Child Health & Social Determinants
“It Takes a Whole Village to Raise a Child.” -- a Nigerian proverb which exists in different forms in many African languages, speaks to the concept that a child’s upbringing and care is a communal effort.
Ghana, located in West Africa, has a long and rich cultural history and is considered one of the most stable and democratic countries in Africa. With strong political and economical systems, vibrant cities, and friendly people, Ghana is the perfect gateway for a colorful, cultural experience in Africa. Despite strong economic growth and a stable political system, it still has a long road to providing quality healthcare for children throughout the country. Ghana has been working tirelessly to reduce infant mortality rates and improve the overall health of the pediatric population in the country. However, social and economic conditions have continued to impact the health of children, with malaria, anemia, and malnutrition the leading contributors to childhood morbidity in Ghana.
Living conditions, nutrition, physical environment, social and community support, water and sanitation, housing, rather than individual factors such as genetics or other behavioral causes are major contributions to the cause and burden of disease. In the bustling capital city of Accra, see firsthand the various factors that directly affect the health of Ghanaian children.
Join local medical professionals in the historic Children's Hospital in Accra and see how these professionals provide care in a resource-poor environment, overcoming challenges such as the financial and structural constraints of the healthcare system itself and the social determinants that lead to illness in children.
Participants will have the unique opportunity to engage with medical professionals in the Outpatient Department, Emergency Room, the various wards to learn about the healthcare and also the prevention and management of various diseases.
Clinical Rotations & Public Health Placements
Children's Hospital, Accra- This facility, which dates back to 1925 when its foundation stone was laid, is a historic landmark because it was the hospital in medical history where Dr. Cicely Williams first diagnosed the disease Kwashiokor. Over time, the hospital has expanded to a capacity of 87 beds. It is a government hospital, which sees about 200 to 300 children every day. During the peak malaria season however, there are about 350 to 400 children admitted. Additionally, the outpatient attendance is about 1600 patients on a weekly basis.
Though several diseases are treated and prevented here, the hospital specializes in the management of malnutrition. It has expanded to become a general pediatric hospital serving the southern half of the country and caters to all socioeconomic classes, particularly to the lower and middle class. The hospital is the only hospital in Ghana that is dedicated solely to pediatrics.
Out Patient Department (OPD), Emergency Department (ER) and Ward rotations- Learn from dynamic health professionals including pediatricians, nurses, house officers, medical officers, residents and laboratory technicians as they work in the OPD (outpatient department), ER (Emergency Room) and other wards of the hospital. The OPD is where new cases are triaged, diagnosed, and often transferred to the ER or admitted to other wards based on the age of the patient and his/her diagnosis. The ER serves the urgent cases. Services are paid mainly through the National Health Insurance system, however there are still limitations on coverage of certain medicines and services. You will witness first-hand how high costs and lack of resources affect the provision of services and management of disease.
Weekly special Clinics- HIV/AIDS and TB, Asthma, Sickle Cell, Neuro, Pediatric Surgical and ENT Nurses Clinic- Engage in clinical rotations in the hospital and clinics with physicians who manage chronic conditions. Observe how follow up and adherence is encouraged in the treatment of Tuberculosis. Witness and see how SDH plays in the life of children who have these various chronic diseases.
Nutrition Rehabilitation Unit and Ward- Engage with the dieticians, nutritionists, and doctors who specialize in the management of malnutrition and other diseases related to malnutrition. Learn how to diagnose, stage, and define the types of malnutrition and learn about the rehabilitation process, feeding options including schedule and supplementation, and the follow up that is conducted with the patients and their families. Learn about the social causes and the health implications of this disease in the population and communities of Ghana.
Public Health Unit- Shadow the nurses and other public health professionals in the hospital, child welfare clinics in outstations, school visits, health education and awareness outreach opportunities.
Home visits, visit to social centers and other stakeholders in health- Participants will follow up with cases from hospital and participate in home visits so as to witness first-hand the surrounding and environment of where patients live, understand the challenges in terms of infrastructure, and see the level of risk in terms of and health safety and primary prevention. Participants will also have the opportunity to visit the surrounding markets, recreational facilities, and social centers around the areas and visit to some national program units and other facilities of stakeholders in health in the country.
Over 2 million people live in Ghana's bustling capital, Accra, situated along the Atlantic coast of West Africa and spread out over 60 miles. Accra serves as the Greater Accra region's economic and administrative hub. It also boasts the largest number and variety of nightclubs, restaurants and hotels in Ghana. The central business district of Accra contains the city's main banks and department stores, and an area known as the Ministries, where Ghana's government administration is concentrated. Ghana has a tropical climate and is hot and humid, especially near the south coast. The ‘dry season’ is December to April, but that is also the hottest time of year, with temperatures in the mid 80’s.
Things to Do
Accra is a city in constant movement, from the lively Makola market to the city's picturesque fishing harbor, and the must-see Arts and Cultural Sales Center. Not far from the city, Bojo Beach is a popular destination, unspoiled as of yet because of its distance from the city. Labadi Beach, located in the city itself, is very active during the day but the pace becomes exhilarating at night when it becomes one of Accra’s best nightspots, with a variety of pubs and eateries with great ocean views.
Accra has an exciting and trendy nightlife scene, with various pubs and nightclubs lining the various downtown areas as well as many local restaurants to try out and enjoy the local cuisine. For history buffs, head for the Kwame Nkrumah Memorial Park to see the former President’s mausoleum and museum. Other tourist attractions include the National Museum of Ghana, the Ghana Academy of Arts and Sciences, the National Theatre, the Accra Centre for National Culture, the Jamestown lighthouse, and the Ohene Djan Stadium.
Aburi Botanical Gardens, about 20 miles north of Accra, is where locals go to relax and enjoy a picnic, boasting beautifully manicured lawns and a collection of trees and plants from Ghana and abroad. Shai Hills Reserve is another day trip option, with throughout the reserve. Visitors can enjoy a horseback ride through the reserve and observe baboons, parrots and antelopes roaming freely.
Accommodations & Homestays
Students will be accommodated in a house named the “CFHI Ghana House” located in Mamprobi, Accra which is about 15-20 minutes away from the clinical site. This is also where the Medical Director currently resides; it is a spacious house with 4 bedrooms with 3 rooms available to the participants. Depending on the number of participants attending, rooms may be shared.
The house includes a kitchen, sitting room, and two bathrooms with good water supply. Rooms are comfortable with beds, closets, and fans. Air-conditioning is also present in each room, but due to high power cost, students who choose to use their air conditions will incur cost of use.
Please do note that there is an energy and power crisis in the country, which has led to load shedding. Therefore, there is limited power distribution, which has restricted electricity to 12-24 hours during certain days of the week. Students will be provided with rechargeable lanterns for nighttime.
Eligibility: Who Can Apply?
This is multi-faceted program ideal for a range of students including medical students/residents, allied health students, pre-health undergraduates, and anthropology and social work majors. Non-students are also eligible. To confirm you are eligible, please read CFHI's general eligibility requirements.
Language Required: English
Ghana is a multicultural and diverse country with over 70 seventy tribal groups and just as many distinct languages spoken. However, Ghana's unifying national official language is English and it is used in government, business and universally for educational instruction. It is spoken and understood fluently by most of the population.
All students should arrive at the Kotoka International Accra airport on the program arrival date. Participants will be picked up by one of the on-site CFHI Local coordinators.
All US citizens should apply for a Ghanaian tourist visa in advance. More information will be provided by CFHI after acceptance into the program.
- Guidance from CFHI staff in San Francisco before departure
- Program-specific materials with information on making travel arrangements, visa requirements, recommended immunizations, etc.
- Airport pick-up upon arrival and transportation to local lodging with local CFHI representative
- Welcome orientation covering safety, transportation, and other logistics
- Educational tour of Accra
- CFHI Local Team: providing instruction, logistical support, and 24/7 emergency response
- Weekly meetings and lectures on local healthcare system and socio-economic determinants of health
- Placement and coordination of clinical/public health activities
- Accommodation and two meals a day
- Local transportation to and from clinical sites
- Local cell phone with start off credits and internet plan- students must refill at own cost
- International emergency medical and evacuation insurance
- Access to CFHI alumni-only LinkedIn group featuring news and career opportunities related to Global Health
- CFHI alumni newsletter highlighting events, resources, and ways to stay involved
Uniquely CFHI, 50% or more of student program fees go directly to the communities they will be visiting, benefiting the local economy at large and specifically underserved health systems. Read more.
Meet the Local Team
Dr. Charles Chineme Nwobu- CFHI Ghana Medical Director- Dr. Charles, one of CFHI’s youngest Medical Directors, is a strong global health advocate with extensive experience in the field. As a medical student, he became involved with the global health and human rights organization called International Federation of Medical Students Association (IFMSA) for about five years where he grew to become one of their global health youth leaders. He had the honor of being elected as the IFMSA Regional Coordinator for Africa for two consecutive years and later on held his last officially elected position as the IFMSA Alumni Relations Support Division Director. He has experience with various public and global health projects and he has taken part in various international meetings, including some UN global health related meetings. Currently, he is a member of the Junior Doctors Network of the World Medical Association.
Along with serving as CFHI’s Medical and Program Director for Ghana, he currently works as a physician-General Practitioner, in both the private and public sector. He holds both a BSc (MedSci) and a medical degree (MBChB) from the University of Ghana. Apart from his passion for global health, he enjoys working out, music, dancing, swimming, traveling, reading good literature, theatre and attending social events.
CFHI Local Coordinators
Local Coordinators will assist in organizing housing, airport pick-up, orientation, weekly meetings and other logistics for all participants.
Nora Oye Abbew hails from the Akuapem people, from a town called Tutu, in the Eastern region of Ghana. Nora currently works at the program’s main rotation site, the Pediatric Hospital in Accra, as a registered general nurse. She has a diploma in General Nursing from a prestigious teaching facility in Accra. Her hobbies include exercising, researching, reading, listening to music, and traveling.
What Alumni Say
"I believe it is helpful to see how systems and resources develop overtime and to understand what they came from. I also learned about the power of patient education. No matter how many medications you provide or the number of times you see a patient, teaching parents why these things are important is the only long term way to improve the health of a child. From HIV management to the prevention of malnutrition, money may be a barrier to improved health but the ultimate challenge is due to a lack of education. This emphasizes the importance of doctors working hand in hand with the entire medical community, social work and public health to educate patients. Overall, this was an amazing and humbling learning experience that I would recommend to all!"
-Elizabeth Margolis, Medical Student, Philadelphia College of Osteopathic Medicine
“My experience in Ghana was incredible! I worked with inspiring health care workers and witnessed first hand how the social context in which a child lives can have a profound effect on overall health and development.”
-Kescha, Pediatrics Resident, Memorial University, St. John’s, Canada
"One of the most striking things for me was the gradual turnaround when you start rehabilitating a child nutritionally. I was lucky enough to catch children at the tail end of their inpatient stay to be able to follow up with them this last week in the outpatient nutritional rehabilitation clinic, which allows women to learn how to prepare balanced meals at the center for themselves and their children..." read more on Julia's fascinating blog (week 1 & 2).
-- Julia Tanguay (4th year medical student at Rocky Vista University College of Osteopathic Medicine)