Introduction

Women are commonly the principal informal carers in the home, taking responsibility for identifying health needs and determining appropriate health actions including use of medication.

Health care in Ghana includes allopathic, herbal and spiritual practices. When two or more systems operate side-by-side, each may influence the others and people move between different sectors according to perceived cause of symptoms and accessibility. Migration between countries requires people to adjust to different approaches to, and systems of, health care.

Objectives

To describe and compare the perspectives of health and characteristics of health seeking behaviours and use of medicines by Ghanaian women resident in London, England and "Kumasi", Ghana.

Method

Semi-structured interviews were conducted with a sample of sixteen Twi speaking Ghanaian women resident in and around London, UK and eighteen in and around Kumasi, Ghana. As no sampling frame of Ghanaian women resident in the UK was available, a "snowball" technique was used to include women of different ages, educational backgrounds, length of time in Britain and with and without long-term health problems. A similar technique was employed in Kumasi to obtain a comparable sample in terms of age of respondents, educational background and reported health problems. The interview guide focused on actions taken with regard to illnesses (short and long-term) that had been experienced in the family, including perceptions, experiences and use of health services, and use of medication. Interviews were conducted at a time and location convenient for the respondents, in the majority of cases this was their own homes. The interviews were conducted in English and/or Twi, audio-taped and transcribed. The two sets of interviews were first analysed separately and then compared.

Results

There were many similarities between the two samples (London and Kumasi) in their perceptions of ill-health and use of medicines, e.g the importance of spirituality in explaining health and disease. Interviews reflected the different patterns of morbidity and health care systems of the two countries. Respondents in London identified ways in which they believed their health�seeking behaviour differed from that of the indigenous population as a result of experiences and practices in Ghana, e.g delays by Ghanaians in seeking help from the formal sector possibly influenced as a result of difficulties in access to formal care in Ghana. They also described their experiences of the British system and changes (or otherwise) in their health behaviour and use of medicines following arrival in Britain.

Conclusion

The social-cultural contexts in which Ghanaians view their health remain apparent despite their adjustment to using the British health care system. In the provision of health care and development of services, awareness of, and sensitivity to, the needs and perspectives of different population groups is an important policy objective.