Health-Seeking Behavior of Persons with Chronic Hepatitis B in Peri-Urban Ghana: Application of the Health Belief Model

Sub-Saharan African countries, including Ghana, are disproportionately affected by hepatitis B. In Ghana, the burden of hepatitis B is unevenly distributed, with the Brong Ahafo region having the highest prevalence (13.7%). Given that people with hepatitis B (PWHB) in Ghana have previously been found to have a lack of understanding of the impact of the infection, we sought to explore their health-seeking behaviour using the health belief model as an organising framework. A qualitative exploratory design was used. In total, 18 people were purposively selected for face-to-face interviews. The data was processed and analysed using QSR NVivo version 11.0 and the Braun and Clarke thematic analysis procedure. The belief that hepatitis B can cause liver cancer and death was the most important determinant of health seeking. Furthermore, access to accurate hepatitis B information, particularly information about availability of effective hepatitis B treatment, influenced a number of participants to seek formal care. However, the high cost of clinical monitoring and treatment to use herbal medicine, despite their concerns about the effectiveness of herbal medicines in managing hepatitis B. Given that hepatitis B information was a factor in health seeking, it is recommended that a hepatitis B awareness campaign focusing on the availability of hepatitis B treatment and where it can be obtained be carried out in the study area. Counselling PWHB at the point of diagnosis should highlight the relevance of life-long clinical monitoring. To remove financial barriers to hepatitis B care in Ghana, the government should include the cost of hepatitis B laboratory investigations and treatment in the health insurance scheme. Hepatitis B is a disease caused by a virus; therefore, individuals must take responsibility for getting tested and vaccinated against the disease. However, people make a decision to seek health for different reasons, We conducted interviews with 18 people living with chronic hepatitis to find out what influenced their decision to seek healthcare. The account of these people revealed the fear of developing liver cancer and dying; information about the disease and treatment were the major reasons for seeking healthcare. However, herbal treatment was preferred due to the high cost of utilising hospital services. People living with Hepatitis B will use hospital services if their treatment is included in the national health insurance scheme and information about treatment is widely shared.