Navigating the dilemma between social realities and public health: Health beliefs and COVID-19 protocol non-adherence among fishers in Winneba, Ghana

Abstract

Globally, the fisheries sector was identified as one of the most vulnerable to the socio-economic impacts of the COVID-19 pandemic, with several countries imposing complete shutdowns. In Ghana, however, the government did not include a total closure of the fishing sector as part of its COVID-19 interventions. Despite awareness of the disease and associated preventive protocols, many fishers in coastal communities in the Central Region, particularly in Winneba, exhibited low adherence. This study sought to identify and explain the cognitive and contextual factors influencing this non-adherence. Guided by the Health Belief Model (HBM) and adopting a qualitative case study approach, the research draws on data collected through interviews with three chief fishermen, three focus group discussions, and observations from transect walks in three fishing communities in Winneba. A thematic analysis of the data reveals that the socio-economic conditions, communal lifestyle, and occupational realities of the fishers serve as significant barriers to the adoption of the preventive behaviours. Moreover, local fishers largely perceived COVID-19 as a distant, dangerous disease that had little relevance to their daily lives. These perceptions were reinforced by health communication cues that lack local relevance or evidential resonance. The study concludes that the fishers' low risk perception, in conjunction with economic and social barriers, leads to their non-adherence to COVID-19 protocols. Without locally grounded, context-specific messaging that reflects the realities of these communities, health communication interventions are unlikely to bring about meaningful behavioural change. The study therefore recommends that health interventions in coastal and, by extension, rural communities should be informed by a communication-based assessment that addresses the unique challenges of the targeted communities and audiences.