Death and dying in Ghana: Implications for palliative and end-of-life care.

In Ghana, death and dying are not simply biomedical endpoints but are deeply rooted in cultural, spiritual, and communal ideologies. These beliefs shape how individuals and families perceive terminal illness, respond to end-of-life (EoL) trajectories, and interact with palliative care (PC) services. Unlike Western medical models that prioritize institutionalized and medicalized death, the Ghanaian perspective is influenced by communalism, ancestral continuity, and religious doctrines that emphasize divine healing and spiritual deliverance. This commentary examines how Ghanaian cultural norms, particularly the conception of good and bad death, the taboo surrounding discussions of dying, and the centrality of family in care decision-making, create both opportunities and challenges for PC and EoL care delivery. While spiritual beliefs offer coping mechanisms that foster resilience, they may also foster unrealistic expectations and delay the initiation of PC services, thereby undermining symptom management and psychosocial support. At the same time, the family's pivotal role in caregiving, decision-making, and bereavement provides a strong foundation for culturally sensitive PC models. The paper calls for healthcare providers and policymakers to develop family-centered and culturally congruent care frameworks, invest in community-based education to destigmatize PC, and integrate bereavement care into the continuum of support. Training providers in culturally competent communication and embedding PC into national health policy and curricula are also recommended.