PREFERENCE AND REASONS FOR PEOPLE CHOOSING A PLACE OF FRACTURE CARE: A CASE STUDY IN SIX COMMUNITIES OF ASSIN NORTH DISTRICT, GHANA

Abstract

Background: Studies in the African Sub-region have highlighted injuries and its associated morbidity and mortality as an emerging public health problem, making it necessary to develop a holistic approach to handle injury outcomes in Ghana. The study purposed to assess the preference and reasons for people choosing a place of fracture care among the general population in the Assin North District of the Central region of Ghana. Method: A prospective cross-sectional study was employed in which 237 participants were randomly selected from six communities in the Assin-North District of the Central Region. Structured questionnaires after verbal informed-consent were used to collect data. The data collected was analyzed using descriptive statistics and chi-square test. Results: A total of 237 participants were interviewed, 14.8% of them had a history of fracture for which 60% sought treatment with Traditional Bone Setters (TBS). About 27.8% of respondents preferred TBS treatment over orthodox fracture care. Most of them (69.6%) were females with more than half (56.1%) being young adults. Only gender (p=0.029) and religion (p=0.043) were associated with the study group’s preference of fracture care. Common reasons for choosing a particular place of fracture care included “perceived” healing methods (77.6%), past experience (20.7%), time to fracture healing (11.8%), and cost of treatment (9.3%). Generally, fear of complications such as mal-union (60.8%), stiff knee (62.1%), delayed union (69.6%), amputation (63.3%), and infection (76%) were some of the reasons why participants chose hospital care over TBS. Conclusion: People make decisions about where to seek fracture treatment (either at a hospital or with a traditional bonesetter) influenced by cost of treatment and knowledge of complications that may result from poorly handled fracture-care. The study showed the need to improve knowledge about the potential benefits of orthodox fracture-care using scientifically tested and reproducible methods which have been shown to consistently improve outcomes.