Razak Mohammed Gyasi

Prevalence and pattern of traditional medical therapy utilisation in Kumasi metropolis and Sekyere south district, Ghana

ETHNOPHARMACOLOGICAL RELEVANCE Whilst over three-quarters of the world׳s population continues to use traditional medicine (TRM) with an increasing trend globally, limited data exist in the Ashanti Region regarding TRM utilisation. This study espoused a retrospective cross-sectional quantitative approach to examine the prevalence and pattern of TRM use among the general population in the Kumasi Metropolis and Sekyere South District, Ghana. MATERIALS AND METHODS A sample of 324, drawn through systematic random sampling was used. The main instrument for data collection was formal face-to-face interviewer-administered questionnaire. Data were analysed using Chi-square and Fishers exact tests from the PASW (V.17.0) with p ≤ 0.05 as significant. RESULTS The survey found that TRM use alongside conventional medicines was pervasive with prevalence of 86.1%. Biologically-based therapies (88.5%) and distant prayer interventions (58.4%) were commonly used modalities through the influence of families (50.3%), friends (19.4%) and the mass media (18.0%). Whilst self-administration and purchases from pharmacy shops remained important sources of TRM, TMPs׳ consultation was less credible (p<0.005). The disclosure rate of TRM use to health care professionals remained low (12.2%; p<0.001). CONCLUSION Concomitant TRM use with conventional therapies without disclosure may interfere with the potency of treatment regimen and result in drug interactions. Inclusion of alternative medicines on the National Health Insurance Schemes drug plan will fortify monitoring and professional administration of TRM. Information as regards TRM use needs to be incorporated into clinical and medical practice, hence the need to prioritise patient-physician communication.

Does spatial location matter? Traditional therapy utilisation among the general population in a Ghanaian rural and urban setting

Despite the recognition for rising consumption rate of traditional medicine (TRM) in health and spatio-medical literature in the global scale, the impact of location in traditional therapy use has been explored least in Ghana. This paper analysed the role of spatial variation in TRM use in Kumasi Metropolis and Sekyere South District of Ashanti Region, Ghana. A retrospective cross-sectional and place-based survey was conducted in a representative sample (N=324) selected through systematic random sampling technique. Structured interviewer-administered questionnaires were espoused as the main research instruments. Data were analysed with Pearsons Chi-square and Fishers exact tests from the Predictive Analytics Software (PASW) version 17.0. The study found that over 86% reported TRM use. Whilst majority (59.1%) of the respondents had used TRM two or more times within the last 12 months, biologically-based therapies and energy healing were common forms of TRM accessed. Although, the use of TRM did not vary (p>0.05), knowledge about TRM, modalities of TRM and the sources of TRM differed significantly across geographically demarcated rural and urban splits (p<0.005). The study advances our understanding of the spatial dimensions as regards TRM utilisation.

Pulled in or pushed out? Understanding the complexities of motivation for alternative therapies use in Ghana

The impact of strong cultural beliefs on specific reasons for traditional medicine (TRM) use among individuals and populations has long been advanced in health care and spatio-medical literature. Yet, little has been done in Ghana and the Ashanti Region in particular to bring out the precise “pull” and “push” relative influences on TRM utilization. With a qualitative research approach involving rural and urban character, the study explored health beliefs and motivations for TRM use in Kumasi Metropolis and Sekyere South District, Ghana. The study draws on data from 36 in-depth interviews with adults, selected through theoretical sampling. We used the a posteriori inductive reduction model to derive broad themes and subthemes. The “pull factors”—perceived benefits in TRM use vis-à-vis the “push factors”—perceived poor services of the biomedical treatments contributed to the growing trends in TRM use. The result however indicates that the “pull factors,” viz.—personal health beliefs, desire to take control of ones health, perceived efficacy, and safety of various modalities of TRM—were stronger in shaping TRM use. Poor access to conventional medicine accounted for the differences in TRM use between rural and urban areas. Understanding the treatment and health-seeking behaviour of a cultural-related group is critical for developing and sustaining traditional therapy in Ghana.The impact of strong cultural beliefs on specific reasons for traditional medicine (TRM) use among individuals and populations has long been advanced in health care and spatio-medical literature. Yet, little has been done in Ghana and the Ashanti Region in particular to bring out the precise “pull” and “push” relative influences on TRM utilization. With a qualitative research approach involving rural and urban character, the study explored health beliefs and motivations for TRM use in Kumasi Metropolis and Sekyere South District, Ghana. The study draws on data from 36 in-depth interviews with adults, selected through theoretical sampling. We used the a posteriori inductive reduction model to derive broad themes and subthemes. The “pull factors”—perceived benefits in TRM use vis-à-vis the “push factors”—perceived poor services of the biomedical treatments contributed to the growing trends in TRM use. The result however indicates that the “pull factors,” viz.—personal health beliefs, desire to take control of ones health, perceived efficacy, and safety of various modalities of TRM—were stronger in shaping TRM use. Poor access to conventional medicine accounted for the differences in TRM use between rural and urban areas. Understanding the treatment and health-seeking behaviour of a cultural-related group is critical for developing and sustaining traditional therapy in Ghana.

Relationship between Health Insurance Status and the Pattern of Traditional Medicine Utilisation in Ghana

This paper examines the relationship between national health insurance status and the pattern of traditional medicine (TRM) use among the general population in Ghana. A retrospective cross-sectional survey of randomly sampled adults, aged ≥18 years (N = 324), was conducted. The results indicate that TRM use was high with prevalence of over 86%. The study found no statistically significant association between national health insurance status and TRM utilisation (P > 0.05). Paradoxically, major sources of TRM, frequency of TRM use, comedical administration, and disclosure of TRM use to health care professionals differed significantly between the insured and uninsured subgroups (P < 0.001). Whereas effectiveness of TRM predicted its use for both insured [odds ratio (OR) = 4.374 (confidence interval (CI): 1.753–10.913; P = 0.002)] and uninsured [OR = 3.383 CI: 0.869–13.170; P = 0.039)], work experience predicted TRM use for the insured [OR = 1.528 (95% CI: 1.309–1.900; P = 0.019)]. Cultural specific variables and health philosophies rather than health insurance status may influence health care-seeking behaviour and TRM use. The enrollment of herbal-based therapies on the national health insurance medicine plan is exigent to ensure monitoring and rational use of TRM towards intercultural health care system in Ghana.

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.

Quality control and standards of medicinal products : a committed agenda

An article published by British Journal of Pharmaceutical Research 6(6): 385-388, 2015, Article no.BJPR.2015.080

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.

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.

Gender, self-rated health and functional decline among community-dwelling older adults

OBJECTIVE This paper examines the association between self-rated health (SRH) and functional decline (FD) in older Ghanaian cohorts and investigates whether the effect differs by gender and also modified by marital status. METHODS The study used cross-sectional survey data (N = 1200) from an Aging, Health, Psychological Wellbeing and Health-seeking Behavior Study (AHPWHB) study conducted in between August 2016 and January 2017. A four-level gendered-stratified logit modeling estimated the SRH-FD association and the interaction terms. RESULTS Overall, 23% of male respondents and 34% of women revealed significant FD (p < 0.001). The fully-adjusted model showed that SRH status was a strong predictor of FD across genders but the effect was most pronounced among men. Compared with excellent/very good SRH, fair and poor SRH (β = 0.160; p < 0.05) and (β = 1.700; p < 0.001) for women and (β = 2.202; p < 0.001) and (β= 2.356; p < 0.001) for men respectively were significantly associated with increased FD. However, good (β = - 1.760; p < 0.001), fair (β = - 2.800; p < 0.001) and poor SRH (β = -2.088; p < 0.001) decreased FD if an older woman was married compared with unmarried women with excellent/very good SRH. CONCLUSION The strength of SRH-FDs association largely differed with gender and also moderated by marital status for women. Improving the SRH and marital quality could be protective of functional abilities, independence and quality of life for older people.

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