Health knowledge and child health in coastal Ghana: What do people know, how do they know it, and does it matter

This research explores some of the sociological determinants of child health in Ghana. Specifically, it is concerned with the determinants of "health knowledge" (knowledge of disease etiology), and the relationship between health knowledge and child health behaviors and outcomes in coastal Ghana.; Despite theoretical attention to the importance of health knowledge in mortality change (Caldwell 1979, Preston and Haines 1991), empirical research on this topic is limited. Toward exploring health knowledge as an intermediate mechanism linking education with child health, this dissertation includes both quantitative and qualitative primary data. The quantitative data source is a representative household-based survey of 2500 men and women in 54 communities in coastal Central Region. We inquired about knowledge of causes, prevention and treatment of three serious child illnesses in Ghana---malaria, diarrheal disease and respiratory infection. The qualitative data source is ten Focus Group Discussions (FGDs) on child health beliefs and practices conducted in five communities in 2003.; Both descriptive and qualitative analyses point to low levels of health knowledge in this area of Ghana. As expected, education is strongly associated with biomedical knowledge---or knowledge of contagion and hygiene. Multivariate analysis reveals that, in addition to the strong influence of formal schooling and literacy, other individual, household and community characteristics---including media exposure, civic participation, migrant experience, household socioeconomic status and urban residence---are also important determinants of health knowledge. In analysis of the relationship between health knowledge and child health behaviors and outcomes, I found that health knowledge is significantly associated with improved health practices, including household cleanliness and hand washing practices. In separate analysis of mothers' health knowledge (with respect to their own young children's illness experiences), I found that children of mothers with greater understanding of the role of hygiene and contagion in disease transmission experience fewer respiratory infections, even when controlling for other important influences. In addition, children of more hygienic mothers suffer from fewer illnesses.; Finally, the finding that there are other, perhaps less expensive, pathways to improved health knowledge, and that health knowledge positively affects child health behaviors and outcomes has important policy implications.