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International Journal of Africa Nursing Sciences
journal homepage: www.elsevier.com/locate/ijans
Research Topic: The realities of religious coping experiences of patients with
diabetes mellitus: Implications for policy formulation in Ghana
Kwadwo Ameyaw Korsah
a,⁎
, Kwame Ameyaw Domfeh
b
a
School of Nursing and Midwifery, Post Office Box LG 43, University of Ghana, Legon, Accra, Ghana
b
University of Ghana Business School, University of Ghana, Legon, Accra, Ghana
ARTICLE INFO
Keywords:
Type 1 and 2 diabetes mellitus
Qualitative investigation and diabetes
Policy and diabetes care in Ghana
Spiritual coping experiences
ABSTRACT
Background: Diabetes mellitus is a chronic and devastating disease condition associated with high blood glucose
level. There are perceived beliefs by patients that diabetes is caused by spiritual forces. Spiritual activities such
as prayers, invocations, use of spiritual substances and dependence on Supreme Being among others are also
perceived to be the treatments for diabetes. In patients’ efforts to look for spiritual treatment for diabetes, they
are abused in diverse ways in pretense of helping them by spiritual healers.
Objectives: This study aimed to explore the spiritual coping experiences of patients with diabetes mellitus in a
Ghanaian hospital, and to determine implications for policy formulation.
Method: Hermeneutic phenomenological approach to qualitative research was employed. Data were audio-re-
corded from both type 1 and 2 diabetes patients through one-on-one interviews, transcribed verbatim and
analyzed using content analysis approach.
Results: A disturbing experience as noted by diabetes patients from their spiritual coping encounters were the
exploitation and abuse in the form of fasting and over starving by their spiritual healers in deception of healing
diabetes.
Conclusion: The findings suggest the need to develop stringent health policy to regulate the activities of faith-
based or spiritual healers in Ghana. It is recommended that the Ministry of Health in Ghana and other stake-
holders should establish surveillance groups to monitor activities of spiritual healers in general.
1. Introduction
Diabetes is a chronic and debilitating medical condition which oc-
curs when the blood sugar of the affected individual goes up. The high
blood glucose level occurs when the pancreas is not able to secrete
insulin or when the body is not able to use effectively the insulin that
has been produced (Soumya & Srilatha, 2011). Religion and spirituality
in general are perceived to have effects on health outcomes of in-
dividuals (Elbarazi et al., 2017). Additionally, research findings in-
dicate correlation between religion, spirituality and physical and
mental health of persons (Vitorino, Lucchetti, Leao, Vallada & Pere,
2018). Some individuals employ religion in general and spirituality in
particular as a means of dealing with predicaments they are confronted
with including diseases (Davies & Thate, 2017). This is against the
backdrop that many diseases and illnesses in Africa and Ghana in
particular are perceived to be caused by spirits (Asare & Danquah,
2017), compared with the disease causation by germs in the Western
world (Asare & Danquah, 2017). It is also a belief that mystical
activities in diverse forms are employed to treat such disease conditions
(Asare & Danquah, 2017).
Specifically, religious activities such as prayers, singing and praising
God with words, reading of talisman, invocations and reciting of Koran,
reading of Biblical quotations and even affiliating with a particular
religious group appear to play a pivotal role in dealing with disease and
illness states (White, 2015). Substances are also prepared as medicines
by the spiritual healers for the treatment of illnesses perceived to have
been caused by bad spirits (White, 2015). Individuals who also perceive
that their ill health is as a result of their past demeanors also employ
religious activities or even visit the shrine to deal with the illness (Asare
& Danquah, 2017).
In some of the spiritual activities for healing of patients, rituals are
usually performed in order to consecrate the substances or the processes
of healing (White, 2015). White (2015) further has noted that rituals
form a means of sanctifying African traditional and spiritual ways of
healing disease conditions. However, in most situations of spiritual
healing, patients are abused in one way or the other. For example,
https://doi.org/10.1016/j.ijans.2020.100245
Received 12 December 2019; Received in revised form 4 June 2020; Accepted 4 September 2020
⁎
Corresponding author.
E-mail addresses: kakorsah@ug.edu.gh (K. Ameyaw Korsah), kadomfeh@ug.edu.gh (K. Ameyaw Domfeh).
International Journal of Africa Nursing Sciences 13 (2020) 100245
Available online 10 September 2020
2214-1391/ © 2020 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/BY-NC-ND/4.0/).
T
patients may be asked to fast in prayer camps by the spiritualist as part
of the healing process (Korsah, 2015). In some of the spiritual treatment
camps, patients’ conditions deteriorate and are rushed to hospital
emergency wards for specialized care and management (Korsah, 2015).
Studies, including White (2015), report that as part of the spiritual
healing, herbs may be prepared for the patient to drink, bath and ad-
ministered as enema in addition to fasting and prayers for specific
number of days. Additional rituals such as pouring of blood of a
slaughtered animal on the head and feet of patients are done to signify
cleansing of the sick person who may be perceived as suffering from a
disease associated with past immoralities.
From the researchers’ personal anecdotes as Ghanaians, it is ob-
served that most patients are exploited fiscally and manipulated in
different ways by some of the traditional and spiritual healers. For in-
stance, patients are asked to pay ‘specified amounts of monies for
prayers in specific categories, captioned as “emergency prayers” by the
so-called spiritual or faith healers’. Some patients are also requested to
buy special fluids called “Florida Water” and similar substances like
“powder”, “salt”, “charcoal” and “pepper” “white or black fowl without
a spot” at exorbitant prices for rituals to heal their diseases.
Per their activities, patients may develop complications due to de-
lays for treatment at the hospital. Complications also develop from the
adverse effects of some of their treatments. It is noted that Ghanaians
are highly religious and ascribe to spirituality in disease causation and
treatment (Assimeng, 2010). However, it appears that in-depth studies
on realities of religious coping experiences such as abuse of patients
with diabetes mellitus in particular, and associated policy implications
have not been broadly explored in Ghana. Therefore the need for this
current investigation using hermeneutic phenomenological approach to
qualitative research (Daher, Corre, Jaramillo, Olivares & Tomicic,
2017).
Baldacchino and Draper (2001) have noted religiosity and spiri-
tuality as essentially important factors for empowering themselves in
ill-health situations. This is achieved when patients employ spiritual
activities such as prayers, dependence on Divine powers for strength
and power, and performing specific rituals to move away nefarious
spirits in times of diseases and misfortunes (Baldacchino & Draper,
2001).
Perceptions about health and illness influence individuals’ health
seeking behaviours, and the decisions regarding treatment of the con-
dition in particular (Wallin & Ahlstrom, 2010). It is believed that faith
in God and reliance on God in general offers meaning and transcen-
dence to people living with chronic diseases (Goggin, Malcarne,
Murray, Metcalf & Wallston, 2007). Mokgobi (2014) suggest that tra-
ditional healing is about practices in a particular culture or society
which is intended to treat disease conditions which Western medicine is
perceived not being able to cure (Asare & Danquah, 2017). On the other
hand, Tsekpe (2004) found high cost of the Western medicine as one of
the major reasons why the African traditional healing practices have
become progressively prevalent and widespread. Other perceptions for
the choice of the traditional healing practices by individuals include the
need to identify the spiritual cause and the respective treatment of the
condition by the diviner or the spiritualist (Popoola, 2005; Yuniarti,
Ningrum, Dewi, & Widiastuti, 2013 &Korsah, 2015).
Further literature examined seems to hover around the same beliefs
and perceptions regarding spiritual causes and treatments of diseases,
but in different contexts (Haque, Chowdhury, Shabjahan, & Huran,
2018).
1.1. Purpose of the research
The study explored the realities of religiosity/spirituality in coping
among diabetes patients and implications for policy formulation in
Ghana.
1.2. Research objectives
1. To explore actualities in religious and spiritual coping experiences
among diabetes patients in Ghana.
2. To propose recommendations on religious and spiritual care related
to coping among diabetes patients in particular and chronicity of
diseases in general.
3. To identify ways to support individuals living with diabetes mellitus
to live productive lives.
1.3. Significance of the study
The findings may offer insights into practicalities and certainties of
religious and spiritual coping among patients with diabetes in parti-
cular. This may help to enhance policies on spiritual healing of diseases
in Ghana against the framework of patient exploitation and maltreat-
ment at some healing and mystical camp-grounds. Findings of this
study may serve as a motivation on how to empower vulnerable pa-
tients through health education to shun negative religious/spiritual
practices, which may compromise positive health outcomes. It would
further offer information on processes involved in how patients muddle
through the hurdles of spiritual coping.
2. Methods
2.1. Research design
In this research, the researchers identified themselves as part of the
research participants being native Ghanaians, researchers and lecturers
in health related programmes who have had interactions with diabetes
patients, hence hermeneutic phenomenological research approach was
employed. This approach suggests that a researcher is inseparable from
the research participants (Daher et al, 2017), which builds on the
supposition that “meanings are co-developed through our shared hu-
manness and life experiences” (Reiners, 2012). Thus, the researchers
are noted as part of the participants’ world where same experiences are
shared by both parties (Pascal, 2010). This view is similar to what
Heidegger (2000) called ‘Dasein’, a concept of “being in the world” with
other individuals. These suggest that as researchers, it was not possible
to detach ourselves from the research participants. Therefore, the
choice of the hermeneutic phenomenological approach to explore the
realities of religious coping experiences among patients with diabetes
mellitus in a Ghanaian hospital. The epistemology of hermeneutic
phenomenological approach to qualitative research rests on under-
standing of subjective experiences, and gaining insights into in-
dividuals’ experiences and actions (Nwozichi, 2015). This involves
techniques of recognizing, identifying, describing and categorizing the
essential structures of the phenomenon under investigation (Nwozichi,
2015; Creswell, 2015).
2.2. Sample and sampling technique
Fifty four (54) patients with both type 1 and 2 diabetes who at-
tended the outpatient department on regular basis were invited through
convenience sampling method to take part in this research. Out of this
number, forty two (42) patients responded to the invitations. However,
five (5) patients out of the 42 who could not speak the Twi or English
language were excluded from the study. Saturation of data occurred on
the twenty seventh (27th) research participant, the point where no new
information was forthcoming (Bengtsson, 2016). Their contact details
were obtained from the attendance record at the diabetes clinic. Per-
mission to have their individual phone numbers and to talk to them was
based on approval by the hospital authorities, authorities of the mu-
nicipal health directorate, and the members of the local diabetes pa-
tients’ association. Subsequently, the patients were contacted on in-
dividual basis to explain the research to them. Inclusion was limited to
K. Ameyaw Korsah and K. Ameyaw Domfeh International Journal of Africa Nursing Sciences 13 (2020) 100245
2
patients diagnosed with diabetes mellitus by a qualified medical doctor
and have commenced treatment at the hospital.
2.3. Data collection
One-on-one audio-recorded interviews were organized for the par-
ticipants who decided to take part upon signing the agreement and the
consent forms. Most of the research participants were interviewed in
the local Twi language and subsequently translated into the English
language by the researcher. Back translation (Nes van, Abma, Jonsson,
Deeg, 2010) was done by a fellow researcher who speaks the Twi lan-
guage fluently to check the accuracy and consistency of first translation
(Nes van et al., 2010) from Twi to English language. Participants’ en-
gagement during the interview continued for about 45 min to one hour.
The main interview focused on how the participants employed spiri-
tuality to deal with diabetes following their diagnosis. Interviews and
data breakdown as well as examination occurred concurrently to check
the need for adjustment to the data collection tool (Bengtsson, 2016). In
all, twenty four (24) interviews took place in the researcher’s office
assigned to him at the hospital, with three (3) remaining interviews
taking place in the residences of the research participants. All the 27
interviews were done by the first author of this paper to ensure con-
sistency in translation from the local Twi language to English. In gen-
eral, data collection lasted for a period of three (3) months, commen-
cing 1st August to 30th October 2009.
2.4. Data analysis
The data was examined using content analysis (Erlingsson &
Brysiewiez, 2017) approach. This method allowed the researchers to
scrutinize the raw data from the research participants for themes and
subthemes (Erlingsson & Brysiewiez, 2017) relating and relevant to the
subject under enquiry. Reading through the raw data, the researchers
identified experiences of patients with diabetes regarding how re-
ligiosity and spirituality in particular were employed to cope with the
condition (Bengtsson, 2016). Qualitative research data collection and
analysis occurred simultaneously (Bengtsson, 2016). Three main
themes relating to the phenomenon under exploration were uncovered.
These were 1) dependence on God to deal with diabetes mellitus 2) use
of prayers, invocations, observance and fasting for diabetes manage-
ment; and 3) the perceptions that God works through other people to
cure diabetes.
2.5. Ethical considerations
Relevant ethical issues were addressed in this study. General ethical
and scientific approval for this study was given by an Institutional
Review Board (IRB). Permission for site approval to collect data was
also given by the authorities of a hospital in Ghana. In addition data
collection from patients with diabetes was allowed by the local branch
of the Diabetes Patients Association of the hospital. Code names were
used to represent the names of the research participants to disguise
their true identity. Participants were assured of privacy and con-
fidentiality in this research (Sanjari, Bahramnezhad, Fomani, Shoghi &
Cheraghi, 2014). The research participants were informed that any data
that would recognize them would not be incorporated in the written
transcript or in any report of the study. The participants were also given
codes to shield their true identity. In addition, the biographic data of
the research participants were separated from the interviewed data to
avoid any linkages between them. Interview materials were kept under
key and luck in the researchers’ custody in a cupboard in their office to
avoid any leakages of the research data. Participant Information Sheets
(PIS) were given to participants who could read for information about
the study 24 h prior to signing of the consent form. The content of the
PIS was explained to the participants who could not read or write.
Participation in this research was voluntary with participants who
agreed to take part being asked to sign or thumb print the consent form
(Sanjari et al., 2014), which was witnessed by the researchers. To avoid
any linkages between biographic data and the data collected, the main
data were disconnected from the biographic data of the participants.
2.6. Trustworthiness of the research process
There are various approaches of ensuring trustworthiness in quali-
tative research, some of them more suitable than others. In this study,
trustworthiness was ensured through four (4) key approaches. First,
personal characteristics of the research participants were taken into
consideration by the researchers. For instance, if a participant was fa-
tigued or busy, the participant was encouraged to rearrange the ap-
pointment to a more suitable time. This was to ensure that participants
respond to the interview questions in a way they would normally do.
Second, 2 piloting interviews were conducted on 2 extended family
members who incidentally have type 2 diabetes. Though, the findings
from the piloting interviews were not added to the main study, they
were very useful in shaping the final version of the interview guide.
Third, the research participants who could read were also given the
opportunity read the transcriptions to validate what were said during
the interviews. On the other hand, the researcher read the transcrip-
tions to the participants who could not read to certify what were said at
the interviews. Finally, the participants were interviewed extensively
by the researcher. This was to ensure sufficient and rich data for this
study in order to unearth major dimensions of the subject under in-
vestigation.
3. Results
Findings focused on expressions of faith in spirituality as strategies
for diabetes management as noted in the next section.
3.1. Dependence on God to deal with diabetes mellitus
The research participants narrated their experiences of spiritual
coping by depending on God as a curator and as a source of life with
diabetes mellitus. They recounted that the mystery around the creation
of man may be equated to the mystery of curing diabetes mellitus
(“mystery of creation of man and mystery of curing a disease condition
are the same”). Their perceptions were based on hope in God to deal
with diabetes mellitus. These were expressed in the following ex-
emplars:
“It is God who created me and brought me into this world and so if
there is any disease condition like diabetes it should be cured by
God” (P14)
“Survival depends on the Creator of human beings and that is God.
Without God, one cannot survive this condition and I rest on Him to
deal with this condition” (P10)
It is obvious in their narratives that as much as diabetes is re-
cognized as a serious chronic condition, it is only the power of an ul-
timate authority, in spiritual fashion, who can cure such a disease.
Another participant in a sorrowful manner recounted spiritual
coping experiences regarding her reliance on God for managing dia-
betes mellitus. Her comments signified expression of optimism for her
survival with the protracted condition. This is what she said:
“I know that God has been on my side for all the years I have had
this condition. I know that God will continue to protect me until my
final days come” (P3)
It is apparent from the participant’s story that there is strong belief
in God for keeping her alive all along, even in the face of the adversity
of diabetes mellitus.
K. Ameyaw Korsah and K. Ameyaw Domfeh International Journal of Africa Nursing Sciences 13 (2020) 100245
3
3.2. The use of prayers, invocations and fasting for diabetes management
The participants noted the use of prayers, fasting and special in-
vocations in combination or single handedly as a way of spiritual
management of the condition. Some participants expressed the hope in
prayers as a means to ameliorate the condition, and articulated ex-
pectations that diabetes would not exterminate them despite the deadly
nature of the condition. Two participants explained that it is advisable
to pray to God when having diabetes mellitus. They respectively had
this to say:
“I always pray that this condition is taken away by God. With
prayers, I believe that there will be improvement in the condition.
Prayers can do lot of good things for diabetes patients including
myself” (P26)
“Without prayers you cannot survive this condition. It is a deadly
condition so with prayers the bad spirits around the disease are
expelled. Through prayers one communicates with God to deal with
the bad spirits that cause it” (P5)
It appears that the participants had much conviction in prayers as a
way to interact with God in illness situation to deal with the condition,
and also to expel bad spirits attributable to the disease condition.
However, three participants recounted their bad experiences with
fasting at prayer camps when they were instructed by the spiritual
healers to fast in order to improve the condition. Two of them had these
to say, respectively:
“I was asked to fast by the pastor to get spiritual strength to deal
with the condition when my friend advised me to attend the prayer
camp with him. I did not eat for the whole day but in the second day
I started having some reactions like shaking of my body. When I told
them I was assured that the disease is moving away from my body.
The next day I found myself on the hospital bed without knowing
what happened to me” (P8)
“When I attended the prayer camp, I was asked to pay some money
and do special prayers with the pastor in order to get healed. In
addition I was asked to fast for three days to gather spiritual strength
to manage the condition. On the second day, I could not stand the
fasting because my body and the general condition were becoming
worse. I left the place to a hospital for treatment but I was admitted
on that day for some fluids” (P11)
The other participant described her sufferings at the prayer camp in
these ways:
“I was accused of causing the condition myself through my bad
demeanors. I was accused of having the condition through my sinful
behaviours, then I was asked to pay special offering for the pastor to
fast and pray for me to be cleansed of my past sins before my con-
dition will be improved” (P12)
“I was instructed to pay special offerings for special prayers to abort
diabetes in my body. As a matter of fact, I paid the money and fasted
for a very long time at the prayer camp and I had impression that it
led to some complication because I developed severe dizziness and
headaches” (P12)
It may be observed from their spiritual coping experiences that the
patients were exploited in one way or the other in pretense of healing
their conditions, at the detriment of their health as diabetes patients
who are prone to having diabetes related complications, including hy-
poglycaemia, dizziness and headaches which are associated with over
starvation.
3.3. The perceptions that God works through other people to cure diabetes
The participants’ accounts also centred around a spiritual phe-
nomenon in which they perceived that God is not present in physical
sense to treat diabetes patients but works through people such as
doctors, nurses, pastors and similar individuals to cure diabetes.
According to some of the participants, doctors, nurses and spiritual
healers (“people with the second eye”) do their best for patients by way
of God working through them. This happens in a miraculous manner to
cure all forms of disease conditions including diabetes mellitus. Some
examples of their stories are illustrated below:
“Doctors, nurses and other persons like those with the double eyes, I
mean the medicine men or the spiritual healers, I know that God
works through them in special way to help individuals living with
diabetes. God will not be physically present to perform healing but
works through such individuals” (P6)
Another participant in a confident manner stated:
“God is not here to be seen as a person to offer you all that you need
as a patient. However, God may express what need to be done for
the patient through other persons to offer the needed support for the
needy. So as diabetes patient God helps me through these people”
(P16)
It is obvious to note that participants’ perceptions around the care
they received from health care providers and spiritual healers stemmed
from a higher being (God) indirectly. As explained elsewhere in this
paper, Ghanaians are very religious and this might have influenced
spiritual coping of patients living with diabetes mellitus. It is therefore
not surprising that the participants exhibited strong religiosity in this
study.
However, it is extremely important to ensure that patients with
diabetes and other conditions who employ spiritual coping strategies in
dealing with their problems are not abused in any form.
4. Discussion of findings
In this study, the participants reported being religious or spiritual in
coping with diabetes mellitus in various ways. As noted from the
findings, the research participants employed prayers, dependence on
help directly from God, fasting as strategies of dealing with diabetes. In
addition, participants’ reliance on nurses, doctors and spiritual healers
as representatives of God to help patients was noted in patients’ coping
experiences as a way of dealing with the condition. In Choi (2019), it
was noted that the research participants acknowledged diabetes as a
chronic disease which needs to be treated by professional medical staff.
However, according to the patients’, additional treatments for such a
debilitating condition should include some religious and spiritual
practices (Choi, 2019). The reason being that after diagnosis of a
chronic condition, the affected individuals should be more spiritual and
closer to God to lessen the effects of the condition (Choi, 2019). Re-
ligion as well as spirituality is also viewed as substantial foundation for
health because of inherent understandings regarding the shared corre-
lation between religion or spirituality and the physical and mental
health of patients (Gupta & Anandarajah, 2014).
Prayers have been identified as one of the most essential religious
and spiritual coping mechanisms to enhance physical, psychological
and spiritual health and wellbeing among patients with diabetes
(Watkins, Quinn, Ruggiero, Quinn, & Choi, 2013; Gupta &
Anandarajah, 2014). Similarly, patients pray for strength to cope with
ill health by controlling the blood glucose fluctuations (Permana, 2018;
Choi, 2019). However, this is not clear as to how prayers as a coping
approach may be used to control blood glucose fluctuations among
diabetes patients. The current findings support Choi (2019) who noted
that diabetes patients view “God as a positive image rather than a ne-
gative image” and as a “supportive actor” as diabetes patients in the
midst of health challenges. Further, the findings build on Parsons,
Cruise, Davenport, and Jones (2006) who found that patients perceive
health care providers as representatives of God through whom God
offers help in the form of treatment for patients. Health care providers
are therefore seen as instruments of God by means of which patients are
K. Ameyaw Korsah and K. Ameyaw Domfeh International Journal of Africa Nursing Sciences 13 (2020) 100245
4
cured (Permana, 2018).
The findings further show consistency with the literature on the role
of religion and spirituality as a phenomenon about health behaviours
relating to coping with diseases and diabetes in particular. It is observed
that spiritual coping experiences among patients in this study are si-
milar to what the literature (Namageyo-Funa, Muilenburg & Wilson,
2015) has reported.
However, what is new regarding the spiritual coping experiences
among diabetes patients in the current Ghanaian study is an aspect of
“fasting” as a coping strategy in diabetes. In addition “abuse of diabetes
patients associated with spiritual coping” in various forms as a “form of
treatment” without basis emerged as an issue of concern in this study.
Indeed, it should be emphasized that “fasting or starvation” of diabetes
patients has no place in clinical care of diabetes patients. It usually
leads to hypoglycaemia, a potential factor for death among these vul-
nerable patients (Shafiee et al., 2012). The diabetes patients in the
current study reported of having body tremors or shakes which were
interpreted by their spiritual healers as “diabetes moving away from
their bodies”. These were significant indicators of hypoglycaemia
which subsequently resulted in emergency hospital admissions of some
patients.
Findings also showed that some of the participants were instructed
to pay “special offerings” for “special prayers” to abort diabetes in their
bodies. These and other forms of inappropriate ways of helping patients
to cope with diabetes ultimately lead to complications, which should be
avoided through education for patients with inclination to secure
treatment at faith based and other healing camps.
5. Limitations of the study
As the researchers are known in the hospital where the research was
done, there was likelihood that power differences between the re-
searchers and the participants could have influenced the results of this
study. The researchers reduced the power relationship by going to the
level of the research participants by speaking in a way they could easily
understand. The data analysis was done manually which could have
introduced some technical errors compared with computer software
analysis which is relatively fast and cost effective. As much as electronic
means of data analysis has specific merits over manual form of data
analysis, feelings and reflections of participants in qualitative research
cannot be captured by electronic devices, therefore the use of manual
data analysis. However, some authors recommend the combination of
both electronic and manual form of data analysis.
6. Conclusion
The study centred on the realities of spiritual coping experiences of
patients with diabetes mellitus. The findings focused on perceptions of
patients with diabetes on how they depend on God as a source of hope
in diabetes care; the use of prayers, invocations and fasting to manage
diabetes; and patients having views that God works through other
people to cure diabetes. Problems associated with the spiritual coping
among the respondents have been discussed. Notable among them is the
efficacy of prayer as a coping approach to bring down the blood glucose
level in patients and their abuse in search for cure in some spiritual
treatment camps.
7. Recommendations
Policy should be formulated by the Ministry of Health, Ghana
Health Service in collaboration with the Christian Council of Ghana,
Pentecostal Council of Ghana and the Charismatic Churches
Association. In this regard, surveillance groups made up of these
agencies should be constituted to embark on routine visits to spiritual
treatment camps to observe what transpires during patient encounter
with the spiritual healers. In addition, the group members may disguise
themselves as patients or ordinary residents and visit these camps to
observe their operating procedures and practices.
Television and radio advertisements that potentially seek to pro-
mote negative activities of spiritual and faith healers should be dis-
couraged. Defiant television and radio stations which air such activities
should be sanctioned together with the spiritual healers. Any adver-
tisement related to spiritual healing of chronic diseases and diabetes in
particular should be screened and approved by regulatory bodies before
they are aired.
Public health education programmes should be promoted by the
Ministry of Health, Ghana Health Service, and other related agencies for
spiritual and faith-based healers in particular to discourage them from
unacceptable and dangerous practices.
CRediT authorship contribution statement
Kwadwo Ameyaw Korsah: Conceptualization, Formal analysis,
Writing - original draft, Data collection, Methodology, Investigation.
Kwame Ameyaw Domfeh: Project administration, Supervision,
Writing - review & editing, Visualization, Resources.
Declaration of Competing Interest
The authors declare that they have no known competing financial
interests or personal relationships that could have appeared to influ-
ence the work reported in this paper.
Acknowledgements
We acknowledge all the participants in this research. Without them
data for this study would not have been possible.
None of the authors received financial support for this study which
needs to be acknowledged.
The authors had ethical and scientific approval from the Research
Ethics Committee of the Faculty of Health and Life Sciences (HLS), De
Montfort University, Leicester, in the United Kingdom. The ethical and
scientific approval of the research was secured on the 23
rd
April 2008
with Registration Number 347.
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