afrol News, 24 March - More than one third of Ghana's population believe that AIDS is caused by witchcraft. But large-scale intervention programmes for improving health standards aree starting to convince people to trust medical explanations of the disease, researchers find.
Belief in supernatural forces is common in Ghana and other African countries. Death, suffering and diseases are often attributed to witchcraft. Over thirty percent of Ghanaians believe such evil forces could be responsible for the spread of HIV/AIDS, according to research data.
Ghanaian PhD-student Phyllis Antwi and Norwegian professor and sociologist Knud Knudsen from the University of Stavanger have examined data from the Ghana Demographic and Health Survey of 2003, involving 10,000 respondents of both sexes between the ages of 15-49. Their analysis is to be published in the international journal 'Global Health Promotion' later this year.
In the large survey, a unique starting point for trying to understand Ghanaians' attitudes and practices in relation to AIDS is provided, Mr Knudsen explains. In addition to fertility and family planning in Ghana, the survey charted people's awareness and conduct towards AIDS and other diseases. Respondents were asked about alternative transmittance models, thereby enabling the researchers to compare their perceptions with modern medical knowledge.
Mr Knudsen thinks the belief in witchcraft as a cause of AIDS is an underestimated factor when developing relevant health programmes in Africa. Implementing standard programmes could be "difficult if people do not understand how the disease is transmitted."
"To Ghanaians in general, witchcraft is a fact of life. Women who have been declared witches are often expelled, and forced to live in special villages. People may feel sorry for them, but this does not seem to alter their belief in witchcraft as a brutal reality," Mr Knudsen says.
But people do live in both a traditional and modern world at the same time. They may be Christians or Muslims, while still holding on to their traditional African religious beliefs. "They may listen to the priest, but they also listen to the local witch doctor. If people fall ill, consulting a physician is not necessarily their first choice."
Mr Knudsen hopes to use this knowledge to understand the different rates of HIV spread in Ghanaian regions. "The spread of AIDS is usually larger in less well-off areas. With lower income, little education and a higher share of illiteracy, Ghana's northern regions are traditionally poorer than the southern ones. Still, people in the Upper East Region seem to have a better grasp of the actual infection mechanism behind this terrible epidemic," Mr Knudsen says.
People living in the poorer northern regions have b
Phyllis Antwi holds up Navrongo and Upper East Region as examples of Ghana-based health programmes
enefited from previous medical initiatives. This may explain their readiness to trust medical expertise, the researchers found. Long-term health programmes were implemented in the Upper East Region, years before the area was affected by the AIDS epidemic.
In 1987, a well-known project for monitoring the effects of vitamin A distribution was initiated in the Kassena-Nankana district. Health conditions among children suffering from diarrhoea, bronchial diseases and measles, were significantly improved by the programme. Furthermore, the strain on health services was eased. Initiatives supporting nurses in health care services contributed to a 60 percent reduction in child mortality rates, compared with similar regions.
"Support among local chiefs and village elders is crucial when launching new initiatives," professor Knudsen points out. "After people have experienced that the science-based medical model works, they tend to accept it."
Although Ghana is not among the African nations most severely affected by the AIDS epidemic, the problems there are still serious. Around three percent of the population is infected, which is relatively low compared to other countries sub-Saharan countries. But it remains a big strain on society as modern medical aid is expensive. There are ongoing discussions in Ghana about how patients should be treated, and how to cover the costs.
Ghanaian researcher Phyllis Antwi, who is an experienced health administrator and teacher at the Accra School of Public Health, holds that Ghana can point at good examples on how to treat the AIDS pandemic effectively by using knowledge about local structures and beliefs.
Health education in Africa has often been characterised by a top-down, Western approach. A number of campaigns have demonstrated international organisations' limited understanding of the African mindset. But Ms Antwi holds up Navrongo and Upper East Region as evidence of the success of long-term, goal-oriented efforts of the opposite approach.
Mr Knudsen refers to local dance groups, like those seen in Ghana, as "an example of a better approach." These dancers had proven themselves to be very effective, especially in addressing young people.
"Being a country with high illiteracy rates, Ghana has a strong oral tradition. Combining this with traditional dancing, these groups are successfully promoting health education in rural areas," Mr Knudsen says. "If one understands people's mindset, one is more likely to connect with them."
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