Bridging Tradition and Science: How Health Campaigns Engage Beliefs in Rural Guinea-Bissau
Improving health outcomes is not only about resources but also about beliefs. Sub-Saharan Africa continues to face major challenges in maternal and infant health, accounting in 2023 for around 70% of global deaths in these categories. Despite substantial efforts and financial investments, progress remains limited, suggesting that non-monetary factors, such as misinformation and persistent traditional beliefs, likely play a crucial role. In many parts of the region, health behaviors are influenced by beliefs in witchcraft or supernatural causes of illness, which distort perceptions and hinder the adoption of effective health practices.
The paper Traditional Beliefs and Health Behaviors: Evidence from Rural West Africa (Alvarez-Pereira et al., 2025) examines this issue in Guinea-Bissau, a country characterized by strong traditional belief systems and deep ethnic and religious diversity, comprising about 40 ethnic groups and a mix of Christian, Muslim, and Animist religions. Guinea-Bissau also faces some of the world’s highest maternal and infant mortality rates, aggravated by extremely limited medical resources, with only 0.22 physicians and 1.05 nurses per 1,000 inhabitants. In comparison, there are about 5 traditional health practitioners per 1,000 people. This context makes it a valuable setting to study how traditional beliefs shape health knowledge, attitudes, and behaviors of those communities.
Design of the Field Experiment
The experimental universe consisted of rural villages located in the administrative regions of Biombo and Cacheu, in Guinea-Bissau. From this population, 180 villages were randomly selected to form the experimental sample. Villages were stratified by health areas, and to minimize potential spillover effects, a minimum distance of two kilometers between two villages in the study was required.
The 180 villages were then randomly assigned into three comparison groups of equal size. Sixty villages were each exposed to three visits of a standard information campaign on best practices for maternal and infant health, communicated through presentations of health specialists, a video and a debate with the community. For this group, the health information provided was purely scientific and made no reference to traditional beliefs, and it was channeled by formal health providers (nurses). Another sixty villages received a beliefs campaign with the same structure, which delivered the same health information but systematically incorporated references to traditional beliefs, and it was channeled by both formal health and traditional health providers. The remaining sixty villages served as the control group, receiving no intervention.
What They Found
The experiment shows that both the standard campaign and the beliefs campaign improved health knowledge and trust in formal health providers, though with different intensities. While the standard campaign produced modest gains, the beliefs campaign was notably more effective, increasing health knowledge by 8% and trust in health center staff by 0.13 standard deviations. The increase in knowledge was strongest among individuals with deeply rooted traditional beliefs, suggesting that the beliefs campaign succeeded in reframing perceptions of health and illness for the population with a mental model more distant from modern medicine. In both campaigns, some uses of the formal health system also increased, while the prevalence of some traditional beliefs about illness and treatment declined.
Overall, results indicate that policies conveying science-based health information while considering traditional beliefs and integrating traditional health practitioners have the potential to improve health outcomes.
Conclusions
Complex problems rarely have simple solutions. In addressing health challenges, researchers recognized that transforming how communities perceive illness and treatment, through targeted information campaigns, could enhance understanding of health issues and strengthen trust in health systems and professionals.
In Guinea-Bissau, religion and ethnicity exerts a profound influence on daily life. Traditional beliefs remain deeply rooted and shape how individuals interpret and respond to health problems. Across Sub-Saharan Africa, health continues to be a pressing global concern. While traditional beliefs play a role, they are only one piece of a much larger puzzle. The real challenge lies in finding ways to bridge science, culture, and trust in pursuit of better health.
Written by Artur Costa BSc in Management by Nova SBE and Member of the NOVAFRICA Student Group.
