The traditional healer in obstetric care: A persistent wasted opportunity in maternal health

Social Science and Medicine, Volume 133, Year 2015

Ukuhunyushwa

I-AI Digest

Study Justification:

The study aimed to explore the role of traditional healers in managing pregnancy-related complications in northern Ghana. Traditional medical systems are often the first choice for healthcare in low-income countries, especially in rural areas. While the role of traditional birth attendants (TBAs) is recognized, the role of other traditional practitioners, such as traditional healers, has received less attention. This study aimed to fill this gap in knowledge and understand the relevance of traditional healers in reducing maternal morbidity and mortality.

Highlights:

– Traditional healers are extensively consulted in northern Ghana to manage obstetric complications.
– Their clientele includes families who prefer traditional medicine due to access issues or cultural beliefs.
– Traditional healers claim expertise in complications related to witchcraft and culturally defined syndromes.
– Many healers expressed a willingness to work with formal health services, as they possess unique knowledge, skills, and community trust.
– However, this integration would require stronger acknowledgement and inclusion within safe motherhood programs.

Recommendations for Lay Reader:

1. Recognize the important role of traditional healers in managing obstetric complications in northern Ghana.
2. Understand that traditional healers are sought after by families who cannot access modern healthcare or have cultural beliefs favoring traditional medicine.
3. Consider the unique expertise and skills possessed by traditional healers in managing complications related to witchcraft and culturally defined syndromes.
4. Support efforts to integrate traditional healers into formal health services, as they have the trust of the community and can contribute to reducing maternal morbidity and mortality.

Recommendations for Policy Maker:

1. Acknowledge the significant role played by traditional healers in managing obstetric complications in northern Ghana.
2. Develop strategies to collaborate with traditional healers and incorporate their expertise into safe motherhood programs.
3. Provide training and support to traditional healers to enhance their knowledge and skills in managing complications.
4. Allocate resources to facilitate the integration of traditional healers into the formal health system, including establishing referral mechanisms and ensuring coordination between traditional healers and modern healthcare providers.

Key Role Players:

1. Traditional healers: They possess unique knowledge and skills in managing obstetric complications and are trusted by the community.
2. Formal health services: Collaboration and integration with traditional healers would require the involvement of healthcare providers and administrators.
3. Community leaders: Their support and endorsement are crucial in promoting the integration of traditional healers into the formal health system.
4. Policy makers: They have the authority to develop policies and allocate resources to support the integration of traditional healers into safe motherhood programs.

Cost Items for Planning Recommendations:

1. Training programs: Budget for developing and implementing training programs to enhance the knowledge and skills of traditional healers in managing obstetric complications.
2. Coordination and referral mechanisms: Allocate resources to establish systems that facilitate communication and coordination between traditional healers and modern healthcare providers.
3. Awareness campaigns: Budget for raising awareness among the community about the benefits of integrating traditional healers into the formal health system.
4. Research and evaluation: Allocate funds for conducting research and evaluation to assess the impact and effectiveness of integrating traditional healers into safe motherhood programs.

Amandla Obufakazi

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is based on a qualitative approach and provides insights into the role of traditional healers in managing obstetric complications. However, the evidence could be strengthened by including quantitative data and a larger sample size. Additionally, the abstract suggests that traditional healers are willing to work with formal health services, but it does not provide specific actionable steps to improve integration within safe motherhood programs. To improve the evidence, future research could include a mixed-methods approach, involving both qualitative and quantitative data collection, and focus on developing concrete strategies for collaboration between traditional healers and formal health services.

Abstract

Traditional medical systems in low income countries remain the first line service of choice, particularly for rural communities. Although the role of traditional birth attendants (TBAs) is recognised in many primary health care systems in low income countries, other types of traditional practitioners have had less traction. We explored the role played by traditional healers in northern Ghana in managing pregnancy-related complications and examined their relevance to current initiatives to reduce maternal morbidity and mortality. A grounded theory qualitative approach was employed. Twenty focus group discussions were conducted with TBAs and 19 in-depth interviews with traditional healers with expertise in managing obstetric complications. Traditional healers are extensively consulted to manage obstetric complications within their communities. Their clientele includes families who for either reasons of access or traditional beliefs, will not use modern health care providers, or those who shop across multiple health systems. The traditional practitioners claim expertise in a range of complications that are related to witchcraft and other culturally defined syndromes; conditions for which modern health care providers are believed to lack expertise. Most healers expressed a willingness to work with the formal health services because they had unique knowledge, skills and the trust of the community. However this would require a stronger acknowledgement and integration within safe motherhood programs.

Izinto zokwakha

N/A

Emisha

The recommendation to improve access to maternal health is to acknowledge and integrate traditional healers within safe motherhood programs. Traditional healers play a significant role in managing obstetric complications in rural communities, where they are often the first line of healthcare. By recognizing their expertise and incorporating them into formal health services, their unique knowledge and skills can be utilized to improve maternal health outcomes. This would involve conducting further research and engaging in dialogue with traditional healers to understand their practices and develop appropriate training programs. By working together, traditional healers and modern healthcare providers can provide comprehensive and culturally sensitive care to pregnant women, especially those who may not have access to or prefer traditional medical systems.

AI Innovations Description

AI Innovations Methodology

To simulate the impact of the main recommendations mentioned in the abstract on improving access to maternal health, the following methodology could be employed:

1. Research Design: Conduct a mixed-methods study that combines qualitative and quantitative approaches to gather comprehensive data.

2. Sampling: Select a representative sample of rural communities in low-income countries where traditional healers play a significant role in managing obstetric complications. Ensure diversity in terms of geographical location, cultural practices, and access to modern healthcare.

3. Data Collection:

a. Qualitative Phase: Conduct focus group discussions with traditional birth attendants (TBAs) and in-depth interviews with traditional healers who have expertise in managing obstetric complications. Use a grounded theory qualitative approach to explore their practices, beliefs, and experiences. Gather information on the types of complications they manage, their knowledge and skills, and their willingness to work with formal health services.

b. Quantitative Phase: Develop a survey questionnaire to collect quantitative data on the utilization of traditional healers for maternal health services, reasons for choosing traditional healers over modern healthcare providers, and perceptions of the effectiveness of traditional healing practices. Administer the survey to a larger sample of pregnant women and their families in the selected communities.

4. Data Analysis:

a. Qualitative Analysis: Transcribe and analyze the focus group discussions and in-depth interviews using thematic analysis. Identify common themes related to the role of traditional healers in managing obstetric complications, their potential contributions to safe motherhood programs, and barriers to their integration into formal health services.

b. Quantitative Analysis: Analyze the survey data using appropriate statistical methods. Calculate frequencies, percentages, and correlations to understand the patterns of traditional healer utilization and the factors influencing their choice.

5. Integration and Dialogue:

a. Organize workshops or meetings with traditional healers, modern healthcare providers, policymakers, and community members to facilitate dialogue and knowledge exchange. Share the findings of the study and discuss the potential benefits of integrating traditional healers into safe motherhood programs.

b. Develop training programs and guidelines in collaboration with traditional healers to enhance their knowledge and skills in managing obstetric complications. Ensure that the training programs are culturally sensitive and respect traditional healing practices.

6. Monitoring and Evaluation:

a. Implement the recommended changes in safe motherhood programs by integrating traditional healers into the formal health system.

b. Monitor the impact of these changes on maternal health outcomes, such as maternal morbidity and mortality rates, access to antenatal care, skilled birth attendance, and postnatal care.

c. Evaluate the effectiveness of the integrated approach by comparing the maternal health indicators before and after the intervention, as well as comparing the outcomes in communities where traditional healers were integrated versus those where they were not.

7. Dissemination and Policy Advocacy:

a. Publish the findings of the study in relevant academic journals and present them at conferences to raise awareness about the potential benefits of integrating traditional healers into safe motherhood programs.

b. Engage with policymakers and stakeholders to advocate for policy changes that recognize and support the integration of traditional healers into formal health services.

By following this methodology, researchers can simulate the impact of integrating traditional healers into safe motherhood programs and assess the potential benefits of this approach in improving access to maternal health.

Ababhali & Co-Ababhali

Statistics:

Citations: 20

Authors: 3

Identifiers:

DOI: 10.1016/j.socscimed.2015.03.046

ISSN: 02779536

Research Areas:

Community Interventions, Health System and Policy, Maternal and Child Health, Quality of Care, Sexual and Reproductive Health, Social Determinants

Study Countries:

Ghana

Study Design:

Grounded Theory

Study Approach:

Qualitative

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