Adopting critical social psychology and community psychology perspectives, this article examines the links between shared social knowledge of diabetes, illness experience and illness action through semi-structured individual and group interviews with diabetes sufferers and lay healthy individuals in two rural Ghanaian communities. Analysis highlights that both groups make sense of diabetes and illness experience by drawing interchangeably from four shared knowledge modalities: common-sense, scientized, religious and emotional. Common-sense notions of health and illness and scientized understandings of diabetes frame illness action goals that merge with biomedical goals. These goals are compromised by structural, community/family and emotional dynamics. Findings suggest that the best immediate solutions lie in addressing availability and cost of biomedical care and quality food, with concomitant attention to community education and self-help groups as negotiators of psychosocial and economic support.
Get full access to this article
View all access options for this article.
References
1.
Adubofuor, K. O. M., Ofei, F., Mensah-Adubofour, J., & Owusu, S. K. (1993). Diabetes in Ghana: A morbidity and mortality analysis . International Diabetes Digest, 4(3), 90–92 .
2.
Akanji, A. O. (1996). Clinical experience with adolescent diabetes in a Nigerian teaching hospital . Journal of the National Medical Association, 88(2), 101–105 .
3.
Amoah, A. G. B., Owusu, K. O., & Adjei, S. (2002). Diabetes in Ghana: A community prevalence study in Greater Accra . Diabetes Research and Clinical Practice, 56, 197–205 .
4.
Anderson, J. M., Wiggins, R., Rajwani, R., Holbrook, A., Blue, C., & Ng, M. (1995). Living with a chronic illness: Chinese-Canadian and Euro-Canadian women with diabetes—exploring factors that influence management . Social Science and Medicine, 41(2), 181–195 .
5.
Bledsoe, C. H., & Goubaud, M. F. (1985). The reinterpretation of western pharmaceuticals among the Mende of Sierra Leone . Social Science and Medicine, 21(3), 275–282 .
6.
Bury, M. (1982). Chronic illness as biographical disruption . Sociology of Health and Illness, 4, 167–182 .
7.
Campbell, C., & Jovchelovitch, S. (2000). Health, community and development: Towards a social psychology of participation . Journal of Community and Applied Social Psychology, 10, 255–270 .
8.
Crossley, M. (2000). Rethinking health psychology. Buckingham: Open University Press .
9.
De Freitas, M. de F. Q. (2000). Voices from the south: The construction of Brazilian community social psychology . Journal of Community and Applied Social Psychology, 10, 315–326 .
10.
Drenowski, A., & Popkin, B. M. (1997). The nutrition transition: New trends in the global diet . Nutrition Reviews, 55, 31–43 .
11.
Garro, L. C. (1995). Individual or societal responsibility? Explanations of diabetes in an Anishinaabe (Ojibway) community . Social Science and Medicine, 40(1), 37–46 .
12.
Graham, H. (1976). Smoking in pregnancy: The attitudes of expectant mothers . Social Science and Medicine, 10, 399–405 .
13.
Helman, C. (2000). Culture, health and illness. Oxford & Boston, MA: Butterworth-Heineman .
14.
Jilek-Aall, L., Jilek, M., Kaaya, J., Mkombachepa, L., & Hillary, K. (1997). Psychosocial study of epilepsy in Africa . Social Science and Medicine, 45(5), 783–795 .
15.
Joffe, H. (1996). AIDS research and prevention: A social representational approach . British Journal of Medical Psychology, 69, 169–190 .
16.
Kamel, N. M., Badaway, Y. A., el-Zeiny, N. A., & Merdan, I. A. (2000). Sociodemographic determinants of management behaviour of diabetic patients. Part II. Diabetics’ knowledge of the disease and their management behaviour . East Mediterranean Health Journal, 5(5), 974–983 .
17.
Kilewo, J., Sandstrom, A., Dahlgren, L., & Wall, S. (1997). Communicating with the people about HIV infection risks as a basis for planning interventions: lessons from the Kagera region of Tanzania . Social Science and Medicine, 45(2), 310–329 .
18.
Kirby, J. P. (1993). The Islamic dialogue with African traditional religion: Divination and healthcare . Social Science and Medicine, 36(3), 237–247 .
19.
Kirby, J. P. (1997). White, red and black: Colour classification and illness management in northern Ghana . Social Science and Medicine, 44(2), 215–230 .
20.
Lang, T. (1999). Diet, health and globalisation: Five key questions . Proceedings of the Nutrition Society, 58(2), 335–343 .
21.
Lupton, D. (1995). The imperative of health: Public health and the regulated body. London: Sage Publications .
22.
Mavi, C. S., Owen, F. A., & Gelfand, M. (1983). The aetiology of illness as determined by divination and methods of treatment of Zimbabwean N’anga. Review of 100 consultants with town n’anga . Central African Journal of Medicine, 29(1), 5–8 .
23.
Muhr, T. (1997). ATLAS/ti-visual qualitative analysis—management-model building. User’s manual. Berlin: Scientific Software Development .
24.
Nwoga, I. A. (1994). Traditional healers and perceptions of the causes and treatment of cancer . Cancer Nursing, 17(6), 470–478 .
25.
Nyamwaya, D. (1987). A case study of the interaction between indigenous and western medicine among the Pokot of Kenya . Social Science and Medicine, 25(12), 1277–1287 .
26.
Ofei, F., Forson, A., & Appia-Kusi, J. (1996). Self-care behaviour amongst Ghanaian diabetics. Unpublished conference paper, available from Dr Francis Ofei, CTCPT, University of Ghana Medical School, PO Box 4236, Accra, Ghana.
27.
Ohaeri, J. U., Shokunbi, W. A., Akinlade, K. S., & Dare, L. O. (1995). The psychosocial problems of sickle cell disease sufferers and their methods of coping . Social Science and Medicine, 40(7), 955–960 .
28.
Ohaeri, J. U., Campbell, O. B., Ilesanmil, A. O., & Ohaeri, B. M. (1998). Psychosocial concerns of Nigerian women with breast and cervical cancer . Psychooncology, 7(6), 494–501 .
29.
Orford, J. (1992). Community psychology, Theory and practice. West Sussex: John Wiley & Sons .
30.
Preker, A. S., Carrin, G., Dror, D., Jakab, M., Hsiao, W., & Arhin-Tenkorang, D. (2002). Effectiveness of community health financing in meeting the cost of illness . Bulletin of the World Health Organization, 80(2), 143–150 .
31.
Radley, A. (1994). Making sense of illness. London: Sage Publications .
32.
Rekdal, O. B. (1999). Cross-cultural healing in east African ethnography . Medical Anthropology Quarterly, 13(4), 458–482 .
33.
Republic of Ghana (Ministry of Health). (2001). Evaluating the health sector 5 year Programme of Work—1996–2001. Republic of Ghana: Ministry of Health .
34.
Rhodes, T. (1998). Risk theory in epidemic times: Sex, drugs and the social organisation of risk behaviour . Sociology of Health and Illness, 4(2), 209–227 .
35.
Sobo, E. J. (1993). Inner-city women and AIDS: The psychosocial benefits of unsafe sex . Culture, Medicine and Psychiatry, 17, 455–485 .
36.
Swartz, M. J. (1997). Illness and morality in the Mombasa Swahili community: A metaphorical model in an Islamic culture . Culture, Medicine and Psychiatry, 21(1), 89–114 .
37.
Valente, T. W., Watkins, S. C., Jato, M. N., van der Straten, A., & Tsitol, L. P. (1997). Social network associations with contraceptive use among Cameroonian women in voluntary associations . Social Science and Medicine, 45(5), 677–687 .
38.
Whitehead, M. (1995). Tackling inequalities: A review of policy initiatives. In M. Benzeval, K. Judge, & M. Whitehead (Eds.), Tackling inequalities on health: An agenda for action. London: King’s Fund , 22–52.
