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

Abstract

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 one's 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.

Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review

“… 20 29–32 42 45 48 49 57 73 74 76 78 85 86 88 91 106 108 118 134 139 141 150 157 175 183 187 188 192 Patients participating in the identified studies were also positively attracted to TCAM for other reasons such as alignment with a patient’s sociocultural, religious and spiritual values with regard to health and disease 12 32 33 42 68 72 73 81 91 106 110 118 149 181 183 187 188 190 192 193 and the sense of patient autonomy of their health. 183 Other pull factors of TCAM use identified from the literature are patients’ trust and confidence in their traditional medicine practitioner to share their personal secrets and the perceived privacy they enjoyed with their traditional medicine practitioner. 187 194 Perceived psychosocial care and support provided by TCAM providers compared with orthodox healthcare providers have also been reported as a pull factor.…”

“… 49 In addition, two population-based studies 48 189 and a subhealth study 192 reported that respondents were reluctant to use traditional medical care due to the perceived demonic nature of TCAM. Further, four population-based studies from Ghana 183 184 189 and Tanzania 73 and subpopulation studies from Nigeria 31 and Ghana 192 cited perceived lack of an appropriate dose for TCAM products and unhygienic practice in product preparation, 31 73 183 184 189 as well as the unregulated TCAM practitioner practice, 183 192 as deterrent to using TCAM. Other barriers to TCAM use were an absence of health financing for traditional health care 183 and a perceived lack of education and training among TCAM practitioners.…”

Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review

“…20 187 188 192 Patients participating in the identified studies were also positively attracted to TCAM for other reasons such as alignment with a patient's sociocultural, religious and spiritual values with regard to health and disease 12 32 33 42 68 72 73 81 91 106 110 118 149 181 183 187 188 190 192 193 and the sense of patient autonomy of their health. 183 Other pull factors of TCAM use identified from the literature are patients' trust and confidence in their traditional medicine practitioner to share their personal secrets and the perceived privacy they enjoyed with their traditional medicine practitioner. 187 194 Perceived psychosocial care and support provided by TCAM providers compared with orthodox healthcare providers have also been reported as a pull factor.…”

“…Further, four population-based studies from Ghana 183 184 189 and Tanzania 73 and subpopulation studies from Nigeria 31 and Ghana 192 cited perceived lack of an appropriate dose for TCAM products and unhygienic practice in product preparation, 31 73 183 184 189 as well as the unregulated TCAM practitioner practice, 183 192 as deterrent to using TCAM. Other barriers to TCAM use were an absence of health financing for traditional health care 183 and a perceived lack of education and training among TCAM practitioners. 36 183 189 non-disclosure of TCAM use to healthcare providers Twenty-five subhealth population studies reported on patients' non-disclosure of TCAM use to their conventional healthcare providers.…”

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

“…According to the findings, this can be attributed to the push by close ties of inpatients—who may sometimes not be in the position to adequately make their own decisions. Many individuals, households and even communities in Ghana tend to grapple with a multiplicity of medical modalities in the light of cultural and belief complexities (Gyasi et al, 2016a; 2016b). Apparently, the critical role of BSC explains the call for a move away from individualistic focus in healthcare delivery to a more holistic approach—one that considers the broader social being of a person by incorporating their social ties in healthcare delivery (Levine & Zuckerman, 1999; Lewis et al, 2014).…”