"It Is Not Easy": Cultural Influences of Sickle Cell Disease Management in Rural, Eastern Sierra Leone. (July 2021)

• Record Type: Journal Article
• Authors: Ibemere, Stephanie O.; Shambley-Ebron, Donna Z.; Tanabe, Paula; Jaja, Cheedy
• Is Part Of: Qualitative health research. Volume 31:Number 8(2021)
• Page Start: 1459
• Page End: 1471
• Publication Date: 2021-07
• Subjects: culture -- sickle cell disease -- health seeking -- disease management -- health determinants -- qualitative -- ethnography -- sub-Saharan Africa -- West Africa; Health -- Periodicals; Health behavior -- Periodicals; Health -- Research -- Methodology -- Periodicals; Health behavior -- Research -- Methodology -- Periodicals; 610.7205
• DOI: 10.1177/10497323211006384
• Languages: English
• ISSNs: 1049-7323

Abstract

Sickle cell disease (SCD) is a chronic genetic disease that causes life-threatening complications and requires robust comprehensive management. Developing comprehensive SCD programs in sub-Saharan African countries requires knowledge of the cultural factors affecting health-seeking behavior. We utilized an ethnographic approach and the frameworks of Dutta and Habermas to explore cultural factors influencing SCD management in rural Sierra Leone. A purposive sample of 27 individuals with SCD and their family and professional caregivers were observed and interviewed from March 2019 to April 2019. We identified four domains (Cultural Beliefs, Cultural Values, Cultural Practices, and Dealing with SCD) of cultural influences on SCD management, and 12 sub-themes (related to collectivism; spiritual, traditional, and Western beliefs and practices; and lived experiences) that reflect the personal, social, structural, and contextual complexities of SCD management. Further research regarding roles of traditional and spiritual leaders, combinations of Western and traditional practices, and culturally centered interventions is warranted.