The Sociology of Healthcare utilization in Ghana; where do we stand? (Part 1)

By: K. Bamfo-Addo

To fully explore issues of health utilization would be to assume that once a patient gets to a health facility in time he/she would have optimum and quality care. (A big assumption that would be, but an important one, nonetheless, to understand the concept). Healthcare utilization refers to the use of available services by persons for the purpose of preventing and curing health problems, promoting maintenance of health and well-being, or obtaining information about one’s health status and prognosis. While it is easier to always blame the Ghanaian healthcare system for poor delivery of service, the issue of healthcare utilization aims to shift the discussion now, to how we as a citizenry efficiently harness already existing mechanisms and institution for good health. This relevant subject is a significant area in medical sociology, (a field which in itself was largely ignored in medicine until probably in the past century or so).

Simply put: what social factors prevent us from reaching health centres or using health tools in time? Answering this, and other questions of health utilization and behaviours for any given locality would require a fair understanding of the history, culture, economics and the politics  of that place. This, probably is what sometimes makes the issues with healthcare in Ghana a fierce animal to tame. It may not be too far fetched to estimate a proportionate number of mortalities in our major hospitals to be associated with late presentations. And if that is indeed the case, we ought then to give the barriers to health utilization enough priority as other issues in the health policy processes.

Culture. Africa prides itself in its rich culture and diversity, an enviable trait which comes with its woes. As we are all ardent believers and of what has been handed down the centuries, we cannot elude the enormous proof and benefit of science and technology. Culture must in our generation be modelled to suit the times. This would require careful conscientious re-education of our societies. The influence of culture on health is vast. It affects perceptions of health, illness and death, beliefs about causes of disease, approaches to health promotion, how illness and pain are experienced and expressed, where patients seek help, and the types of treatment patients prefer. Among some African tribes for instance, children with neonatal teeth have been killed soon after the birth, as it was believed to bring misfortune.  Sadly and regrettably, I have encountered a patient who refused expert medical care because the doctor was from a particular ethnic group. Not far from many homes in rural communities are the unexplainable bizarre cultural remedies  to some ailments; drinking one’s urine to cure typhoid, using cattle excreta as dressing for boils, among others. While alternative medicine has its role in the healthcare system it should be founded on science, hygiene and technology. Where do we go from here? Culture is inherent in our nature, but culture is also dynamic. So we may have to build on its dynamism to steer and refine it towards development rather.

An increase in the level of formal education among people has been proven to affect how they prioritize their health. People with adequate knowledge on the complications of untreated disease conditions tend to visit health centers regularly for general medical examinations for early detection and treatment of illnesses.  While uneducated individuals are likely to delay from other interacting reasons until illnesses have advanced before seeking medical treatment.

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