally vulnerable sustainably through social business
Ensuring the availability, access and consumption of nutrients-dense complementary foods is essential for securing good nutrition for every child. The approaches adopted to facilitate the availability of, and access to nutrients-dense food – especially those in the supplements category – directly impact the sustainability of both the efforts and the resulting gains. Whereas in food crises situations, donation is a required humanitarian approach for addressing malnutrition, in non-crises situations, other approaches that empower beneficiary communities to (eventually) own the solutions to malnutrition would be more sustainable and more supportive of robust domestic nutrition, health, and food systems, as well as livelihoods.
Consequently, GNIP adopts a market-based distribution of KOKO Plus® to offer availability and access by, respectively, placing the product in convenience stores close to health facilities and the settlements of caregivers, and keeping the price within the reach of the bottom of the pyramid (around 10 US cents per sachet). In doing this, GNIP adopts a social business approach, ensuring that the entire value chain is primarily managed by local people to address the malnutrition problem while strengthening local supply chains and improving livelihoods. This allows a direct contribution to the materialization of the pledge of the Sustainable Development Goals to leave no one behind.
Consumption for good nutrition is a knowledge-driven endeavour. For infants and young children, their nutrient intake heavily depends on the level of nutrition knowledge of caregivers, as this directly influences food selection, preparation and feeding practices. For that vulnerable group, breastfeeding and complementary feeding are critical nutrition pillars. These, done right, prevent the more than 30% of infant and young child deaths that are attributable to undernutrition. It is reported that poor breastfeeding practices results in more than 1 million child deaths, whiles an additional half a million deaths are linked to suboptimal complementary feeding. These highlight the need for caregiver education on what constitutes optimal feeding.
In 2018, TAF and its local (Ghana) operating agency – KOKO Plus Foundation (KPF) – signed a memorandum of cooperation with the Ghana Health Service (GHS) through which the nutrition education efforts of the latter are augmented with co-developed, easy-to-use and easy-to-understand job-aids and tools for knowledge and skills transfer on optimal complementary feeding. Those materials are used in training health workers and for educating caregivers. Through this public-private partnership (PPP), TAF/KPF and GHS have strengthened the social behaviour change communication (SBCC) in health service delivery, thereby contributing to the improvement of caregiver knowledge on IYCN. The SBCC activities involve stepwise one-on-one nutrition counselling as well as food and cooking demonstrations to show caregivers how to intentionally select and prepare nutritious foods for children. The use of KOKO Plus® is also recommended for improving the nutrient-density of meals. In 2019, more than 1,200 caregivers were trained in 20 cooking demonstrations organized in one of the beneficiary districts in the Central Region of Ghana. As at 2023, over 280 thousand caregivers had been reached nationwide.
The synergy of SBCC and markets for driving improvements in nutrition
Through the combination of SBCC and market-based distribution of KOKO Plus®, GNIP is facilitating the creation of a sustainable cycle for preventing infant and young child malnutrition by improving caregiver nutrition knowledge along with market-based distribution of KOKO Plus®. From 2019 to 2021, TAF/KPF, GHS and the World Food Programme (WFP) tested the synergy of SBCC and market-based nutrition intervention with KOKO Plus® in the Ashanti and Northern Regions of Ghana. The SBCC component involved education on optimal infant and young child feeding (IYCF) practices, whiles the market component entailed making KOKO Plus® available on the market for purchase. It was found that counselling on IYCF through SBCC resulted in the following:
1. caregivers recorded more knowledge of optimal IYCF practices that an baseline (see Fig. 1);
2. caregivers recorded a higher purchase of KOKO Plus® (81.3% of caregivers purchased post-intervention vs. 60% at baseline);
3. children of caregivers who received IYCF were 15% less likely to have anaemia at follow-up.
These suggest that the SBCC improved the understanding of caregivers on optimal IYCF, leading to a modified practice of intentionally selecting nutritious foods for their ward.
Furthermore, their decision to purchase KOKO Plus® for their wards highlights their willingness to spend on good nutrition after receiving nutrition education. Fig. 1 summarizes the link between nutrition knowledge and purchase of KOKO Plus®. The data suggests that IYCF knowledge increased after the SBCC, which subsequently led to an increase in the purchase of KOKO Plus®. Additionally, intentional purchase of KOKO Plus® may be considered an indicator of intentional selection of nutritious foods in general, which in turn may have contributed to better nutrition and health outcomes (e.g., the observed lower incidence of anaemia). Thus, the increase in the purchase of KOKO Plus® after the nutrition education may be considered a proxy for the link between nutrition education and willingness to spend on nutritious foods.
Scaling up the synergy, widening the social impact
Building on the results of the 2019 – 2021 collaborative project, TAF/KPF, GHS and WFP with the support of the Japanese government, entered a second phase of the project in October 2021 to expand the SBCC and market-based nutrition intervention to 90 districts, targeting a population of 252,000 caregivers. The goal is to improve IYCF knowledge among caregivers in urban and periurban areas through SBCC, emphasizing dietary diversity and recommending KOKO Plus® to prevent malnutrition, particularly stunting and micronutrient deficiencies in children. Through the project, it is expected that caregivers will be empowered to intentionally select locally available nutritious foods for their wards and use KOKO Plus® to improve the nutrient-density of complementary foods. These, ultimately, are envisaged to improve the local nutrition, health and livelihoods situation.
Securing sustainable good nutrition in the first 1000 days: The synergy of localization, social behaviour change communication and markets from Francois Stepman
Conclusion
Through the Ghana Nutrition Improvement Project (GNIP), The Ajinomoto Foundation (TAF) in its public-private partnership with the Ghana Health Service, has shown that a combination of social behavior change communication (SBCC) and market-based delivery of nutritious food holds promise for sustainable nutrition improvement, as it fosters a change in mindset regarding what constitutes good nutrition and willful purchase of nutritious foods. Furthermore, the reliance of this approach on localization – realized in the use of local raw materials, food production and distribution systems, and respect for the local food culture – strengthens its support for local livelihoods, thus reinforcing its sustainability.
Kennedy Bomfeh (PhD) is the Director for Supply Chain and Academic Affairs at KOKO Plus Foundation and has been on the Ghana Nutrition Improvement Project since 2011.
Esi Foriwa Amoaful is a nutritionist, public health specialist and Maternal, Child Health and Nutrition advocate. She is a retired Director of Nutrition for the Ghana Health Service.
The Moon Festival: A Cultural Treasure in Agbogbloshie
The Moon Festival: A Cultural Treasure in Agbogbloshie
Nagasaka Mago, the CEO of Mago Motors and a Japanese artist, established the Moon Festival. This festival aims to foster peace among the 12 tribes in the northern part of Ghana, hence the name ‘Moon’ which symbolizes peace, and which also serves as an annual celebration for the employees of Mago Motors. It is celebrated in Agbogbloshie as all the 12 tribes are well represented in the area. The festival, which marked its 5th anniversary in 2023, is a dance celebration for the tribes.
To commemorate this milestone, the people of Agbogbloshie teamed-up at the Agbogbloshie Scraps dump site on December 24th, 2023, to construct a synthetic moon using recycled PET bottles.
The Koko Plus Foundation (KPF) was present and supported by contributing 2,000 sachets of its protein and micronutrient powder (P-MNP), a supplement used to enrich traditional home-made meals for infants aged 6 months and older.
The KPF team educated the mothers on the importance of providing nutritious meals for their infants and children’s health and demonstrated how to properly use KOKO Plus in traditional homemade dishes. The program participants then received wholesome meals of mashed kenkey, and beetroot maize porridge enriched with KOKO Plus.
Is mealtime a struggle?
Getting babies and toddlers to eat well can be a challenge, but it’s important to set them up for healthy eating habits early on. Here are some tips:
- Start early. As soon as your baby is ready to start solids, introduce a variety of healthy foods. This will help them develop a taste for a wide range of flavors and textures.
- Make mealtimes fun. Babies and toddlers are more likely to eat if they enjoy mealtime. Try serving food in fun shapes, using colorful plates and utensils, and letting them help feed themselves.
- Offer small portions. Babies and toddlers have small stomachs, so it’s best to offer them small portions that they can easily finish. You can always offer more if they’re still hungry.
- Don’t force it. If your baby or toddler doesn’t want to eat something, don’t force them. Just try again later. It may take several exposures to a new food before they accept it.
- Be a good role model. Children learn by watching the adults in their lives. Make sure you’re eating a healthy diet and setting a good example for your child.
Here are some additional tips for getting toddlers to eat well: - Offer choices. Toddlers like to feel like they have control, so offer them choices at mealtime. For example, you could let them choose between two different fruits or vegetables, or two different types of soups.
- Get them involved. Let your toddler help you prepare meals and snacks. This will make them more likely to be interested in eating what they’ve helped to create.
- Make it fun. Cut food into fun shapes, use cookie cutters, or serve food on colorful plates. You can also make mealtime more fun by singing songs, playing games, or telling stories.
- Be patient. It may take some time for your toddler to develop healthy eating habits. Don’t get discouraged if they don’t always eat everything on their plate. Just keep offering them healthy foods and be a good role model.
If you’re concerned about your baby or toddler’s eating habits, talk to your pediatrician. They can offer additional tips and guidance.
Empowering Children for a Healthy Future
Empowering Children for a Healthy Future: Improved Feeding Practices for the First 1000 Days Project (IFP)
The Improved Feeding Practices for the First 1000 Days Project (IFP) has been a remarkable initiative that has made significant strides in addressing malnutrition in selected districts in Ghana. The project, funded by the Japan Social Development Fund (JSDF) via the World Bank had immense contributions from the Ajinomoto Foundation and World Vision and was undertaken in three districts: Kassena Nankana West District (Upper West), Sekyere East (Ashanti Region), and Kintampo South (Bono East).
It ran from July 2020 to August 2023, targeting 4,800 households in 70 communities, and sought to improve dietary habits among women of reproductive age and the nutrient intake of children under two years.
A key component of IFP was using KOKO Plus, a protein and micronutrient supplement designed to improve nutrition in children aged 6 – 24 months and suitable to add to any complementary food. Over 13,000 children aged 6 – 24 months benefited from improved meal quality through the distribution of KOKO Plus. The Ajinomoto Foundation distributed 200,000 sachets of KOKO Plus to the beneficiaries and recorded a 96 % utilization rate. Other beneficiaries included 70 community-based health volunteers trained to deliver nutrition counseling using appropriate complementary feeding campaigns and social behavior change communication (SBCC) approaches. Additionally, over 104,000 women of reproductive age and men profited from these nutrition counseling sessions.
One of such beneficiaries, Madam Akangurege Amenga-etigo in the Zampengo community, indicated how her daughter of 18 months with suspected Severe Acute Malnutrition (SAM), had a remarkable improvement in her overall health and body weight after the introduction of KOKO Plus in addition to a varied diet.
The IFP project is an example of how concerted efforts and sustainable approaches like these can positively impact the health and well-being of vulnerable populations. It shows how a simple intervention with KOKO Plus can transform the lives of children in Ghana, giving them a chance to grow up healthy and strong.
As we look towards a future where every child reaches their full physical and cognitive potential, initiatives like the IFP project serve as a beacon of hope.
Resources
https://www.wvi.org/stories/ghana/collaborating-improve-feeding-practices-ghanaian-communities
https://www.faapa.info/blog/world-vision-ghana-launches-ifp-project-to-address-malnutrition/
