A multi-perspective assessment of knowledge, attitudes, and barriers to viral hepatitis care in Ghana

Abstract

Viral hepatitis B and C are a significant public health burden in Ghana, yet elimination efforts, as outlined by the WHO, are hindered by gaps in understanding and access to care. This cross-sectional study aimed to assess the knowledge, misconceptions, and barriers to care from the critical perspectives of patients, caregivers, and healthcare workers (HCWs) in Ghana. We used structured questionnaires to evaluate the awareness, risk perception, understanding of transmission, chronicity, treatment preferences, and recognition of high-risk groups among 449 participants. While general awareness was high, specific knowledge about sources of infection and symptoms was poor among the patient participants (p < 0.05). Less than 50% of patient participants were aware of their HCV status. About 4-20% of all the study participants believed the disease is caused by ageing, having malaria, eating oily foods, witchcraft and curses, or engaging in laborious work. Disparity existed in serostatus awareness (HCWs: 91.2%; patients and caregivers: 56%) and personal risk perception. Major barriers included cost (cited by 75%), distance, and unpleasant interactions between patient-care providers. Most study participants correctly identified clinical risk groups. However, 16% of community participants failed to recognise multiple sexual partners as a risk factor. The findings reveal a significant gap between the aetiology of viral hepatitis disease and community understandings of the disease, driven by misconceptions and structural barriers. To achieve elimination targets as outlined by the World Health Organisation, public health strategies must integrate cultural beliefs into education, destigmatisation, and health system strengthening to improve access to prevention, testing, and treatment services.