The proliferation of generative artificial intelligence (GAI) in education necessitates an understanding of the foundational skills required for its effective adoption and use. This qualitative interpretive case study, grounded in constructive learning theory, investigates the foundational skills needed for GAI integration in Ghanaian higher education and examines how students' skills influence their ability to interact with and utilize GAI tools effectively. Semi-structured interviews and observations were conducted with 67 students across six diverse institutions in Northern Ghana. Thematic analysis revealed critical foundational skills, including programming proficiency, data manipulation expertise, algorithmic thinking, critical thinking, and communication skills. The study highlights the unique aspects and applications of these skills within GAI contexts and emphasizes the importance of active learning, collaborative environments, and institutional support in fostering skill development. The findings contribute to the understanding of GAI integration in higher education and provide valuable insights for curriculum development, pedagogical approaches, and policy initiatives in developing countries.