‘We’re doing our best, but we’re doing it alone’: navigating trust, social media use for health, and the systemic absence of institutional health support among Ghanaian youth

Social media platforms have become everyday sources of health information and support for young people; however, little is known about how youth in low-resource settings navigate trust, relevance, and systemic gaps in institutional health support. This study examined how Ghanaian youth use social media for health-related purposes within contexts shaped by infrastructural limitations, cultural misalignment, and weak public health systems. We conducted 22 in-depth interviews with youth aged 18–30 across Accra, Obuasi, and Winneba. Guided by the culture-centered approach and trust frameworks, thematic analysis explored how participants engaged with social media health content and negotiated broader structural constraints. Participants relied heavily on social media to learn, interpret, and share health information, yet this engagement unfolded within inequities such as high data costs, unreliable internet, limited access to youth-friendly health services, and the absence of institutional guidance, barriers that could not be overcome through personal resilience alone. A central finding was that young people felt they were “doing it alone,” navigating health challenges on social media without supportive systems. Youth trusted creators who felt authentic, relatable, and culturally grounded, while foreign content, featuring unfamiliar foods, body ideals, and inaccessible health products, often felt alienating or irrelevant. Despite their agency, participants described emotional fatigue from evaluating credibility and adapting content to local realities. Ghanaian youth actively rework social media–based health information to fit their circumstances, yet their reliance on these platforms reflects a deeper systemic absence of institutional health support. Achieving equity in how youth engage with health information on social media requires more than connectivity; it demands affordable infrastructure, culturally resonant communication, and strengthened public health systems that reduce the burden currently placed on individuals. These findings indicate the need for structural interventions aligned with SDGs 3, 4, 9, and 10.