research topics on social issues in ghana

(Stanford users can avoid this Captcha by logging in.)

• Send to text email RefWorks EndNote printer

Contemporary social problems in Ghana

Available online, at the library.

Green Library

More options

• Find it at other libraries via WorldCat
• Contributors

Description

Creators/contributors, contents/summary.

• Contemporary social problems in Ghana / Steve Tonah
• Over fifty years of higher education in Ghana : what has happened to equity? / Agnes A. Apusigah
• Earth shrines : prison or sanctuary? : Ghanaian "witch camps" and the dawn of the rights of culture / Jon P. Kirby
• Making peace in northern Ghana : the role of non-governmental organizations and traditional authorities / Artur Bogner
• Ghana at fifty : reflections on the evolution and development of culture of human rights in Ghana / Chris Dadzie
• The challenge of ageing in rural and urban Ghana / Steve Tonah
• Widowhood rites in Ghana : a study among the Nchumuru, Kasena and the Ga / Joana Brukum, Alice Pwamang and Steve Tonah
• Changing trends in Ghanaian funeral celebrations : a case study of the Ga Mashi Traditional Area, Accra / Juliana Naa-Dedei Attoh
• Street hawkers and the management of urban space in central Accra / Dzifa Akpalu
• Chieftaincy conflicts in northern Ghana : a challenge to national stability / Alhassan S. Anamzoya
• The legal versus the domestic treatment of child sexual defilement in Ghana / Kodjovi Akpabli-Honu
• Indigenous farmers versus migrant Fulani herdsmen in central Ghana / Abdulai Abubakari and Steve Tonah.

Bibliographic information

Browse related items.

• Stanford Home
• Maps & Directions
• Search Stanford
• Emergency Info
• Terms of Use
• Non-Discrimination
• Accessibility

© Stanford University , Stanford , California 94305 .

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• v.8(3); 2017 Sep

Emerging issues in public health: a perspective on Ghana’s healthcare expenditure, policies and outcomes

1 School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Perth, WA 6027 Australia

Kwasi Frimpong

2 School of Natural Sciences, Edith Cowan University, Perth, WA 6027 Australia

3 Department of Mathematics and Statistics, La Trobe University, Melbourne, Victoria 3083 Australia

4 Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, 100069 China

5 School of Public Health, Taishan Medical University, Taian, Shandong 271000 China

Ghana’s healthcare expenditure has increased over the past two decades. Increased healthcare expenditures are required to enhance the acquisition of better hospital resources that may improve healthcare. This study presents an overview of healthcare expenditures and health outcomes (i.e. infant mortality, under-5 mortality and life expectancy) from 1995 to 2014 in Ghana. Infant and under-5 mortalities have declined by 50 and 25%, respectively, as of 2014, while life expectancy has increased from 60.7 to 64.8 years. Private spending on health, especially out-of-pocket payments, declined but is higher than the World Health Organization’s recommended financial threshold. Non-communicable diseases (NCDs) are rising with healthcare costs leading to catastrophically high healthcare expenditures in the future. While government’s investments on healthcare have yielded positive results, the improvement in the health outcomes cannot be attributed to increased health expenditure alone. Therefore, this paper outlines policies on maternal health, national health insurance and healthcare reforms that have influenced health outcomes. In parallel, the paper highlights challenges of the Ghana health system of which the major ones are (1) inadequate financial investments in health and (2) limited health workforce and facilities. These challenges can be ameliorated by (1) establishing new health institutions and expanding existed ones; (2) providing incentives to discourage the exodus of health workers; (3) introduction of the concept of predictive, preventive and personalized medicine (PPPM) for treating NCDs; and (4) alternative insurance schemes for vulnerable groups. This, coupled with the will of the government to curb misappropriation of funds, will be important to achieving better health outcomes.

Introduction

Public spending on healthcare enhances the efficiency of healthcare services and boosts health outcomes, and therefore, establishing a robust health financing system has been a priority among many countries worldwide [ 1 ]. However, increasing health expenditure has been challenging even among wealthy countries because of frequent economic recession and rising healthcare costs [ 2 ]. In low-income countries, public healthcare spending has been relatively low, despite the potential benefits that could be achieved in regard to health outcomes [ 3 ]. The little public healthcare spending that happens in these countries is mainly financed with insufficient tax revenues, internal and external loans and restricted foreign grants [ 3 ]. Other healthcare funding sources available are either private or out-of-pocket payments, fee-for-service and private health insurance schemes [ 3 – 5 ].

In the past two decades, Ghana has experienced rapid economic growth, along with the increase in spending on health [ 6 , 7 ]. Since 2001, the country has increased its public healthcare spending by 11%, which is 15% higher than the accompanying increase in government revenues [ 8 ]. Concurrently, there has been a tremendous population growth over the past decade with at least 65% of the populace expected to be urban dwellers by 2030 [ 9 , 10 ]. With this growth in population coupled with ageing, rapid urbanization and increasing adoption of sedentary lifestyle, there could be a shift in focus from communicable diseases (CD) to non-communicable diseases (NCD), which would place further pressure on the scarce healthcare resources [ 11 , 12 ].

The positive association between increased healthcare spending on health outcomes has been shown in other studies [ 3 , 11 ]. Nonetheless, there has to be a reassessment of the impact of healthcare spending in tandem with public healthcare policies on health outcomes. This study presents an overview of healthcare expenditures and health outcomes (i.e. life expectancy, infant mortality and under-5 mortality) in Ghana. The paper also outlines and compares the baseline information in terms of the three health outcomes since the implementation of policies on maternal health and the national health insurance.

Total healthcare expenditure

Total health expenditure is defined as the measure of the sum of revenues collected from different sources and comprises general, private and out-of-pocket. In Ghana, general expenditures rose after 2003 and slightly decreased in 2008. Apart from Ghana’s socioeconomic problems, this decrease could be attributed to the global financial crisis [ 8 ] (Fig. ​ (Fig.1). 1 ). Yet compared with neighbouring countries such as Togo, Benin, Niger, Nigeria, Burkina Faso and Cote d’Ivoire, Ghana seems to have performed better in its commitment to health. The general government health expenditure increased from 53 per capita US$ in 1995 to 60 per capita US$ in 2014 (Fig. ​ (Fig.2 2 ).

Types of health expenditures in Ghana from 1995 to 2014. Data from the WHO and Gapminder databases ( http://apps.who.int/nha/database/ViewData/Indicators/en ) ( http://www.gapminder.org/data/ )

General government health expenditures among neighbouring countries. Data from the WHO and Gapminder databases ( http://apps.who.int/nha/database/ViewData/Indicators/en ) ( http://www.gapminder.org/data/ )

Both private and out-of-pocket expenditures were high between 1995 and 2004 but declined after 2005. The introduction of the National Health Insurance Scheme (NHIS) in 2004 could have resulted in high general healthcare spending and a reduced share of private and out-of-pocket spending (Fig. ​ (Fig.1 1 ) .

Although private and out-of pocket expenditures have declined over the years, the financial protection in Ghana has been inadequate [ 8 ] (Table ​ (Table1). 1 ). Some of the determinants of increased out-of-pocket expenditures are inadequate health insurance coverage and poverty [ 7 , 13 , 14 ]. Government’s investments have not been enough to meet the rising healthcare costs. Funding inadequacy has therefore fuelled hospital commercialization. Thus, hospitals are compelled to increase service prices to generate funds for maintaining medical equipments. It has been predicted that high out-of-pocket expenditures on healthcare will continue to have a devastating effect on the socioeconomic status of households unless pragmatic steps are taken to address the prevailing challenges [ 3 ].

Descriptive statistics of health expenditure and health outcomes from 1995 to 2014

Another factor that may have contributed to the high out-of-pocket expenditures is over-dependence on foreign aids and grants for financing healthcare [ 3 , 10 ]. External sources rose from 1999 but declined after 2003. A study that analyzed data from the World Bank suggested that remittances to developing countries, including Ghana, reduced by 5.5% (US$307 billion) in 2009 [ 15 ]. Workers’ remittances to Ghana also reduced from US$126 million in 2008 to US$114 million in 2009 [ 15 ].

Health expenditures and the impact on life expectancy

From 1995 to 2014, the life expectancy of Ghanaians has increased steadily (Fig. ​ (Fig.3). 3 ). Life expectancy at birth increased from 60.7 to 64.8 years. Expenditures on healthcare as a share of per capita total healthcare expenditures show a positive association with life expectancy at birth. Other studies not limited to Ghana that investigated the association between public healthcare spending and health outcomes have reached similar conclusions [ 3 , 16 , 17 ]. This important data shows that the healthcare system has somehow done well in certain areas of measurable outcomes. The increased life expectancy may be attributed to several factors, such as new medicines and vaccines, good governance, education, social structures, income distribution, environmental changes and lifestyle changes [ 11 ].

Life expectancy by per capita total health expenditures from 1995 to 2014. Data from the WHO and Gapminder databases ( http://apps.who.int/nha/database/ViewData/Indicators/en ) ( http://www.gapminder.org/data/ )

Health expenditures and the impact on infant and under-5 mortalities

Increased public healthcare spending has reduced infant and under-5 mortalities. In the years when total healthcare expenditures per capita were very low (~US$10), infant and under-5 mortalities were high, 72/1000 live births and 111/1000 live births, respectively. As total healthcare expenditures increased, mortality declined, and by the end of 2014, these figures have reduced to 44.2/1000 live births and 78/1000 live births, respectively (Figs. ​ (Figs.3 3 and ​ and4 4 ) . It is also possible that certain factors have had contributed to the decrease in mortality other than health spending alone. Improvements in health outcomes can be attributed to the structure of the Ghana healthcare system that strengthens healthcare service provisions [ 8 ]. The healthcare system is distributed across the national, regional and district levels to promote accessibility, quality and easy transmission of healthcare information within the various levels in the sector [ 8 ]. Additionally, positive health outcomes can be attributed to the introduction/implementation of various healthcare policies by the Ministry of Health (MoH) in Ghana [ 18 ] (Fig. ​ (Fig.5). 5 ). While there are many of such healthcare policies, this paper will highlight the major ones.

Infant and under-5 mortality by per capita total health expenditures from 1995 to 2014. Data from the WHO and Gapminder databases ( http://apps.who.int/nha/database/ViewData/Indicators/en ) ( http://www.gapminder.org/data/ )

Factors that influence health outcomes

Child healthcare policies

United Nations Children Fund (UNICEF) reports that one in 12 children worldwide dies before the 5th birthday [ 19 ]. In 2011, nearly 2.9 million children representing 44% of children under 5 years died worldwide mainly from preventable childhood diseases [ 20 ]. Some identified causes of these deaths include child malnutrition, sepsis, pneumonia, meningitis, malaria, diarrhoea, upper respiratory infections, asphyxia, prematurity and low birth weights [ 21 – 24 ]. Child stunting, defined as growth retardation due to inadequate consumption of food, is also a major contributor to child deaths [ 24 ]. Child malnutrition and stunted growth account for 40% and 20% of childhood deaths in Ghana, respectively [ 22 ].

Two of the interventions are the Ghana Child Health Policy (CHP) and the Child Health Strategy (CHS) [ 22 ]. These interventions focus on ways to improve accessibility to healthcare, guarantee quality of medical care and increase the demand for essential services [ 22 ]. Predominant diseases, such as cholera and diarrhoea that mostly affect infants, are targeted. Low-osmolarity oral rehydration salts and zinc are adopted to manage diarrhoea, and new vaccines against measles, pneumococcal disease and rotavirus are introduced. Immunization programs are widespread in Ghana, and there was an improvement in the immunization rate for measles from 68.8% in 1998 to 79.9% in 2008 and 87.7% in 2010 [ 22 ]. In 2000, community-based health planning and services (CHPS) and the Ghana Essential Health Intervention Project (GEHIP) were also established to reduce child mortality, particularly in rural areas [ 22 , 25 ]. Under the CHPS and GEHIP, community healthcare officers are trained to treat malaria, diarrhoea, acute respiratory diseases and administer child immunizations [ 25 ]. These implemented policies have fuelled a drastic reduction in both infant and under-5 mortalities as shown in Figs. ​ Figs.3 3 and ​ and4. 4 . Therefore, when compared with some states within the West African region, Ghana seems to have performed better in terms of reduction in under-5 mortality rates. For example, under-5 mortalities per 1000 live births in the selected West African countries are Mali (115/1000), Guinea Bissau (93/1000), Guinea (94/1000), Burkina Faso (89/1000), Niger (96/1000), Nigeria (109/1000) and Cote d’Ivoire (93/1000). Likewise, Ghana is better in infant mortality rates compared to Mali (75/1000), Guinea Bissau (60/1000), Guinea (61/1000), Burkina (61/1000), Nigeria (69/1000) and Cote d’Ivoire (67/1000) [ 26 ].

However, comparing under-5 mortality rate (per 1000 live births) with developed countries such as UK (4/1000), Australia (4/1000), Canada (5/1000), Italy (4/1000), Germany (4/1000), USA (7/1000) and Japan (3/1000) and infant mortality UK (4/1000), USA (6/1000), Australia (3/1000), Canada (4/1000), Germany (3/1000), Italy (3/1000) and Japan (2/1000), under-5 and infant mortality rates in Ghana are high [ 26 ]. Apparently, Ghana is not able to achieve the millennium development goal of reducing child mortality to 43/1000 live births [ 26 ].

Similarly, compared to other advanced/rapid developing countries such as Singapore (2/1000) and Malaysia (6/1000) and China (9/1000), Ghana lags behind in reducing infant and under-5 mortalities [ 26 ]. Surprisingly, many of these countries attained independence nearly the same period as Ghana [Ghana (1957) [ 27 ], Malaysia (1957) [ 28 ] and Singapore (1965) [ 29 ]. This indicates that the performance of the healthcare system has been sub-optimal, and the education aspects of the policies have not yet trickled down to remote communities. Some communities, for instance, still perceive child stunting (measure of chronic malnutrition in children) as normal, and therefore, related medical advice was sometimes neglected. Childhood malnutrition should be researched in depth. It is also imperative not to limit malnutrition to just weight, but also to the height of the child. Measuring height should be a critical part of assessing child growth. Breastfeeding programs should emphasize exclusive breastfeeding for the first 6 months to ensure that babies develop normally.

Maternal healthcare policies

Maternal mortality accounts for 14% of all female deaths, making it the second leading cause of female mortalities in Ghana [ 30 , 31 ]. Before 2000, it was estimated that between 540 and 650 mothers died for every 100,000 live births in Ghana [ 31 , 32 ]. With this high maternal mortality rate, the Ghana Health Service (GHS) implemented several policies that can help improve maternal health and reduce maternal deaths. First, there was the introduction of an antenatal care policy and a safe motherhood initiative 1998 [ 31 ]. These policies had a limited effect on maternal mortality. Financial inadequacies and preference for unskilled maternity care services were major contributors for maternal mortalities [ 31 ]. Therefore, the MoH introduced the delivery exemption policy in 2003 to provide free maternal delivery and reduce the financial constraints associated with using skilled maternal services [ 31 , 33 , 34 ]. The inclusion of the free maternal care policy in the NHIS has been beneficial. The number of mothers registered in the NHIS rose from 421,234 in 2008 to 754,648 in 2012, and on-going participation growth is evident [ 15 , 35 ]. The policy covers normal deliveries, assisted deliveries, caesarean sections and management of complications arising from maternal deliveries [ 35 ]. Ghana improved its maternal care by increasing the skilled care coverage from 47% in 2003, 55% in 2010 [ 33 – 37 ] and 68% in 2015 [ 37 ]. Because of these policies, maternal mortalities declined to 350/100,000 live births by 2013 [ 15 ] and 319 deaths in 2015 [ 38 ]. Although the implementation of these initiatives have improved access to medical care, maternal mortality in Ghana remains high. When compared with some states within the West African region, Ghana seems to have performed well in terms of reduction in maternal mortality rates. For example, maternal mortality per 100,000 live births in the selected West African countries are: Mali (587/100,000), Guinea Bissau (547/100000), Guinea (679/100,000), Burkina Faso (89/100,000), Niger (553/100,000), Togo (368/100,000), Nigeria (814/100,000) and Cote d’Ivoire (647/100,000) [ 38 ]. However, comparing maternal mortality rates (per 100,000) in selected developed countries such as UK (9/100,000), Australia (6/100,000), Canada (7/100,000), Italy (4/100,000), Germany (6/100,000), USA (14/100,000) and Japan (5/100,000), the maternal mortality rate in Ghana is high and unacceptable [ 38 ]. Similarly, Ghana’s maternal mortality rate is high compared to Singapore (10/100,000), Malaysia (40/100,000) and China (27/100,000) [ 38 ]. Several factors can be attributed to this: inadequate healthcare facilities in rural areas, preference for traditional birth attendants (TBAs) and lack of funds for transporting emergencies to better-resourced hospitals. An inadequate data set for the medical history of expectant mothers also impedes proper healthcare investigations [ 30 , 31 , 37 ]. Further, maternal mortalities are fuelled by limited access to contraceptives especially among women residing in the rural areas. Contraceptive use can assist in preventing unwanted/unplanned pregnancies, allows adequate spacing of pregnancies and limits the incidence of unsafe abortions [ 38 ].

More research on ways to improve the quality of life of expectant mothers after caesarean sections and maternal experiences after childbirth should be a priority while at the same time, efforts should be strengthened to scale up health impact interventions that will increase deliverability in health facilities [ 19 , 37 ]. For mothers that do not have health insurance especially those in the rural areas, medicines for treating sepsis and preterm births and vaccines against infections should be affordable and easily accessible.

The National Health Insurance Scheme policy

An estimated 150 million people globally experience financial hardship after accessing medical care through out-of-pocket payments [ 39 – 42 ]. Therefore, protecting the poor from catastrophic healthcare spending has become a priority in most countries [ 39 – 42 ]. Ghana spearheaded a community-based health insurance scheme (CBHIS) experiment in Sub-Saharan Africa (SSA) [ 43 ]. The scheme covered only 1% of the population and failed to improve the accessibility for the poor [ 43 , 44 ]. A more inclusive national policy led to the enactment of the National Health Insurance Law in 2003, which was later referred to as the National Health Insurance Scheme (NHIS) in 2004 [ 45 , 46 ].

The inception of the NHIS has offered enormous benefits to the populace and presently covers 95% of all diseases in Ghana [ 46 ]. Active members in the scheme have risen from 2.5 million in 2004 to 8,885,757 million in 2012 and 10,145,196 million in 2013 [ 45 ], covering 38% of the entire Ghanaian population [ 46 ]. Insured individuals pay half the cost of their healthcare treatments and, thus, have greatly reduced out-of-pocket expenditures [ 46 ]. Available data shows an increase in outpatient department cases, pharmaceutical usage, prenatal care, delivery services and maternal healthcare services [ 44 – 46 ].

Despite these important achievements, a high proportion of the populace (often rural citizens) are yet to enrol because of poverty, as they are unable to afford the NHIS registration fee [ 47 , 48 ]. This implies that universal health coverage has only become a vision. For instance, poverty-stricken regions in Ghana, primarily in the upper west, upper east and northern areas, have recorded low enrolment in the scheme compared to urban areas [ 47 , 48 ].

Chronic non-communicable diseases and policy interventions

The distribution of health outcomes (i.e. life expectancy, maternal, infant and under-5 mortalities) has been influenced by the pattern of disease. Rapid urbanization, affluence and globalization have led to physical inactivity and sedentary lifestyles. Additionally, the pattern of nutrition especially in the urban cities of Ghana has largely been skewed towards refined carbohydrates, red meats, snacks, processed and fats foods, while those rich in fibre, legumes and vegetables are abandoned [ 12 , 49 , 50 ]. Taken together, these behaviours have fuelled the prevalence of NCDs. NCDs are responsible for the death of an estimated 86,200 people in Ghana each year [ 51 ]. Presently, the leading causes of NCD deaths are cardiovascular (18%), cancer (5%), chronic respiratory (2%), diabetes (2%) and other NCDs (14%) [ 51 ]. Despite these alarming NCD-related deaths and its associated burden on the people affected, the majority of people living with known risk factors including hyperglycaemia, high blood pressure, dyslipidaemia among others, are not aware [ 49 , 50 ]. Surprisingly, Ghana does not have a comprehensive chronic disease policy yet [ 51 ]. At the same time, treatment for most of the NCD diseases is not covered by the NHIS, and with the limited government subsidy on prescription medicines, patients are compelled to pay before they could access medical care [ 15 ], which has also led to increased out-of pocket and catastrophic expenditures.

Ghana relies on low-level interventions that emphasize healthcare promotions and lifestyle modifications. It is therefore not surprising that health outcomes particularly life expectancy in Ghana (61.4) is still low when compared to developed countries such as Japan (83.59 years), Australia (82.25 years), USA (78.94 years), Canada (81.96 years), Italy (82.69 years), Germany (80.84 years) and the UK (81.06 years) [ 52 ].

It should be clear by now that the present health outcomes in Ghana are because of the combined effects of increasing health expenditure and healthcare policies. However, this paper cannot conclude without highlighting the main challenges that have been affecting the health sector in general.

Challenges facing the health system

A major problem facing the healthcare system is finance, and this is partly attributed to the Government of Ghana’s (GoG) low fiscal capacity and commitment to health [ 53 ]. For example, the government spent 4.9% of its gross domestic product (GDP) on healthcare in 2009 and increased it to 5.2% in 2012. As a result, Ghana could not honour the Abuja Declaration pledge where governments promised to allocate 15% of their GDP to health [ 2 , 53 ] and obviously, the insufficient budgetary health investment could not meet Ghana’s rising healthcare needs [ 8 ]. The MoH also reported that budgetary allocation on healthcare rose from GH¢771 million (US$191.078 million) in 2011 to GH¢1750 million (US$433.705 million) in 2012. Nonetheless, this increment was inadequate and has not made a significant impact [ 54 ]. On the other hand, financial obstacles amidst incessant financial losses have largely affected the smooth running of the NHIS. In 2012, the total revenue accrued by the NHIS was GH¢773.83 million (US$191.779 million) and total expenditures were GH¢788.32 (US$195.371 million), representing a net deficit of GH¢14.49 million (US$3.59 million) [ 45 , 46 ]. By 2013, the total revenue has increased to GH¢904.3 million (US$203.319) while the total expenditure was GH¢1001.10 million (US$225.083 million) representing a net deficit of GH¢96.80 million (US$21.76 million) [ 45 , 46 ].

Besides inadequate funds for public health, financial mismanagement is a major setback for achieving improved health outcomes [ 15 ]. Adequate public spending on healthcare alone cannot improve health outcomes because it needs to be accompanied by proper financial management. The trend in the Ghana healthcare system does not show adequate financial management. An estimated 36% of healthcare expenditures are wasted due to inefficiencies and financial misappropriation [ 15 ]. Presently, millions of dollars are still lost due to rising costs and corruption. With appropriate financial management, the government could save at least 36% of its total expenditures, which is enough to pay approximately 23,000 nurses [ 15 ].

Ghana has been facing a shortage of healthcare personnel. The doctor-to-patient ratio was 1:10,000 in 2010 and 1:9,043 in 2014 while the midwife to patient ratio was 1:1077 in 2010 and 1:1374 in 2014 [ 54 ]. More concerning is that the distribution of the health workforce is largely skewed to the two popular urban cities in Ghana: Accra and Kumasi [ 54 ] while rural hospitals have few and less well-qualified health personnel. Consequently, the few health workforce are compelled to work for extremely long hours without rest amidst poor working conditions. This results in substandard healthcare with most health workers feeling that they are not being rewarded for their efforts. The exodus of healthcare workers to developed countries, a concept known as ‘brain drain’, has therefore become prominent [ 14 , 15 , 55 ]. It is reported that more than 57% and 24% of doctors and nurses, respectively, are working abroad [ 14 ].

A study has also shown that the number of hospital beds is low, and Ghana has not shown enough commitment to increasing key resources and infrastructure [ 8 ]. Medical equipment and logistics are generally inadequate for the enormous number of patients that access the health service. Additionally, transportation and communication poses are formidable challenge throughout the country. This leads to delays in getting to healthcare facilities with the situation even worse in the rural parts of the country where most districts do not have ambulance services to attend to emergencies. Increased pressure on limited resources and equipment is often the case, and consequently, many patients are denied access to proper healthcare [ 55 ].

Recommendations and outlook

There should be adequate investments in district and local hospitals to improve early disease detection and facilitate early treatment. Adequate incentives, such as affordable housing, vehicle allowances, scholarships for aspiring medical professionals among others, can encourage healthcare personnel to stay instead of leaving for better opportunities abroad. Like the University of Health and Allied Sciences that was set up to solely train health professionals, more of such institutions should be set up across the country to increase the total health workforce. Concurrently, existing healthcare institutions should be expanded and equipped with state-of-the art facilities to improve healthcare delivery. There should be an increase in health revenues, better approaches for resource mobilization, tax exemptions on medical/diagnostic equipment and logistics, and strengthening public-private partnerships all of which will help bridge the funding gab and limit the impact of external resource decline [ 53 , 56 ].

While the government is trying and looking for approaches to accelerate the enrolment of vulnerable people to the scheme, useful alternative will be to adopt the voluntary insurance scheme such as the one introduced by the Chinese Government (fastest/largest developing country in the world) in 2002. In this scheme, rural dwellers are allowed to voluntarily enrol while the scheme is supported with funds from private institutions, local government and the central government [ 57 ]. Utilizing this innovative scheme, 72 million people that make up 83% of the entire rural population were insured and it has hugely reduced the economic burden of diseases among rural dwellers in China [ 57 ].

As stated previously, NCDs have hugely affected health outcomes leading to several premature deaths. Some of these deaths could have been prevented or perhaps delayed with the correct health education or health literacy. This is where the concept of predictive, preventive and personalized medicine (PPPM) comes in [ 58 ]. On the one hand, PPPM promotes the recognition of people who are intermediate in health and disease-suboptimal health and thus able to identify them (e.g. using screening tools) prior to clinical manifestation [ 59 ]. In such individuals, the potential progression to NCDs can be reversed with appropriate intervention. On the other hand, a unique characteristic of PPPM is to ‘identify the right patient, treat him or her with the right therapy with the right dose at the right time’ [ 58 ]. A person’s quality of life whether healthy or patient is influenced by multiple determinants such as environmental, economic, traditional and behavioural factors (Fig. ​ (Fig.5). 5 ). PPPM takes into consideration all these factors and thus providing a holistic platform for healthcare givers/professionals to treat and manage diseases [ 58 – 61 ]. Therefore, PPPM should be the next direction to improving healthcare in Ghana.

Hospital commercialization and the high level of uninsured individuals should not be politicized but should instead provide an overarching direction for increasing the utilization of healthcare services for all. We concur with the recommendation that there should be specialized healthcare agencies set up and tasked with regulating the allocation of healthcare resources within the sector. In other words, the government should strengthen these agencies and also set up independent anticorruption bodies to prevent financial mismanagement. Probity, transparency and accountability should also be priorities of the government and the healthcare sector so that citizens can hold the government accountable.

Based on our review, we conclude that the challenges of the healthcare system in Ghana can be ameliorated by (1) further investments in health, (2) establishing new health institutions and expanding existed ones, (3) providing incentives to discourage the exodus of health workers, (4) introduction of PPPM for managing and treating NCDs and (5) alternative insurance schemes for vulnerable groups. This, coupled with the will of the government to curb misappropriation of funds, will be important to realizing better health outcomes.

Abbreviation

CBHIS, community-based health insurance scheme; CDs, communicable diseases; CHP, Child Health Policy; CHPS, Community-Based Health Planning and Services; CHS, Child Health Strategy; GDP, gross domestic product; GEHIP, Ghana Essential Health Intervention Project; GHS, Ghana Health Service; GoG, Government of Ghana; MoH, Ministry of Health; NCDs, non-communicable diseases; NHIS, National Health Insurance Scheme; PPPM, predictive, preventive and personalized medicine; SSA, Sub-Saharan Africa; UNICEF, United Nations Children Fund

Acknowledgements

The authors are very grateful to colleagues who read the manuscript and especially to Emmanuel Aboagye at the Unit of Intervention and Implementation Research, Karolinska Institute, who gave valuable comments during the manuscript writing.

Author’s contributions

All authors contributed significantly for the completion of the paper. EA wrote the manuscript. WW revised the manuscript to ensure that intellectual content is maintained and gave the final approval for the paper to be published. KF and Xia Li were involved in the research design, offered constructive criticisms and proofread the manuscript.

Compliance with ethical standards

Ethical approval.

None sought.

EA is supported by Edith Cowan University under the International Postgraduate Research Scholarship. WW is supported by the Importation and Development of High-Calibre Talents, Taishan Medical University, China.

Conflict of interest

The authors declare that they have no conflict of interest.

Science as a Development Tool in Ghana: Challenges, Outcomes, and Possibilities for Women Academic Scientists

• First Online: 06 May 2020

Cite this chapter

• Josephine Beoku-Betts 3  

297 Accesses

This chapter examines how academic women scientists in Ghanaian universities situate and articulate their position in the development of science as a policy objective for higher education and sustainable development. It focuses on how political and economic conditions over the past two decades, and a persistent patriarchal institutional environment, impact the ability of women to effectively contribute to the scientific and technological development agenda in their society. It addresses how Ghanaian women scientists navigate these conditions, shape their own understandings, and situate a shared membership through community engagement. The study is based on semi-structured interviews of academic women scientists in three public universities in Ghana. Data analysis is informed and framed around feminist discourses on globalization and higher education in Africa.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save.

• Get 10 units per month
• Download Article/Chapter or Ebook
• 1 Unit = 1 Article or 1 Chapter
• Cancel anytime
• Available as PDF
• Read on any device
• Instant download
• Own it forever
• Available as EPUB and PDF
• Compact, lightweight edition
• Dispatched in 3 to 5 business days
• Free shipping worldwide - see info
• Durable hardcover edition

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Scientific Research and Human National Development in Moroccan Universities: Toward the Implementation of a Glocalized Scientific Research Culture

Women’s Empowerment Initiatives in Brazilian Universities: Cases of Extension Programs to Promote Sustainable Development

Research Collaborations for Enhanced Performance and Visibility of Women Scientists

https://data.worldbank.org/indicator/SP.POP.TOTL.FE.ZS?locations=GH

http://hdr.undp.org/sites/default/files/Country-Profiles/GHA.pdf

https://www.cia.gov/library/publications/resources/the-world-factbook/geos/gh.html

http://www.gh.undp.org/content/ghana/en/home/countryinfo/

Bibliography

Acker, Sandra, and Carmen Armenti. 2004. Sleepless in Academia. Gender and Education 16 (1): 3–24.

Article   Google Scholar  

Assié-Lumumba, N’Dri T. 2005. Critical Perspectives on the Crises, Planned Change, and the Prospects for Transformation in African Higher Education. Journal of Higher Education in Africa/Revue de l’enseignement supérieur en Afrique 3 (3): 1–29.

Google Scholar  

Blackmore, Jill. 2000. Hanging on to the Edge: An Australian Case Study of Women, Universities, and Globalization. In Globalization and Education: Integration and Contestation Across Cultures , ed. Nelly P. Stromquist and Karen Monkman, 333–352. Lanham: Rowman and Littlefield.

Brokensha, David, Dennis Michael Warren, and Oswald Werner, eds. 1980. Indigenous Knowledge Systems and Development . Washington, DC: University Press of America.

Currie, Jan, Bev Thiele, and Patricia Harris. 2002. Gendered Universities in Globalized Economies: Power, Careers, and Sacrifices . Lanham/Boulder: Lexington Books.

Etzkowitz, Henry, Carol Kemelgor, and Brian Uzzi. 2000. Athena Unbound: The Advancement of Women in Science and Technology . Cambridge, UK: Cambridge University Press.

Book   Google Scholar  

Imam, Ayesha M., and Amina Mama. 1994. The Role of Academics in Limiting and Expanding Academic Freedom. In Academic Freedom in Africa , ed. Mahmood Mamdani and Mamadou Diouf, 73–107. Dakar: CODESRIA.

Kwesiga, Joy. 2002. Women’s Access to Higher Education in Africa: Uganda’s Experience . Kampala: Fountain Publishers.

Lamptey, Alice. 1992. Promoting Women’s Participation in Teaching. Research and Management in African Universities. In Higher Education in Africa: Trends and Challenges for the 21st Century . Dakar: UNESCO Regional Office.

Mama, Amina. 2003. Restore, Reform But Do Not Transform: The Gender Politics of Higher Education in Africa. Journal of Higher Education/Revue de l’enseignement supérieur en Afrique 1 (1): 101–125.

Manuh, Takiywaa. 2002. Higher Education: Condition of Scholars and the Future of Development in Africa. CODESRIA Bulletin 3–4: 42–48.

Manuh, Takyiwaa, Sulley Gariba, and Joseph Budu. 2007. Change and Transformation in Ghana’s Publicly Funded Universities: A Study of Experiences, Lessons, and Opportunities. Oxford/Accra: James Currey/Woeli.

Mashelkar, Raghunath A. 2002. The Role of Intellectual Property in Building Capacity for Innovation for Development. In Indigenous Knowledge and the Integration of Knowledge Systems: Toward a Philosophy of Articulation , ed. Catherine A. Odora Hoppers, 188–199. Claremont: New Africa Education (NAE).

Moja, Teboho. 2004. Policy Responses to Global Transformation by African Higher Educational Systems. In African Universities in the Twenty-First Century , Liberalization and Internationalization, ed. Paul T. Zeleza and Adebayo Olukoshi, vol. 1, 21–41. Dakar: CODESRIA.

Morley, Louise. 1999. Organising Feminisms: The Micropolitics of the Academy . New York: St. Martin’s Press.

———. 2005. Gender Equity in Commonwealth Higher Education. Women’s Studies International Forum 28 (2–3): 209–221.

Hoppers, Odora, and A. Catherine, eds. 2002. Indigenous Knowledge and the Integration of Knowledge Systems: Towards a Philosophy of Articulation . Claremont: New Africa Books (Pty) Ltd.

Pereira, Charmaine. 2007. Gender in the Making of the Nigerian University System. Oxford/Ibadan: James Currey/Heinemann Educational Books (Nigeria).

Pincock, S. 2006. The Long Journey Home: The Future of Science in Africa. Scientist 20 (6): 44–51.

Prah, M. 2002. Gender Issues in Ghanaian Tertiary Institutions: Women Academics and Administrators at Cape Coast. Ghana Studies 5: 1–20.

Richards, Paul. 1985. Indigenous Agricultural Revolution: Ecology and Food Production in West Africa . London: Hutchinson.

———. 1996. Fighting for the Rain Forest: War, Youth & Resources in Sierra Leone . London: The International African Institute.

Sall, Ebrima, Yann Lebeau, and Ron Kassimir. 2003. The Public Dimensions of the University in Africa. Journal of Higher Education in Africa 1 (1): 126–148.

Stromquist, Nelly P., ed. 2007. The Professoriate in the Age of Globalization . Rotterdam/Taipei: Sense Publishers.

Stromquist, Nelly P., Manuel Gil-Antón, Carol Collatrella, Reitumtse Obakeng Mabokela, Anna Smolentseva, and Elizabeth Balbachevsky. 2007. The Contemporary Professoriate: Towards a Diversified or Segmented Profession. Higher Education Quarterly 61 (2): 114–135.

Subrahmanyan, Lalita. 1998. Women Scientists in the Third World: The Indian Experience . New Delhi/Thousand Oaks: Sage.

Tamale, Sylvia, and J. Oloka-Onyango. 2000. Bitches at the Academy: Gender and Academic Freedom in Africa. In Women in Academia: Gender and Academic Freedom in Africa , ed. Ebrima Sall, 1–23. Dakar: CODESRIA.

Teferra, Damtew. 2003. Scientific Communication and Research in African Universities: Challenges and Opportunities in the Twenty-First Century. In African Higher Education: An International Reference Book , ed. Damtew Teferra and Philip G. Altbach, 128–142. Bloomington: Indiana University Press.

Teferra, Damtew, and Philip G. Altbach. 2004. African Higher Education: Challenges for the 21st Century. Higher Education 47 (1): 21–50.

Thomas, S. 2003. Critical Issues Pertaining to the Gender Dimension of Biotechnology Policy . Commissioned paper for the Gender Advisory Board, United Nations Commission on Science and Technology for Development, July.

UN (United Nations). 2010. Gender, Science and Technology: Report of the Expert Group Meeting. Paris, September 28–October 1.

UNCTAD (United Nations Conference on Trade and Development). 2011. Science, Technology & Innovation Policy Review: Ghana. New York and Geneva. http://unctad.org/en/Docs/dtlstict20098_en.pdf . Accessed 5 Apr 2016.

UNDP (United Nations Development Programme). 2000. Ghana Development Report: Science, Technology and Human Development. Institute of Statistical, Social and Economic Research (ISSER), Accra.

———. 2018. Human Development Report: Ghana. http://hdr.undp.org/en/countries/profiles/GHA . Accessed 1 Sept 2019.

UNESCO (United Nations Educational, Scientific and Cultural Organization). 2010. UNESCO Science Report 2010: The Current Status of Science Around the World. UNESCO, Paris. http://uis.unesco.org/sites/default/files/documents/unesco-science-report-2010-the-current-status-of-science-around-the-world-en.pdf . Accessed 6 Apr 2016.

Download references

Author information

Authors and affiliations.

Center for Women’s Gender, and Sexuality studies, Florida Atlantic University, Boca Raton, FL, USA

Josephine Beoku-Betts

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Josephine Beoku-Betts .

Editor information

Editors and affiliations.

Cornell Law School, Cornell University, Ithaca, NY, USA

Muna B. Ndulo

Africana Studies and Research Center, Cornell University, Ithaca, NY, USA

N'Dri T. Assié-Lumumba

Rights and permissions

Reprints and permissions

Copyright information

© 2020 The Author(s)

About this chapter

Beoku-Betts, J. (2020). Science as a Development Tool in Ghana: Challenges, Outcomes, and Possibilities for Women Academic Scientists. In: Ndulo, M., Assié-Lumumba, N. (eds) Education and Development. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-40566-3_6

Download citation

DOI : https://doi.org/10.1007/978-3-030-40566-3_6

Published : 06 May 2020

Publisher Name : Palgrave Macmillan, Cham

Print ISBN : 978-3-030-40565-6

Online ISBN : 978-3-030-40566-3

eBook Packages : Economics and Finance Economics and Finance (R0)

Share this chapter

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Publish with us

Policies and ethics

• Find a journal
• Track your research

Addressing Contemporary Public Health Challenges in Ghana for Improved Outcomes: Getting to SDG 3

Original Research 12 December 2023 “We have nice policies but…”: implementation gaps in the Ghana adolescent health service policy and strategy (2016–2020) Emelia Afi Agblevor ,  4 more  and  Irene Akua Agyepong 2,390 views 1 citations

Original Research 14 August 2023 Why district assemblies disburse resources to district health systems for service delivery at district level in the context of decentralization: a comparative study of two districts in the Volta Region of Ghana Andrews Ayim ,  1 more  and  Nana Enyimayew 907 views 1 citations

Original Research 07 July 2023 How and why pharmaceutical reforms contribute to universal health coverage through improving equitable access to medicines: a case of Ghana Augustina Koduah 1,813 views 0 citations

Loading... Systematic Review 26 June 2023 Implementation of the Community-based Health Planning and Services (CHPS) in rural and urban Ghana: a history and systematic review of what works, for whom and why Helen Elsey ,  12 more  and  Irene Agyepong 3,700 views 1 citations

Original Research 25 May 2023 Universal coverage and utilization of free long-lasting insecticidal nets for malaria prevention in Ghana: a cross-sectional study Seth Kwaku Afagbedzi ,  6 more  and  Chris Guure 1,388 views 1 citations

Original Research 09 May 2023 Continuity of care among diabetic patients in Accra, Ghana Veronica Awumee  and  Samuel Kennedy Kangtabe Dery 1,196 views 1 citations

Original Research 09 May 2023 Making districts functional for universal health coverage attainment: lessons from Ghana Humphrey Cyprian Karamagi ,  9 more  and  Francis Chisaka Kasolo 1,127 views 0 citations

Original Research 13 April 2023 District-level analysis of socio-demographic factors and COVID-19 infections in Greater Accra and Ashanti regions, Ghana Alex Barimah Owusu ,  2 more  and  Edwin Takyi 2,583 views 1 citations

Original Research 09 February 2023 Maternal factors and child health conditions at birth associated with preterm deaths in a tertiary health facility in Ghana: A retrospective analysis Seth Kwaku Afagbedzi ,  2 more  and  Henrietta Taylor 1,574 views 0 citations

Loading... Original Research 03 February 2023 Influencing factors of work stress of medical workers in clinical laboratory during COVID-19 pandemic: Working hours, compensatory leave, job satisfaction Gang He ,  2 more  and  Houzhao Wang 2,921 views 4 citations

Original Research 22 December 2022 Estimation method for distance cost to access medical services: Policy and patient privacy implications in Taiwan Siao-Jing Guo ,  1 more  and  Chia-Feng Yen 1,858 views 0 citations

Original Research Frontiers in Public Health The role of community engagement towards ensuring healthy lives: A case study of COVID-19 management in two Ghanaian municipalities Matilda Aberese-Ako ,  8 more  and  Evelyn Ansah 1,335 views 0 citations

• Corpus ID: 155163617

Social problems and social work in Ghana: Implications for sustainable development

• Michael Baffoe , M. Dako‑Gyeke
• Published 1 March 2013
• Sociology, Education

19 Citations

Changing public perceptions and supporting improved working conditions for the social service workforce: expert perspectives from a global delphi study, social support structures; a catalyst to sustainable adolescents’ reproductive health programming in ghana, financial capability and asset building training in ghana through project-based learning.

• Highly Influenced

CARING FOR “PARENTLESS” CHILDREN: AN EXPLORATION OF WORK STRESSORS AND RESOURCES AS EXPERIENCED BY CAREGIVERS IN CHILDREN’S HOMES IN GHANA

An investigation of the operations of children’s homes in ghana, ‘being heard’: the socio-economic impact of psychiatric care on people diagnosed with mental illness and their caregivers in ghana, hurt or help understanding intimate partner violence in the context of social norms as practised in rural areas, the role of gender power imbalances in the spread of hiv among women in intimate relationships: guidelines for social work practice, ageing in ghana, perspectives of key informants on child abuse: qualitative evidence from northern ghana, 56 references, social work in africa: issues and challenges.

• Highly Influential

Redefining social work's emphasis on the 'social': the path to development

Social work education in africa: whence and whither, rural-urban migration and socioeconomic development in ghana: some discussions., a situation analysis of mental health services and legislation in ghana: challenges for transformation., domestic violence in ghana: an initial step., local suffering and the global discourse of mental health and human rights: an ethnographic study of responses to mental illness in rural ghana, empowerment in social work practice. a sourcebook., social work with children and their families: pragmatic foundations, coping strategies of independent child migrants from northern ghana to southern cities., related papers.

Showing 1 through 3 of 0 Related Papers

• Search Menu
• Sign in through your institution
• Advance Articles
• Editor's Choice
• Supplements
• E-Collections
• Virtual Roundtables
• Author Videos
• Author Guidelines
• Submission Site
• Open Access Options
• About The European Journal of Public Health
• About the European Public Health Association
• Editorial Board
• Advertising and Corporate Services
• Journals Career Network
• Self-Archiving Policy
• Terms and Conditions
• Explore Publishing with EJPH
• Journals on Oxford Academic
• Books on Oxford Academic

Article Contents

• < Previous

Ghana: health system review 2021

• Article contents
• Figures & tables
• Supplementary Data

D Opoku, AK Edusei, P Agyei-Baffour, G Teddy, K Polin, W Quentin, Ghana: health system review 2021, European Journal of Public Health , Volume 31, Issue Supplement_3, October 2021, ckab164.577, https://doi.org/10.1093/eurpub/ckab164.577

• Permissions Icon Permissions

A health system review provides a detailed description of a health care system and of reform and policy initiatives in progress or under development. The health system review of Ghana serves as an effort to also assess the system's performance towards the attainment of universal health coverage (UHC). A workshop was organized in 2018 to develop a template for writing the health system review of Ghana. This serves as a pilot study to test the feasibility of using a template somewhat like that of the WHO European Observatory on Health Systems and Policies for writing health system reviews of African countries. The health system review of Ghana is the first to be written for an African country modelled after the HiT reviews by the European Observatory. One key characteristics of the health system of Ghana is the introduction and reform of the national health insurance scheme (NHIS) in 2003 and 2012 respectively. About 40% of the population are enrolled and 60% enrolled are exempted from premium payments. Ghana has since 2010 scaled-up a national telemedicine programme, becoming one of the first adopters and innovators in Africa to integrate digital health technologies into mainstream health care system. Since 2018, Ghana has implemented the NHIS mobile renewal service, which allows payment of health insurance coverage using mobile money technologies. Ghana is one of the first countries to introduce a nationwide health insurance in Africa. The NHIS is one significant effort towards health systems strengthening and achieving UHC. Enrolment in in the NHIS contributes to better access to health care and improved financial protection. However, not only is population coverage low, but there is a serious concern about the system's financial sustainability. A promising approach is to improve the mobile-money based intervention through the high mobile-phone penetration rates in Ghana to enable more effective household saving arrangements towards UHC.

Ghana presents important lessons, including the introduction of a national health insurance. This contributes to better access to health care and improved financial protection.

Ghana is exploiting the use of mobile phone technologies and has become one of the first adopters and innovators in Africa to integrate digital health technologies into mainstream health care system.

• thrombocytopenia, heparin-induced
• health services accessibility
• health insurance
• telemedicine
• world health organization
• national health interview survey
• health care systems
• cell phones
• medical insurance coverage
• health information technology
• mobile health
• cell phone use

Email alerts

Citing articles via.

• Contact EUPHA
• Recommend to your Library

Affiliations

• Online ISSN 1464-360X
• Print ISSN 1101-1262
• Copyright © 2024 European Public Health Association
• About Oxford Academic
• Publish journals with us
• University press partners
• What we publish
• New features  
• Open access
• Institutional account management
• Rights and permissions
• Get help with access
• Accessibility
• Advertising
• Media enquiries
• Oxford University Press
• Oxford Languages
• University of Oxford

Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide

• Copyright © 2024 Oxford University Press
• Cookie settings
• Cookie policy
• Privacy policy
• Legal notice

This Feature Is Available To Subscribers Only

Sign In or Create an Account

This PDF is available to Subscribers Only

For full access to this pdf, sign in to an existing account, or purchase an annual subscription.

Global site navigation

• Celebrity biographies
• Messages - Wishes - Quotes
• TV-shows and movies
• Bizarre facts
• Celebrities
• Family and Relationships
• Real Estate

7 serious social problems in Ghana and their solutions: be in the know

Like other developing countries in Africa, Ghana faces multiple issues. Its contemporary society is highly influenced by rapid social and technological changes. These changes can no longer be solved using traditional approaches. It is time to think about new solutions to various social problems in Ghana.

A social problem is any condition or situation that adversely affects many people in a country. It disrupts the normal functioning of society. There are multiple social problems in Ghana. Some can be resolved easily, while others are more complex to solve.

Serious social problems in Ghana and their solutions

The social problems experienced by most Ghanaians today tend to form a chain. One challenge often leads to another.

Main social problems in Ghana in 2022

Below is a list of social problems in Ghana and their solutions.

1. Unemployment

Unemployment refers to the share of the labour force without work but are available for and seeking employment. The rate of unemployment in Ghana in 2020 was 4.70%, a 0.05% increase from 2020.

Macron vs the unions: What's at stake for France?

The Ghanaian Times reports that about 1.74 million people, which is equivalent to 13.4% of the total working population of 13 million aged 15 years and above.

The rate of unemployment can be attributed to numerous factors, including the prevailing economic recession, corruption , slow economic growth, and a sharply increasing population.

2. Corruption

One of the most pressing social problems in Ghana in 2022 is corruption. The same is being experienced in multiple African nations.

For a long time, Ghana has earned a significant amount of cash from its natural resources, including gold, manganese, bauxite, and diamonds. Unfortunately, a considerable portion of these resources goes down the cesspool created by corruption.

This means that despite the nation being naturally endowed, resources benefit a few and leave the rest in poverty. The country has many institutions and departments where one cannot receive service without bribing the officers.

Poor countries call for debt revolution at UN summit

3. Illiteracy and inaccessibility of quality education

Education is an important tool for development in any country. In Ghana, the quality of education is lagging behind. While there have been a few positive developments in the sector, much is desired.

The Ghanaian educational sector faces multiple challenges, especially in rural areas. The basic facilities in public schools are in deplorable states and inadequate. Besides, the human resources to fill the minimum criteria of a school are inadequate.

Many children, especially those from resource-poor settings, do not go to school or drop out early. As a result, the level of illiteracy is quite high.

According to Oxfam , approximately 24.2% of the Ghanaian national population lives below the poverty line. Numerous people, especially on the northern side of the nation, earn less than one American dollar a day.

Although the country is blessed with the resources needed to end extreme poverty and bridge the disparities between the rich and poor, it is failing to do so because of corruption.

France faces massive strikes over pension reform

5. Forest encroachment and desertification

Ghana is among the tropical countries that have suffered the most from deforestation in recent years. Shocking results show the forest cover has shrunk up to five times in one century.

The increasing human population has also encroached on land that should otherwise be left for forests and wildlife. Forest encroachment and desertification have led to climate change, especially long episodes of drought.

6. Rural-urban migration

Many young Ghanaians move from their rural homes to urban areas looking for jobs. In the capital city of Accra , for instance, the population has doubled since the ’90s.

Young people perceive urban areas to be the epicentre of economic opportunities and exciting modern lifestyles. Some of the challenges of rural-urban migration are poor housing conditions due to congestion in the cities, increased crime rates, and deterioration of the rural economy leading to chronic poverty.

UN development chief sounds alarm over debt distress

7. Lack of well-defined child welfare practice systems

Child rights and gender-based violations are pretty common in the country. Many would expect that in 2022, children's welfare is prioritised. Unfortunately, that is not the case.

The nation has poorly defined child welfare practices . In fact, it lacks a clear definition of what child abuse is. This makes it hard for social workers to fully protect the rights and freedoms of children and women.

The existing social service agencies often fail to meet the needs of the populations they serve due to a lack of clear policies and guidelines. The problem is further aggravated by poverty and corruption.

Solutions to social problems in Ghana in 2022

How can Ghana solve the problems explored above? Below are feasible measures that can be enacted to resolve the challenges.

Solving unemployment in Ghana

The high rate of lack of jobs can be solved in the following ways.

Texas: Wind and solar stake claim to land of oil

• The government should provide better financial support to technical institutions in the country. The demand for hands-on skills outdoes the supply, so the government should encourage young people to pursue technical courses.
• A youth-programmed fund should also be initiated to fund start-up businesses for the youth.
• The relevant authorities should also address the monster of corruption. If addressed, funds to expand the economy and create jobs will be availed.
• Additionally, the government should facilitate the export of human capital to get qualified Ghanaians job opportunities overseas.

Solving corruption

The government can implement the following anti-corruption measures.

• Make reforms in public administration and finance management. This should be coupled with strengthening the mandate of auditing bodies and agencies.
• Providing rewards and incentives to citizens who report corruption cases.
• Creating pathways that empower citizens with relevant tools and knowledge to engage and participate in their government.
• Promoting transparency and access to information.
• Creating, funding, and strengthening agencies that prosecute corruption cases.

China to unveil lowest growth goal in years: analysts

Solving illiteracy and inaccessibility of quality education

Illiteracy and inaccessibility of quality education can be resolved in the following ways.

• Ensuring the education sector is well-funded.
• Every child has the right to an education in a safe and healthy setting, so basic education should be made mandatory for all.
• Setting up programs that ascertain students transition from different levels of study to the highest where they earn the right skills.

Solving poverty in Ghana

The country can resolve poverty in the following ways.

• Ensuring all children access quality education.
• Ensuring basic health care for all.
• Prevent child marriages and promote proper child welfare practices.
• Supporting environmental programmes.
• Improving childhood nutrition.

Solutions to forest encroachment and desertification

Forest encroachment and desertification be solved in the following ways.

• Sensitising all citizens about the dangers of forest encroachment and desertification to society.
• Running tree planting programmes in communities.
• Resettling people who have settled in forest zones and giving stringent punishments to those who encroach on these areas.

Protesters demanding a census revolt in Bolivian city

Rural-urban migration

Rural-urban migration can be solved in the following ways.

• Creating employment opportunities in rural areas.
• Promoting agriculture in rural areas.
• Improving transport and communication network services.

Solving poor child welfare practice systems

Child welfare practice systems should be improved in the country. Policies on children's welfare should be updated, and terms should be defined clearly.

What is the meaning of a social problem?

A social problem is an issue that affects many people within a society. It arises from fundamental faults in the structure of a society.

What are the social problems in Ghana?

The social problems in Ghana include rural-urban migration, unemployment, forest encroachment and desertification, corruption, poverty, illiteracy, and inaccessibility of quality education.

What are 5 social problems?

The five pressing social problems in Ghana are unemployment, poverty, corruption, rural-urban migration, and the inaccessibility of quality education.

What are some of the social issues?

Fine girl in trouble: Hajia4Real allegedly arrested in the UK over $8m fraud, man drops full details

Some of the social problems in the world are unemployment, poverty, corruption, rural-urban migration, forest encroachment and desertification, and inaccessibility of quality education.

What are some of the economic problems facing Ghana?

Some of the economic challenges facing Ghana are unemployment, corruption, state-society gap, inconsistent economic policies, poor human capital development, poor health system, and crime and terrorism.

What is Ghana struggling with?

Ghana is struggling with unemployment, corruption, inaccessibility of quality education, poverty, forest encroachment and desertification, rural-urban migration, and poor child welfare practice systems.

What are examples of social problems?

Examples of social problems are corruption, unemployment, poverty, inaccessibility of quality education, forest encroachment and desertification, rural-urban migration, and poor child welfare practice systems.

There are several pressing social problems in Ghana. Most of them can be solved by implementing stringent government policies and measures.

READ ALSO: 25 profitable business ideas in Ghana in 2022 listed and explained

Climate activists challenge TotalEnergies CEO at COP27

Yen.com.gh recently published a list of profitable business ideas in Ghana in 2022. The high unemployment rate among Ghanaian youths is worrying. One way of solving the menace is turning to self-employment.

People of all ages can start and run successful businesses in the country. Before starting any venture, do a feasibility study to ascertain whether it is profitable.

Source: YEN.com.gh

Simon Ayub Simon Ayub is an adept content strategist and writer who generates content mainly focusing on the Facts and Life Hacks category. With over half a decade of creating relatable content for various brands, Simon has amassed sufficient knowledge to give every website a palpable spark – ample precedence for an ever-growing audience. Simon holds a BSc in Agricultural Economics and is a Certified Public Accountant. He studied SEO tactics and analytics out of his love for writing.

Chris Ndetei (Lifestyle writer) Christopher Ndetei is a junior reporter writer who joined the Yen team in May 2021. He graduated from the Machakos Technical College in 2009 with a diploma in ICT. Chris has over two years of experience in content creation and more than ten working in the hospitality industry. He covers lifestyle/entertainment, focusing on biographies, life hacks, gaming and guides. In 2023, Christopher finished the AFP course on Digital Investigation Techniques. You can reach him at [email protected]

You are using an outdated browser. Please upgrade your browser or activate Google Chrome Frame to improve your experience.

Thanks for signing up as a global citizen. In order to create your account we need you to provide your email address. You can check out our Privacy Policy to see how we safeguard and use the information you provide us with. If your Facebook account does not have an attached e-mail address, you'll need to add that before you can sign up.

This account has been deactivated.

Please contact us at [email protected] if you would like to re-activate your account.

On Sept. 24, 2022, Global Citizen Festival: Accra lit up the iconic Black Star Square, with some of the world’s leading artists, world leaders, business leaders, philanthropists, and Global Citizens coming together to drive change in the mission to end extreme poverty NOW. 

The Global Citizen Festival campaign culminated in $2.4 billion mobilised to help end extreme poverty — including more than $440 million earmarked exclusively to support initiatives to end extreme poverty in Africa. 

But as well as this, it was a crucial moment to bring together young Ghanaians to take action for girls, for the planet, and to create change. 

In the run up to Global Citizen Festival: Accra, we hosted a series of events to engage young people in Ghana and empower them to take action on the issues they care about most. From beach cleanups , to a Festival of Cultures, to popups with sustainable fashion designers, to a youth forum that culminated in a petition to Ghana’s government highlighting the changes young Ghanaians want to see — Global Citizens got involved in their hundreds. 

At these events, we took the opportunity to ask young Ghanaians what issues matter most to them, and what action they want to see to drive real, lasting change in their lives and the lives of their communities. Here’s what they said. 

Youth Unemployment

Regina Buabeng is a student of Regional Maritime University in Accra. She wants to see more action taken to combat youth unemployment, which is a huge issue both in Ghana and across the continent. You can find out more about why youth unemployment is such a significant issue across Africa by taking our quiz . 

Regina Buabeng is a student in Ghana Image: Betty Kankam-Boadu for Global Citizen

Ghana’s youth unemployment rate, according to a 2021 census , is at an all-time high of 13.4% — almost three times higher than in 2010. It’s a worrying trend for soon-to-be graduates like Buabeng, who we caught up with at a beach cleanup we hosted with Plastic Punch Ghana at Regional Maritime University on Sept. 10. 

“Thinking about all the money my parents have spent on my education and going out being unemployed makes me feel bad,” she told Global Citizen.

Anita Laryea is an auditor based in Accra and she wants to see more action taken to improve sanitation in Ghana — just like Global Citizen Festival: Accra headliner, Stonebwoy , who is also Ghana’s global ambassador for sanitation . 

According to UNICEF, there is still no urban sanitation strategy in Ghana , meaning that various efforts to improve sanitation aren’t being effectively monitored or coordinated. The capital, Accra, continues to battle annual floods which affect lives, health, properties, and businesses. This flooding is partly attributed to the changing climate, but also the issue of improper disposal of waste — with waste, much of it plastic, blocking existing drainage systems. 

Anita Laryea is an auditor in Ghana Image: Betty Kankam-Boadu for Global Citizen

“You walk around town you see someone drinking water and the person just throws it on the streets,” Laryea said, when we spoke with her at the beach cleanup on Sept. 10. “Some people make rubbish in their houses and throw it in the gutters. It causes the flooding.”

The rains in May and June this year left many parts of Accra and Kumasi flooded, bringing into question the cities’ climate resilience plans. 

Frances Quayson highlighted corruption in Ghana’s police service as an issue he wants to see addressed. A survey, released in July 2022 by the Ghana Statistical Service, named the Ghana Police Service as the most corrupt institution in Ghana . 

Frances Quayson works in media industry in Ghana Image: Betty Kankam-Boadu for Global Citizen

“I work in the media and I have been seeing them taking money anytime I travel from Accra to Takoradi,” Quayson said. “If somebody wants to do something bad they can easily pay and do it.”

Economic Crisis

Kwaku Kumi, the owner of Gold Coast Tokota, a manufacturer of made-in-Ghana footwear, is concerned about the exchange rate in Ghana and what it means for the financial security of Ghanaians. The continuous weakening of the country’s currency against the US dollar has made it one of the worst-performing currencies in the world , according to Bloomberg. 

Kwaku Kumi is an entrepreneur in Ghana Image: Betty Kankam-Boadu for Global Citizen

Kumi told us: “I am doing business in Ghana now and, trust you me, the dollar rate is not helping us. It’s not easy to operate a business in Ghana. I am still in business because I am taking that leap of faith that things will change.”

Eugenia Tenkorang, a local journalist, wants to see more action taken to tackle poverty and the impact it’s having on Ghanaians' lives. 

In 2022, around 3.4 million people in Ghana are living in extreme poverty — meaning on less than $1.90 a day — and the vast majority of these ( about 3.1 million ) live in the country’s rural areas. 

But while extreme poverty in the country is falling, there are many ways poverty can be experienced beyond the extreme poverty criteria of living on less than $1.90 a day — including being deprived of health, education, living standards, and more. 

Eugenia Tenkorang is a journalist in Ghana Image: Betty Kankam-Boadu for Global Citizen

According to a 2020 report from the Ghana Statistical Service and the UN Development Programme (UNDP), around 2 in 5 Ghanaians are identified as poor beyond monetary deprivations — or an estimated 14 million Ghanaians who are “ multi-dimensionally poor ”. 

As Tenkorang added: “The level of poverty, which is seen in almost all spheres, really gets to me.” 

“Personally, I know a woman who grew up in poverty,” she continued. “She got married and raised all her three children in poverty. The kids have graduated, but have not gotten employed yet. And so, these children, whose parents were looking forward to a brighter future for them, have grown up to continue the poverty cycle.”  

Global Citizen Asks

Demand Equity

5 Key Issues That Matter Most to Young People in Ghana

Oct. 11, 2022

• High contrast
• ABOUT UNICEF
• THE CONVENTION ON THE RIGHTS OF THE CHILD
• THE SITUATION OF CHILDREN IN GHANA
• Work for UNICEF
• PRESS CENTRE

Search UNICEF

Research and reports, publications, data, information and analysis related to unicef's work in ghana.

Find out more about UNICEF's latest publications, reports and information in Ghana

Championing Change for Children - Advocacy Bulletin

A UNICEF Ghana Bulletin

The Impact of COVID-19 on Adolescent Girls in Ghana

A Mixed-method Study

2022 District League Table Report

Measurement index that tracks national development across 261 districts in Ghana

2023 UNICEF Ghana Budget Briefs

A budgetary analysis of the key social sectors in Ghana

Generation Unlimited Ghana

2022 Country Assessment of the Youth Ecosystem

UNICEF Ghana Newsletter: Q2 2023

A summary of our achievements from April to June 2023

UNICEF Ghana Newsletter: Quarter One

January to March 2023 Highlights

The State of the World’s Children 2023

For every child, vaccination

Bridging the Gender Digital Divide

Challenges and an Urgent Call for Action for Equitable Digital Skills Development

Extreme Jeopardy

Ten million children in the central Sahel need humanitarian assistance amid spiralling conflict and punishing climate.

UNICEF in Ghana Newsletter Q4

A summary of achievements from October to December 2022

UNICEF in Ghana Newsletter - Quarter 3

A summary of achievements from July to September 2022

UNICEF Ghana Budget Briefs 2022

The 2021 District League Table Report

This paper is in the following e-collection/theme issue:

Published on 2.7.2024 in Vol 26 (2024)

Issues Related to the Use of Visual Social Networks and Perceived Usefulness of Social Media Literacy During the Recovery Phase: Qualitative Research Among Girls With Eating Disorders

Authors of this article:

Original Paper

• Elena Faccio 1 , Prof Dr   ; 
• Margherita Reggiani 2 , Dr   ; 
• Michele Rocelli 1 , PhD, Dr   ; 
• Sabrina Cipolletta 3 , PhD, Prof Dr  

1 Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padua, Italy

2 Psychologist-Operator at Vivere Verde Onlus, Roma, Italy

3 Department of General Psychology, Padova, Italy

Corresponding Author:

Elena Faccio, Prof Dr

Department of Philosophy, Sociology, Education and Applied Psychology

University of Padova

Via Venezia 14

Padua, 35131

Phone: 39 3479607182

Email: [email protected]

Background: The patient-centered approach is essential for quality health care and patient safety. Understanding the service user’s perspective on the factors maintaining the health problem is crucial for successful treatment, especially for patients who do not recognize their condition as clinically relevant or concerning. Despite the association between intensive use of visual social media and body dissatisfaction and eating disorders, little is known about the meanings users assign to posting or searching for edited photos and the strategies they use to protect themselves from digital risks.

Objective: This study aims to examine how young women recovering from eating disorders in Northern Italy perceive the health risks and potential benefits associated with visual social networks (ie, Instagram and Snapchat). The literature has found these platforms to be detrimental to online body comparisons. It also explores the perceived usefulness, willingness, and personal interest in coconstructing social media literacy programs with girls recovering from eating disorders.

Methods: A total of 30 semistructured interviews were conducted with adolescent girls aged 14-17 years at the end of their treatment for eating disorders. The following areas of research were addressed: (1) the meanings associated with the use of Instagram and Snapchat; (2) the investment in the photographic dimension and feedback; (3) the impact of visual social networks on body experiences; (4) the potential and risks perceived in their use; (5) the importance of supporting girls undergoing treatment for eating disorders in using social networks; and (6) the usefulness and willingness to co-design social network literacy programs. Content analysis was applied.

Results: A total of 7 main contents emerged: active or passive role in using social networks, the impact of online interactions on body image, investment in the photographic dimension, effects on self-representation, perceived risks, self-protective strategies, and potential benefits. The findings highlight a strong awareness of the processes that trigger body comparisons in the virtual context, creating insecurity and worsening the relationship with oneself. The self-protective behaviors identified are the development of critical thinking, the avoidance of sensitive content, increased control over social networking site use, and a certain skepticism toward developing antagonistic ideologies. All these topics were considered fundamental.

Conclusions: The findings provide important insights for health professionals working with youth in preparing media literacy programs. These programs aim to reduce potential risks and amplify the positive effects of online resources. They underscore the importance of addressing this issue during hospitalization to develop skills and critical thinking aimed at changing small habits that perpetuate the problem in everyday life. The inherent limitations in current service practices, which may not adequately address individual needs or impact posttreatment life, must also be considered.

Introduction

Although intensive use of visual social media and online body comparisons have been strongly linked to body dissatisfaction and eating disorders (EDs) [ 1 , 2 ], the literature has only partially explored the potential impact of competence development in the mindful use of social media during hospitalization for EDs [ 3 ].

Recent research on the topic has primarily been divided into 2 main strands: one focusing on the specific ways social media is used by individuals with EDs [ 4 , 5 ], and the other exploring the online environment as a potential “place” for therapy [ 6 , 7 ]. There are no examples of collaborative projects involving mental health professionals and service users during recovery from EDs that aim to jointly examine visual social media in new ways and co-construct new awareness about its use.

The concept that the process of care is a collaborative journey involving various stakeholders—researchers, health care providers, and service users—is a principle prominently featured in official health care documents [ 8 ] but less frequently implemented in practice [ 9 ]. This principle suggests that patients are “real experts” and that their embodied knowledge can form the foundation for coproducing the care pathway. This approach presupposes that care program design occurs within the context of people’s lived experiences, including their discourses around the body, how they perceive it, and the environments in which they socialize about ideals of desirable bodies (eg, social media). It emphasizes the importance of engaging with users in their own worlds and languages, rather than being confined to the perspectives of health care professionals [ 9 ].

During hospitalization for ED treatment, girls are usually either not allowed to use mobile phones or only permitted to use them during restricted time slots. If the use of social networking sites (SNSs) is not discussed and explicitly addressed, returning home may lead patients to revert to their previous SNS usage and interpretations, potentially undermining the long-term effectiveness of the treatment. Social media literacy programs aimed at improving body image–related outcomes should be implemented not only in the context of ED prevention but also in rehabilitation [ 3 ]. According to Fitzsimmons-Craft et al [ 10 ], only 20% of therapists have asked patients with ED about the perceived impact of social media on their body image experiences. Understanding the meanings and ways in which girls use SNSs is essential for designing educational and rehabilitation pathways that help build self- and body perception based on criteria different from those that contributed to the development of the ED [ 11 , 12 ].

Our research represents the first step in drafting a collaborative project involving researchers, health professionals, and service users. The goal is to identify the most salient and relevant issues related to social media use from the perspective of girls undergoing treatment.

SN Use and Body Image Concern: What Psychological Processes Come Into Play?

Social media is a significant source of sociocultural pressure regarding appearance and influences adolescents’ relationships with others as well as their perceptions of their own bodies. Active engagement in activities related to the photographic dimension on social networks (SNs) has been shown to contribute significantly to the development and perpetuation of concerns related to body image and food intake [ 13 , 14 ]. Such activities include publishing photographs, viewing others’ photographs, commenting or liking posts, and receiving feedback. Compared with the passive use of SN platforms, these active behaviors are more insidious in fostering dynamics of comparison and competition between bodies, thereby exposing individuals to the scrutiny of social judgment [ 15 - 17 ].

A clear and direct connection between posting edited photos and risk factors for EDs has been consistently confirmed by various studies [ 18 ]. Indeed, social media usage is a plausible risk factor for the development of EDs, a finding supported by research from Asia, indicating that this association is not limited to traditionally Western cultures [ 19 ].

Intensive use of SNSs has been linked to the internalization of the thinness ideal, self-objectification, and body dissatisfaction [ 20 - 22 ]. The literature defines the internalization of the thinness ideal as the degree to which an individual cognitively adopts socially defined standards of attractiveness and engages in behaviors aimed at approximating these ideals [ 20 ]. This process of striving for an ideal physique through the intensive use of social media can lead to body dissatisfaction and subsequently to disordered eating behaviors. Individuals may pursue an idealized body image that is often unattainable, which can persist even during recovery from EDs and increase the risk of relapse. Moreover, the habit of viewing bodies as objects on social media can socialize girls into self-objectification, as they internalize an external spectator’s perspective of their own bodies. This encourages habitual monitoring of one’s physical appearance, a phenomenon known as self-surveillance. It can lead to feelings of anxiety, reduced awareness of one’s own internal states, body shame, and a fear of internalized judgment from others. Another factor that could influence the relationship between exposure to SNSs and the development of EDs is the significance placed on feedback received through social media. Research has shown that the extent of one’s SN, as measured by the number of “friends” [ 23 ], may predict a stronger inclination toward pursuing thinness. Facebook (Meta Platforms, Inc.) use has been identified as a prospective predictor of increased symptoms related to EDs [ 13 ]. Moreover, research indicates that high “appearance exposure” specifically through Facebook, rather than overall Facebook use, is positively correlated with increased body image issues among adolescent girls [ 14 ].

Visual SNs and the Risk of Developing EDs

Regular sharing of self-images on social media platforms such as Facebook, Instagram (Meta Platforms, Inc.), or Snapchat (Snap Inc.), along with actively manipulating these images before sharing, seems to be linked to heightened perceptions of body shape and weight, increased body dissatisfaction, and tendencies toward dietary restriction [ 24 ]. Facebook users tend to be older compared with Instagram users, and this age difference may contribute to younger Instagram users being at higher risk of developing EDs and expressing greater concerns about the impacts of sharing their images on SNs [ 4 ]. Analyzing fitness content on Instagram, particularly posts tagged with hashtags such as #fitspiration, #fitspo, and #thinspiration, reveals that the majority of images depict women with 2 prominent characteristics: thin bodies that are also visibly toned and muscular. This portrayal reinforces the notion that only a thin body can be considered fit [ 25 ]. The pairing of thinness with muscularity appears in as many as two-thirds of the photos posted by influencers [ 20 ], and these images have a more significant impact on body image concerns compared with photos posted by celebrities or models [ 25 ].

Another SNS that emphasizes the visual dimension and has experienced rapid growth is Snapchat. Currently, there is limited research dedicated to investigating the effects of this platform. One of its distinctive features is that users can apply filters to alter their appearance before sharing photos. Additionally, Snapchat is known for its privacy settings and the ephemerality of content, which is typically automatically deleted shortly after being viewed [ 26 ].

Comparative research indicates that the correlation between photo manipulation using specific editing tools (filters) and body image concerns appears to be stronger on Snapchat than on Instagram [ 27 ]. Those who frequently use Snapchat’s lenses to enhance their photos appear to experience higher levels of dissatisfaction with their appearance, leading them to seek out environments that are highly appearance-oriented and focused on enhancing their appearance. Posts on Instagram tend to be more curated, with teenagers often spending considerable time and effort choosing the “right” content before taking a photo, rather than editing it after it has been taken [ 28 ]. This investment of time and energy before capturing the photo may strongly correlate with concerns about body image compared with postphoto retouching [ 29 , 30 ]. Moreover, while Snapchat is often used to connect with close contacts, users may be less focused on their physical appearance when taking pictures. By contrast, the larger audience on Instagram may have a more significant influence on body image concerns.

Research Aims

In light of these considerations, one might inquire about how adolescent girls undergoing treatment for EDs utilize SNs. What significance do they attribute to their SN usage? Do they differentiate between manipulated and unedited images? What strategies do they use to shield themselves from the impact of the content they post or view? Are they cognizant of which modes of SN use could potentially influence clinically significant outcomes?

Our focus is on exploring the usage of purely photographic platforms such as Instagram and Snapchat, which are particularly insidious in terms of fostering comparisons between bodies on the network [ 27 - 30 ]. We are interested in investigating the different emotions and experiences participants have when sharing their own photos in a private and intimate network among friends, such as Snapchat [ 27 ], versus sharing them in front of a larger audience, as is the case with Instagram [ 30 ].

Another area of interest for our investigation involves understanding the meanings associated with the permanence or short duration of content created and received on social media platforms. Specifically, while content published or shared on Instagram is permanent, on Snapchat, users determine the lifespan of their content, after which it is automatically deleted [ 27 ].

Additionally, we are interested in understanding whether girls use strategies to mitigate the potential influence of exposure to certain images, whether they can differentiate between edited and unedited photos, and whether they protect themselves from uncritically accepting messages from SNs. The literature [ 29 ] has demonstrated that visual social media can also be utilized during the recovery process from an ED to promote health messages and well-being. Paradoxically, the use of SNs that involve transforming one’s own photos has also been identified as an important tool, albeit in a positive sense [ 26 ]. Therefore, it is not merely the photo itself but how it is used that determines whether it serves as an “exit” or “entry” point in managing eating behaviors.

The ability to alter one’s images has both positive and negative implications. It allows individuals to transform their appearance inexpensively and democratically, fostering a sense of personal empowerment. However, the ease of digitally altering one’s appearance also leads to an increase in the number of manipulated images that people view and are confronted with. This phenomenon may subsequently heighten dissatisfaction with one’s physical appearance and intensify the pressure to alter it.

In conclusion, we also sought participants’ opinions on the relevance of the proposed topics and what other subjects they would consider important in a collaboratively designed program focused on the responsible use of SNs, intended for potential users in the recovery process.

Sampling and Recruitment

After sharing the objectives and content of the research with health care staff, we informed users of the local health unit for the treatment of EDs within the National Health Service in Eastern Veneto (specifically, the Casa delle Farfalle Residential Protected Therapeutic Community for Children).

The health care staff presented the research to the girls, obtained their consent, requested authorization from their parents, and provided information about the study. They also organized the schedule for appointments. All the girls who were invited agreed to participate; none declined the invitation. The participants and their families were informed of their right to withdraw from the study at any time. They signed a written informed consent form regarding their participation in the research and its potential publication.

Thirty adolescent girls, with a mean age of 15 (range 14-17) years, expressed interest in participating. The inclusion criteria were as follows: a diagnosis of an ED, being in the early stages of treatment with at least 15 days of hospitalization, having an active Instagram and Snapchat profile for at least six months before admission, and willingness to participate in interviews.

We extended the invitation to participants who were at the beginning of their treatment journey because we preferred individuals who had not yet been significantly influenced by the discussions occurring between users and health care providers during their hospitalization period.

The interviews were conducted by MRe, one of the authors of this study. After confirming their availability, she held several preliminary meetings to establish rapport and further explain the study’s objectives and implications. The interviews were conducted individually in a room on the ward where each participant met with the research assistant.

Ethical Considerations

The research protocol was approved by the Ethical Committee of the School of Padova, University of Padova (approval number 2018/2745-10/7). Before commencing the interviews, participants and their parents were informed that participation in the research was voluntary and without any compensation, and their consent was obtained. The original informed consent that participants signed included permission to conduct secondary analysis without additional consent. The final data set is anonymized, ensuring that no identifiable private information linked to participants is included.

Data Collection and Analysis

A semistructured interview consisting of 9 open-ended questions was designed specifically for this research ( Table 1 ). It covered the following areas: (1) the meanings attributed to the use of Instagram and Snapchat; (2) the level of engagement with the photographic aspect and the interactivity generated around it, particularly in terms of feedback; (3) the perceived impact of Instagram and Snapchat usage on body experiences; (4) the potential benefits and risks associated with the use of SNs; (5) the importance of providing support and guidance to girls undergoing treatment for EDs in their use of SNs; and (6) the willingness to participate in and contribute to the co-design of SN literacy programs.

The researchers formulated the questions based on the research objectives. Initially, there were twice as many questions, but they were later streamlined to focus on the most comprehensible ones. The first interviews helped refine these questions further, addressing any areas that appeared unclear or prone to misunderstanding.

Finally, the girls were asked to provide feedback on the relevance of the suggested themes for developing programs on critical thinking regarding SN use during hospitalization. They were also encouraged to add any additional topics they considered important. The interviews took place between June and July 2021. Each interview lasted approximately 45 minutes and was audio-recorded and transcribed verbatim.

Content analysis was conducted following the guidelines outlined by Creswell [ 31 ]. The responses from participants were read and coded, creating meaning units that were categorized accordingly. This process resulted in the development of a codebook, which was then systematically applied to analyze all responses. A triangulation of analyses involving 3 researchers (MRe, EF, and SC) was conducted. This process included sharing one researcher’s initial coding to critically discuss the initial coding patterns and subsequently reach a consensus on the overall interpretation of the data. This approach allowed for interpretations to be challenged, refined, and ultimately agreed upon through collaborative discussion among the researchers.

As the analysis moved from macrocategories (general) to microcategories (specific), there was a progressive refinement and detailed coding of the responses. Initially, responses were categorized at a broader and more anonymous level, providing a general commentary. As the analysis proceeded, categories became more specific, focusing on individual experiences and emotional impacts on personal lives. For instance, the macrocategory “virtual world configuration (VW)” is subdivided into 2 categories: “VW as an extension of reality” and “VW as a world distinct from real life.” These categories represent opposite ends of a continuum that delineates how participants perceive the relationship between the virtual world and the real world. The category “virtual world as an extension of reality” is further detailed in the subcategory (self-reference) “the virtual world significantly influences self-perception.” Participants who hold this view consider the virtual world relevant, viewing it as a source of inspiration for their real-life decisions (microcategory, fourth level of analysis). Conversely, individuals who perceive the virtual world as “separate and distinct from the real world” (category—second level of analysis) specify that the virtual world “has no impact on their self-concept” (subcategory—third level of analysis) and they “regard it as transient” (microcategory, fourth level of analysis). Another example of the categorization system and codebook created can be seen in describing the use of SNSs: we classified as “active use” everything related to actively seeking contacts and interactions, engaging in discussions, sharing personal information, and editing photos and stories. By contrast, we classified as “passive use” those actions oriented toward reading and viewing content made available by others, without active personal involvement. This position entails observing rather than actively participating in the virtual scene.

The second step was quantitative: each category was assigned a code of 1 or 0 based on its presence or absence. We focused on the number of respondents who mentioned a particular category, rather than the frequency of mentions for that category. This approach allowed us to provide an overview of the girls’ attitudes toward the investigated issue. It was particularly important for us to gain a general understanding of the impact and prevalence of specific types of experiences, as well as to explore the personal meanings the girls attributed to the topic in a more qualitative manner.

After completing the analysis, all authors of the paper convened to review the results and make any required adjustments. The draft summary of the main results paper was also shared and discussed during the collaborative analysis and writing phases.

Virtual Word’s Configuration

An overview of the results and the codebook developed during the analysis can be found in Multimedia Appendix 1 .

The thematic coding of the text collected in reference to the first answer revealed 2 main categories: the first, mentioned 28 times, portrays the virtual world as an extension of everyday reality, where online activities have a tangible impact on how respondents perceive themselves. The second category, mentioned only twice, contrasts with the first by viewing the virtual world as an ephemeral and transient realm where an idealized self-image is projected. In this perspective, the impact of online activities is perceived as less significant compared with activities in “real” life, which are seen as separate and more concrete.

SNs’ Active or Passive Ways of Use

Regarding the mode of SN use, 2 main polarities emerged: one characterized by more active engagement and the other by more passive interaction. The proactive category included initiating relationships with others (5 mentions), sharing personal narratives (11 mentions), posting personal photos or stories (3 mentions), and searching for information (23 mentions). By contrast, the passive end of the spectrum included consulting content posted by others (21 mentions). Regarding proactive use, Instagram was noted for fostering positive emotional experiences through contact and exchange with other users (3 mentions), whereas Snapchat was valued for its utility in sharing daily life and disclosing personal information (2 mentions). The most frequently mentioned activity, active information seeking through SNs, was primarily described as a source of stimulation and inspiration, driven by curiosity (13 mentions), to reinforce and update interests (2 mentions), and also as focused information seeking on body-related issues (16 mentions).

As for the eating disorder, I used it a lot to watch food videos, videos of people cooking or even people doing particular sports, gym, like, I don’t know, all those fitness posts. That was the main use. [Participant 2]

Finally, the use of photo editing functions was noted. Passive use of Instagram and Snapchat refers to the reception of content generated by other users for entertainment purposes.

Online Interactions’ Impact

The impact attributed to SNS use is expressed in terms of “social confirmation,” as they are viewed as significant for providing a channel of self-recognition (20 mentions) that includes both approval and disapproval (12 mentions). This results in emotions of personal gratification (7 mentions), support (3 mentions), and encouragement (5 mentions), but also anxiety related to the fear of judgment (5 mentions) and feelings of disconfirmation when few likes are received (10 mentions).

Back then, I thought that if more people commented on my content, that meant more people liked me. The more likes I received, the more others liked me [...]. [Participant 6]

The impact of online interactions varied depending on the specific use of Instagram or Snapchat (20 mentions): Instagram is perceived as having a more tangible and “real” impact compared with Snapchat (18 mentions). Feedback received on Instagram is deemed more significant, to the extent that some respondents consider it a metric for determining their personal worth (8 mentions). There was also a notable sense of distrust toward feedback gathered through SNSs (10 mentions). Consequently, receiving likes and comments was perceived as unimportant due to skepticism about the authenticity of posts. Some respondents rarely received likes and comments, feeling unpopular (6 mentions) and disregarded both on social media and in everyday life.

Regarding Snapchat, the automatic deletion of content and the narrow composition of the network seem to foster a playful, humorous atmosphere (5 mentions) and encourage creativity. This moderates the impact of feedback received (11 mentions).

Investment in the Photographic Dimension

The use of photographs on social media platforms shifts from total involvement (24 mentions) to complete disengagement (6 mentions). Photographs serve not only for self-promotion (20 mentions), fulfilling the desire to be seen (11 mentions), and presenting the best version of oneself (7 mentions), but also for gaining a deeper understanding of oneself (9 mentions) and celebrating specific events (4 mentions). Active involvement in the photographic dimension was specifically associated with Instagram, attributed to its high degree of self-image exposure (16 mentions). SNSs are portrayed as platforms where users consistently share only the best aspects of themselves to appear perfect (7 mentions). The use of Instagram, in particular, fosters second thoughts and inhibitions regarding photo publication (10 mentions). The high degree of exposure on Instagram promotes a tendency to hyper-control the quality of photographs, induces concerns about the perfection of one’s images, and encourages individuals to scrutinize and edit their photos extensively.

When I was going to use Instagram, I never published photos [...] because many more people can see it there, even two hundred, three hundred people can see it [...] [Participant 3]

The “disinvestment” contents (6 mentions) were primarily attributed to feelings of embarrassment (3 mentions) and discomfort (4 mentions). By contrast, Snapchat’s emphasis on ephemerality (3 mentions) and frivolity (2 mentions) in its content contributes to a platform dominated by carefree attitudes toward self-image. This reflects a disengagement from the photographic dimension.

Self-Representation

The collected texts appear polarized: they describe a correlation between the body presented online and the body perceived in the real world (17 mentions), but also refute this congruence (10 mentions) in favor of emphasizing the dominance of the real. Users primarily discussed self-representation on Instagram due to Snapchat’s ephemeral nature. Sharing photographs of themselves is viewed as a means to express their ways of being and interacting with others and the world (5 mentions), as well as a method to foster deeper personal understanding (3 mentions). There was considerable emphasis on portraying a “true” image of themselves (8 mentions). In some cases, it seems feasible to accept photos from the past, particularly those depicting a thinner body, alongside acceptance of the current body image (2 mentions). However, in other cases, confronting images of oneself from a thinner period can be agonizing (3 mentions), often evoking a sense of regret. Ten responses conveyed a sense of discrepancy between the real-life body and the online representation, attributed to efforts to present oneself in a more favorable light, sometimes accentuating flaws or concealing them (2 mentions). This can lead to a perception of projecting a false self-image (8 mentions) compared with one’s subjective self-image. The existence of photos that diverge so significantly from each other also contributes to a sense of fragmentation in one’s self-image (1 mention).

SNs’ Risks

All the collected texts addressed the risks associated with SNSs’ use, especially activities involving the photographic dimension (30 mentions). Content on Instagram, along with related interactive activities, is perceived as significantly influential in shaping ideas about the body and self-representation (21 mentions). This influence is evident in the promotion of a singular body prototype characterized by thinness, perfection, and muscularity (17 mentions). Viewing photos of others is seen as the initial step toward attaining this ideal, although it is perceived subjectively as deceptive (8 mentions). Unrealistic content shared on Instagram aims to bolster this ideal through maladaptive behaviors (11 mentions), sometimes progressing toward images that align with the “Pro-Ana” direction (5 mentions).

Many responses (24 mentions) emphasized the risk of deteriorating one’s relationship with their body due to a heightened focus on physical appearance and an increased attention to the body dimension. Participants acknowledged the role played by Instagram in exacerbating concerns about weight and body shape (11 mentions), particularly through pages where individuals provide tips related to EDs (10 mentions). The heightened concerns are perceived to induce feelings of being “wrong” (2 mentions) and body dissatisfaction (8 mentions). Comparison with images posted online is a dominant theme (19 mentions), where physical attributes, particularly thinness, are frequently cited as comparison criteria, often accompanied by feelings of envy (4 mentions) and inferiority (9 mentions).

A sort of “vicious circle” of negative influence through imitation has been described:

A famous girl puts up a picture then maybe she sees that the picture has many comments from girls who say, “You’re so thin, you’re so beautiful”, and all this, and then she continues to put up pictures of that type, and the girls obsess more and more. [Participant 4]

In relation to the interactive dimension, risks are linked to social judgment and the pressure toward conformity (2 mentions). Finally, another risk identified is the underestimation and casual approach with which users engage with SNs, not fully recognizing the impact and influence that published content can have on people’s lives (5 mentions).

Regarding Snapchat, the texts indicated a more self-deprecating attitude toward sharing content and less anxiety about posting images. This makes Snapchat perceived as a platform where users feel free from concerns about their physical appearance and comparison with others.

Self-Protective Strategies While Using SNSs

Regarding self-protective strategies, the primary defense that empowers the use of SNs without negative impacts on one’s body image is subjective critical capacity (17 mentions). This includes the ability to recognize and distinguish true content from edited ones (4 mentions) and an awareness that each person has about their own unique body (11 mentions). Useful strategies to promote this critical capacity could be implemented by the Instagram platform itself (4 mentions). One form of defense involves actively avoiding sensitive content (7 mentions), self-exposure (2 mentions), or excessive SN use (1 mention). However, some participants noted the challenge of implementing this strategy due to their strong curiosity to view certain content. The Instagram platform itself should develop protective measures regarding the generation of certain content, which could include content control (2 mentions) or content removal (2 mentions).

From the text analysis, skepticism (8 mentions) and a sense of helplessness (4 mentions) emerged regarding the lack of control over online content, as well as a feeling of inescapability (5 mentions) due to the unavoidable accessibility of certain content on Instagram’s home page, even when not intentionally sought. Additionally, other defensive strategies should involve parental controls (1 mention) and the sharing of experiences and content (3 mentions).

SNs’ Potentials

Several potentials were identified regarding the use of SNs, especially concerning the photographic dimension. These potentials are linked to the possibility of improving one’s relationship with their body by emphasizing spontaneity and naturalness in content creation (4 mentions), which is also perceived as a protective measure against the potential for negative comments (2 mentions). The act of searching for content is perceived as supportive during difficult times (3 mentions), providing an opportunity to follow individuals who have faced similar challenges and who, having overcome them, serve as sources of support (2 mentions) and encouragement (1 mention). Platforms such as Instagram also facilitate personal expression (9 mentions) and allow individuals to take an external perspective on their experiences (3 mentions). Exploring profiles of influencers and artists who promote diverse ideas about the body offers an opportunity to discover perspectives that might not be encountered otherwise. These individuals can inspire the exploration of values that challenge prevailing trends.

Another potential lies in actively creating content that emphasizes authenticity (6 mentions) and carefreeness (5 mentions) rather than solely focusing on physical appearance or presenting oneself in an idealized manner. By promoting authentic content, individuals can contribute to limiting the proliferation of unrealistic body ideals and reducing the circulation of idealized and unrealistic representations of the body (3 mentions). However, this aspiration is tempered by skepticism regarding the actual impact of sharing “realistic” content and finding nondeceptive body ideals. Finally, some texts emphasize the potential offered by the opportunity to connect with other people (6 mentions).

With regard to the importance of guiding girls undergoing treatment for EDs to reflect on the topic, there was unanimous agreement (30 mentions), confirming all proposed topics as relevant. If the project had been implemented, the girls would have enthusiastically participated in the group, viewing it as a safe space to find the courage and express themselves (28 mentions) and being inspired by individual choices (20 mentions). To advocate for content that goes beyond the pursuit of bodily perfection, one needs to observe behaviors in others (15 mentions). Expressing oneself with humor and levity is considered the best antidote (15 mentions), but it necessitates self-confidence and a willingness to reject the sanctity often placed on one’s image (15 mentions).

The interest and willingness were confirmed for both participating in person to listen to other girls undergoing rehabilitation (30 mentions) and discussing these issues on an equal footing with peers in similar situations. Additionally, after completing the therapy course, there is interest in potentially serving as a testimonial to set a positive example of the conscious use of social media based on personal life experiences (28 mentions). This opportunity could enable several outcomes: providing support to others (15 mentions), creating a space for personal reflection (7 mentions), hearing about the challenges others have faced in overcoming EDs (8 mentions), and connecting with peers who share similar experiences (7 mentions).

Principal Findings and Comparison With Prior Studies

This research investigated how young women recovering from EDs perceive both the health risks and potential benefits of visual SNs, specifically Instagram and Snapchat, which have been identified in the literature as platforms where harmful body comparisons can occur. Additionally, the study explored the participants’ willingness and interest in collaboratively developing social media literacy programs aimed at supporting individuals recovering from EDs.

The study’s findings underscore a keen awareness among participants of the mechanisms that trigger body comparisons in the online realm, which contribute to feelings of insecurity and detrimentally impact self-relationships. However, the girls do not consistently harness this awareness to their benefit. The identified self-protective behaviors include the development of critical thinking, avoidance of sensitive content, increased control over SNSs, and a degree of skepticism toward the propagation of conflicting ideologies. All these topics were deemed fundamental by the participants.

For the young people participating in the study, 3 primary modes of using Instagram and Snapchat emerged. The first mode was characterized by the relational dimension, involving affective experiences of contact and exchange, which reduced feelings of loneliness and enhanced perceptions of social support. The second mode of use focused on self-presentation and self-disclosure, particularly evident in relation to Instagram. The third mode of use involved active information seeking, specifically the search for stimuli, inspiration, curiosity, and updates related to one’s passions, interests, appearance, and eating behaviors.

The topics emerging from the data confirm findings in the literature regarding the problematic use of SNs and the development of EDs among preclinical samples. Following appearance-focused accounts on Instagram and engaging in photo-based activities, such as posting selfies or liking and commenting on photos, were associated with poorer body image outcomes [ 14 , 15 , 28 , 31 , 32 ]. Passive use characterized by role passivity, which involves the passive reception of content generated by other users for entertainment or spectatorship purposes, has been linked to a decrease in subjective well-being through social comparison [ 2 ]. Among our participants, even the passive mode of social media use—simply opening food- and body-related videos—was acknowledged by the girls as reinforcing problematic behaviors from a symptomological point of view, such as dieting and exercise obsession.

One of the most alarming findings from our research was the significant disparity between perspectives regarding the online environment either as a continuation of reality or as distinct from it (28 vs 2). Participants who viewed the virtual world as an extension of reality tended to perceive the feedback received as highly impactful on their self-perception and sense of self-worth. The significance of online feedback was closely tied to the validation it provided, through either approval or disapproval. However, some participants expressed skepticism about the authenticity of SNs, viewing the images and content as misleading. As a result, they perceived the impact of online feedback as less meaningful compared with feedback received in real life [ 33 , 34 ].

This finding could be pivotal for a project focused on training, discussing, and reflecting on the subject: Highlighting the distinction between individuals who trust the authenticity of the online environment and those who approach it with skepticism is an initial step toward fostering distance and increasing awareness of one’s online presence and behavior.

Self-promotion emerged as a significant motivator for engaging in photographic activities on SNs. Users aimed to portray their best selves and sought positive recognition from others, aligning with existing findings in the literature [ 35 , 36 ]. The study also identified other motivations such as celebrating moments or events and seeking visibility among others [ 2 ], which are enhanced by Instagram’s exposure and amplification features. Conversely, users’ disengagement was primarily driven by feelings of embarrassment and discomfort associated with self-exposure, as well as the ephemeral and light-hearted nature of content shared on Snapchat [ 37 ].

All participants reported using criteria to select photographs for publication, particularly on Instagram. Those who noted a gap between their online self-presentation and their real selves emphasized an awareness that the virtual world perpetuates a sense of falsity by showcasing only the most desirable image of oneself. Regarding risks associated with photo-related activities, Instagram was seen as a highly visual platform centered around photos, with a strong focus on aesthetic content and a prevalence of edited photos that promote unhealthy, unrealistic, and deceptive body ideals [ 38 ]. These body ideals are perceived as highly influential in promoting and striving for perfection and the thin ideal [ 29 ]. Despite often being perceived as unattainable, media portrayal of this ideal leads women to view it as normative and central to attractiveness, thereby internalizing socially constructed appearance ideals [ 39 , 40 ]. This internalization and subsequent comparison lead to decreased satisfaction with one’s own body, efforts to manage one’s appearance to reach this ideal, and increased concerns about body image [ 41 ]. Social comparisons upward tend to evoke envy and feelings of inferiority, in terms of not only physical appearance but also the personality and lifestyle of individuals within one’s SN. Moreover, participants emphasized the risks associated with the interactivity facilitated by SNs. This phenomenon is referred to in the literature as “body talk,” which involves interpersonal interactions focused on bodies and physical appearance [ 42 ]. Body talk reinforces the value and significance of appearance and contributes to the construction of appearance ideals [ 43 ]. Previous research has demonstrated that body talk is positively correlated with body surveillance, body shame, and perceived pressure to conform to thinness ideals [ 42 ].

In terms of the potential of SNSs, participants emphasized the significance of being able to create, choose, and share content freely. They viewed promoting active sharing of naturalistic and unedited content, characterized by authenticity and spontaneity, as a potential means to enhance their relationship with their own bodies and for personal self-expression [ 44 ]. Improving the relationship with their own bodies was also seen as potentially helpful in finding support from people who have had a similar experience. Finally, users highlighted the potential of SNs to stabilize and enhance peer relationships with previously inaccessible groups, as well as the possibility of discovering things that might be difficult to encounter in everyday offline life. Our participants also highlighted the challenge of self-discipline and avoiding potentially harmful online content. Therefore, in the context of social media literacy programs, it could be beneficial to create spaces where girls can cultivate the courage to block the use of social media in such situations, as they suggested.

Regarding defense strategies against the influence of content published on SNSs, users primarily proposed empowering subjective critical capacity. They suggested developing and enhancing social media awareness and adopting a critical approach to viewing and scrutinizing images and posts, including considerations about the realism of the images and the intentions of the posters. They also suggested enhancing the control that platforms themselves could exercise over the type and quality of images and content posted online, even advocating for automatic deletion of content that could pose risks to users’ body image. However, some users expressed skepticism and uncertainty about the feasibility and legitimacy of such controls. They believed that the best strategy was to avoid content perceived as subjectively risky for their body image and that could potentially expose their image in an undesirable way.

It should be noted, however, that recent literature suggests enhancing critical thinking about the media may not be the sole or primary mechanism of change in effective media literacy interventions. There is uncertainty about whether literacy programs aimed at reducing the risk of EDs also effectively address critical thinking about the media. Future research will need to clarify this ambiguity [ 45 ].

What emerged from our research as a whole is that girls often have an awareness of risks but struggle to use this awareness to their advantage. They can recognize edited photos but still perceive them as authentic. Only a few responses indicated that “distrust” can serve as a strategy to mitigate perceived influence. These findings suggest that enhancing critical thinking about the media may not be the sole or primary mechanism of change for effective media literacy interventions.

However, we did not explore the influence of context, particularly the role of parents and the school environment, in moderating social media use and coping with body dissatisfaction. Among the limited qualitative research available on the meanings associated with social media use, Burnette et al’s [ 46 ] study sheds light on this topic. The authors found that among adolescent girls in general (not necessarily those in treatment for EDs), parental control devices for social media and school environments may be particularly effective in helping adolescents enhance their strategies for filtering out the most harmful messages and developing a broader conception of beauty. These factors act as protective measures against the risks associated with social media use.

Practical Implications

Given the intricate connection between SN usage and its effects on mental health [ 47 ], it is crucial to investigate this phenomenon by valuing the personal perspectives of individuals who directly experience discomfort and pain related to SN use. Health professionals should integrate discussions about SN use into their treatment of body dissatisfaction and disordered eating [ 2 ]. Much of the content emerging from the research explores new dimensions of SNS use beyond existing literature. These include identifying 3 primary modes of use, understanding the challenge of distinguishing between real and online environments and the resulting behaviors, addressing emotional detachment strategies, and considering the implications of interacting with apps that feature permanent visual content and large followings. Additionally, the study discusses platforms with temporary photo availability and intimate networks, strategies to enhance positive social media use through peer support, and methods to mitigate risks shared between users and platform providers.

Considering the ineffectiveness of prohibiting adolescents from using SNs, it could be beneficial to focus on teaching them how to navigate these environments safely instead. Rather than restricting access [ 48 ], leveraging existing SN platforms for targeted interventions is possible. This approach can utilize anonymous access to health information available on the internet, which is appealing to young people seeking such resources [ 49 ]. This strategy aims to empower youth with the knowledge and skills needed to use SNs responsibly and effectively manage their online experiences.

We believe that every problem has its solution. In other words, starting from where young people are—specifically, their desire to engage and immerse themselves in the methods and meanings of SN use—we can empower credible and interested role models (such as girls with EDs) to influence others toward more mindful use of self-protective strategies on SNs. The most impactful approach to wield this influence is to engage these individuals as influencers and collaborate with them to develop literacy programs within treatment frameworks. This research introduces fresh insights and underscores the necessity of addressing sensitive issues to design and implement more effective and tailored educational programs tailored to individual health care recipients [ 47 ].

Limitations

Several study limitations should be noted, including the small sample size and the fact that all participants had undergone treatment at a specialized center for EDs, indicating they already had awareness of the issue. Future research could broaden the survey to include a wider range of participants, including those in the preclinical phase of EDs. This approach would enable professionals to enhance their understanding of potential histories, distress forms, and health promotion strategies, thereby guiding the management of early signs of distress. Another limitation is self-selection, as participants were invited by health care staff and chose to participate voluntarily rather than being randomly selected. This may result in a biased and unrepresentative sample of the population, as those who choose to participate may possess specific characteristics that distinguish them from the broader population. However, it is important to note that qualitative research such as this does not aim to generalize findings to the entire population. Instead, its focus is on exploring the lived experiences and meanings ascribed to those experiences by the participants themselves.

Another limitation arises from the context of ED treatment services where participants were restricted from using phones, which meant their responses relied on memory rather than current experiences. A third limitation that could be addressed in future research involves assessing the long-term retention and application of knowledge about the risks and potentials of social media use over time.

Conclusions

While previous literature extensively covers studies on the risks of using SNs and prevention programs, our study contributes numerous ideas on addressing this topic with young people undergoing therapy for EDs by involving them as experts by experience. It allows the identification of the most significant themes that may arise, enabling health professionals to incorporate them into discussions and share the self-protection strategies identified. There is a call to leverage the potential of SNSs, such as user-generated content and interactivity, to promote beauty ideals divergent from the prevailing model, alongside content that emphasizes humor rather than appearance-centric narratives. However, the crux of the research lies not only in what to propose but also in how to propose it. Enrolling girls as coparticipants in the programs represents, in our view, the real breakthrough.

Being able to share their experiences and offer their stories as a potential source of inspiration and influence among peers allows individuals to transform from passive recipients of life, influenced by others, into conscious leaders who guide and inspire others. This involves coconstructing care pathways, creating space, and negotiating ideas with those willing to take on the new role, such as that of a patient who, after completing their treatment journey, makes themselves available to assist others at the beginning of their own journey. Co-design indeed necessitates flexibility and a strong willingness from all participants. It is not about predefined content but rather entails collaborative decision-making where meetings and individuals together determine the objectives to pursue.

Acknowledgments

We express our gratitude to all the mental health workers who contributed to the research, actively participating in every stage of it, and to all the girls with whom the research project was collaboratively constructed. They gave their time to reflect and share their experiences sincerely and showed a genuine and generous interest in this work. We are also very grateful to our young colleagues Ludovica Aquili (PhD student in Social Sciences) and Lia Bitetti (psychologist, psychotherapist in training, graduated from the University of Padua) for their support and expertise in editing this work.

Data Availability

The data sets generated or analyzed during this study are not publicly available due to privacy restrictions. Indeed, they contain information that could compromise the privacy of research participants. They are available from the corresponding author upon reasonable request.

Authors' Contributions

EF contributed substantially to the conception and design of the work. MRe created the structure and collected the data. Together, both drafted the work and revised it critically for important intellectual content. All authors participated in the analysis and interpretation of the data.

Conflicts of Interest

None declared.

Overview of the results and the codebook of analysis. The 4 categories are indicated from the general (macrocategories and categories) to the particular (subcategories and microcategories). The number in brackets refers to the number of respondents who evoked the relevant category upon the 30 involved. The categories were not always subdivided further; in some cases, in fact, no details were added during the interview. Interviews with young women in recovery from eating disorders (EDs) were held in North Italy in 2021.

• Fardouly J, Rapee RM. The impact of no-makeup selfies on young women's body image. Body Image. Mar 2019;28:128-134. [ CrossRef ] [ Medline ]
• Saunders J, Eaton A. Snaps, selfies, and shares: how three popular social media platforms contribute to the sociocultural model of disordered eating among young women. Cyberpsychol Behav Soc Netw. Jun 2018;21(6):343-354. [ CrossRef ] [ Medline ]
• Gordon CS, Jarman HK, Rodgers RF, McLean SA, Slater A, Fuller-Tyszkiewicz M, et al. Outcomes of a cluster randomized controlled trial of the SoMe social media literacy program for improving body image-related outcomes in adolescent boys and girls. Nutrients. Oct 27, 2021;13(11):3825. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Sanzari CM, Gorrell S, Anderson LM, Reilly EE, Niemiec MA, Orloff NC, et al. The impact of social media use on body image and disordered eating behaviors: content matters more than duration of exposure. Eat Behav. Apr 2023;49:101722. [ CrossRef ] [ Medline ]
• Sidani JE, Shensa A, Hoffman B, Hanmer J, Primack BA. The Association between social media use and eating concerns among US young adults. J Acad Nutr Diet. Sep 2016;116(9):1465-1472. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Au ES, Cosh SM. Social media and eating disorder recovery: an exploration of Instagram recovery community users and their reasons for engagement. Eat Behav. Aug 2022;46:101651. [ CrossRef ] [ Medline ]
• Kasson E, Vázquez MM, Doroshenko C, Fitzsimmons-Craft EE, Wilfley DE, Taylor CB, et al. Exploring social media recruitment strategies and preliminary acceptability of an mHealth tool for teens with eating disorders. Int J Environ Res Public Health. Jul 28, 2021;18(15):7979. [ FREE Full text ] [ CrossRef ] [ Medline ]
• National Collaborating Centre for Mental Health. Working well togethervidence and tools to enable co-production in mental health commissioning. National Collaborating Centre for Mental Health. 2019. URL: https://tinyurl.com/mtpdcrx3 [accessed 2024-06-25]
• Ezaydi N, Sheldon E, Kenny A, Buck ET, Weich S. Service user involvement in mental health service commissioning, development and delivery: a systematic review of service level outcomes. Health Expect. Aug 08, 2023;26(4):1453-1466. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Fitzsimmons-Craft EE, Krauss MJ, Costello SJ, Floyd GM, Wilfley DE, Cavazos-Rehg PA. Adolescents and young adults engaged with pro-eating disorder social media: eating disorder and comorbid psychopathology, health care utilization, treatment barriers, and opinions on harnessing technology for treatment. Eat Weight Disord. Dec 2020;25(6):1681-1692. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Rocelli M, Aquili L, Giovanazzi P, Puecher A, Goglio MM, Faccio E. 'All about my ideal mental health service': users, family members and experts by experience discussing a co-designed service. Health Expect. Apr 2024;27(2):e13999. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Rocelli M, Sdrubolini F, Romania V, Faccio E. ‘Doctor, I’m not here to quit drugs!’ Hidden goals that undermine shared decision-making during access to services by young people who use substances. Addiction Research & Theory. May 13, 2023;32(1):10-19. [ CrossRef ]
• Mabe AG, Forney KJ, Keel PK. Do you "like" my photo? Facebook use maintains eating disorder risk. Int J Eat Disord. Jul 2014;47(5):516-523. [ CrossRef ] [ Medline ]
• Meier EP, Gray J. Facebook photo activity associated with body image disturbance in adolescent girls. Cyberpsychol Behav Soc Netw. Apr 2014;17(4):199-206. [ CrossRef ] [ Medline ]
• Cohen R, Newton-John T, Slater A. The relationship between Facebook and Instagram appearance-focused activities and body image concerns in young women. Body Image. Dec 2017;23:183-187. [ CrossRef ] [ Medline ]
• McLean S, Paxton S, Wertheim E, Masters J. Selfies and social media: relationships between self-image editing and photo-investment and body dissatisfaction and dietary restraint. J Eat Disord. Nov 23, 2015;3(S1):729-735. [ CrossRef ]
• Faccio E, Belloni E, Cipolletta S, Iudici A, Castiglioni M, Mannarini S. The power of weight and the weight of power in adolescence: a comparison between young and adult women. Journal of Family Studies. Jun 20, 2016;25(1):46-60. [ CrossRef ]
• Wick MR, Keel PK. Posting edited photos of the self: increasing eating disorder risk or harmless behavior? Int J Eat Disord. Jun 2020;53(6):864-872. [ CrossRef ] [ Medline ]
• Dane A, Bhatia K. The social media diet: a scoping review to investigate the association between social media, body image and eating disorders amongst young people. PLOS Glob Public Health. 2023;3(3):e0001091. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Boepple L, Thompson JK. A content analytic comparison of fitspiration and thinspiration websites. Int J Eat Disord. Jan 2016;49(1):98-101. [ CrossRef ] [ Medline ]
• de Vries DA, Peter J. Women on display: the effect of portraying the self online on women’s self-objectification. Computers in Human Behavior. Jul 2013;29(4):1483-1489. [ CrossRef ]
• Tiggemann M, Miller J. The internet and adolescent girls’ weight satisfaction and drive for thinness. Sex Roles. Apr 28, 2010;63(1-2):79-90. [ CrossRef ]
• Tiggemann M, Slater A. Facebook and body image concern in adolescent girls: a prospective study. Int J Eat Disord. Jan 18, 2017;50(1):80-83. [ CrossRef ] [ Medline ]
• McLean S, Paxton S, Wertheim E, Masters J. Photoshopping the selfie: self photo editing and photo investment are associated with body dissatisfaction in adolescent girls. Int J Eat Disord. Dec 2015;48(8):1132-1140. [ CrossRef ] [ Medline ]
• Ahrens J, Brennan F, Eaglesham S, Buelo A, Laird Y, Manner J, et al. A longitudinal and comparative content analysis of Instagram fitness posts. Int J Environ Res Public Health. Jun 03, 2022;19(11):6845. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Burnell K, George M, Kurup A, Underwood M, Ackerman. Associations between self-reports and device-reports of social networking site use: an application of the truth and bias model. Commun Methods Meas. 2021;15(2):156-163. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Maqsood A, Sangra S. The effect of Snapchat filters on self-image: a study of Netflix’s ‘The Social Dilemma’. Global Media Journal. 2021;3(3):1-9. [ FREE Full text ]
• Chua T, Chang L. Follow me and like my beautiful selfies: Singapore teenage girls’ engagement in self-presentation and peer comparison on social media. Computers in Human Behavior. Feb 2016;55(Part A):190-197. [ FREE Full text ] [ CrossRef ]
• Cohen R, Fardouly J, Newton-John T, Slater A. #BoPo on Instagram: an experimental investigation of the effects of viewing body positive content on young women’s mood and body image. New Media & Society. Feb 06, 2019;21(7):1546-1564. [ FREE Full text ] [ CrossRef ]
• McLean SA, Paxton SJ, Wertheim EH. The role of media literacy in body dissatisfaction and disordered eating: a systematic review. Body Image. Dec 2016;19:9-23. [ CrossRef ] [ Medline ]
• Creswell J. Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. New York, NY. SAGE Publications; 2013.
• Cohen E. Should you 'Friend' your doctor on Facebook? CNN Health. 2009. URL: http://www.cnn.com/2009/HEALTH/09/03/friending.your.doctor/index.html [accessed 2024-06-25]
• Sabik N, Falat J, Magagnos J. When self-worth depends on social media feedback: associations with psychological well-being. Sex Roles. Jul 4, 2019;82(7-8):411-421. [ FREE Full text ] [ CrossRef ]
• Hong S, Jahng M, Lee N, Wise K. Do you filter who you are?: Excessive self-presentation, social cues, and user evaluations of Instagram selfies. Computers in Human Behavior. Mar 2020;104:106159. [ FREE Full text ] [ CrossRef ]
• Huang Y, Su S. Motives for Instagram use and topics of interest among young adults. Future Internet. Aug 09, 2018;10(8):77. [ FREE Full text ] [ CrossRef ]
• Tiggemann M, Anderberg I, Brown Z. Uploading your best self: selfie editing and body dissatisfaction. Body Image. Jun 2020;33:175-182. [ CrossRef ] [ Medline ]
• Xu B, Chang P, Welker C, Bazarova N, Cosley D. Automatic archiving versus default deletion: what Snapchat tells us about ephemerality in design. CSCW Conf Comput Support Coop Work. 2016;2016:1662-1675. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Couture Bue AC, Harrison K. Visual and cognitive processing of thin-ideal Instagram images containing idealized or disclaimer comments. Body Image. Jun 2020;33:152-163. [ CrossRef ] [ Medline ]
• Anixiadis F, Wertheim E, Rodgers R, Caruana B. Effects of thin-ideal instagram images: the roles of appearance comparisons, internalization of the thin ideal and critical media processing. Body Image. Dec 2019;31:181-190. [ CrossRef ] [ Medline ]
• Casale S, Gemelli G, Calosi C, Giangrasso B, Fioravanti G. Multiple exposure to appearance-focused real accounts on Instagram: effects on body image among both genders. Curr Psychol. Mar 14, 2019;40(6):2877-2886. [ FREE Full text ] [ CrossRef ]
• Wenninger H, Cheung C, Krasnova H. College-aged users behavioral strategies to reduce envy on social networking sites: a cross-cultural investigation. Computers in Human Behavior. Aug 2019;97:10-23. [ FREE Full text ] [ CrossRef ]
• Wang Y, Yang J, Wang J, Yin L, Lei L. Body talk on social networking sites and body dissatisfaction among young women: a moderated mediation model of peer appearance pressure and self-compassion. Curr Psychol. Mar 16, 2020;41(3):1584-1594. [ FREE Full text ] [ CrossRef ]
• Jones D, Crawford J. The peer appearance culture during adolescence: gender and body mass variations. J Youth Adolescence. Mar 2, 2006;35(2):243-255. [ FREE Full text ] [ CrossRef ]
• Collin P, Rahilly K, Third A. The benefits of social networking services: a literature review. Western Sydney University. Melbourne, VIC, Australia. Cooperative Research Centre for Young People, Technology and Wellbeing; 2011. URL: https:/​/www.​westernsydney.edu.au/​__data/​assets/​pdf_file/​0003/​476337/​The-Benefits-of-Social-Networking-Services.​pdf [accessed 2024-06-25]
• Bennett BL, Martin-Wagar CA, Boswell RG, Forrest LN, Perelman H, Latner JD. Skepticism of and critical thinking about media messages: conflicting relationships with body dissatisfaction. Eat Behav. Dec 2023;51:101820. [ CrossRef ] [ Medline ]
• Burnette C, Kwitowski MA, Mazzeo SE. "I don't need people to tell me I'm pretty on social media:" a qualitative study of social media and body image in early adolescent girls. Body Image. Dec 2017;23:114-125. [ CrossRef ] [ Medline ]
• Singleton A, Abeles P, Smith I. Online social networking and psychological experiences: the perceptions of young people with mental health difficulties. Computers in Human Behavior. Aug 2016;61:394-403. [ FREE Full text ] [ CrossRef ]
• Mitchell K, Ybarra M. Social networking sites: finding a balance between their risks and benefits. Arch Pediatr Adolesc Med. Jan 2009;163(1):87-89. [ CrossRef ] [ Medline ]
• Valentine L, McEnery C, D’Alfonso S, Phillips J, Bailey E, Alvarez-Jimenez M. Harnessing the potential of social media to develop the next generation of digital health treatments in youth mental health. Curr Treat Options Psych. Sep 11, 2019;6(4):325-336. [ FREE Full text ] [ CrossRef ]

Abbreviations

Edited by A Mavragani; submitted 04.10.23; peer-reviewed by L Aquili, Y Wang, R Vitelli, A Nerini, A Mentasti, R von Brachel; comments to author 02.02.24; revised version received 29.03.24; accepted 20.05.24; published 02.07.24.

©Elena Faccio, Margherita Reggiani, Michele Rocelli, Sabrina Cipolletta. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 02.07.2024.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research (ISSN 1438-8871), is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

• SUGGESTED TOPICS
• The Magazine
• Newsletters
• Managing Yourself
• Managing Teams
• Work-life Balance
• The Big Idea
• Data & Visuals
• Reading Lists
• Case Selections
• HBR Learning
• Topic Feeds
• Account Settings
• Email Preferences

Research: Speed Matters When Companies Respond to Social Issues

• Alison Wood Brooks,
• Maya Balakrishnan,
• Julian De Freitas

An analysis of Instagram posts by Fortune 500 companies after George Floyd’s murder found that customers were skeptical of those who waited too long to make a statement.

Companies and their leaders face new pressures to make public statements about controversial and sometimes divisive social and political issues. New research shows that timing matters: consumers perceive a relationship between speed and authenticity, and discount statements from companies that wait too long to respond. Leaders can use four questions to understand when and how they should shape their response.

In the wake of George Floyd’s killing by Minneapolis police officers in 2020, individuals began protesting racial injustice both in person and online. But it wasn’t just individuals — many well-known companies in corporate America seemed to publicly align themselves with protestors, rather than staying silent or neutral.

• Alison Wood Brooks is the O’Brien Associate Professor of Business Administration at Harvard Business School.
• JN Jimin Nam is a doctoral candidate in marketing at Harvard Business School.
• MB Maya Balakrishnan is a doctoral candidate in technology and operations management at Harvard Business School.
• Julian De Freitas is an assistant professor in the marketing unit at Harvard Business School.

Partner Center

Articles on Young people and wellbeing

Displaying all articles.

What can you do if you think your teen already has unhealthy social media habits?

Carmel Taddeo , University of South Australia and Barbara Spears , University of South Australia

Emotional problems in young people were rising rapidly even before the pandemic

Rebecca E Anthony , Cardiff University

‘I was putting like 20 resumes in a month’: research tracks young Australians’ precarious work and study lives after Year 12

Lucas Walsh , Monash University

Related Topics

• disadvantage and institutions series
• School friendships
• Social media use
• Young people
• Young people and mental health
• Youth mental health

Top contributors

Professor and Director of the Centre for Youth Policy and Education Practice, Monash University

Research Associate at the Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement and Wolfson Centre for Young People's Mental Health, Cardiff University

Adjunct Professor of Education and Social Development, University of South Australia

Senior Lecturer at UniSA Education Futures, University of South Australia

• X (Twitter)
• Unfollow topic Follow topic

• Get involved

• The 2023 Ghana National Human Development Report.pdf pdf (7.3 MB)

The 2023 Ghana National Human Development Report

The 2023 Ghana National Human Development Report.pdf

June 26, 2024

The 2023 Ghana Human Development Report highlights the challenges facing Ghana's workforce, including a large informal sector (75%) and high youth unemployment (65% among 15-24-year-olds). The report emphasizes the need for strategic investments in human capital and infrastructure to create sustainable job opportunities. It recommends simplifying regulations, providing targeted training, and promoting entrepreneurship to formalize the informal sector.

The report also stresses the importance of STEM/STEAM education, digital infrastructure, and efficient infrastructure in energy, transport, water, ICT, and housing. To achieve long-term development goals, the report calls for a national consensus on job creation, infrastructure investment, and educational reforms. Implementation will require collective effort from all stakeholders, including government, private sector, civil society, and individuals.

Document Type

Regions and countries, sustainable development goals, related publications, publications, enabling investments into malaysia care economy.

This report summarizes the findings and recommendations made in a longer report “MALAYSIAN CARE ECONOMY: LANDSCAPE ANALYSIS” which was commissioned by the Unite...

Samoa National Anti-Corruption Policy & Strategy 2023 - 2...

This national policy aims to achieve anti-corruption culture across our nation. Samoa must strive to be known as a nation with integrity. Hence the vision of th...

Untapped opportunities for livelihood recovery in crisis ...

This policy brief explores the potential of leveraging cultural and creative industries, especially through music, to assist in the recovery from crisis and pos...

South Sudan: Assessing and Strengthening Local Governance...

This report aims to examine technical institutional gaps in economic governance at the subnational level. It covers the status and challenges and suggests a way...

Youth civic and political participation curriculum

The UNDP “Curriculum on Youth Civic and Political Participation” is a comprehensive training manual crafted by subject-matter experts to cater to trainers who a...

Liveability Index of Hulhumalé Maldives - Key Findings an...

This research paper is intended for the general public, researchers, and councils interested in crafting their own Liveability Index. It primarily concentrate...

Numbers, Facts and Trends Shaping Your World

Read our research on:

Full Topic List

Regions & Countries

• Publications
• Our Methods
• Short Reads
• Tools & Resources

Read Our Research On:

• Americans’ Views of Government’s Role: Persistent Divisions and Areas of Agreement

2. Americans’ views of government aid to poor, role in health care and Social Security

Table of contents.

• Views on the efficiency of government
• Views on the government’s regulation of business
• Confidence in the nation’s ability to solve problems
• Views on the effect of government aid to the poor
• Views on government’s role in health care
• Views on the future of Social Security
• Trust in government
• Feelings toward the federal government
• Acknowledgments
• The American Trends Panel survey methodology

Majorities of Americans see a role for government on several safety net issues.

• 65% say the government has a responsibility to ensure all Americans have health care coverage.
• 55% say government aid to the poor does more good than harm.
• 79% say Social Security benefits should not be reduced in any way.

A majority of Americans (55%) say that, overall, government aid to the poor does more good than harm, while about four-in-ten (43%) say it does more harm than good.

Republicans and Republican-leaning independents continue to be critical of government aid to the poor:

• 65% say government aid does more harm than good, while 34% say it does more good than harm.
• However, the share of Republicans saying government aid has a positive effect is up 6 percentage points since 2022.

As in past years, about three-quarters of Democrats (76%) say government aid to the poor has an overall positive effect (23% say it does more harm).

About half of Americans (52%) now say the government should do more to help the needy, even if it means going deeper into debt. By comparison, 45% say the government can’t afford to do much more to help the needy.

Support for doing more to help those in need, even if the debt increases, is 6 percentage points lower than it was in June 2020, in the early months of the COVID-19 pandemic.

• About seven-in-ten Democrats (72%) say the government should do more to help the needy, down from 79% who said the same in 2020.
• A far smaller share of Republicans – 33% – say the government should do more even if it leads to additional debt. Views among Republicans are largely unchanged since 2020.

Government assistance to people in need

About four-in-ten Americans (41%) say the government should provide more assistance to people in need, while about a quarter say it should provide less (27%). Three-in-ten say the government is providing about the right amount of assistance.

Like other attitudes about social safety net policies, there are wide partisan differences.

Six-in-ten Democrats say the government should provide more assistance to people in need. Just one-in-ten say it should provide less, while three-in-ten say the current level is about right.

By comparison, 46% of Republicans say the government should provide less assistance, while 21% say it should provide more.Three-in-ten say the government is providing the right amount of assistance.

There are other demographic differences:

• Two-thirds of Black adults say the government should provide more assistance to people in need, while smaller shares of Asian (40%), Hispanic (39%) and White (37%) adults say the same.
• Younger adults are more likely than older adults to say the government should provide more assistance.
• A majority of lower-income adults (56%) say the government should provide more assistance. Smaller shares of middle- (36%) and upper-income (31%) adults say the same.

About two-thirds of Americans (65%) say it is the federal government’s responsibility to make sure all Americans have health care coverage, while roughly a third (34%) say it does not.

Americans are slightly more likely to say it is the government’s responsibility to ensure health care coverage for all than they were a few years ago (62% in 2021). While Democratic opinion has not changed over this period, the share of Republicans who say government has this responsibility has grown.

• Four-in-ten Republicans and Republican-leaning independents now say it is the government’s responsibility to ensure health care coverage for all, up from 32% who said this in 2022. Six-in-ten say it is not the government’s responsibility, down from 68% who said the same three years ago.
• Democrats and Democratic leaners overwhelmingly hold the view that the government has a responsibility to ensure health care coverage: 88% say this. Democrats’ views on this question are largely unchanged in recent years.

Views by party and income

Majorities of adults at all income levels say the government is responsible for ensuring health care coverage. However, lower-income adults (73%) are more likely than upper- (63%) or middle-income (62%) adults to say this.

Among Republicans, there are differences within income groups on whether government is responsible for ensuring all Americans have health care coverage:

• 56% of lower-income Republicans say it is the government’s responsibility to make sure all Americans have health care coverage, including about a quarter (24%) who say this should be done through a single national government program.
• Middle-income (36%) and upper-income Republicans (29%) are far less likely to say the government has a responsibility to ensure people have health care coverage. Majorities in both of these groups say it is not the government’s responsibility.

By comparison, more than eight-in-ten Democrats across all income levels say the government is responsible for ensuring all Americans have health care coverage.

• Overall, about half of Democrats (53%) say this should be done through a single national government program. About six-in-ten upper-income (57%) and middle-income (58%) Democrats say this, compared with about four-in-ten lower-income Democrats (43%).

Americans overwhelmingly (79%) say Social Security benefits should not be reduced in any way, including four-in-ten who say it should cover more people with greater benefits. Roughly two-in-ten (19%) say some future reductions need to be considered.

Wide majorities of both Republicans and Democrats do not support Social Security benefit reductions: 77% of Republicans and 83% of Democrats say Social Security benefits should not be reduced in any way.

However, Democrats (51%) are more likely than Republicans (29%) to say Social Security should be expanded.

Across demographic groups there is broad opposition to Social Security benefit cuts. But there are more sizable differences in support for expanding benefits:

• Black (58%) and Hispanic (51%) adults are more likely than White (33%) and Asian (38%) adults to say benefits should be expanded.
• Older adults are less likely than those in other age groups to say benefits should be expanded to cover more people with greater benefits: 26% of those 65 and older say this. By comparison, adults under 30 (51%) are most likely to favor expansion. 
• Lower-income adults are the most supportive of expanding Social Security benefits: 53% say this, compared with 39% of those in middle-income families and 23% of upper-income adults.

Sign up for our weekly newsletter

Fresh data delivery Saturday mornings

Sign up for The Briefing

Weekly updates on the world of news & information

• Election 2024
• Federal Government
• Government Spending & the Deficit
• Health Care
• Partisanship & Issues
• Social Security & Medicare
• Trust in Government

Third-party and independent candidates for president often fall short of early polling numbers

6 facts about presidential and vice presidential debates, biden, trump are least-liked pair of major party presidential candidates in at least 3 decades, cultural issues and the 2024 election, more than half of americans are following election news closely, and many are already worn out, most popular, report materials.

1615 L St. NW, Suite 800 Washington, DC 20036 USA (+1) 202-419-4300 | Main (+1) 202-857-8562 | Fax (+1) 202-419-4372 |  Media Inquiries

Research Topics

• Email Newsletters

ABOUT PEW RESEARCH CENTER  Pew Research Center is a nonpartisan fact tank that informs the public about the issues, attitudes and trends shaping the world. It conducts public opinion polling, demographic research, media content analysis and other empirical social science research. Pew Research Center does not take policy positions. It is a subsidiary of  The Pew Charitable Trusts .

© 2024 Pew Research Center