In Accra, Ghana, the ward glowed ocean blue under phototherapy lamps. Chlorhexidine lingered in the air, cardboard rustled beneath a mother’s thin blanket, and the soft gasp of a preterm infant punctuated the hum of monitors. A baby’s drool pooled at the corner of her mouth; when my gloved fingers brushed her cheek, she flinched. Her body spoke a language beyond words, and her mother translated every twitch with love.

Behind these intimate moments is a national story measured in stark numbers. In Ghana, 37 out of every 1,000 children do not reach their fifth birthday, and 21 out of every 1,000 die in the first month of life. These numbers are a significant improvement from three decades ago, but they still tell a harrowing story. Worldwide in 2023, an estimated 4.8 million children under five died, nearly half in the neonatal period. Maternal mortality remains unacceptably high at 234 deaths per 100,000 live births, a sobering reminder that child survival starts with a healthy mother.

The burden of malnutrition and disease

Unsurprisingly, malnutrition keeps its grip in Ghana, where the term kwashiorkor has its roots from Ga, a local language. Kwashiorkor, or “the sickness the baby gets when the new baby comes,” is a type of malnutrition that still affects a significant number of Ghanaian children. Approximately 17 percent to 18 percent of Ghanaian children under five are stunted, with progress slowing in recent years.

Sickle cell disease compounds the burden; between 15,000 and 20,000 Ghanaian babies are born with the condition annually, and roughly one in four Ghanaians carry a sickle cell trait.

Ghana must prioritize preventive, precision pediatric and maternal care, and ensure that safe, consistent delivery of treatments is not a luxury confined to tertiary hospitals but a guarantee from the first antenatal visit through newborn life. That means investing in systems and training, standardizing protocols, funding what families cannot afford, and building a culture that recognizes children are not small adults but patients who demand meticulous attention.

A personal perspective

This matters to me beyond the data. I have spent more than a decade as a midwife and midwifery educator, and today I am a medical student rotating through maternal, pediatric, and neonatal care departments. I have watched mothers sleep on cardboard to stay within arm’s reach of a baby with short bowel syndrome, and I have listened to the unending cry of a child whose hydrocephalus keeps him awake through the night. It is this experience that has prompted my advocacy for preventive care and for the voices of caregivers and young patients. These babies’ futures should not be determined by what their families can afford to access.

Time-bound action and partnerships

Action must be time-bound and shared.

• Government financing: The Ministry of Health and Ghana Health Service should leverage the Mahama Cares Ghana Medical Trust Fund to close financing gaps for specialist neonatal feeds, pediatric chemotherapy supportive care, and sickle cell essentials such as hydroxyurea and prophylactic antibiotics, aligning allocations in the next budget cycle and fast-tracking the draft bill already prepared for Parliament.
• Strategic partnerships: Ghana Health Service and USAID should leverage the 2024 five-year, $25 million government-to-government partnership to equip Community-based Health Planning and Services compounds and district hospitals within the Networks of Practice with bilirubin meters, calibrated irradiance readers, eye shields, and standardized phototherapy protocols, and expand supportive supervision over the next 12 months.
• Sickle cell strategy: The national sickle cell strategy and screening guidelines must move from launch to everyday practice. This will require the integration of newborn screening at birth facilities across all regions within 12 months, linking of at-risk infants to care, and building of genetic counseling capacity drawing on gatekeeper investments that have already expanded screening and on collaborative projects supported by major funders.
• Philanthropic alignment: Philanthropy can accelerate and de-risk these steps. The Bill & Melinda Gates Foundation’s maternal and newborn priorities (including low-cost interventions for postpartum hemorrhage and early neonatal care) and the new $500 million Beginnings Fund operating in countries that include Ghana should be aligned to district-level plans so that procurement, training, and data systems strengthen the public sector rather than bypass it.
• Workforce development: Regionally, the Mastercard Foundation’s Saving Lives and Livelihoods partnership with Africa CDC has trained tens of thousands of health workers and integrated vaccination sites; its second phase should be used to build a durable cadre of community health workers who deliver antenatal and newborn education, track bilirubin and weight, and bring fathers into care pathways by the end of the next calendar year.

Some will say resources are too scarce, donors are fatigued, and precision is unrealistic outside major cities. I understand the worry. Yet the USAID-GHS partnership was explicitly designed to strengthen primary care where families live, and the Mastercard initiative has already shown that large partnerships can leave behind trained workers and integrated sites rather than temporary supplies. Gates-backed maternal and newborn investments focus on low-cost interventions with large impact, exactly the kind of care that changes outcomes quickly and sustainably.

I return to that ward, to the blue light and the mothers who stay. Pediatrics is where fragility meets resilience, and where care must extend beyond cure. My stance is that Ghana must act now: Fund the gaps, standardize the care, train the teams, and place families at the center. The numbers demand urgency. The children demand precision. The future demands both.

Benedicta Yayra Adu-Parku is a nurse midwife in Ghana.