Every individual craves to be accepted as a member of a cultural group. Inevitably, every one belongs to one group or the other and is easily identified as a member of the group when he conforms to a particular way of life. This way of life makes us cultural beings. This article seeks to bring to light some cultural practices and beliefs that affect health care delivery and its access in Ghana.

Culture is defined as the shared patterns of behaviors and interactions, cognitive constructs, and affective understanding that are learned through a process of socialization. These shared patterns identify the members of a culture group while also distinguishing those of another group.

It is not merely material objects and other tangible aspects of human societies but the way people within a particular culture usually interpret the meaning of symbols, artifacts, and behaviors in the same or in similar ways; this is referred to as cultural behavior.

The characteristics of culture are defined by everything from language, religion, cuisine, social habits, music, attitudes about health and arts. Health care refers to the organized provision of medical care to individuals or a community. It encompasses the diagnosis, treatment, and prevention of disease, illness, injury, and sickness.

It involves taking preventive or necessary medical procedures to improve a person's well-being. This may be done with surgery, the administering of medicine, or other alterations in a person's lifestyle. Health care systems are basically made up of hospitals, clinics, health care volunteers and physicians.

A well-functioning health care system requires a robust financing mechanism, a well-trained and adequately-paid workforce, reliable information on which to base decisions and policies, and well maintained facilities and logistics to deliver quality medicines and technologies.

Health care is conventionally regarded as an important determinant in promoting the general physical, mental health and well-being of people around the world and contribute to a significant part of a country's economy.

Some cultural factors influence health care delivery and its access in Ghana. To better understand these influences some instances have been provided below.

 In a conversation with some friends, I realized that, there are times when people self-medicate instead of going to the hospital. I assume such people consider traditional treatment of diseases are better than the orthodox. Their "excuse" may be that, our forefathers never visited the hospital but were very strong and lived longer as compared to recent years.

 My maternal grandmother once told me that, although traditional birth attendants may be unskilled, delivering at home showed a mark of bravery and fidelity to husbands and therefore a woman who died during childbirth was considered as having an extra-marital affair.

This is the reason why some women who utilize hospitals and the like for delivery of babies refuse to be operated on during child birth. This so called “natural birth” sometimes leads to the death of the mothers and distress of the babies.
 
 I also learnt from the internet that, there have also been cases when female patients have refused to be attended to by male doctors mostly in the Northern part of Ghana. They believe a man should not see the nakedness of any woman except that of his wife. They hold this believe so high that, male traditional birth attendants in that part of the Country claim that during the delivery of babies, they do not see the nakedness of the woman. Their concentration is only on the baby. The mother may even be bleeding excessively and they may not realize it because of this "see no evil" attitude.

 Some other people are not necessarily against orthodox medicine, they just have a preference for traditional treatments since they believe one herb can cure many ailments while doctors prescribe too many different drugs.

*They profess to know more about health care than orthodox health care providers, not realizing that everyone has a field of knowledge*. Strictly, they prefer to take only traditional medicine to treat their diseases. This sometimes leads to the use of poisonous herbs for treatment. While the medicinal properties of herbs cannot be denied, in some cases herbs may be harmful and may result in severe infections or even death.

The history of disease treatment as outlined on the internet says that, in precolonial Ghana, traditional village priests were important in providing treatment for the sick. The role of village priests in the medical sphere reflected the belief that unexplained illness, misfortune, and premature deaths were caused by supernatural agents.

They were perceived as punishments for breaking taboos and other agents. In the treatment of such illnesses, the usual process was for the priest to use divination to determine the source of the malady and to suggest sacrifices to appease the causal agents before herbal medicine was prescribed for the patient.

Due to this, some sick people were kept at home and various unsuccessful traditional treatments applied whereas a simple antibiotic could have cured such an individual.

 In all, not all cultural attitudes affecting health care delivery and its access are bad.
 There are instances where natural birth has proved successful and safer even when doctors advised otherwise.
 Traditional herbs have also successfully treated diseases that seemed incurable with orthodox medicine.
 Orthodox health care providers have successfully carried out public health education campaigns to curb harmful practices like Female Genital Mutilation (FGM).

 In the past, health care providers usually worked with people who spoke their language, the situation is different now due to cross cultural interactions. So, to better treat someone, the provider must appreciate the cultural values of the patient. The benefits of health care, whether traditional or orthodox, cannot be undermined.

By: Akosua Badu Akuoko

http://www.ghanaculture.gov.gh/index1.php?linkid=65&adate=08/04/2015&archiveid=2302&page=2