Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-28T03:20:15.459Z Has data issue: false hasContentIssue false
  • English
  • Français

Provider perspectives on Asram in Ghana

Published online by Cambridge University Press:  19 April 2021

Sharla Rent Open the ORCID record for Sharla Rent [Opens in a new window] ,
Ashura Bakari ,
Gyikua Plange-Rhule ,
Yemah Bockarie ,
Stephanie Kukora  and
Cheryl A. Moyer Open the ORCID record for Cheryl A. Moyer [Opens in a new window]
Sharla Rent*
Affiliation:
Department of Pediatrics, Duke University, Durham, NC, USA
Ashura Bakari
Affiliation:
Suntreso Government Hospital, Ghana Health Service, Kumasi, Ghana
Gyikua Plange-Rhule
Affiliation:
Department of Pediatrics, Komfo Anokye Teaching Hospital, Kumasi, Ghana
Yemah Bockarie
Affiliation:
Cape Coast Teaching Hospital, Cape Coast, Ghana
Stephanie Kukora
Affiliation:
Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
Cheryl A. Moyer
Affiliation:
Departments of Learning Health Sciences and Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
*
*Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Neonatal mortality is one of the leading causes of under-five mortality globally, with the majority of these deaths occurring in low- and middle-income countries. In Ghana, there is a belief in an array of newborn conditions, called Asram, that are thought to have a spiritual, rather than physical, cause. These conditions are predominantly managed by traditional healers as they are considered unable to be treated by allopathic medical providers. Through a series of semi-structured qualitative interviews of medical providers in Kumasi, Ghana, conducted in July–August 2018, this study sought to elucidate perspectives of allopathic medical providers about Asram, including the perceived implications of traditional newborn care patterns on newborn health and higher-level neonatal care. Twenty health care providers participated and represented a tertiary care hospital and a district hospital. Medical providers were universally aware of Asram but varied on the latitude they gave this belief system within the arena of newborn care. Some providers rationalized the existence of Asram in the backdrop of high neonatal mortality rates and long-standing belief systems. Others highlighted their frustration with Asram, citing delays in care and complications due to traditional medical treatments. Providers utilized varying approaches to bridge culture gaps with families in their care and emphasized the importance of open communication with the shared goal of improved newborn health and survival. This study describes the importance of providers being aware of socio-cultural constructs within which pregnant women operate and suggests a focus on the shared goal of timely and effective newborn care in Ghana.

Keywords

Global HealthNewborn HealthGhana
Type
Research Article
Information
Journal of Biosocial Science , Volume 54 , Issue 3 , May 2022 , pp. 437 - 449
Copyright
© The Author(s) 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abdullahi, AA (2011) Trends and challenges of traditional medicine in Africa. African Journal of Traditional, Complementary and Alternative Medicines 8 (Supplement 5), 115–123.CrossRefGoogle ScholarPubMed
Attride-Stirling, J (2001) Thematic networks: an analytic took for qualitative research. Qualitative Research 1(3), 385–405.CrossRefGoogle Scholar
Bazzano, AN, Kirkwood, BR, Tawiah-Agyemang, C, Owusu-Agyei, S and Adongo, PB (2008) Beyond symptom recognition: care-seeking for ill newborns in rural Ghana. Tropical Medicine and International Health 13(1), 123–128.CrossRefGoogle ScholarPubMed
Bell, A J, Arku, Z, Bakari, A, Oppong, SA, Youngblood, J, Adanu, RM and Moyer, CA (2020) ‘This sickness is not hospital sickness’: a qualitative study of the evil eye as a source of neonatal illness in Ghana. Journal of Biosocial Science 52(2), 159–167.CrossRefGoogle Scholar
Dako-Gyeke, P, Aikins, M, Aryeetey, R, Mccough, L and Adongo, PB (2013) The influence of socio-cultural interpretations of pregnancy threats on health-seeking behavior among pregnant women in urban Accra, Ghana. BMC Pregnancy Childbirth 13, 211.CrossRefGoogle ScholarPubMed
Engmann, CM, Adongo, PB, Aborigo, RA, Gupta, M, Logonia, G, Affah, G et al. (2013) Infant illness spanning the antenatal to early neonatal continuum in rural northern Ghana: local perceptions, beliefs and practices. Journal of Perinatology 33(6), 476–481.CrossRefGoogle ScholarPubMed
Farnes, C, Beckstrand, RL and Callister, LC (2011) Help-seeking behaviours in childbearing women in Ghana, West Africa. International Nursing Review 58(4), 491–497.CrossRefGoogle ScholarPubMed
Ganle, JK and Dery, I (2015) 'What men don’t know can hurt women’s health': a qualitative study of the barriers to and opportunities for men’s involvement in maternal healthcare in Ghana. Reproductive Health 12, 93.CrossRefGoogle ScholarPubMed
Ganle, JK, Dery, I, Manu, AA and Obeng, B (2016) 'If I go with him, I can’t talk with other women': understanding women’s resistance to, and acceptance of, men’s involvement in maternal and child healthcare in northern Ghana. Social Science & Medicine 166, 195–204.CrossRefGoogle ScholarPubMed
Gold, KJ, Abdul-Mumin, AP, Boggs, ME, Opare-Addo, HS and Lieberman, RW (2014) Assessment of ‘fresh’ versus ‘macerated’ as accurate markers of time since intrauterine fetal demise in low-income countries. International Journal of Gynaecology and Obstetrics 125(3), 223–227.CrossRefGoogle ScholarPubMed
Gold, KJ, Jayasuriya, TG, Silver, JM, Spangenberg, K, Wobil, P and Moyer, CA (2013) How well do mothers in Ghana understand why their newborn is hospitalized? Paediatrics and International Child Health 33(3), 181–186.CrossRefGoogle ScholarPubMed
Gupta, ML, Aborigo, RA, Adongo, PB, Rominski, S, Hodgson, A, Engmann, CM and Moyer, CA (2015) Grandmothers as gatekeepers? The role of grandmothers in influencing health-seeking for mothers and newborns in rural northern Ghana. Global Public Health 10(9), 1078–1091.CrossRefGoogle ScholarPubMed
Hill, E, Hess, R, Aborigo, RA, Adongo, PB, Hodgson, A, Engmann, CM and Moyer, CA (2014) ‘I don’t know anything about their culture’: the disconnect between allopathic and traditional maternity care providers in rural northern Ghana. African Journal of Reproductive Health 18(2), 36–45.Google Scholar
Hill, Z, Kendall, C, Arthur, P, Kirkwood, B and Adjei, E (2003) Recognizing childhood illnesses and their traditional explanations: exploring options for care-seeking interventions in the context of the IMCI strategy in rural Ghana. Tropical Medicine and International Health 8(7), 668–676.CrossRefGoogle ScholarPubMed
Kennedy, BM, Rehman, M, Johnson, WD, Magee, MB, Leonard, R and Katzmarzyk, PT (2017) Healthcare providers versus patients’ understanding of health beliefs and values. Patient Experience Journal 4(3), 29–37.CrossRefGoogle ScholarPubMed
Krah, E, De Kruijf, J and Ragno, L (2018) Integrating traditional healers into the health care system: challenges and opportunities in rural northern Ghana. Journal of Community Health 43(1), 157–163.CrossRefGoogle ScholarPubMed
Ghana Ministry of Health (2017) Holistic Assessment of 2017 Health Sector Programme of Work. URL: https://www.moh.gov.gh/wp-content/uploads/2018/09/2017-Holistic-Assessment-Report_Final_09.08.2018.pdf (accessed 4th January 2021).Google Scholar
Okyere, E, Tawiah-Agyemang, C, Manu, A, Deganus, S, Kirkwood, B and Hill, Z (2010) Newborn care: the effect of a traditional illness, asram, in Ghana. Annals of Tropical Paediatrics 30(4), 321–328.CrossRefGoogle ScholarPubMed
Sumankuuro, J, Mahama, MY, Crockett, J, Wang, S and Young, J (2019) Narratives on why pregnant women delay seeking maternal health care during delivery and obstetric complications in rural Ghana. BMC Pregnancy Childbirth 19(1), 260.CrossRefGoogle ScholarPubMed
Tabi, MM, Powell, M and Hodnicki, D (2006) Use of traditional healers and modern medicine in Ghana. International Nursing Review 53(1), 52–58.CrossRefGoogle ScholarPubMed
Tong, A, Sainsbury, P and Craig, J (2007) Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal of Qualitative Health Care 19(6), 349–357.CrossRefGoogle ScholarPubMed
UNICEF (2018) Global Under-Five, Infant and Neonatal Mortality Rates, 1990–2017. URL: https://data.unicef.org/topic/child-survival/under-five-mortality/ (accessed 4th January 2021).Google Scholar
UNICEF (2020) Country Profile: Ghana. URL: https://data.unicef.org/country/gha/ (accessed ???? 2021).Google Scholar
World Bank (2017) Maternal Health Survey 2017. Ghana Statistical Service Accra, Ghana. URL: https://microdata.worldbank.org/index.php/catalog/3186 (accessed 4th January 2021).Google Scholar
World Health Organization (2015) Estimates for Child Causes of Death 2000–2015. URL: http://www.who.int/healthinfo/global_burden_disease/estimates_child_cod_2015/ (accessed Jan 4, 2021).Google Scholar
World Health Organization (2019) World Health Statistics Data Visualizations Dashboard. URL: http://apps.who.int/gho/data/view.sdg.3-2-data-reg?lang=en (accessed 4th January 2021).Google Scholar