Disease classification in rural Ghana: Framework and implications for health behaviour

Abstract

The prime concern of this paper is twofold: to investigate how the people of Berekuso, a rural community in Ghana, classify diseases; and to examine the extent to which this classification affects the utilization of existing health care facilities. Previous research on this topic has been conducted by identifying beliefs and behaviour at the same point in time, thus confounding beliefs with behaviour. In this study, however, a two-phase interview survey of a systematic sample of households was adopted. It was found that the basis of the disease classification system is what is believed to be the cause or source of a disease. This is because the diagnosis of the cause of a disease is the most important aspect of therapy. Using the cause as the main distinguishing factor, diseases are classified into three main types—diseases which are believed to be caused by natural agents, those which are believed to be caused by supernatural agents, and those whose causes embrace both natural and supernatural agents. This classification counters some previous assertions that Africans, and preliterate people generally, classify diseases only in supernatural terms. The study revealed that the way diseases are classified affects utilization behaviour. In this regard, the knowledge of the cause of a disease allowed a fairly accurate prediction of what health care facility would be used.