Skip to main content Accessibility help

‘This sickness is not hospital sickness’: a qualitative study of the evil eye as a source of neonatal illness in Ghana

  • April J. Bell (a1), Zelda Arku (a2), Ashura Bakari (a3), Samuel A. Oppong (a4), Jessica Youngblood (a1), Richard M. Adanu (a5) and Cheryl A. Moyer (a1)...


Previous research has described the evil eye as a source of illness for pregnant women and their newborns. This study sought to explore the perceptions of the evil eye among mothers whose newborns had experienced a life-threatening complication across three regions of Ghana. As part of a larger, quantitative study, trained research assistants identified pregnant and newly delivered women (and their newborns) who had survived a life-threatening complication at three tertiary care hospitals in southern Ghana to participate in open-ended, qualitative interviews about their experiences in March–August 2015. All interviews were audio-recorded and transcribed verbatim into English and analysis using the constant comparative method of theme generation. A total of 37 mothers were interviewed, 20 about neonatal illnesses and 17 about maternal illnesses. Six of the 20 mothers interviewed about their newborn’s illnesses spoke at length about the evil eye being a potential cause of newborn illness. The evil eye was described in a variety of terms, but commonalities included a person looking at a pregnant woman, her newborn baby, the baby’s clothes and even the mother’s food, causing harm, even unintentionally. Prevention required mothers covering themselves while pregnant and keeping the baby away from others until it was old enough to ward off the evil eye. Treatment required traditional medicine, yet some indicated that allopathic medicine could help. The evil eye appears to serve a social control mechanism, encouraging pregnant women to dress modestly, stay indoors as much as possible and behave appropriately. The evil eye is a pervasive, universally understood phenomenon across three regions of Ghana, even amongst a hospitalized population receiving allopathic health care for life-threatening complications of childbirth. Understanding the role of the evil eye in newborn illness attribution is important for clinicians, researchers and programmatic staff to effectively address barriers to care seeking.


Corresponding author

*Corresponding author. Email:


Hide All
Adanikin, AI, Onwudiegwu, U and Akintayo, AA (2014) Reshaping maternal services in Nigeria: any need for spiritual care? BMC Pregnancy & Childbirth 14, 196.
Adusi-Poku, Y, Edusei, AK, Bonney, AA, Tagbor, H, Nakua, E and Otupiri, E (2012) Pregnant women and alcohol use in the Bosomtwe District of the Ashanti Region of Ghana. African Journal of Reproductive Health 16(1), 5560.
Alexander, A, Mustafa, A, Emil, S, Amekah, E, Engmann, C, Adanu, RM and Moyer, CA (2013) Social support during delivery in rural central Ghana: a mixed-methods study of women’s preferences for and against inclusion of a lay companion in the delivery room. Journal of Biosocial Science 46(5), 669685.
Amare, Y, Degefie, T and Mulligan, B (2012) Newborn care seeking practices in Central and Southern Ethiopia and implications for community based programming. Ethiopian Journal of Health Development 27(1), 37.
Dako-Gyeke, P, Aikins, M, Aryeetey, R, Mccough, L and Adongo, PB (2013) The influence of socio-cultural interpretations of pregnancy threats on health-seeking behavior among pregnant women in urban Accra, Ghana. BMC Pregnancy and Childbirth 13(211).
Gebrehiwot, T, San Sebastian, M, Edin, K and Goicolea, I (2014) Health workers’ perceptions of facilitators of and barriers to institutional delivery in Tigray, Northern Ethiopia. BMC Pregnancy & Childbirth 14(137).
Ghana Statistical Service (2010) 2010 Population and Housing Census. URL:
Ghana Statistical Service, Ghana Health Service and DHS Program (2015) Ghana DHS, 2014. URL:
Koblinsky, M, Moyer, CA, Calvert, C, Campbell, J, Campbell, O, Feigl, A et al. (2016) A call to action for maternal health: accelerating progress in the next five years. The Lancet 388(10057), 23072320.
Lawn, JE, Blencowe, H, Oza, S, You, D, Lee, AC, Waiswa, P et al. (2014) Every newborn: progress, priorities, and potential beyond survival. The Lancet 384(9938), 189205.
Lui, L, Oza, S, Hogan, D, Chu, Y, Perin, J, Zhu, J et al. (2016) Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals. The Lancet 388(10063), 30273035.
Matsuyama, A, Karama, M, Tanaka, J and Kaneko, S (2013) Perceptions of caregivers about health and nutritional problems and feeding practices of infants: a qualitative study on exclusive breastfeeding in Kwale, Kenya. BMC Public Health 13(525).
Nyambura, R, Nyamache, T and Gechiko, B (2013) Evil eye: an African overview. Journal of Education and Social Science 2(1), 115121.
O’Kyere, E, Tawiah-Agyemang, C, Manu, A, Deganus, S, Kirkwood, B and Hill, Z (2010) Newborn care: the effect of a traditional illness, asram, in Ghana. Annals of Tropical Pediatrics 30(4), 321328.
O’Neill, SA, Clark, E and Grietens, KP (2017) How to protect your new-born from neonatal death: infant feeding and medical practices in Gambia. Women’s Studies International Forum 60, 136143.
Oppong, SA, Bakari, A, Bell, AJ, Bockarie, Y, Adu, J, Turpin, CA et al. (2019) Incidence, causes and correlates of maternal near-miss morbidity: a multi-centre cross-sectional study. British Journal of Obstetrics and Gynecology
Otoo, P, Habib, H and Ankomah, A (2015) Food prohibitions and other traditional practices in pregnancy: a qualitative study in Western Region of Ghana. Advances in Reproductive Science 3, 4149.
Say, L, Souza, JP and Pattinson, RC (2009) Maternal near-miss: towards a standard tool for monitoring quality of maternal health care. Best Practices & Research Clinical Obstetrics and Gynecology 23, 287296
SEND-Ghana (2017) High Maternal Deaths Partly Blamed on Evil Eye. URL: (accessed 15 August 2018).
Sina, OJ, Iyabo, JL and Ayodele, I (2014) Pregnancy care and maternal mortality in Ilesa, Osun State, Nigeria. Standard Research Journal of Medicine and Medical Science 2(1), 4456.
Souza, JP, Cecatti, JG, Haddad, SM, Parpinelli, MA, Costa, ML, Katz, L et al. (2012) The WHO maternal near-miss approach and the maternal severity index model (MSI): tools for assessing the management of severe maternal morbidity. PLoS One 7(8), e44129.
Tong, A, Sainsbury, P and Craig, J (2007) Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist of interviews and focus groups. International Journal of Quality in Health Care 19(6), 349357.
Wanjohi, M, Griffiths, P, Wekesah, F, Muriuki, P, Muhia, N, Musoke, RN, et al. (2017) Sociocultural factors influencing breastfeeding practices in two slums in Nairobi, Kenya. International Breastfeeding Journal 12(5), doi 10.1186/s13006-016-0092-7.
WHO (2014) Trends in Maternal Mortality 1990–2013. URL: (accessed 29 September 2017).
WHO (2015) Global Health Observatory Data. Maternal Mortality. URL: (accessed 15 August 2018).
WHO (2016) Trends in Maternal Mortality: 1990-–2015. URL: (accessed 15 August 2018).


Related content

Powered by UNSILO

‘This sickness is not hospital sickness’: a qualitative study of the evil eye as a source of neonatal illness in Ghana

  • April J. Bell (a1), Zelda Arku (a2), Ashura Bakari (a3), Samuel A. Oppong (a4), Jessica Youngblood (a1), Richard M. Adanu (a5) and Cheryl A. Moyer (a1)...


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.