‘This disease is not meant for the hospital, it is Asram’: Implications of a traditionally-defined illness on healthcare seeking for children under-5 in rural Ashanti, Ghana
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Date
2022
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PLOS ONE
Abstract
Every child has the right to survive, grow and develop. However, in spite of the considerable
global gains that have been made in child survival, Sub-Saharan Africa still has the highest
child mortality rates and accounts for the greatest burden of mortality globally. The majority
of these children die without ever reaching a health facility. The practice of appropriate
healthcare-seeking behaviour has a great potential to reduce the occurrence of severe and
life-threatening childhood illnesses. Several factors, however, influence healthcare-seeking
behaviour, including perceptions of the cause of illness and socio-cultural perspectives.
This study seeks to understand local concepts of a traditionally-defined illness complex,
Asram, and its influence on healthcare seeking behavior of mothers/caregivers. This qualita tive
study was conducted from October 2019 to February 2020. Four Focus Group Discus sions were
conducted with mothers/caregivers of children under-5 and 22 Key Informant Interviews with
mothers/caregivers of children who had Asram, health workers at district, facility, and community
levels, and Asram healers. Participants were selected from two rural communities, Akutuase and
Wioso of the Asante Akim North district in the Ashanti region of Ghana. Data analysis was carried
out iteratively throughout data collection, using a thematic analysis approach. The study shows that
Asram is a childhood illness complex that is per ceived to have been acquired spiritually and/or
inherited. Nine types of Asram were described. This childhood illness was said to be treatable by
Asram healers who had sub specialties in treatment approaches that were determined by the
Asram type reported. Mothers/caregivers trusted Asram healers and preferred to call on them first.
This was found to be the main reason for delays in seeking healthcare for children under-5 who
showed symptoms of Asram. Asram is a childhood illness complex that is believed to be bet ter
managed outside the health facility setting. This study complements existing knowledge
Description
This article is published by Plos One and is also available at https://doi.org/10.1371/journal.pgph.0000978
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Citation
Acheampong PR, Mohammed A, Twumasi-Ankrah S, Sylverken AA, Owusu M, Acquah-Gyan E, et al. (2022) ‘This disease is not meant for the hospital, it is Asram’: Implications of a traditionally-defined illness on healthcare seeking for children under-5 in rural Ashanti, Ghana. PLOS Glob Public Health 2(9): e0000978