Padmore Adusei Amoah

Do health beliefs explain traditional medical therapies utilisation? Evidence from Ghana

Abstract Although the direct impact of health beliefs on unconventional medical therapies consumption are well documented, the previous empirical findings of the relationship have been much inconsistent and theoretically subtle in Ghana. Using social cognitive thesis, this paper examines how relative effects of personal health beliefs influence the use of traditional medicine in the Ashanti Region of Ghana. Drawing on a qualitative approach involving rural and urban peculiarities and 36 in-depth interviews, this research study adopts a posteriori inductive reduction model to derive broad- and sub-themes. Results suggest that health-seeking behaviour in Ghana is a socially negotiated process in which cultural beliefs play a major role in moulding the use of unconventional therapies. Perceived displeasure and pure medicalisation of western medicine push individuals into traditional medicine use. Cultural norms and health beliefs in the form of personal philosophies, desire to be part of the healing process, illness perceptions and aetiology, holistic and natural healing approaches, and perceptions on quality of care ascribe the widespread use of traditional medicine. The complexities of personal belief constructs underscore behavioural change towards traditional medicine uptake. This paper theorises that health-seeking behaviour is subject to the complex sociocultural orientation and belief paradigm. Policies targeted at improving health services delivery at the community level should be tailored to appreciate the role of traditional structure and cultural beliefs of the people.

Sociocultural hegemony, gendered identity, and use of traditional and complementary medicine in Ghana

ABSTRACT This study investigated gender differences in the use of traditional and complementary medicine (TCM) in Ghana. Using an interviewer-administered questionnaire, we collected data from March to June 2013 from 324 randomly sampled adults in the Ashanti region. The prevalence of TCM use in the prior 12 months was 86 percent. Females constituted the majority (61 percent) of TCM users. Female TCM users were more likely than male users to have had only a basic education, been traders (p ˂ .0001), and have health insurance (p ˂ .05). Using multiple logistic regression, TCM use was associated with urban residence for females (odds ratio [OR] = 7.82; 95 percent confidence interval [CI]: 1.28–47.83) but negatively related for males (OR = 0.032; 95 percent CI: 0.002–0.63). Being self-employed was associated with TCM use among males (OR = 7.62; 95 percent CI: 1.22–47.60), while females’ TCM use was associated with higher income (OR = 3.72; 95 percent CI: 1.21–11.48) and perceived efficacy of TCM (OR = 5.60; 95 percent CI: 1.78–17.64). The African sociocultural structure vests household decision-making power in men but apparently not regarding TCM use, and the factors associated with TCM use largely differed by gender. These findings provide ingredients for effective health policy planning and evaluation. Adoption and modernization of TCM should apply a gendered lens.

Strengthening the Referral System through Social Capital: A Qualitative Inquiry in Ghana

The referral system in health care has been noted as very influential in determining which services are accessed and when. Nonetheless, existing studies have relied on specific measurable factors relating to health personnel, transportation and communication infrastructure, and finance to explain the challenges facing the referral policy in developing countries. While this is understandable, the role of social capital remains mostly uncharted even though it is implicit in the well-known lay referral system. Using various facets of the social capital concept, this paper empirically examines how the resources embedded in both structural and cognitive aspects of social relationships influence knowledge of, and adherence to, referral policy. This study is based on semi-structured in-depth interviews conducted with 79 adults in the Ashanti Region of Ghana in 2015. Of the 79 participants, 28 lived in urban areas and 51 in rural localities. Eight health personnel and eight community leaders also contributed to the study. Additionally, six focus group discussions were held. The findings indicated that both cognitive and structural forms of social capital considerably underpinned the ability and willingness of people to adhere to the referral process. Moreover, the role of social capital was double-barrelled. It contributed in a significant way to encouraging or dissuading potential patients from rightly embracing the policy. In addition, precepts of social capital reinforced both positive and adverse effects of the other determinants of the policy such as finance and transportation. However, the magnitude of such impact was linked to how ‘resourceful’ and ‘trustworthy’ one’s available social acquaintances were. The paper suggests that a cautious engagement with social capital will make it a potentially powerful tool for understanding the gaps in and improving the effectiveness of referral policy.

Health literacy and self-perceived health status among street youth in Kumasi, Ghana

Abstract Street youth often have poor health. A number of studies have been commissioned across contexts to appreciate and address the problem. Conspicuously missing from extant researches about street youth in relation to their health however are those relating to health literacy. This study assesses general health literacy (GHL) and its association with self-perceived health status among street youth in Kumasi, Ghana. Two hundred and ninety street youth with an average age of 18 years (±3.1) participated in the study. The majority (78%) of street youth demonstrated limited GHL. Age, education, and acknowledging the streets as home, were significantly associated with GHL. Being an adult (β = −0.32, p < 0.01), being female (β = 0.26, p < 0.05), living on the streets for more than 3 years (β = 0.29, p < 0.05), and acknowledging the streets as home (β = 0.254, p < 0.05) significantly predicted limited GHL. Inadequate GHL (β = −0.50, p < 0.01) and problematic GHL (β = −0.39, p < 0.01) were inversely associated with self-perceived health status after adjusting for a number of sociodemographic variables. General health literacy is thus essential for improving the health status of this group of urban poor and should be duly recognised and systematically applied in a bid to ameliorate the health-related wellbeing of street youth.

Social Networks and Health: Understanding the Nuances of Healthcare Access between Urban and Rural Populations

Communities and individuals in many sub-Saharan African countries often face limited access to healthcare. Hence, many rely on social networks to enhance their chances for adequate health care. While this knowledge is well-established, little is known about the nuances of how different population groups activate these networks to improve access to healthcare. This paper examines how rural and urban dwellers in the Ashanti Region in Ghana distinctively and systematically activate their social networks to enhance access to healthcare. It uses a qualitative cross-sectional design, with in-depth interviews of 79 primary participants (28 urban and 51 rural residents) in addition to the views of eight community leaders and eight health personnel. It was discovered that both intimate and distanced social networks for healthcare are activated at different periods by rural and urban residents. Four main stages of social networks activation, comprising different individuals and groups were observed among rural and urban dwellers. Among both groups, physical proximity, privacy, trust and sense of fairness, socio-cultural meaning attached to health problems, and perceived knowledge and other resources (mainly money) held in specific networks inherently influenced social network activation. The paper posits that a critical analysis of social networks may help to tailor policy contents to individuals and groups with limited access to healthcare.

Geography and Traditional Therapies Utilization: A Convergence ofHealth Behaviors in Rural and Urban Settings?

Interest in traditional medicine utilization is burgeoning in Ghana and worldwide. Whereas one in seven people in Ghana utilize one sort of traditional medicine or another over the past decades, Complementary and Alternative Medicine (CAM) has become widely used in Asia and advanced environments or elsewhere. The 2007 National Health Interview Survey by the National Centre for Complementary and Alternative Medicine (NCCAM) and the National Centre for Health Statistics for example show, that approximately 38% of adults in the United States were using some forms of CAM, and accordingly, total expenditure for CAM therapies was estimated at

Who'll do all these if I'm not around?: Bonding social capital and health and well-being of inpatients.

34 billion in 2007 [1]. Estimates in 2010 show that over 244 medicinal plant products, representing 186–209 species and 951 tons of crude herbal medicine are available at Ghana’s herbal markets with a total value of more than US

Social participation, health literacy, and health and well-being: A cross-sectional study in Ghana

7.8 million [2,3].

Gauging the dispositions between indigenes, Chinese and other immigrant traders in Ghana: towards a more inclusive society

ABSTRACT Purpose: Although social capital influences health-related decisions and behavioural patterns in many developing countries, minimal attention has been paid to the nuances of its effect on healthcare. This paper examines how bonding social capital affects healthcare delivery for inpatients in Ghana. Methods: Semi-structured in-depth interviews were used and thematic analysis method employed to analyse the data. Interviews were conducted with health professionals and relatives and close friends of inpatients in three public health facilities in Ashanti region. Results: Relatives and close friends of inpatients were a critical source of instrumental support such as provision of meals, laundry services, running errands and financial assistance as well as emotional support. These functions—that were both ‘expected’ and ‘encouraged’— reduced the burden on the health facilities, which apparently had limited resources to offer adequate care. However, the relatives of inpatients sometimes inadvertently obstructed efficient healthcare delivery through actions such as extending ‘unapproved’ alternative care to patients. Moreover, the process of contributing towards health and well-being of the sick exposed the relatives to health risks due to poor living conditions. Conclusion: A well-defined and befitting role must be devised for at least an immediate social relation of inpatients to improve the positive effects of bonding social capital on healthcare delivery.

Social institutions and same-sex sexuality: Attitudes, perceptions and prospective rights and freedoms for non-heterosexuals

Numerous studies attest to the salubriousness of social participation across contexts. Factors such as health-related behaviour, health risk aversion, and psychosocial traits partly explain this association. While a study of these factors contributes to an understanding of the role that social participation plays in health-related outcomes, significant gaps still exist in this field of investigation. In particular, existing studies have not explored the relationship between social participation and health literacy and how it affects health and well-being adequately. This paper addresses this gap by examining the responses of some 779 rural and urban residents in Ashanti Region in Ghana. The study used path analyses within structural equation modelling (SEM) to assess the mediational role of health literacy in the association between social participation (religious participation, volunteer activities and group membership), and health status and subjective well-being. All the proxies of social participation significantly predicted health literacy. It was also evident that social participation influences health and well-being substantially. After controlling for socio-demographic variables, religious participation and group membership indirectly predicted well-being and health status through health literacy. Volunteer activities showed a negative indirect effect; thus, social participation does not always have a favourable effect on health and well-being. However, the findings suggest that overall, enhancing social participation may be promising for effective health promotion.