Determinants of chronic non-communicable disease screening among adults in Ghana

The pervasiveness and growing concern of non-communicable diseases (NCDs) in developing countries, which were considered not in the distant historical past, as diseases of only the affluent and of developed countries, is no longer in doubt. The proportion of deaths attributable to NCDs today includes figures never witnessed in any previous historical period. Delayed screening is one of the drivers of this worrying trend. The objective of this study, therefore, was to examine the determinants of NCD screening in Ghana. We fitted logistic regression models to a sample of 1342 individuals who successfully completed a cross-sectional survey across three cities in Ghana. Results show that factors such as knowledge on the causes of NCDs, health insurance, high neighbourhood social capital, poor self-rated health, and exposure to NCDs campaign messages significantly predicted an increased likelihood of NCDs screening. However, socio-cultural beliefs such as developing NCDs being the will of God or the enemy being able to spiritually inflict an individual with NCDs were found to be associated with a lower likelihood of screening for NCDs. Beyond the traditional determinants of health, this study expands the analytical gaze and frontiers of the determinants of NCDs in Ghana through the lens of socio-cultural belief systems. While improving access to healthcare, exposure and knowledge through educational programs as well as building community social capital might be important in scaling up NCD screening, dismantling untenable beliefs and misconceptions is similarly crucial.