'If you sell your sickness, you will get its medicine': care and intrafamilial communication for chronic diseases in southern Ghana

Knowledge of family health history can help to mitigate risk for chronic non-communicable diseases known to run in families. However, disclosure of disease or illness is not always a given. This paper explores the relationship between care and intrafamilial communication regarding chronic health conditions in Ghanaian families, drawing on concepts of generativity and reciprocity. Data were drawn from a qualitative description study on family histories and health. This paper analyses four focus group discussions and two intergenerational family interviews conducted among 35 older adults and their adult children and grandchildren in the Greater Accra Region of Ghana. Data were analysed thematically using an inductive approach and themes relating to care and intrafamilial communication were assessed for this analysis. Findings showed that intergenerational care can serve as a means to disclose and communicate family health histories while disclosure of illness serves as a means to receive and give care for oneself and one's family. Furthermore, care services can sometimes be a barrier to communication of family health histories while concealment of disease and of family health histories and identities may be a form of care. Finally, intergenerational family health history discussions may prompt encouragement of care-seeking behaviours and preventive care. The results of this pilot study suggest avenues through which care arrangements could be capitalised on to promote the sharing of health history information within families to better manage chronic disease risk. In addition, they illustrate the potential for family health history discussions to further encourage care-seeking for chronic disease prevention