Religion and women's health in Ghana: insights into HIV/AIDs preventive and protective behavior
Introduction
There has been a recent and growing interest in studies dealing with religion in the lives of contemporary Africans, which appears to be motivated in part by the reported resurgence or revival in religious activities in many African countries during the last several decades (Woodward, 2001; Ojo, 2000; Ghana Review International (GRI), 2000; Meyer, 1995; Bediako, 1995; Gifford (1994a), Gifford (1994b).1 In Ghana, Assimeng (1989) counted over 500 Christian denominations during the early 1980s. Since then, the number of Ghanaians who view themselves as religious has increased substantially, with La Verle (1994) reporting that the percentage of the general population claiming to be Christians rose sharply from a reported 42 percent prior to the 1980s to about 62 percent during the mid-1980s. More recently, Gallup International (2000) interviewed 50,000 people in 60 different countries as part of a millennium survey and reported that the majority of Ghanaians (98 percent) polled professed belonging to a religious denomination, with about 82 percent reporting regular church attendance.
Not only are Ghanaians becoming more religious, it has been suggested that the types of religious organizations in the country continue to change as well (Assimeng, 1986). Alongside the mainstream traditional Christian denominations (i.e., old established churches such as Protestant2 and Catholic), a collection of groups that include African syncretic, faith healing organizations, charismatic, evangelical, as well as Pentecostal Churches have emerged (Yirenkyi, 1999; Gifford, 1994b; Nukunya, 1992; Assimeng (1981), Assimeng (1986), Assimeng (1989)).3 Both Nukunya (1992) and Assimeng (1986) suggest that the growing popularity of these “new” Christian groups reflect the growing disenchantment with the monotony of the old denominations, and the fact that these new churches often involve the use of “healing” and “salvation,” something which seems to appeal to the needs of an impoverished population dissatisfied with their current socioeconomic condition.
While the reasons behind the resurgence in religious activities in Africa overall and Ghana in particular are still not clear, the social and political ramifications of these faith-based organizations have not gone unnoticed.4 Indeed, literature examining the relationship between religion and various aspects of social life in the region has burgeoned (Garner, 2000; Yirenkyi, 2000; Lagarde, Enel, & Seck, 2000; Adongo, Phillips, & Binka (1999), Addai (2000); Adongo, Phillips, & Binka, 1998; Ellis & ter Haar, 1998; Riviere, 1997; Kirby (1993), Kirby (1997); Gifford, 1995; Meyer, 1995; Aboagye-Mensah, 1994; Pobee, 1991; Assimeng, 1989). In the case of Ghana, several scholars have pointed out that religion has emerged as a potent social force in both private and public life (Noretti, 2002; Yirenkyi (1999), Yirenkyi (2000); ter Haar, 1998; Kirby (1993), Kirby (1997); Gifford, 1995; Meyer, 1995). For example, Yirenkyi (2000) and Aboagye-Mensah (1994) have reported that since the 1980s, the Christian churches in Ghana have taken a more activist role in national politics than ever before. Recently, Addai (1999) also investigated the connections between religion and contraceptive use and found religion to be a significant predictor of contraceptive use. In another study, Addai (2000) reported that women who belonged to liberal religious groups (defined here to include Protestants and Catholics) were more likely to report engaging in premarital sex than women from conservative religious groups. Writing about the ongoing fertility transition, Takyi and Addai (2001) have also observed significant variations in overall family size by religious affiliation.
Despite recent research interest on religion and the behavior of contemporary Africans, few studies focus on religion and HIV/AIDS.5 As Agadjanian (2001) has reported, in contemporary Africa, church participation is relevant for the analysis of overall reproductive health, not so much as a direct measure of religious piety, but also as an indicator of social exposure and interaction. Besides, some recent findings from the few studies that have looked at religion and AIDS in Africa have found religion to be an important predictor of AIDS protective and risk behavior (UNAIDS, 1998).6 In a study in Edendale, South Africa, Garner (2000) found that some Christian churches encouraged their members to reduce engaging in extra- and pre-marital sexual activity (EPMS), thereby reducing their risks for AIDS.
Another salient reason for studying religion and sexual behavior derives in part from the social capital and network ties that it fosters (Agadjanian, 2001; Kohler, Behrman, & Watkins, 2001; Valente, Watkins, Jato van der Straten, & Tsitsol, 1997; Sherkat & Wilson, 1995; Cornwall (1988), Coleman (1990); Cornwall, 1987). Given that many women in Ghana spend considerable time in faith and other church-based interactions where the diffusion of AIDS information is more likely to occur, it is likely that social capital gained through the network of relationships and church-based social ties could lead to the dissemination of AIDS information. Rather than facilitate the diffusion of new ideas, it is possible, however, that the influence of religious organizations could constrain individual actions such as not using condoms because they go against Church tenets. Such an expectation is possible, for, as Garner (2000) points out, religious organizations manifest “extensive” and “intensive” power, power that has the potential to influence the behavior of their members. 7
Section snippets
Background
The rapid spread of HIV/AIDS in sub-Saharan Africa and the toll the epidemic is exacting on societies in the region have attracted considerable research attention during the past two decades (Caldwell, 2000; Ezzell, 2000; McGeary, 2001; Bosompra, 2001; Latré-Gato Lawson, 1999; UNAIDS, 1999a; Caldwell, 1999; Bongaarts, 1996; Anarfi (1993), Anarfi (1995); Awusabo-Asare, 1995; Caldwell & Caldwell, 1993; Hunter, 1993; van de Walle, 1990). In part, the increased attention given to the region
Methods
The data employed in this analysis are taken from the 1998 Ghana Demographic Health Survey (GDHS98). GDHS98 is the third of a series of nationally representative probability sample surveys conducted in Ghana during the past three decades.17 These cross-sectional surveys were designed to provide policy makers with the most up-to-date information on demographic processes in that country (GSS and Macro International
Results
We begin our analysis by assessing whether religious affiliation affects AIDS risk status (Table 2). As reported in Table 2, the effect of religious affiliation on self-reported HIV/AIDS risk status is significant (p<0.001). For the most part, women from the Christian churches (56 percent of Protestants, 55 percent of Catholics, and a similar percentage of other Christians) were more likely to report a lower level of AIDS risk than those among the non-Christian groups (49 percent for Muslims
Discussion and conclusions
Surprisingly few studies examine the impact of religion on AIDS-preventive behavior in West Africa even though religious beliefs and norms may be salient to AIDS prevention. As Agadjanian (2001) has pointed out, church participation in Africa creates an environment for social exposure and interaction to new ideas, which could then influence AIDS prevention. Furthermore, Garner (2000) has suggested that religious groups have different levels of power that could influence the behavior of their
Acknowledgements
I am grateful to Drs. Mark Tausig, Gabriel Fosu, Kwasi Yirenkyi, Isaac Addai, and anonymous reviewers of this journal for their valuable comments on an earlier version of this paper.
References (105)
- et al.
Review or self-efficacy and locus of control for nutrition- and health-related behavior
Journal of American Dietetic Association
(1997) - et al.
Determinants of condom use to prevent HIV infection among Youth in Ghana
Journal of Adolescent Health
(1999) - et al.
Breaking the silenceSetting realistic priorities for AIDS control in the LDC
Lancet
(2000) Determinants of condom use intentions of university students in GhanaAn application of the theory of reasoned action
Social Science and Medicine
(2001)Women and AIDS in developing countries
Social Science and Medicine
(1992)Disease classification in rural GhanaFramework and implications for health behavior
Social Science and Medicine
(1981)Women's orientation toward help-seeking for mental disorders
Social Science and Medicine
(1995)- et al.
Transforming AIDS prevention to meet women's needsA focus on developing countries
Social Science and Medicine
(1995) Social vs. BiologicalTheories on the transmission of aids in Africa
Social Science and Medicine
(1996)- et al.
Religious differences in morbidity and mortality
Social Science and Medicine
(1987)
Prediction of motivation and behavior change following health promotionRole of health beliefs, social support, and self-efficacy
Social Science and Medicine
The Islamic dialogue with African traditional religionDivination and health care
Social Science and Medicine
White, red and blackColor classification and illness management in Northern Ghana
Social Science and Medicine
Religion and health—is there an association, is it valid, and is it causal?
Social Science and Medicine
How religion influences morbidity and healthReflections on natural history salutogenesis and host resistance
Social Science and Medicine
African women and AIDSNegotiating behavioral change
Social Science and Medicine
Social network associations with contraceptive use among Cameroonian women in voluntary associations
Social Science and Medicine
Mission and democracy in Africa
Does religion matter in contraceptive use among Ghanaian women?
Review of Religious Research
Religious affiliation and sexual initiation among Ghanaian women
Review of Religious Research
The influence of traditional religion on fertility regulation among the Kassena–Nankana of Northern Ghana
Studies in Family Planning
Religion, social milieu, and contraceptive revolution
Population Studies
Global priorities for HIV/AIDS intervention research
International Journal of STD and AIDS
Understanding attitudes and predicting behavior
Sexuality, migration and AIDS in GhanaA socio-behavioral study
Health Transition Review
The condition and care of AIDS victims in GhanaAIDS sufferers and their relations
Health Transition Review
Social structure of Ghana a study in persistence and change
Saints and social structures
Religion and social change in West Africa
Aids and behaviorAn integrated approach
Living with AIDSPerceptions, attitudes and post-diagnosis behavior of HIV/AIDs patients in Ghana
Health Transition Review
The health belief model and sick role behavior
Health Education Monograph
AIDS and behavioral changes to reduce riskA review
American Journal of Public Health
Christianity in AfricaRenewal of a non-western religion
Women who are HIV-infectedThe role of religious activity in psychosocial adjustment
AIDS Care
Global trends in AIDS mortality
Population and Development Review
Migration, sexual behavior and the risk of HIV in Kenya
International Migration Review
Can behavior be modified to preserve health?
International Social Science Journal
Rethinking the African AIDS epidemic
Population and Development Review
The nature and limits of the Sub-Saharan African AIDS epidemicEvidence from geographic and other patterns
Population and Development Review
Towards an epidemiological model of AIDS in sub-Saharan Africa
Social Science History
The family and sexual networking in sub-Saharan AfricaHistorical regional differences and present-day implications
Population Studies
The social context of AIDS in sub-Saharan Africa
Population and Development Review
The making of HIV epidemicsWhat are the driving forces?
AIDS
Religion and healthPublic health research and practice
Annual Review of Public Health
Sexual behavior in the face of riskPreliminary results from first AIDS-related surveys
Health Transition Review
The social bases of religionA study of the factors influencing religious beliefs and commitment
Review of Religious Research
Foundations of social theory
Social capital in the creation of human capital
American Journal of Sociology
Sex, gender, and healthThe need for a new approach
British Medical Journal
Cited by (107)
Religiousness and adolescent risk behavior
2023, Encyclopedia of Child and Adolescent Health, First EditionConnecting religion to homeownership: exploring local perspectives in Ghana
2020, CitiesCitation Excerpt :However, religion in Ghana is not static but dynamic leading to rapid changes. For instance, religious groups such as Charismatic, evangelical, Pentecostal Churches African syncretic and faith healing organizations have mostly emerged out of mainstream orthodox groups such as Catholic and Protestant churches (Takyi, 2003). However, the contribution of mainline Christian churches to the political landscape of Ghana is more apparent than that of Islam or Traditional religions because most elites received formal education at schools established by mainline Christian churches (Gifford, 2004).
Social participation, health literacy, and health and well-being: A cross-sectional study in Ghana
2018, SSM - Population HealthCitation Excerpt :Existing studies show that social participation presents opportunities for even the socioeconomically disadvantaged to obtain health-related information from others (Lee et al., 2008). Research in Ghana indicates that when people have an opportunity to interact with others through avenues such as market centres and religious affiliation, their health-related knowledge improves (Takyi, 2003, Andrzejewski et al., 2009). This is attributed to access to potentially knowledgeable persons who can positively influence health literacy (Takyi, 2003, Andrzejewski et al., 2009).
Spirituality, religiosity, aging and health in global perspective: A review
2016, SSM - Population HealthDeterminants of antenatal HIV testing in the opt-out approach in Nigeria: Findings from the Nigerian Demographic and Health Survey
2020, Journal of Biosocial Science