Barriers and Facilitators of Substance Abuse Treatment in Ghana (West Africa): a Social-ecological Perspective Using Photovoice

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Introduction: Drug abuse remains a controversial issue around the world. It brings enormous loss to many lives, and its effects spill over into general society, thereby hindering the population's functionality and growth. In Ghana, harm is magnified by poor economic and living conditions.

Methods: A key informant facilitated access to four addiction recovery centers in Ghana. Ten adults receiving addiction recovery treatment were recruited and participated in the 3 week Photovoice process. Participatory Action Research and Social Ecological Model (SEM) was utilized to guide picture taking and final interpretation. Participants were trained on the principles of SEM and asked to take pictures of perceived barriers and facilitators to substance abuse treatment at each SEM level in their community. Pictures were contextualized and categorized into themes by participants using the SHOWed technique.

Results: Ignorance, family, stigma, lack of treatment centers, treatment cost, and poverty were themes indicated by participants as barriers to substance abuse treatment. Facilitators of treatment included knowledge, religion, media, and family support. Multiple action items were developed to address barriers to treatment.

Discussion: Substance abuse treatment remains an issue in Ghana as addiction is not classified as a disease, but only a moral issue. This study is the first in many necessary steps to bring attention to this public health epidemic and the need for government support in the form of decriminalization and other policy changes. This can help reduce the intense stigma of substance abuse in the Ghanaian society, encouraging treatment seeking behavior.


American Public Health Association Annual Meeting (APHA)


Denver, CO