Abstract:
Cancer has become a major public health problem worldwide. In sub-Saharan Africa and in Ghana in particular, the considerable increase in cancer incidence has become an issue of great concern. However, cancer research in developing countries has been scanty, with most of these researches being quantitative and biomedical in nature, and focusing on treatments. This research examines the behavioural perspective of cancer patients regarding their choice of health care. This involves their conceptualization of their illness with respect to illness causation, reasons for and implications of their choices. This study is based on the theory of illness causation advanced by Foster (1979) and Murdock et al. (1976) which indicates that belief about illness causation, as embedded in people’s culture, is fundamental to understanding the health care patterns and attitude of the sick in any given society.
Focused ethnographic approach was used to collect in-depth information for this study. After obtaining institutional ethical approval, purposive sampling technique was used to recruit 35 patients with varied types and at different stages of cancer from the Komfo Anokye Teaching Hospital in Kumasi. Semi-structured interviews were conducted through face to face interactions with patients to explore their beliefs on illness causation and how these influence their choice of health care. Also, two (2) medical doctors, four (4) nurses, managers of three (3) herbal centres and one (1) herbal/spiritual centre were interviewed. Fifteen (15) family members of cancer patients who were at the hospital were also interviewed. All interviews were audiotaped and transcribed for thematic content analysis.
The study revealed that cancer patients ascribed both physical and spiritual causality to their illness. As such, they combined orthodox treatment with spiritual healing, in essence, “giving to Caesar what is Caesar’s and to God what is God’s”. Regarding the order of therapeutic search, patients reported to herbal and spiritual centres before coming to the hospital, a phenomenon which accounts for the late reporting and diagnosis as well as bad prognosis of cancers in Ghana. The findings of this research elucidate on the relationship between culture and health care choices of cancer patients in Ghana.
