Indigenous Health Practitioners Research Articles

Collaboration between African Indigenous and Biomedical Health Practitioners: Perceptions Regarding Tuberculosis Treatment

Despite programmes developed to alleviate tuberculosis (TB) infection worldwide, South Africa is still reporting high rates of infection. Most South Africans believe in and consider using the medicine provided by African indigenous health practitioners (AIHPs) rather than consulting practitioners at modern health facilities. The isolated functioning of these two groups of practitioners motivated the government to establish the Traditional Health Practitioners Act (22 of 2007), to encourage AIHPs and biomedical health practitioners (BHPs) to collaborate on the healing of different diseases, including TB. The Mpumalanga province has been hit the hardest by TB and has a high infection rate. The study aimed at exploring and describing the perceptions of AIHPs and BHPs on collaboration concerning TB treatment in the Ehlanzeni district, Mpumalanga. A semi-structured interview guide was used to collect data from focus groups with 21 AIHPs and in-depth individual interviews with 10 BHPs. The findings of the study reveal differing perceptions, as some BHPs accept the Act and acknowledge collaboration, while others have concerns about standards of care, patient safety, and overdosing. They are reluctant to accept integration, as they see AIHPs as unscientific practitioners who use strong medicine that is detrimental to patients. The AIHPs welcomed the idea of working together and mutual teaching with the aim of empowering each other with knowledge regarding the treatment of TB, for the ultimate benefit of patients.

The relationship between Indigenous and allopathic health practitioners in Africa and its implications for collaboration: a qualitative synthesis

ABSTRACT Background There have been increasing calls for collaboration between Indigenous health practitioners (IHPs) and allopathic health practitioners (AHPs) in Africa. Despite this, very few successful systems exist to facilitate formal collaboration. Direct relationships between providers, and at a health systems level are crucial to successful collaboration, but the nature and extent of these relationships have yet to be adequately explored. Objective To explore the relationship between IHPs and AHPs in Africa, and to discuss the implications of this for future collaboration. Methods An interpretive qualitative synthesis approach, combining elements of thematic analysis, meta-ethnography, and grounded theory, was used to systematically bring together findings of qualitative studies addressing the topic of collaboration between Indigenous and allopathic health practitioners in Africa. Results A total of 1,765 papers were initially identified, 1,748 were excluded after abstract, full text and duplicate screening. Five additional studies were identified through references. Thus, 22 papers were included in the final analysis. We found that the relationship between Indigenous and allopathic health practitioners is defined by a power struggle which gives rise to lack of mutual understanding, rivalry, distrust, and disrespect. Conclusion The power struggle which defines the relationship between IHPs and AHPs in Africa is a hindrance to their collaboration and as such could partly account for the limited success of efforts to foster collaboration to date. Future efforts to foster collaboration between IHPs and AHPs in Africa must aim to balance the power disparity between them if collaboration is to be successful. Since this would be a novel approach, decision-makers and organisations who trial this power balancing approach to facilitate collaboration should evaluate resultant policies and interventions to ascertain their feasibility and efficacy in fostering collaboration, and the lessons learnt should be shared.

Implementation Challenges in Public Policies Towards Indigenous Peoples: The Impact of Health Policies in Urban Contexts

ABSTRACT How are indigenous public health policies implemented in contexts of diversity? The rural-urban migration processes that indigenous people have experienced since the mid-1990s in Latin American countries have affected the implementation of public policies, especially in the field of health. These processes have put pressure on ancestral practices of territorial representation, challenging traditional mechanisms that have supported western health policies. Based on a case study in urban Chile, this article examines the implementation processes of indigenous public policies in field of intercultural health. The analysis is informed by data collected from in-depth interviews with 35 key actors (Indigenous health practitioners, managers, health professionals, users, indigenous leaders), who have played a role in different stages in the implementation process of ‘Indigenous Peoples Special Health Program (PESPI)’. The data points to some challenges that persist with the implementation and adaption to this policy into a Western Health Model, where indigenous practices do not always find space to develop. The data collected reveals the efforts that indigenous people make in order to maintain their traditions and practices in different territorial contexts. The findings have the potential to enrich discussion and decision-making on intercultural and or indigenous health policies in other countries experiencing similar issues.

Decolonising the mindsets, attitudes and practices of the allopathic and indigenous health practitioners in postcolonial society: An exploratory approach in the management of patients.

BackgroundThe indigenous health care system continues in the postcolonial era to be perceived by antagonists as a threat to Western medicine. It has been associated with ‘witchcraft’, actively discouraged and repressed through official government prohibition laws. Despite that, human immunodeficiency virus and acquired immunodeficiency syndrome (HIV and AIDS) patients consult both allopathic and indigenous health practitioners.AimThe study explored a collaboration model between allopathic and traditional health practitioners in the management of patients living with HIV and AIDS in postcolonial South Africa.SettingWe conducted six combined focus group discussions and four separate group discussions with each category of co-researchers.MethodsCombined and separate focus group discussions were conducted with community members, allopathic and indigenous health practitioners, applying the cyclical method in the decolonisation process. Their perceptions and experiences in the management of HIV and AIDS patients were explored, and finally decolonisation strategies suitable for collaboration in their context were identified.ResultsThe two health systems were rendering services to the same HIV and AIDS communities. Lack of communication created confusion. Collaboration was long overdue. A change in mindsets, attitudes and practices among practitioners was critical, with an acknowledgement that ‘neither health system is better than the other, but the two should be complementary, recognising that the culture and beliefs of patients influence their health-seeking behaviour’.ConclusionCo-researchers were committed to working together in the fight against HIV and AIDS infections. Their model for collaboration addresses the challenges of patients’ secrecy, treatment overdose and the abandonment of antiretroviral treatment. Through the application of a decolonisation process, their mindsets, attitudes and practices towards each other were changed, enabling the joint development of a custom model for collaboration between allopathic health practitioners and indigenous health practitioners in the management of patients living with HIV and AIDS.

Experiential learning to increase palliative care competence among the Indigenous workforce: an Australian experience

ObjectivesImproving Indigenous people’s access to palliative care requires a health workforce with appropriate knowledge and skills to respond to end-of-life (EOL) issues. The Indigenous component of the Program of Experience...

Biomedical health practitioners’ views regarding the practices and health care delivery methods of the African indigenous health practitioners’ in Mpumalanga province, South Africa

Biomedical health practitioners’ views regarding the practices and health care delivery methods of the African indigenous health practitioners’ in Mpumalanga province, South Africa

A Call to Wellness – Whitiwhitia i te ora: Exploring Māori and Occupational Therapy Perspectives on Health

The World Health Organization records that indigenous peoples throughout the world experience poor health. The concept of health was explored from a Māori world view and compared with occupational therapy perspectives. The aim was to understand and value indigenous knowledge and promote culturally safe responsive practice. Māori methodologies were employed to protect the Māori knowledge shared in the study. This involved applying seven principles, including respect for people, be cautious, and look, listen, and speak. Perspectives on health and wellbeing were collected in 2008-2009 from indigenous occupational therapists, other occupational therapists and indigenous health practitioners using interviews and a questionnaire. The findings are presented as a conceptual framework, depicting a whare, a Māori meeting house to show relationships between culture and health. Key concepts held by occupational therapists and Māori were spirituality, holistic views, client responsive practice, and environmental contexts. Areas of difference were the focus on occupations, the interdependence of indigenous relationships, and the place of the extended family in supporting wellness. A strength was the respect for Māori methodologies and limitations were the number of participants (N = 23) and the small proportion of Māori therapists in Aotearoa/New Zealand. Attention to culture is vital for appropriate, safe, and responsive practice. The conceptual framework provides a tool to inform, guide, and evaluate practice understandings. It acknowledges the importance of the individual within their extended family, their natural environment, and the historical, social, and political realities of living as Māori. Further research should explore the use of the framework and interaction between occupational therapy practice and specific indigenous cultures.

Indigenous Traditional Medicine and Intercultural Healthcare in Bolivia: A Case Study From the Potosi Region

Indigenous peoples have the worst socio-demographic indicators and the largest inequalities in terms of access to social services and health in the Latin American region, Bolivia included. In the last few years, attempts to implement policies that support indigenous people's health rights led to the development of intercultural health approaches. Yet, acceptance and integration of indigenous medicine into the biomedical health system presents a major challenge to intercultural health in Latin America. The objective of this article is to analyze the case of a health center in Tinguipaya, one of the first and few examples of intercultural health initiatives in Bolivia. This intercultural health project, which represents a pioneer experience with regard to the creation of intercultural health services in Bolivia, aims to create a network between local communities, traditional healers, and biomedical staff and offer a more culturally sensitive and holistic health service for indigenous people living in the area. The aim of this article is to critically assess this initiative and to analyze the main challenges met in the creation of a more effective intercultural health policy. The extent to which this initiative succeeded in promoting the integration between indigenous health practitioners and biomedical staff as well as in improving access to health care for local indigenous patients will also be examined.

Synergy between indigenous knowledge systems, modern health care system and scientific research – a vision for the 21st century

Research already conducted in African countries indicates that the majority of patients still seek help from the traditional indigenous health care systems.
 
 Opsomming
 Navorsing wat reeds in Afrika-lande onderneem is, dui aan dat die meerderheid pasiënte steeds hulp soek vanaf die tradisioneel inheemse gesondheidsorgsisteme.
 
 *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

Can collaborative programs between biomedical and African indigenous health practitioners succeed?

The paper explores the various factors that appear to constrain the implementation in sub-Saharan Africa of the WHO/UNICEF Alma Ata resolutions that member states support the use of indigenous health practitioners in government health programs. It also presents arguments and evidence that suggest ways to overcome the constraining factors. Discussion focuses on traditional healers as distinct from traditional birth attendants. The question posed in the title is not fully answered, but a considerable amount of fact, programmatic experience, and observation related to the issue is assembled and discussed in order to approach an answer, and to inform those who hold a variety of positions with regard to the Alma Ata resolutions.

Induced Abortion in a Rural Area of Bangladesh

Mortality rates from indigenous abortion practices have not been described previously. From September 1982 to August 1983, traditional birth attendants, under medical supervision, collected data on all identifiable pregnant women and pregnancy outcomes in a geographically defined population in rural Bangladesh. Of 9,906 pregnancies, 9,317 ended in live birth, 412 in induced abortion, and 177 in spontaneous abortion. All abortions were induced by indigenous health practitioners. The abortion-to-live-birth ratio was 44.2 per 1,000. Ten women died after induced abortion, yielding a death-to-case rate of 2.4 percent. The death-to-case rate was highest for women 35 and older and women of parity five and higher. The authors conclude that improved distribution of safe, acceptable means of fertility regulation may save many mothers' lives.