Main Article Content

Abstract

Background: Autoimmune conditions occur when the immune system cannot differentiate between foreign substances and the body’s cells. In multiple sclerosis (MS), the immune system attacks the central nervous system and causes debilitating symptoms. Various factors impact healthcare choices in Africa, including beliefs and social class.


Methods: This qualitative study explored the health-seeking behavior of five (5) purposively selected patients with MS in Ghana through in-depth interviews.


Results: The results of the study, as reported using vignettes, showed a lack of awareness about MS, and the high cost of treatment caused patients to seek non-biomedical forms of care, such as herbal remedies and divine healing.


Conclusion: This study highlights a lack of awareness regarding MS and how this affects the health-seeking behavior of patients. Desperation for an absolute cure to end suffering and the unending drain on their finances led patients to seek other modes of care. Public awareness is needed regarding the condition and alternative means of funding.

Keywords

Autoimmune conditions multiple sclerosis health-seeking behavior religion herbal remedies vignette Ghana

Article Details

Author Biography

Belinda Dentaa Oduro, University of Media, Arts and Communication, Ghana

Belinda Dentaa Oduro is currently serving as an Assistant Lecturer in Broadcast Journalism at the Institute of Film and Television (IFT) of the University of Media, Arts and Communication (UniMAC) in Accra, Ghana. She holds an MPhil in Communication Studies from the University of Ghana and is currently working towards a Doctorate in Sociology at the same institution. Her research interests encompass the Sociology of Health, Media Framing and Representation, New Media, and Online Journalism.

How to Cite
Oduro, B. D. (2024). Understanding the Health-Seeking Behaviour of Multiple Sclerosis Patients in Ghana Through Vignettes. Pan-African Journal of Health and Environmental Science, 3(1), 74–92. https://doi.org/10.56893/ajhes2024v03i01.07

References

  1. Abu Khader, I., Malak, M. Z., & Jallad, M. (2022). Knowledge about multiple sclerosis among Palestinian community dwellers in the West Bank. Journal of Public Health, 30(12). https://doi.org/10.1007/s10389-022-01803-2
  2. Abukari, S., Agbenyefia, G. M., & Akotey, M. K. (2021). Religion and mental illness in Ghana: The Christian perspective. ADRRI Journal of Medical and Biomedical Research, 3(1), 10-24.
  3. Acquah, P. (2020, October 24). Cover multiple sclerosis treatment under NHIS – Medical doctor. Graphic Online. https://www.graphic.com.gh/news/health/cover-multiple-sclerosis-treatment-under-nhis-medical-doctor.html
  4. Adelowo, O. O., & Bello, M. K. N. (2014). Systemic autoimmune diseases: Not so rare in black Africans. Rheumatology (Sunnyvale), 4(1). https://doi.org/10.4172/2161-1149.1000130
  5. Aderinto, N., Muili, A. O., & Opanike, J. (2023). Navigating the journey of multiple sclerosis management in Africa, overcoming hurdles and harnessing opportunities: a review. Annals of Medicine and Surgery, 85(5), 1774-1779. https://doi.org/10.1097/MS9.0000000000000560
  6. Aikins, A. D. (2005). Healer shopping in Africa: New evidence from rural-urban qualitative study of Ghanaian diabetes experiences. BMJ (Clinical Research Ed.), 331(7519), 737. https://doi.org/10.1136/bmj.331.7519.737
  7. Amissah-Arthur, M. B., Gyaban-Mensah, A., Boima, V., Yorke, E., Dey, D., Ganu, V., & Mate-Kole, C. (2022). Health-seeking behaviour, referral patterns and associated factors among patients with autoimmune rheumatic diseases in Ghana: A cross-sectional mixed method study. PLoS ONE, 17(9). https://doi.org/10.1371/journal.pone.0271892
  8. Anderson, A. (2002). Pentecostal approaches to faith and healing. International Review of Mission, 91(363), 523-534. https://doi.org/10.1111/j.1758-6631.2002.tb00365.x
  9. Anderson, G. J. (2019). “God has instructed me to sell”: Questioning the practice of commercialisation of religion in neo-prophetic and Pentecostal/Charismatic churches in Ghana. All Nations University Journal of Applied Thought, 6(2), 172-188. https://anujat.anuc.edu.gh/universityjournal/anujat/Vol6/No2/8.pdf
  10. Asampong, E., Dwuma-Badu, K., Stephens, J., Srigboh, R., Neitzel, R., Basu, N., & Fobil, J. N. (2015). Health seeking behaviours among electronic waste workers in Ghana. BMC Public Health, 15(1065). https://doi.org/10.1186/s12889-015-2376-z
  11. Ayifah, E., Romm A. T., Kollamparambil, U., & Vosti, S. A. (2022). Effect of religion on the risk behaviour of rural Ghanaian women: Evidence from a controlled field experiment. Review of Social Economy, 80(2), 138-171. https://doi.org/10.1080/00346764.2020.1725831
  12. Aziato, L., & Antwi, H. O. (2016). Facilitators and barriers of herbal medicine use in Accra, Ghana: An inductive exploratory study. BMC Complementary and Alternative Medicine, 16(142). https://doi.org/10.1186/s12906-016-1124-y
  13. Benyon, K. (2014). Health literacy. InnovAiT, 7(7), 437-440. https://doi.org/10.1177/1755738014532627
  14. Boadu, K. (2002). Social class and health status in Ghana. Current Sociology, 5(4), 531-553. https://doi.org/10.1177/0011392102050004004
  15. Boateng, K. A., Danso-Appiah, A., Turkson, B. K., & Tersbøl, B. P. (2016). Integrating biomedical and herbal medicine in Ghana – experiences from the Kumasi South Hospital: A qualitative study. BMC Complementary and Alternative Medicine, 16(189). https://doi.org/10.1186/s12906-016-1163-4
  16. Busia, K. A. (2023). K. A. Busia on Africa: Africa in search of democracy. Routledge. https://doi.org/10.4324/9781003260295
  17. Chitnis, T., & Khoury, S. J. (2022). Neuroimmunology. In J. Jankovic, J. C. Mazziotta, S. L. Pomeroy, & N. J. Newman (Eds.), Bradley and Daroff’s Neurology in Clinical Practice (8th ed., pp. 709-729). Elsevier Inc.
  18. Compston, A., Lassmann, H., & McDonald I. (2006). The story of multiple sclerosis. In A. Compston, C. Confavreux, H. Lassmann, I. McDonald, D. Miller, J. Noseworthy, K. Smith, & H. Wekerle (Eds.), McAlpine’s Multiple Sclerosis (4th ed., pp. 3-68). Churchill Livingstone.
  19. Creswell, J. W. (2013). Qualitative inquiry and research design: Choosing among five approaches (3rd ed.). SAGE Publications, Inc.
  20. Dehghani, A. (2021). Health literacy in multiple sclerosis patients: A concept analysis using the evolutionary method. Journal of Caring Sciences, 10(1), 49-56. https://doi.org/10.34172/jcs.2021.010
  21. Dowd, F. J., & Norton, N. S. (2014). Multiple sclerosis. In M. Caplan (Ed.), Reference module in biomedical research (pp. 1-6). Elsevier. https://doi.org/10.1016/B978-0-12-801238-3.05157-6
  22. Ekholuenetale, M., Nzoputam, C. I., & Barrow, A. (2021). Prevalence and socioeconomic inequalities in eight or more antenatal care contacts in Ghana: Findings from 2019 population-based data. International Journal of Women’s Health, 13, 349-360. https://doi.org/10.2147/IJWH.S306302
  23. Ercolini, A. M., & Miller, S. D. (2009). The role of infections in autoimmune disease. Clinical and Experimental Immunology, 155(1), 1-15. https://doi.org/10.1111/j.1365-2249.2008.03834.x
  24. Faran, E. K., Waggas, D. S., Alkhunani, T. A., Almuwallad, S. A., & Aljohani, R. A. (2021). Assessment of multiple sclerosis awareness and knowledge among the community of Jeddah, Saudi Arabia. Journal of Neurosciences in Rural Practice, 12(4), 733-738. https://doi.org/10.1055/s-0041-1734009
  25. Ghazvini, P. (2010). Introduction: Immunology and autoimmune diseases. Journal of Pharmacy Practice, 23(2), 85. https://doi.org/10.1177/0897190010362456
  26. Gordon, T., Booysen, F., & Mbonigaba, J. (2020). Socioeconomic inequalities in the multiple dimensions of access to healthcare: The case of South Africa. BMC Public Health, 20, 289. https://doi.org/10.1186/s12889-020-8368-7
  27. Humphries, C. (2012). Progressive multiple sclerosis: The treatment gap. Nature, 484, S10. https://doi.org/10.1038/nature11108
  28. Jasinski, L., Nokkala, & Juusola, H. (2021). Reflecting on the value of vignettes in higher education research: Toward a preliminary typology to guide future usage. European Journal of Higher Education, 11(1), 522-536. https://doi.org/10.1080/21568235.2021.1999841
  29. Jimmy, B., & Jose, J. (2011). Patient medication adherence: Measures in daily practice. Oman Medical Journal, 26(3), 155-159. https://doi.org/10.5001/omj.2011.38
  30. Kahissay, M. H., Fenta, T. G., & Boon, H. (2017). Beliefs and perception of ill-health causation: A socio-cultural qualitative study in rural North-Eastern Ethiopia. BMC Public Health, 17(1), 124. https://doi.org/10.1186/s12889-017-4052-y
  31. Karamangi, H. C., Ben Charif, A., Afriyie, D. O., Sy, S., Kipruto, H., Oyelade, T., & Droti, B. (2023). Mapping health service coverage inequalities in Africa: A scoping review protocol. BMJ Open, 13(5). https://doi.org/10.1136/bmjopen-2022-068903
  32. Kpobi, L., & Swartz, L. (2019). Indigenous and faith healing in Ghana: A brief examination of the formalising process and collaborative efforts with the biomedical health system. African Journal of primary health care & family medicine, 11(1), 1-5. https://doi.org/10.4102/phcfm.v11i1.2035
  33. Kuuire, V. Z., Bisung, E., Rishworth, A., Dixon, J., & Luginaah, I. (2016). Health-seeking behaviour during times of illness: A study among adults in a resource poor setting in Ghana. Journal of Public Health, 38(4), 545-553. https://doi.org/10.1093/pubmed/fdv176
  34. Makhani, N., & Tremlett, H. (2021). The multiple sclerosis prodrome. Nature Reviews Neurology, 17, 515-521. https://doi.org/10.1038/s41582-021-00519-3
  35. Mbiti, J. S. (1990). African religions and philosophies (2nd ed.). Heinemann Educational Publishers.
  36. Nyamah, I., & Diko, S. (2013). Poverty effects on child development in Ghana: Evidence from households and street children in the Northern region of Ghana. Lambert Academic Publishing.
  37. Okyerefo, M. P. K., & Fiaveh, D. Y. (2017). Prayer and health-seeking beliefs in Ghana: Understanding the ‘religious space’ of the urban forest. Health Sociology Review, 26(3), 308-320. https://doi.org/10.1080/14461242.2016.1257360
  38. Olenja, J. (2003). Health seeking behaviour in context. East African Medical Journal, 80(2), 61-62. https://doi.org/10.4314/eamj.v80i2.8689
  39. Pathak, K., & Das, R. J. (2013). Herbal medicine – A rational approach in health care system. International Journal of Herbal Medicine, 1(3), 86-89.
  40. Patton, M. Q. (1990). Qualitative evaluation and research methods (2nd ed.). Sage.
  41. Quansah, E., Ohene, L. A., Norman, L., Mireku, M. O., & Karikari, T. K. (2016). Social factors influencing child health in Ghana. PLoS ONE, 11(1). https://doi.org/10.1371/journal.pone.0145401
  42. Quashigah, K. (2015). Religion and the secular state in Ghana. Religion and the Secular State, 331-340.
  43. Racke, M. K., Frohman, E. M., & Frohman, T. (2022). Pain in multiple sclerosis: Understanding pathophysiology, diagnosis, and management through clinical vignettes. Frontiers in Neurology, 12. https://doi.org/10.3389/fneur.2021.799698
  44. Read, U. (2012). “I want the one that will heal me completely so it won’t come back again”: The limits of antipsychotic medication in rural Ghana. Transcultural psychiatry, 49(3-4), 438-460. https://doi.org/10.1177/1363461512447070
  45. Reay, T., Zafar, A., Monteiro, P, & Glase, V. (2019). Presenting findings from qualitative research: One size does not fit all! In T. B. Zilber, J. M. Amis & J. Mair (Eds.), The production of managerial knowledge and organizational theory: New approaches to writing, producing and consuming theory (Research in the Sociology of Organizations, Vol. 59, pp. 201-216). Emerald Publishing Limited. https://doi.org/10.1108/S0733-558X20190000059011
  46. Sasu, D. D. (2023, January 20). Religious affiliation in Ghana as of 2010-2021. Statista. https://www.statista.com/statistics/1172414/religious-affiliation-in-ghana/
  47. Senah, K. (2004). In the mighty name of Jesus: Faith healing and health-seeking behaviour in Ghana. Legon Journal of Sociology, 1(1), 59-70.
  48. Smith, J. A., & Osborn, M. (2008). Interpretative phenomenological analysis. In J. A. Smith (Ed.), Qualitative psychology: A practical guide to research methods (pp. 53-80). SAGE Publications.
  49. Sompayrac, L. (2019). How the immune system works (6th ed.). Wiley-Blackwell.
  50. Stanifer, J. W., Maro, V., Egger, J., Karia, F., Thielman, N., Turner, E. L., Shimbi, D., Kilaweh, H., Matemu, O., & Patel, U. D. (2015). The epidemiology of chronic kidney disease in Northern Tanzania: A population-based survey. PLoS ONE, 10(4). https://doi.org/10.1371/journal.pone.0124506
  51. Suwakhong, D., & Liamputtong, P. (2015). Cultural insiders and research fieldwork: Case examples from cross-cultural research with Thai people. International Journal of Qualitative Methods, 14(5), 1-7. https://doi.org/10.1177/1609406915621404
  52. Takyi, B. K. (2003). Religion and women’s health in Ghana: Insights into HIV/AIDs preventive and protective behaviour. Social Science & Medicine, 56(6), 1221-1234. https://doi.org/10.1016/s0277-9536(02)00122-3
  53. Takyi, B. K., & Addai, I. (2002). Religious Affiliation, Marital Processes and Women’s Educational Attainment in a Developing Society. Sociology of Religion, 63(2), 177. https://doi.org/10.2307/3712564
  54. Takyi, B., Opoku-Agyeman, C., & Kutin-Mensah, A. (2010). Religion and the Public Sphere: Religious Involvement and Voting Patterns in Ghana’s 2004 Elections. Africa Today, 56, 62–86. https://doi.org/10.1353/at.0.0117
  55. White, P. (2015). The concept of diseases and healthcare in African traditional religion in Ghana. HTS Theological Studies, 71(3). https://doi.org/10.4102/hts.v71i3.2762
  56. Yarney, L., Adjei-Mensah, E., Darko, J., & Frempong, A. N. A. (2022). Health-seeking behaviour among Ghanaian urban residents: A quantitative exploratory case study. Research Journal in Medical and Health Sciences, 3(1), 12-24.