Abstract
BackgroundUnderstanding perceptions of the causes of ill-health common in indigenous communities may help policy makers to design effective integrated primary health care strategies to serve these communities. This study explored the indigenous beliefs of ill-health causation among those living in the Tehuledere Woreda /district/ in North East Ethiopia from a socio-cultural perspective.MethodsThe study employed a qualitative ethnographic method informed by Murdock’s Theory of Illness. Participatory observation, over a total of 5 months during the span of one year, was supplemented by focus group discussions (n = 96 participants in 10 groups) and in-depth interviews (n = 20) conducted with key informants. Data were analyzed thematically using narrative strategies.ResultsIn these communities, illness is perceived to have supernatural (e.g., almighty God/ Allah, nature spirits, and human agents of the supernatural), natural (e.g., environmental sanitation and personal hygiene, poverty, biological and psychological factors) and societal causes (e.g., social trust, experiences of family support and harmony; and violation of social taboos). Therefore, the explanatory model of illness causation in this community was very similar to that of the Murdock model with one key difference: social elements need to be added to the model.ConclusionMembers of the study community believes that supernatural, natural and social elements are linked to ill-health causation. A successful integrated primary health care strategy should include strategies for supporting patients’ needs in all three of these domains.
Highlights
Understanding perceptions of the causes of ill-health common in indigenous communities may help policy makers to design effective integrated primary health care strategies to serve these communities
This study aimed to explore the socio-cultural context of indigenous beliefs regarding ill-health among five Tehuledere communities found in the Amhara Regional State of Ethiopia
A theoretical approach initially used to frame and subsequently to interpret the data from this study allowed for a more thorough explanation of beliefs and perceptions of illness causation. This ethnographic exploration with the study communities in Tehuledere revealed that perceived causes of illhealth can be grouped into three main categories: supernatural, natural, and social elements
Summary
Understanding perceptions of the causes of ill-health common in indigenous communities may help policy makers to design effective integrated primary health care strategies to serve these communities. Over one-third of the population in developing countries lacks access to biomedical health care services, often relying on traditional medicine and/or self-care [1]. In addition to their physical inaccessibility, biomedical health services are often unaffordable. The beliefs and perceptions of ill-health are influenced by the socio-cultural context and indigenous healers, who form an alternative health service in many societies, may Biomedical health care institutions and policies often do not recognize the important role indigenous illhealth beliefs and medicinal knowledge plays in rural health care, especially in developing countries. Others acknowledge that indigenous medicine should be embraced as an important part of health care systems in indigenous communities [3,4,5]
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