The former model did not make a speech but those who met her said afterwards that unlike her mysterious public image she was "warm" and "gentle" in the flesh.

"She's very friendly, easy-going and interactive," said Rabiu Fauziya, a 28-year-old paediatric nurse who helped show Trump the neonatal room in the hospital.

From there, she met her Ghanaian counterpart, Rebecca Akufo-Addo, at the presidential residence, Jubilee House, where the pair exchanged gifts of an silver Chippendale tray engraved with an image of the White House and Ghanaian kente cloth.

The women met for the first time at the UN General Assembly last month at which President Trump railed against globalism, earning him stern rebukes from world leaders.

On her four-country, week-long tour of Africa, Trump is aiming to cast a more positive light on her embattled husband's administration and its "America First" agenda.

The 48-year-old is promoting her Be Best initiative, her official agenda unveiled in May designed to improve children's well-being.

Her office has described the trip as a "showcase" for the work of the US Agency for International Development even at a time when her husband's government is looking to slash US aid across the world.

The president has equally promised to only provide aid to friendly countries.

But unlike her predecessors, Melania Trump's tour will be followed closely to see if she can build bridges after her husband's apparent disparaging comments.

In addition to Ghana, the first lady is due to visit Malawi, Kenya and Egypt before returning to Washington early on October 7.

Trump has typically stayed out of the spotlight since her husband became president yet she has made headlines for rare public appearances.

In June, she made a surprise visit to Texas to visit detained children at the Mexican border, wearing a jacket emblazoned with the words "I really don't care. Do U?"

No one knew who the message was intended for, leaving it -- and her -- up for interpretation.

This ambiguity has led some pundits to describe her as a "Rorschach test in Louboutins" after the interpretative ink blots used in psychoanalysis and the luxury shoes.

But as she attempts to step out of her husband's shadow, the Africa trip has been seen as an attempt for her to carve her own diplomatic path.

She has previously travelled alone to Canada and joined her husband on several foreign visits.

Spokeswoman Stephanie Grisham said the Africa tour is close to her heart. 

"This is her trip, her initiative," she said.

That has not stopped Donald Trump from weighing in last week, when he told journalists that his wife was "making a big trip to Africa".

"We both love Africa. Africa is so beautiful, the most beautiful part of the world, in many ways," he added.

The US president has yet to travel to Africa since taking office.

Trump's visit to Ghana has inevitably drawn comparisons to that of former president Barack Obama and his wife Michelle in 2009.

During that visit, Barack Obama gave a speech to parliament saying "Africa doesn't need strongmen, it needs strong institutions".

He also toured the Cape Coast Castle, a former slavery outpost, with his family.

Ghana is seen as a haven of stability in an often turbulent region but despite the interest back home, the first lady's visit did not appear to have generated similar fervour locally.

Unlike the Obamas' visit, the roads from the airport were not packed with onlookers while there was little fanfare in the local media, according to an AFP reporter on the ground.

"We in Africa, we like the other administration that came before this one," said Yaw Cobblah, a 46-year-old taxi driver in the capital.