“Her hospital card is missing”: a qualitative investigation into the facilitators of and barriers to formal healthcare use among sickle cell patients in Ghana
Bibliographic record
Abstract
BACKGROUND: Access to and use of healthcare is a crucial aspect of sickle cell disease (SCD) management. However, healthcare utilisation is often challenging, particularly among sickle cell patients. Adequate utilisation of healthcare services for people with SCD could improve their life expectancy. As no previous empirical work has been available, this study explores the facilitators of and barriers to formal healthcare use among SCD patients in Ghana. METHODS: This study was conducted using a phenomenological approach in the Ashanti Region of Ghana. A convenience sampling technique was used to recruit 27 parents of children with SCD and adults with SCD. Data were collected from October 2022 to November 2022. Interview guides were used to collect data on demographic and socio-economic factors, as well as facilitators of and barriers to formal healthcare utilisation. Data were analysed using thematic analytical frameworks. RESULTS: The mean age of the participants was approximately 22 years [8-56 years], and most were females (n = 16). Also, 6 of them had no formal education. The results showed that fear of health consequences for not using formal healthcare, experience of severe pain and crisis, and trust in the services offered by formal healthcare providers serve as facilitators of formal healthcare use among the participants. The results further demonstrated that barriers to formal healthcare use were financial barriers, location and transportation problems, workload and time constraints, use of alternative healthcare services (herbal medicine, faith-based healing, and self-medication) and poor health systems, such as long waiting time at the health facilities and poor patient-centred care and ineffective communication. CONCLUSION: This is the first known study to examine the facilitators of and barriers to formal healthcare use among sickle cell patients in Ghana. The findings demonstrate several facilitators of and barriers to formal healthcare utilisation among the participants. The findings provide much evidence and information for developing policies and interventions that promote formal healthcare use among sickle cell patients in Ghana.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".