Date of Award


Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Rafael Pérez-Escamilla

Second Advisor

Amber Hromi-Fiedler


Buduburam Refugee Settlement was established in Ghana in 1990 by the United Nations High Commission for Refugees (UNHCR) in response to Liberia’s first civil war (1989-1997). A limited amount of research on intergenerational differences and acculturation with respect to diet in refugee populations has been published, despite refugees’ susceptibility to food insecurity and diet-related health conditions. As the worldwide refugee population continues to grow, it becomes increasingly important to develop socio-cultural frameworks to address specific health and nutrition needs of refugees. Therefore, the purpose of this qualitative study was to understand among Liberian refugees in Buduburam Refugee Settlement: 1) dietary practices in Liberia prior to the migration to Ghana; 2) whether these practices changed since being at the camp, and if so, why; and 3) how the availability, accessibility, and cost of food sources, as well as dietary practices and cultural beliefs surrounding food, influence the way they eat.

In-depth interviews were collected as part of a larger cross-sectional study that used both qualitative and quantitative methods to examine: a) shifts in dietary practices among Liberians since living in a protracted situation in a refugee settlement camp and b) the influence of Liberians on Ghanaians living in and around that refugee settlement. Seven domains emerged, forming direct and indirect pathways influencing dietary patterns among Liberian refugees and Ghanaians: national identity (proxy for culture), food preparation, food availability, food access, social support, food beliefs, and nutrition knowledge. Our qualitative findings provide key insights into the major factors driving dietary practices among refugees and local communities in and around a former refugee settlement. Our results strongly suggest that nutrition education, food availability, and access issues need to be addressed with well thought out, culturally-sensitive programs targeting both the refugee as well as the host communities.

Open Access

This Article is Open Access