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Healer shopping in Africa: new evidence from rural-urban qualitative study of diabetes experiences

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  • de-Graft Aikins, Ama

Abstract

Objectives To provide counterevidence to existing literature on healer shopping in Africa through a systematic analysis of illness practices by Ghanaians with diabetes; to outline approaches towards improving patient centred health care and policy development regarding diabetes in Ghana. Design Longitudinal qualitative study with individual interviews, group interviews, and ethnographies. Settings Two urban towns (Accra, Tema) and two rural towns (Nkoranza and Kintampo) in Ghana. Participants 26 urban people and 41 rural people with diabetes with diverse profiles (sex, age, education, socioeconomic status, diabetes status). Results Six focus groups, 20 interviews, and three ethnographical studies were conducted to explore experiences and illness practices. Analysis identified four kinds of illness practice: biomedical management, spiritual action, cure seeking (passive and active), and medical inaction. Most participants privileged biomedicine over other health systems and emphasised biomedical management as ideal self care practice. However, the psychosocial impact of diabetes and the high cost of biomedical care drove cure seeking and medical inaction. Cure seeking constituted healer shopping between biomedicine, ethnomedicine, and faith healing; medical inaction constituted passive disengagement from medical management and active engagement with faith healing. Crucially, although spiritual causal theories of diabetes existed, they were secondary to dietary, lifestyle, and physiological theories and did not constitute the primary motivation for cure seeking. Cure seeking within unregulated ethnomedical systems and non-pharmacological faith healing systems exacerbated the complications of diabetes. Conclusions To minimise inappropriate healer shopping and maximise committed biomedical and regulated ethnomedical management for Ghanaians with diabetes, the greatest challenges lie in providing affordable pharmaceutical drugs, standardised ethnomedical drugs, recommended foods, and psychosocial support. For health systems, the greatest challenges lie in correcting structural deficiencies that impinge on biomedical practices, regulating ethnomedical diabetes treatment, and foregrounding faith healer practices within diabetes policy discussions.

Suggested Citation

  • de-Graft Aikins, Ama, 2005. "Healer shopping in Africa: new evidence from rural-urban qualitative study of diabetes experiences," LSE Research Online Documents on Economics 49550, London School of Economics and Political Science, LSE Library.
    • Handle: RePEc:ehl:lserod:49550
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    File URL: http://eprints.lse.ac.uk/49550/
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    References listed on IDEAS

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    1. DeJong, Jocelyn, 1991. "Traditional medicine in sub-Saharan Africa : its importance and potential policy options," Policy Research Working Paper Series 735, The World Bank.
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    Cited by:

    1. Victor Mogre & Natalie A. Johnson & Flora Tzelepis & Christine Paul, 2019. "Barriers to diabetic self‐care: A qualitative study of patients’ and healthcare providers’ perspectives," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(11-12), pages 2296-2308, June.
    2. Olutobi Adekunle Sanuade & Sandra Boatemaa & Mawuli Komla Kushitor, 2018. "Hypertension prevalence, awareness, treatment and control in Ghanaian population: Evidence from the Ghana demographic and health survey," PLOS ONE, Public Library of Science, vol. 13(11), pages 1-18, November.
    3. Mukolo, Abraham & Cooil, Bruce & Victor, Bart, 2015. "The effects of utility evaluations, biomedical knowledge and modernization on intention to exclusively use biomedical health facilities among rural households in Mozambique," Social Science & Medicine, Elsevier, vol. 138(C), pages 225-233.
    4. Sato, Azusa, 2012. "Does socio-economic status explain use of modern and traditional health care services?," Social Science & Medicine, Elsevier, vol. 75(8), pages 1450-1459.
    5. Santah, Colette & Bröer, Christian, 2022. "Agency through medicalization: Ghanaian children navigating illness, medicine and adult resistance," Social Science & Medicine, Elsevier, vol. 315(C).
    6. Jiannan Li & Bocong Yuan, 2019. "Rural‐urban disparity in risk exposure to involuntary social health insurance transition in China: An investigation of chronic disease patients' mental health problems," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1760-1773, October.
    7. John W Stanifer & Uptal D Patel & Francis Karia & Nathan Thielman & Venance Maro & Dionis Shimbi & Humphrey Kilaweh & Matayo Lazaro & Oliver Matemu & Justin Omolo & David Boyd & Comprehensive Kidney D, 2015. "The Determinants of Traditional Medicine Use in Northern Tanzania: A Mixed-Methods Study," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-17, April.
    8. Delali A. Dovie, 2018. "Leveraging Healthcare Opportunities for Improved Access among Ghanaian Retirees: The Case of Active Aging," Social Sciences, MDPI, vol. 7(6), pages 1-18, June.
    9. de-Graft Aikins, Ama, 2006. "Reframing applied disease stigma research: a multilevel analysis of diabetes stigma in Ghana," LSE Research Online Documents on Economics 49551, London School of Economics and Political Science, LSE Library.
    10. P. M. Amegbor, 2017. "An Assessment of Care-Seeking Behavior in Asikuma-Odoben-Brakwa District: A Triple Pluralistic Health Sector Approach," SAGE Open, , vol. 7(2), pages 21582440177, June.
    11. Isaac Addai & Chris Opoku-Agyeman & Sarah Amanfu, 2014. "Exploring Predictors of Subjective Well-Being in Ghana: A Micro-Level Study," Journal of Happiness Studies, Springer, vol. 15(4), pages 869-890, August.

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    More about this item

    Keywords

    diabetes; complementary medicine; diet;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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