Reintegrating Women Accused of Witchcraft in Northern Ghana: A Culturally Grounded Reintegration Framework for Mental Health Promotion

Abstract

Witchcraft accusations in Northern Ghana have led to the banishment of hundreds of older women to isolated camps, resulting in profound social exclusion and mental distress. While previous studies have explored their lived experiences, limited attention has been given to strategies that enable safe return and psychosocial recovery. To develop an evidence-informed, culturally grounded framework for mental-health promotion and sustainable reintegration of women previously accused of witchcraft in Northern Ghana. This conceptual paper draws on evidence from a mixed-methods doctoral programme comprising qualitative interpretive interviews, stakeholder discussions, and a cross-sectional survey of 268 camp residents in northern Ghana, supplemented by documentary and policy analysis. Framework development was guided by three complementary lenses – the socio-ecological model, Kleinman’s explanatory model, and the social determinants of health – used to structure a Framework Method synthesis that informed the Culturally Grounded Reintegration Framework (CGRF). Reintegration is constrained by persistent stigma, precarious livelihoods, weak institutional protections, and limited access to mental health and social welfare services. Simultaneously, culturally authoritative mechanisms including mediated reconciliation by traditional and faith leaders, collective labour practices, and storytelling, provide meaningful pathways for restoring dignity, belonging, and psychological wellbeing. The CGRF integrates four mutually reinforcing components: (1) culturally adapted psychosocial support; (2) family and spiritual reconciliation; (3) community inclusion and livelihood security; and (4) legal and institutional safeguards. Reintegration is a therapeutic, social justice, and culturally mediated process rather than physical relocation alone. The CGRF offers a locally grounded, theoretically informed model aligned with WHO mhGAP principles and the Sustainable Development Goals, with potential relevance (with adaptation) for other settings facing spiritually mediated stigma, ageism, and gendered exclusion.