Healthcare providers’ perceptions of dementia: understanding help-seeking behaviour for dementia in northern region of Ghana

Abstract

Background. Dementia is a significant global health challenge, particularly in low and middle-income countries like Ghana. Research on dementia reveals that there has been a substantial increase in the number of people living with dementia worldwide due to an increasing ageing population. Despite the rapid increase of dementia cases worldwide, symptoms of dementia are often unrecognised in Sub-Saharan Africa. Furthermore, there is very little evidence of research that explore perceptions of dementia and help-seeking behaviour for dementia in Sub-Saharan Africa, particularly in Ghana. Understanding the socio-cultural dynamics of dementia and help-seeking behaviours for dementia in a Sub-Saharan African setting such asGhana is crucial for developing culturally appropriate health promotion strategies. Therefore, this study aimed to explore healthcare providers' perceptions of dementia and their perspectives on factors influencing help-seeking behaviour for people with dementia in the Northern Region of Ghana. Method. The PEN-3 cultural model was adopted as the conceptual framework for this research, which aided in the understanding of perceptions and help-seeking behaviour for dementia within a socio-cultural context. An interpretative philosophical stance was adopted to answer the research questions and to achieve researchobjectives. The study employed two complementary methodologies: a systematic review and a qualitative method. The systematic review critically synthesised and appraised existing primary qualitative evidence-based studies that explored healthcare providers' perceptions of dementia and their perspectives on help-seeking behaviour for people with dementia in Sub-Saharan Africa. The review employed Joanna Briggs Institute's (JBI) critical checklist for qualitative research to draw current existing evidence. The primary qualitative approach used semi-structured interviews. A total of 43 interviews were conducted among formal and informal healthcare providers. Data were analysed using Braun and Clarke's (2006) step-by-step guideto thematic analysis approach. Findings. The systematic review's findings revealed that there is limited knowledge and understanding of dementia in Sub-Sahara Africa. It also shows that help-seeking behaviour for dementia is influenced by perceptions of dementia associated with normal ageing, spirituality and the availability of healthcare services. The findingsfrom the primary qualitative study indicate that there is limited knowledge and understanding of dementia, particularly among informal healthcare providers. The findings reveal that healthcare providers in the Northern Region of Ghana hold varying perceptions about dementia; ranging from supernatural beliefs and normal ageing among informal healthcare providers to biomedical models among formal healthcare providers. Furthermore, the findings identified four different help-seeking pathways: first point of call for help-seeking pathway, emergency or deteriorated help-seeking pathway, blended or multiple help-seeking pathway, and informed or advice-based help-seeking pathway. The main factors influencing help-seekingbehaviour are identified as: religious or cultural factors, socio-economic factors, trust or reliability of healthcare services, attitudes and professionalism of healthcare providers, and Language barrier. Conclusion and recommendation. The study highlights the need for targeted educational interventions to enhance healthcare providers' understanding of dementia and to promote appropriate help-seeking behaviour. Furthermore, it highlights the importance of community engagement, emphasising on collaboration between community-based healthcare providers such as faith healers, traditional healers, and healthcare professionals.

Date of Award	11 Feb 2025
Original language	English
Awarding Institution	University of Bedfordshire
Supervisor	Nasreen Ali (Supervisor) & Yannis Pappas (Second supervisor)