Exploring Biomedical and Ethnomedical Representations of Diabetes in Ghana and the Scope for Cross-professional Collaboration: a Social Psychological Approach to Health Policy

Abstract

This article examines the ways in which ethnomedical and biomedical representations of chronic illness and approaches to treatment impact on illness action. Using diabetes care in Ghana as a case study, qualitative interviews were conducted with rural and urban biomedical and ethnomedical practitioners to examine professional representations of diabetes, descriptions of the treatment process and assessment of in-group and out-group knowledge base and practices. The social representations concept of cognitive polyphasia is used as an analytical tool to examine consensus and conflict within and between group narratives. Three major findings are outlined. Firstly, there are more areas of consensus than conflict across professional groups, particularly on the broad themes of health, illness and treatment processes. Secondly, the clash between the two groups is fuelled by internal as well as acrossgroup conflict on notions of cure and the spiritual basis of illness. The function of this clash is to underscore professional legitimacy and expertise in a complex area of illness where individuals are in constant eclectic search for answers to cure. Thirdly and critically, there is strong indication that the function of the clash is constantly undermined by illness action, and it is recognition of this that opens up practical ways for cross-professional collaboration. In the concluding sections, some practical recommendations for improving health policy are outlined and discussed.