The Logic of "Rational" Drug Use: the Case of a Rural Ghanaian Costal Community. Essential Drugs Monitor No. 014 (1993)
(1993; 2 pages)


Dr. Kodjo Senah from the Department of Sociology at the University of Ghana conducted a study on the effect of cultural perceptions on the use of pharmaceuticals. The study was conducted in Niiman, a village on the western coast of Ghana, 36 km from the capital city of Accra. Niiman has little social infrastructure, irregular water supply, poor sanitation, and high endemicity of environmental, parasitic, and infectious diseases. Despite the severe health problems, there are no public health outposts. Instead, Niiman is covered by a fortnightly primary health care outreach program on immunization and ante-/post-natal care with large monetary charges. To compensate for the lack of public health care, two drug stores that are only licensed to sell over-the-counter medications often sell antibiotics and other prescription drugs. Senah found that villagers knew the effects of different pharmaceuticals and consequently would use drugs to treat specific symptoms rather than the condition for which the drug is intended. There are also five traditional healers and two traditional birth attendants. Senah observed that villagers understood the difference between pharmaceuticals and traditional medicines. Because of low availability, high costs, and general distrust of pharmaceuticals, villagers also used self-medication. If medications were needed, they used traditional medicines more often than pharmaceuticals. Senah also observed that adults in Niiman developed considerable stoicism towards their own illnesses as a means of coping with limited medical resources. He concluded that the poverty in Niiman promoted dependence on ethno-medicines and that developing a rational drug policy was not enough to ensure essential drugs were available. The problem in Niiman was not a lack of drugs; it was a lack of education about use, drug monitoring, and medical infrastructure. (Abstract by Flannery Bowman, 2013)

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