The history of nursing in Ghana is a story of transformation—from traditional caregiving rooted in indigenous knowledge systems to a formal profession influenced by colonial structures and Western practices. Before the introduction of modern healthcare, the responsibility of caring for the sick rested in the hands of spiritual healers, herbalists, and mostly women within the home. This form of care was deeply connected to cultural beliefs and family obligations. However, the arrival of European missionaries, colonial administrators, and medical personnel brought new ideas about health, hygiene, and professional nursing.
Over time, Ghana’s nursing profession evolved, shaped by social, cultural, and economic changes. It navigated challenges such as low public perception, gender roles, and limited access to education, especially for women. Despite these barriers, nursing gradually gained recognition and respect, becoming one of the key pillars of Ghana’s healthcare system. This article traces that journey—from its humble beginnings to its growth into a structured and respected career—and highlights the people, policies, and cultural shifts that made it possible.
The Early Days of Nursing in Ghana
In traditional Ghanaian society, there were no written records about nursing. Health care was mostly handled by traditional healers such as herbalists, spiritualists, and fetish priests. These healers used herbs, rituals, and spiritual practices to treat illnesses, based on the beliefs and customs of the time.
Women played an important role in caring for the sick at home. They were not formally trained, but learned through experience by taking care of relatives and managing households. According to Docia Kisseih, Ghana’s first Chief Nursing Officer, elderly women cared for the sick long before professional nursing started. Their knowledge came from years of practice, not from schools.
Colonial Influence and European Nurses
When Europeans arrived during colonial times, they brought new ideas about health care. The harsh climate of West Africa led to many illnesses, and both Europeans and Africans still relied heavily on traditional medicine. In 1878, the Basel Mission sent a doctor to the Gold Coast (now Ghana), but he died of fever within six weeks.
In 1878, two European nurses arrived to care for colonial officials, although little is known about their experience. More efforts followed to send British nurses abroad. By 1896, some were sent to Accra to explore the possibility of a permanent nursing presence. Their main roles were to care for patients, support doctors, and train local helpers.
These British nurses were expected to represent their country, maintain discipline, and wear spotless white uniforms. They were often compared to soldiers, praised for their dedication and readiness to work in difficult environments. Over time, more nurses arrived to build a permanent system of hospital-based nursing in Ghana.
Introducing Local Nurses
As hospitals developed, it became clear that British nurses alone could not meet the demand. Local people were needed to help doctors, care for patients, and manage basic tasks like cleaning wounds and feeding the sick. Most of the first trained local nurses were men.
There were several reasons for this. At the time, women were expected to stay home, help with chores, and take care of the family. Working in hospitals, especially with strangers and in jobs involving blood and bodily fluids, was seen as inappropriate for women. Also, a few girls attended school, while boys were considered better investments for formal education.
Working in hospitals was not popular. The pay was low, conditions were tough, and the work was often seen as unpleasant. Many young men preferred jobs in cocoa farming or mining, which paid better. Even those who trained as nurses had few chances for promotion, as higher positions were reserved for Europeans.
Challenges in Training and Acceptance
Training for local nurses took place in major towns like Accra, Cape Coast, Sekondi, and Kumasi. It involved hands-on practice and classroom lessons in subjects like anatomy, first aid, and medical care. After three years, successful trainees received certificates and became Second Division Nurses in the civil service.
However, standards were not yet fully developed, and students came from different educational backgrounds. Most senior positions remained with expatriates, and there was little room for advancement. Additionally, cultural and religious differences often led to tension between British doctors and local nurses.
One surgeon in 1901 expressed frustration with the local recruits, describing them as poorly educated and unsuitable. The work schedules were strict, with long shifts and few days off, making it difficult to keep staff. All of these factors contributed to an early shortage of nurses.
Midwifery, Public Health, and Women’s Entry into Nursing
Over time, new roles emerged in healthcare, such as dispensers who treated wounds and administered medicine. These roles were more respected and attracted many trained men away from nursing, creating further shortages. Meanwhile, public health nurses began working in Accra, focusing on welfare and visiting homes—this was the beginning of public health nursing in Ghana.
In 1928, the first midwifery school opened at Korle Bu Hospital in Accra. Midwifery was seen as a respectable job for women, and many girls who finished secondary school chose this career path. This marked the beginning of wider female participation in nursing.
Steps Toward Standardisation and Recognition
By 1944, plans were underway to improve nursing education, create uniform standards, and get recognition from the British Nursing Society. Despite the earlier challenges, interest in nursing began to grow. A retired nurse recalled how hard it was at first to convince families to let their daughters become nurses because the work was considered strange and dirty. Cleaning wounds and handling soiled sheets was not considered proper for women.
Training was often informal, depending on the experience of the British nurse in charge. However, as time passed, nursing gained respect. Seeing British women in uniform, working with authority, and earning recognition helped change public opinion. Girls began to see nursing as a respectable and even prestigious profession.
Nursing as a Gendered and Colonial Profession
Historically, nursing around the world began as a female role, especially within families. Women, often wives or daughters, cared for sick relatives, while men, as healers or doctors, took credit for the recovery. In early European hospitals, nurses were usually religious women, such as nuns, who cared for the poor and dying.
When British nurses arrived in Ghana, they brought with them a strong moral image—hardworking, disciplined, and religious. This ideal was slowly passed on to local nurses through training and example.
Conclusion
The journey of formal nursing in Ghana reflects a mix of cultural resistance, colonial influence, and gradual change. While women at home handled traditional care, the early nursing profession was dominated by trained men. Cultural expectations made it difficult for women to enter the field initially, but over time, as education improved and perceptions changed, women became a vital part of the nursing workforce.
Nursing came to be seen as a respected and valuable profession, especially when it offered opportunities for education, uniforms, and social standing. However, it’s important to note that the nursing system developed in Ghana closely followed the British model, with little room for local cultural practices or traditional healing. This reflected a broader pattern seen in other colonies, where Western models were imposed with limited adaptation to local contexts.
Despite these challenges, nursing in Ghana evolved into a strong and essential part of the healthcare system, shaped by both local resilience and global influence.
