Abstract
Much of Sub-Saharan Africa meets the rising rates of musculoskeletal injury with traditional bone setting, especially given limitations in access to allopathic orthopaedic care. Concern for the safety of bone setter practices as well as recognition of their advantages have spurred research to understand the impact of these healers on public health. Our study investigates the role of bone setting in Tanzania through patient utilization and perspectives. We surveyed 212 patients at the outpatient orthopaedic clinic at Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania. Surveys were either self-administered or physician-administered. Summary statistics were calculated using XLSTAT. Open responses were analyzed using a deductive framework method. Of all surveys, 6.3% (n=13) reported utilizing traditional bone setting for their injury prior to presenting to KCMC. Of the self-administered surveys, 13.6% (n=6) reported utilizing bone setting compared to 4.3% (n=7) of the physician-administered surveys (p=0.050). Negative perceptions of bone setting were more common than positive perceptions and the main reason patients did not utilize bone setting was concern for competency (35.8%, n=67). Our study found lower bone setting utilization than expected considering the reliance of Tanzanians on traditional care reported in the literature. This suggests patients utilizing traditional care for musculoskeletal injury are not seeking allopathic care; therefore, collaboration with bone setters could expand allopathic access to these patients. Patients were less likely to report bone setter utilization to a physician revealing the stigma of seeking traditional care, which may present an obstacle for collaboration.
Highlights
Prior to colonialism, traditional medicine was the sole source of health care across Africa, and it has remained the main source to this day despite growth of allopathic healthcare sectors[1,2,3,4]
Medical care for musculoskeletal injury is limited by the capacity of orthopaedic care and in many Sub-Saharan African countries traditional bone setting has helped to alleviate this growing burden[9]
The highest level of education achieved by the majority of respondents was primary school (44.6%, n = 90) and most worked as farmers (32.2%, n = 55) and made under 500,000 Tanzanian Shillings (TSH), equivalent to $220 per month (76.7%, n = 125)
Summary
Traditional medicine was the sole source of health care across Africa, and it has remained the main source to this day despite growth of allopathic healthcare sectors[1,2,3,4]. Much of Sub-Saharan Africa meets the rising rates of musculoskeletal injury with traditional bone setting, especially given limitations in access to allopathic orthopaedic care. Conclusion: Our study found lower bone setting utilization than expected considering the reliance of Tanzanians on traditional care reported in the literature This suggests patients utilizing traditional care for musculoskeletal injury are not seeking allopathic care; collaboration with bone setters could expand allopathic access to these patients. Patients were less likely to report bone setter utilization to a physician revealing the stigma of seeking traditional care, which may present an obstacle for collaboration.
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