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
Participants would be accommodated in a home located at Mamprobi, Accra which is about 15-20 minutes away from the clinical partner site. This is the rented home of CFHI Medical Director, where at least one Local Coordinator will also reside. The house is a spacious 4-bedroom home, and depending on the number of participants per cohort, rooms may be shared. The house includes a kitchen, living room, two bathrooms, and a 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 air conditioner will pay for this cost separately at the program site.
Please do note that there are energy and power outages in Ghana, which sometimes leads to an intermittent power supply. Furthermore, electricity is restricted to 12-24 hours during certain days of the week. When this happens, students will be provided with rechargeable lanterns for night-time.
Note that this accommodation is for only those that are attending CFHI Programs in Accra. Other participants are not entitled to this lodging.
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 is a Public Health Physician in Maternal, Adolescent, Reproductive, Sexual and Child Health and a Development Specialist. He holds a Master’s in Public health for development from the London School of Hygiene and Tropical Medicine (LSHTM) and was a student ambassador of this leading institution in public health. He also has a certification in International Development from the prestigious University of Cambridge, UK. He additionally holds a BSc in Medical Sciences and a medical degree (MBChB) from the University of Ghana Medical School. He has experience working in the public and the private health sector in Ghana as Physician - Family/General Practitioner mostly in Maternal and Child Health. He is a strong global health advocate with prior experience working as a regional leader in the global health organisation IFMSA (International Federation of Medical Students Associations) where he served as the IFMSA Regional Coordinator for Africa for two consecutive years and next as the Alumni Relations Support Division Director. He is part of the Junior Doctors Network (JDN) of the World Medical Association (WMA).
Along with serving as CFHI’s Medical and Program Director for Ghana, he also currently serves as a steering and working committee member of an international network known as CHIFA (Child Health and rights Information for All), with the head office based in the U.K. In the African region, he currently serves as one of the chosen consultants in the expert community of the current African Union Youth Envoy. Apart from his passion for public, global health and human rights, he enjoys working out, music, dancing, swimming, traveling, reading good literature, theatre and attending social events.
Jacqueline Elikem Amegee comes from the Ewe tribe, from a town called Dzelukope, in the Volta region of Ghana. She currently serves as the Deputy Country Medical Director supporting the Country Medical and Program Director in his work. She has a long standing experience working with him as a Nurse Practitioner in Maternal and Child Health. She currently works at The Trust Hospital Limited in Accra Ghana as a Nursing Officer. She has a diploma in General Nursing from Western Hills school of Nursing and a Bsc. Nursing Degree from a Central University College in Accra. Her hobbies include reading, swimming and traveling.
CFHI Local Coordinators
Local Coordinators will assist in organizing housing, airport pick-up, orientation, weekly meetings and other logistics for all participants.
Roland Awinuse is a native of the Kassena Nankana tribe of Navrongo in the Upper East Region of north Ghana. He is a graduate from the University of Ghana with a Bachelor's degree in Sociology. He has about three years working experience in different fields such as; working as a Biostatistician (Medical Records Officer), being involved in Community Health Care Research, and in the field of coordinating foreign volunteers in Ghana. He loves indoor games like Ludo, playing cards (spade) and a following local and international politics.
Nora Oye Abbew hails from the Akuapem people, from a town called Tutu, in the Eastern region of Ghana. Nora currently works at one of the program’s main rotation site, the Princess Marie Louise Children’s Hospital in Accra, as a registered general nurse. She has a diploma in General Nursing and currently serves as one of the Local Coordinators in Accra. Her hobbies include exercising, researching, reading, listening to music, and traveling.
Theresa Abena Amankwah hails from a town named Ejisu in the Ashanti region of Ghana. She is a Registered General Nurse with long-standing experience working in public and private health institutions in the Ghana Health Service. She also has experience working together with the Country Medical and Program Director as a Nursing Officer in Maternal and Child Health. Apart from supporting him by serving as his Deputy Medical Director for Accra Programs and Local Coordinator, she also works primarily as a Nurse Practitioner with the Trust Hospital Company Limited. Theresa holds a BSc. Nursing from the University of Ghana and loves to read, listen to music and travel.
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)