HIV/AIDS education and counselling: experiences from Ghana

The emergence of HIV/AIDS in sub-Saharan Africa presents a challenge not only to public health paradigms but also models for public health education. Although the nature and spread of the disease have common features with a number of known diseases, the initial reactions to the disease have contributed to produce what Jeanneney (1987) refers to as 'a collective emotional hysteria' characteristic of the debate on syphilis in the early part of the twentieth century. Fear and ignorance associated with the hysteria have led to various reactions such as panic, scapegoating, stigmatization and denial (Jeanneney 1987; Awusabo-Asare and Agyeman 1993). As with some previous epidemics, the strategy has been to make factual and understandable information accessible to people (Carballo and Kenya 1994). The basic philosophy is that people should not die from ignorance. For sub-Saharan Africa, some of the pertinent questions are: how do we provide culturally relevant and socially acceptable information within the existing socio-economic constraints? Given the high illiteracy rate how should information be presented so as to reach as many people as possible? How should audience segmentation be approached in view of the limited resources available for educational campaigns on HIV infection? What are some of the socio-cultural constraints to the counselling of AIDS patients and their relations? The aim of this paper is to describe some of the approaches adopted in three settings in Ghana to provide community education and counselling for communities, patients and their relatives on HIV/AIDS infection. The three areas are Berekum District of Brong-Ahafo Region, Manya and Yilo Krobo Districts of Eastern Region and Assin District of Central Region (Figure 1). The services are operated from the Berekum Holy Family Hospital, the Agomanya Saint Martin de Porres clinic and the Assin Fosu Saint Francis Xavier Hospital. All three hospitals belong to the Catholic Church.