Differences between Nursing and Midwifery in Ghana: Which is better?

Nursing and midwifery training in Ghana follows regulated programs under the Nursing & Midwifery Council (N&MC). Nursing programs typically last 3 years (diploma) or 4 years (bachelor’s degree). Students study general health care across all patient groups. Midwifery programs are often 3-year diplomas for direct entrants from high school. (Some colleges also offer a 4-year BSc. Midwifery degrees.)

After completing coursework and clinical rotations, graduates must pass the N&MC licensure exam to register as a Registered Nurse (RN) or Registered Midwife (RM). Entry requirements are similar for both: WASSCE/SSSCE credit passes in core subjects (including English, Maths, Integrated Science) and electives (e.g. Biology, Chemistry). For example, the Tumu Midwifery Training College requires WASSCE aggregate ≤36 (with credits in English, Math, Science), while the University of Development Studies School of Nursing demands six credits, including Integrated Science for its 3-year diploma programs.

Many colleges across Ghana – public and private – offer these programs. The N&MC lists dozens of accredited institutions (e.g. Nursing & Midwifery Training Colleges in Accra, Kumasi, Sunyani, Tamale, etc.) offering Registered General Nursing (RGN) and Registered Midwifery (RM) training. After training, passing the N&MC exam yields a Professional ID Number (PIN) and certificate; nurse assistants (2‑year programs) receive an auxiliary ID (AIN).

Duration: Nurses – 3‑year diploma or 4‑year degree; Midwives – 3‑year diploma (or 4‑year BSc).
Entry Requirements: Both need WASSCE credits (English, Math, Science) with an aggregate ~36 or better.
Certifications: All graduates must pass the N&MC licensure. Nurses become RNs (PIN); midwives become RMs (PIN) after exams.

Roles and Responsibilities

Nurses and midwives share some professional duties, but their clinical focus differs. According to the N&MC, registered nurses “practice independently and in collaboration with other health professionals” doing general nursing functions, and they supervise nurse assistants. In practice, RNs care for patients of all ages and conditions – in hospitals, clinics and communities – administering medications, dressing wounds, monitoring vital signs, supporting rehabilitation, and educating patients. They can specialise through post-basic programs (e.g. Mental Health Nursing, Ophthalmic, Critical Care, Public Health). For example, N&MC lists Ophthalmic Nursing, Peri-Operative/Critical Care, Public Health and other specialities as post-basic options.

Midwives, in contrast, specialise in maternal and newborn health. A Ghanaian midwife “obtains [a patient’s] obstetric history and conducts physical examination,” manages normal childbirth, and “administers medicines used in midwifery to mother and child,” as well as counsels families on maternal and infant care. In essence, midwives provide antenatal care, deliver babies, handle immediate newborn needs, and offer postnatal support. They are trained to recognise complications (referring when needed) and to educate mothers on breastfeeding, family planning and disease prevention. (Some experienced midwives take on roles like Public Health Midwife or Clinical Educator.)

In summary, nurses cover a broad scope of patient care and ward management, while midwives focus deeply on pregnancy, delivery and women’s health. Both can play leadership and teaching roles in healthcare teams.

Nurse scope: General patient care, disease prevention, chronic/acute care in wards, clinics, community; many specialities (ICU, paediatrics, psychiatry, etc).
Midwife scope: Women’s reproductive care from conception through childbirth and postnatal period; newborn care; family planning; community maternal health education.
Collaboration: Both coordinate with doctors and other professionals; senior nurses often supervise junior staff or Nurse Assistants.

Uniforms, Ranks, and Promotion

Healthcare uniforms and rank insignia denote role and seniority. In Ghana, nurses and midwives have distinct uniforms and belts. Registered nurses typically wear white dresses/blouses (for diploma nurses) or navy blue (for degree nurses) with colored belts indicating rank. Registered midwives usually wear green (or olive) uniforms. By regulation, N&MC requires professional ID photos in uniform: registered nurses use a white-background passport photo, while nurse assistants use a red-background photo. (Midwives have their own prescribed uniform for IDs.)

Career ladder in nursing (Ghana)

Healthcare careers have formal hierarchies. For example, nursing ranks begin at Enrolled Nurse (certificate-level) and progress through Senior Enrolled and Principal Enrolled Nurse, Staff Nurse (diploma or degree RN), Senior Staff Nurse, Nursing Officer, Senior Nursing Officer, Principal Nursing Officer, up to Deputy Director of Nursing and Director/Chief Nursing Officer. (Midwifery ranks are analogous: e.g. Staff Midwife → Senior/Principal Midwife → Principal Midwife Officer → senior management.) Promotion requires additional experience, education and passing internal examinations. For instance, a diploma nurse often starts as a Staff Nurse and can be promoted to Senior Staff Nurse, then Nursing Officer, etc., whereas a new BSc graduate may start at a higher initial grade. Ceremonially, Ghanaian nurses wear colored belts to indicate rank (white belt for Nursing Officer, blue for Senior NO, etc.), while midwives wear black belts. Together, these uniforms and insignia provide a clear visual hierarchy of responsibility.

Uniforms: Nurses: white (diploma) or navy (degree) uniforms; midwives: green uniforms. Belts (white/blue/black) denote rank (Nursing Officer, Senior NO, midwife). ID photo guidelines: Nurses – uniform on white background; Nurse Assistants – uniform on red background.
Ranks: Entry-level: Enrolled Nurse (nursing) or Community Health Nurse, Staff Nurse/Staff Midwife. Senior ranks: Nursing/Midwifery Officer, Principal Officer, then Directors. See diagram.
Promotion: Based on experience and qualifications. Diploma holders climb through “Staff” to “Officer” ranks; degree holders may enter at Officer level and advance to Senior/Principal roles.

Salary and Allowances

Nurses and midwives in Ghana are paid under the Single Spine Salary Structure (SSSS). Entry-level salaries depend on qualification: diploma-trained nurses/midwives start at lower spine levels (e.g. SIS Level 14–17), while BSc graduates start higher (e.g. Level 18L). Base salaries have gradually increased with cost-of-living adjustments. According to the Ghana Registered Nurses & Midwives Association, a typical Ghanaian nurse (and by extension midwife) “takes home between GHS 2,000 and GHS 2,500 a month”. This net pay includes basic salary plus allowances. In practice, a fresh diploma nurse’s gross base pay is around GHS 1,300–1,400, but allowances (for rural postings, night duty, risk, etc.) can significantly boost earnings. The Association has noted that average take-home pay in 2024 is GHS2–2.5k, which nurses say is low compared to other countries.

Pay rises with rank and promotion. For example, each promotion to Senior Staff Nurse, Nursing Officer, Senior NO, etc., moves the worker up several steps on the spine scale. Experienced senior nurses and midwives (e.g. Principal Nursing Officer, Chief Midwife) can see gross salaries in the GHS3,000–4,000+ range, before allowances. Other benefits may include health insurance and (for midwives) professional development support. Allowances are an important part of total compensation: the government often pays a 20% rural posting allowance for health workers in underserved areas, as well as smaller hardship or transport allowances. Overall, while specific figures vary, key points are:

Starting Pay: Diploma nurse/midwife ~GHS 2,673.20 base (net ~GHS 1,500–2,200 after deductions). BSc nurse ~GHS1,800 base. (Exact figures depend on the year’s wage agreements.)
Typical Take-home: ~GHS2,000–2,500/month including allowances.
Higher Ranks: Senior officers and managers can earn well above GHS3,000/month (gross).
Allowances: Extra for night duty, rural service (often 20%), feeding, etc., applied on top of base pay.

Comparison Table: Main Differences Between Nurses and Midwives in Ghana

Aspect	Nursing	Midwifery
Training Duration	3-year Diploma in Nursing, or 4-year BSc Nursing.	3-year Diploma in Midwifery (direct entry), or 4-year BSc Midwifery.
Entry Requirements	WASSCE/SSSCE credits (Eng, Math, Sci); aggregate ≤36 (WASSCE).	Similar WASSCE/SSSCE credit requirements (eng, math, integrated science).
Certifications	Must pass N&MC licensure exam to register as RN (PIN issued).	Must pass N&MC licensure exam to register as RM (PIN issued).
Scope of Practice	General patient care across settings; medication admin, wound care, etc.; many specialties (pediatric, ICU, mental health, community health, etc.).	Maternal–child health: prenatal care, delivery, postpartum, newborn care; family planning & women’s health education.
Specializations	General patient care across settings; medication admin, wound care, etc.; many specialities (pediatric, ICU, mental health, community health, etc.).	Some advanced roles (e.g. Public Health Midwife, Midwifery Educator) but mainly clinical obstetrics focus.
Uniform (Basic)	White or navy-blue dress/uniform for Registered Nurses; student nurses may wear white apron/veil.	Olive-green or brown dress/uniform for Registered Midwives.
Rank Insignia	Staff Midwife → Senior Staff Midwife → Principal Midwife → Midwifery Officer → Senior Midwife Officer → Principal Midwife Officer → Deputy Director (Midwifery) → Director of Midwifery (if applicable). (Parallel to the nursing ladder.)	Midwives typically wear black belts to denote their cadre (Staff/Senior Midwife).
Career Ranks	Enrolled Nurse → Senior Enrolled → Principal Enrolled → Staff Nurse (RN) → Sr. Staff Nurse → Nursing Officer → Sr. Nursing Officer → Principal NO → Deputy Dir. of Nursing → Dir. of Nursing/Chief Nursing Officer.	Gross salary is roughly GHS 2,673.20 for an entry-level RN (diploma) (before allowances). Net take-home around GHS1,500–2,200.
Starting Pay (GHS)	Colored belts on uniform: white belt (Nursing Officer), blue belt (Senior Nursing Officer), red (Chief Nursing Officer), mauve belt (Director).	Extensive post-basic training in fields like Critical Care, Ophthalmic, Public Health, Psychiatric, and Community Health.
Average Take-home (GHS)	~2,000–2,500/month including all allowances.	~2,000–2,500/month including allowances (on same pay spine as nurses).
Pay Progression	Increases with promotion: Senior Staff, Nursing Officer, etc. Degree holders start at higher spine steps.	Increases with promotion: Senior Staff Midwife, Principal Midwife, etc. (Degree midwives similarly start higher).
Allowances	Night duty, risk, rural posting (typically 20%), feeding and transport allowances added to base pay.	Same allowance types as nurses (rural, hazard, night shift, etc.).