Adolescents at risk of self-harm in Ghana: a qualitative interview study exploring the views and experiences of key adult informants

Background In Ghana, rates of self-harm in young people are as high as they are in high income countries. Self-reported interpersonal, familial and societal stressors form the most important background, and self-harm is seen by young people as a way of responding to that stress. In the present study, we obtained the views of key adult informants about self-harm among adolescents in Ghana – what they thought as possible reasons for self-harm in young people and what actions might be needed at an individual or population level to respond to the problem. Methods We interviewed face-to-face 11 adults, using a semi-structured interview guide. We used an experiential thematic analysis technique to analyse the transcribed interviews. Results The analysis identified five themes: “underestimating the prevalence of self-harm in adolescents”, “life on the streets makes self-harm less likely”, “self-harm in adolescents is socially and psychologically understandable”, “ambivalence about responding to adolescent self-harm”, and “few immediate opportunities for self-harm prevention in Ghana”. Adolescent self-harm was acknowledged but its scale was underestimated. The participants offered explanations for adolescent self-harm in social and psychological terms that are recognisable from accounts in high income countries. Low rates among street-connected young people were explained by their overarching orientation for survival. Participants agreed that identification was important, but they expressed a sense of inadequacy in identifying and supporting adolescents at risk of self-harm. Again, the participants agreed that self-harm in adolescents should be prevented, but they recognised that relevant policies were not in place or if there were policies they were not implemented – mental health and self-harm were not high on public or political priorities. Conclusions The adults we interviewed about young people who self-harm see themselves as having a role in identifying adolescents at risk of self-harm and see the organisations in which they work as having a role in responding to individual young people in need. These are encouraging findings that point to at least one strand of a policy in Ghana for addressing the problem of self-harm in young people

Adolescent self-harm in Ghana: a qualitative interview-based study of first-hand accounts

Background: Recent prevalence studies suggest that self-harm among adolescents in sub-Saharan Africa is as common as it is in high income countries. However, very few qualitative studies exploring first-person accounts of adolescent self-harm are available from sub-Saharan Africa. We sought to explore the experiences and first-person perspectives of Ghanaian adolescents reporting self-harm - for deeper reflections on the interpretive repertoires available in their cultural context for making sense of self-harm in adolescents. Methods: Guided by a semi-structured interview protocol, we interviewed one-to-one 36 adolescents (24 in-school adolescents and 12 street-connected adolescents) on their experiences of self-harm. We applied experiential thematic analysis to the data. Results: Adolescents’ description of the background to their self-harm identified powerlessness in the family context and unwanted adultification in the family as key factors leading up to self-harm among both in-school and street-connected adolescents. Adolescents’ explanatory accounts identified the contradictory role of adultification as a protective factor against self-harm among street-connected adolescents. Self-harm among in-school adolescents was identified as a means of “enactment of tabooed emotions and contestations”, as a “selfish act and social injury”, as “religious transgression”, while it was also seen as improving social relations. Conclusions: The first-person accounts of adolescents in this study implicate familial relational problems and interpersonal difficulties as proximally leading to self-harm in adolescents. Self-harm in adolescents is interpreted as an understandable response, and as a strong communicative signal in response to powerlessness and family relationship difficulties. These findings need to be taken into consideration in the planning of services in Ghana and are likely to be generalisable to many other countries in sub-Saharan Africa

African Communitarianism and Difference

There has been the recurrent suspicion that community, harmony, cohesion, and similar relational goods as understood in the African ethical tradition threaten to occlude difference. Often, it has been Western defenders of liberty who have raised the concern that these characteristically sub-Saharan values fail to account adequately for individuality, although some contemporary African thinkers have expressed the same concern. In this chapter, I provide a certain understanding of the sub-Saharan value of communal relationship and demonstrate that it entails a substantial allowance for difference. I aim to show that African thinkers need not appeal to, say, characteristically Euro-American values of authenticity or autonomy to make sense of why individuals should not be pressured to conform to a group’s norms regarding sex and gender. A key illustration involves homosexuality

Ethnoontology: Ways of world‐building across cultures

This article outlines a program of ethnoontology that brings together empirical research in the ethnosciences with ontological debates in philosophy. First, we survey empirical evidence from heterogeneous cultural contexts and disciplines. Second, we propose a model of cross‐cultural relations between ontologies beyond a simple divide between universalist and relativist models. Third, we argue for an integrative model of ontology building that synthesizes insights from different fields such as biological taxonomy, cognitive science, cultural anthropology, and political ecology. We conclude by arguing that a program of ethnoontology provides philosophers both with insights about traditional issues such as debates about natural kinds and with novel strategies for connecting philosophy with pressing global issues such as the conservation of local environments and the self‐determination of Indigenous communities

Science-based health innovation in Ghana: health entrepreneurs point the way to a new development path

<p>Abstract</p> <p>Background</p> <p>Science, technology and innovation have long played a role in Ghana’s vision for development, including in improving its health outcomes. However, so far little research has been conducted on Ghana’s capacity for health innovation to address local diseases. This research aims to fill that gap, mapping out the key actors involved, highlighting examples of indigenous innovation, setting out the challenges ahead and outlining recommendations for strengthening Ghana’s health innovation system.</p> <p>Methods</p> <p>Case study research methodology was used. Data were collected through reviews of academic literature and policy documents and through open-ended, face-to-face interviews with 48 people from across the science-based health innovation system. Data was collected over three visits to Ghana from February 2007 to August 2008, and stakeholders engaged subsequently.</p> <p>Results</p> <p>Ghana has strengths which could underpin science-based health innovation in the future, including health and biosciences research institutions with strong foreign linkages and donor support; a relatively strong regulatory system which is building capacity in other West African countries; the beginnings of new funding forms such as venture capital; and the return of professionals from the diaspora, bringing expertise and contacts. Some health products and services are already being developed in Ghana by individual entrepreneurs, which are innovative in the sense of being new to the country and, in some cases, the continent. They include essential medicines, raw pharmaceutical materials, new formulations for pediatric use and plant medicines at various stages of development.</p> <p>Conclusions</p> <p>While Ghana has many institutions concerned with health research and its commercialization, their ability to work together to address clear health goals is low. If Ghana is to capitalize on its assets, including political and macroeconomic stability which underpin investment in health enterprises, it needs to improve the health innovation environment through increasing support for its small firms; coordinating policies; and beginning a dialogue with donors on how health research can create locally-owned knowledge and be more demand-driven. Mobilizing stakeholders around health product development areas, such as traditional medicines and diagnostics, would help to create trust between groups and build a stronger health innovation system.</p

Addiction in the Light of African Values: Undermining Vitality and Community

In this article I address the question of what makes addiction morally problematic, and seek to answer it by drawing on values salient in the sub-Saharan African philosophical tradition. Specifically, I appeal to life-force and communal relationship, each of which African philosophers have at times advanced as a foundational value, and spell out how addiction, or at least salient instances of it, could be viewed as unethical for flouting them. I do not seek to defend either vitality or community as the best explanation of when and why addiction is immoral, instead arguing that each of these characteristically African values grounds an independent and plausible account of that. I conclude that both vitalism and communalism merit consideration as rivals to accounts that Western ethicists would typically make, according to which addiction is immoral insofar as it degrades rationality or autonomy, as per Kantianism, or causes pain or dissatisfaction, à la utilitarianism

Philosophical racism and ubuntu: In dialogue with Mogobe Ramose

This article discusses two complementary themes that play an important role in contemporary South African political philosophy: (1) the racist tradition in Western philosophy; and (2) the role of ubuntu in regaining an authentic African identity, which was systematically suppressed during the colonial past and apartheid. These are also leading themes in Mogobe Ramose’s African Philosophy Through Ubuntu. The first part concentrates on John Locke. It discusses the thesis that the reprehensible racism of many founders of liberal political philosophy has lethally infected liberal theory

Workers’ Perceptions of Workplace Safety: An African Perspective

This study investigated workers’ perceptions of workplace safety in an African work environment, specifically in Ghanaian work places. Workers’ safety perceptions were examined with Hayes et al.’s. (1998) Work Safety Scale. Comparative analyses were done between high- and low-accident groups, and t tests were employed to test for differences of statistical significance. Relative to their colleagues in the low-accident category, workers in the high-accident category exhibited negative perceptions on safety. They had negative perceptions regarding work safety, safety programmes, supervisors, and co-workers’ contributions. Besides, they expressed less job satisfaction and were less committed to safety management policies. Perceptions regarding management’s attitude towards safety between the 2 groups were not of statistical significance. The analyses provided an explanation for the cause of a substantial portion of the high rate of industrial accidents in Ghana’s work environment. Implications for safety management are discussed

Workers’ Perceptions of Workplace Safety and Job Satisfaction

A lot of attention has been focused on workers’ perceptions of workplace safety but relatively little or no research has been done on the impact of job satisfaction on safety climate. This study investigated this relationship. It also examined the relationships between job satisfaction and workers’ compliance with safety management policies and accident frequency. A positive association was found between job satisfaction and safety climate. Workers who expressed more satisfaction at their posts had positive perceptions of safety climate. Correspondingly, they were more committed to safety management policies and consequently registered a lower rate of accident involvement. The results were thus consistent with the notion that workers’ positive perceptions of organizational climate influence their perceptions of safety at the workplace. The findings, which have implications in the work environment, are discussed