Ohemeng-Tinyase Naana Abena, Hambali Mohammed Gazali, Agyemang-Duah Williams
Awotwe Sickle Cell Foundation Inc, 2883 South Hills, Riverdale, GA, 30296, USA.
Department of Geography, University of British Columbia, 2075 West Mall, Vancouver, BC, V6T, 1Z2, Canada.
BMC Prim Care. 2025 Aug 25;26(1):266. doi: 10.1186/s12875-025-02791-4.
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.
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.
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.
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.
获得和利用医疗保健是镰状细胞病（SCD）管理的一个关键方面。然而，医疗保健的利用往往具有挑战性，特别是在镰状细胞病患者中。为镰状细胞病患者充分利用医疗保健服务可以提高他们的预期寿命。由于以前没有实证研究，本研究探讨了加纳镰状细胞病患者使用正规医疗保健的促进因素和障碍。
本研究采用现象学方法在加纳的阿散蒂地区进行。采用便利抽样技术招募了27名镰状细胞病儿童的父母和成年镰状细胞病患者。数据收集于2022年10月至2022年11月。使用访谈指南收集有关人口和社会经济因素以及正规医疗保健利用的促进因素和障碍的数据。使用主题分析框架对数据进行分析。
参与者的平均年龄约为22岁[8 - 56岁]，大多数为女性（n = 16）。此外，其中6人没有接受过正规教育。结果表明，对不使用正规医疗保健的健康后果的恐惧、严重疼痛和危机的经历以及对正规医疗保健提供者提供的服务的信任是参与者使用正规医疗保健的促进因素。结果进一步表明，正规医疗保健使用的障碍包括经济障碍、地点和交通问题、工作量和时间限制、使用替代医疗保健服务（草药、基于信仰的治疗和自我用药）以及不良的卫生系统，如在医疗机构等待时间长、以患者为中心的护理差和沟通无效。
这是第一项研究加纳镰状细胞病患者使用正规医疗保健的促进因素和障碍的已知研究。研究结果表明了参与者使用正规医疗保健的几个促进因素和障碍。这些发现为制定促进加纳镰状细胞病患者使用正规医疗保健的政策和干预措施提供了大量证据和信息。
