None of the dietitians could recollect any references to trained dietitians practicing in any hospital in Ghana during this period. The catering officers were trained locally in institutional management. According to one retired dietitian: ‘During early

part of my career, there were no dietitians in many places in Ghana. However, because institutional management training was available in Ghana, the catering officers were in greater numbers and were in many hospitals and may have played the role of a dietitian where there was none.’- (Retired Dietitian #1) The second period of the history of dietetics in Ghana begins in the early sixties when foreign-trained Ghanaian dietitians were recruited to work in the hospitals. This changing tide resulted in serious role conflict between these two groups of professionals about who had superior decision-making authority over patients’ diets and supervision of meal preparation. Lapatinib molecular weight ‘Wherever a see more dietitian was posted, the catering officer jostled for recognition and supremacy. You always had to quarrel with the catering officer and you had to find a way to work with them. The locally trained catering officers were more difficult to work with than those trained in the United Kingdom.’ – (Retired Dietitian #1) Because there were only a few dietitians at this time, only hospitals in major cities (i.e. Accra and Kumasi) had dietitians. This was

partly because all dietitians were either trained in the United Kingdom or the United States of America and there were only a few in practice.

During this period, many of those who were sponsored by government to study dietetics abroad refused to return home to practice in Ghana. Thus, the unmet need for dietitians kept growing. Therefore, beginning from Thymidine kinase 1998, a 6-month intensive training program in dietetics was initiated at Korle-bu. This skill-based program which became known as the “stop-gap program” admitted bachelor graduates from nutrition and home sciences. The new program marked the beginning of the third major period in the history of dietetics practice in Ghana and trained two cohorts of dietitians, who went on to fill key dietitian positions in the Ministry of Health. Contemporary dietetics practice In 2013, our nation-wide enquiry identified 35 qualified dietitians practicing in various public and private institutions in Ghana, as shown in table 1. The GHS employs nine dietitians who work in five hospitals. In addition, the four regional hospitals of the Ministries of Health and of Defence also employ 16 dietitians. Three dietitians working in private hospitals were also identified. Table 1 Number of dietitians and the Institutions in which they are employed in Ghana Twenty-eight (80%) of the dietitians are practicing in the Accra metropolis with the remainder working in only four other regions. Thus there are three regions without the services of qualified dietitians.