The power of community and culture: a study on community-based HIV/AIDS health promotion strategies in Ghana

Purpose This study aims to explore culturally nuanced health promotion strategies that have proven effective in combating HIV/AIDS in rural communities in Ghana. Design/methodology/approach Guided by a phenomenological design, face-to-face in-depth interviews were conducted with 24 community health workers across 6 rural health facilities in the Savannah region of Ghana to understand their successful approaches to HIV/AIDS health promotion in rural cultural contexts. The data were analyzed using thematic data analysis procedure. Findings With 58.33% of the participants being male and 62.50% having worked three to five years, this study identified that in rural Ghanaian communities, HIV/AIDS health promotion achieves remarkable success through the innovative integration of community durbars – cultural gatherings that blend traditional performances with health education, sanctified by the presence of chiefs and elders who serve as cultural gatekeepers for health messaging. The study also reveals a sophisticated dual-approach strategy where health workers complement these large-scale cultural gatherings with targeted community talks at schools and Parent and Teacher Association meetings, while leveraging prenatal care visits as intimate spaces for HIV education. Research limitations/implications Only the experiences of community health workers in the Northern part of Ghana were solicited. The results of the current study could be deepened with data from Southern Ghana. Hence, the authors recommend further studies in this region that the current study did not include. This notwithstanding, the current study has clear methodological strength for replication in the other region and presents the direct voices of practitioners in rural communities. Hence, it has enormous implications for national rural health promotion policy. Practical implications The authors propose establishing permanent “cultural health hubs” in communities where health education integrates seamlessly with cultural practices through storytelling, dance and arts. These hubs should be complemented by innovative “community health apprenticeship” programs that pair young community members with both health-care workers and cultural leaders. To ensure sustainability and cultural authenticity, health centers should establish “health heritage committees” comprising traditional healers, health workers and community leaders to develop culturally grounded approaches to health communication that effectively bridge medical science with indigenous wisdom. Originality/value This study offers a novel perspective by eliciting rural community health workers’ insider views on effective HIV/AIDS health promotion in Ghana. A key finding is the strategic engagement of chiefs and elders to lend validity and convene community durbars, reflecting their influential role in rural cultures. These rare insights into leveraging traditional authority structures contribute valuable evidence for optimizing HIV/AIDS interventions in rural Ghana. Based on these, the study recommends that, despite the limited resources to engage in extensive nationwide efforts, Ghana’s Ministry of Health, through the Ghana AIDS Commission and other stakeholders, should strengthen local health facilities in rural communities to fluidly consider the nuances in rural living and adopt culturally appropriate strategies for health promotion. Future research should, instead of exploring only the northern region, include the southern region of Ghana.