Community and health system factors influencing snake envenomation management practices in three districts of Ghana: a qualitative inquiry from health stakeholders and snakebite victims

Abstract

AbstractIntroductionSnakebite is a neglected public health issue affecting individuals of all ages in many tropical countries. Venom from snakebite is a potentially life-threatening disease associated with severe morbidities and mortalities. However, literature on snakebite envenoms management practices remains understudied. This study sought to explore community and health system factors influencing snake envenomation management practices in three districts in the Oti region of Ghana. Also, we assessed the current adherence to snakebite treatment protocols to the national and World Health Organization (WHO) recommended protocols.MethodsThe study adopted an exploratory descriptive qualitative study design. Purposive sampling technique was used to recruit participants for the study. The participants included snakebite victims, traditional healers, and health professionals. In-depth interviews and focused group discussions were used to collect data from the participants. All the interviews were audio recorded and transcribed verbatim and exported to Atlas Ti for data management and analyses. The transcribed data were analyzed using the content analysis method to develop the categories for the study findingsFindingsTwenty-six (26) participants were recruited including 16 males and 10 females. The study found three main factors that influenced snake envenomation management practices. These factors included health system factors, community-level factors, and adherence to national and WHO-recommended protocols. The health system factors included the unavailability of anti-snake venom, high-cost ASV, and inadequate or no supply of ASV from Ghana Health Service. The community factors included delay in seeking treatment, transportation, and accessibility challenges, and non-community acceptance facility treatment of snakebites. Almost all the health care professional who provide care for snakebite victims adhered to the WHO recommendations.ConclusionThe evidence adduced from this study could be used by public health practitioners to empower the community by increasing awareness of the prevention of snakebites, first aid, and appropriate treatment-seeking behavior. Culturally appropriate interventions that seek to increase awareness to improve the acceptability of hospital management and sensitize the community for early referral of snakebite victims to the nearest health facility having anti-venom treatment.Authors summaryThe negative responses by the community’s acceptance of the kind of treatment given in the health facilities and the unavailability of Anti-snake Venom (ASV) in the study districts’ health facilities inhibit the management of snakebites.