Preference For Traditional Medicine Research Articles

"'You Just Want to Give me Some Medicine and be on my Way': Preferences, Beliefs, and Experiences Related to Western Medication among Members of a State-Recognized Tribe".

Background: Native American/American Indian (NA/AI) people have higher rates of chronic disease, including substance use and mental health disorders, compared to White Americans. Though pharmaceuticals can be helpful in addressing many chronic healthcare conditions, many people do not take medications as prescribed. NA/AI identity has been found to be associated with lower rates of medication adherence compared to White Americans. Purpose: The purpose of this study is to better understand NA/AI women's perceptions, beliefs, and experiences related to medication. Methods: Thirty-one semi-structured interviews were conducted with NA/AI women from a state-recognized tribe located in the Gulf South. Interviews were transcribed and analyzed using a qualitative description approach. Results: Eighteen women discussed their experiences using medications when asked about their healthcare experiences. Participants identified the following themes in their discussion of medication: (a) Cost of Medication as a Barrier; (b) Negative Side Effects of Western Medication; (c) Fear of Resistance and Dependence; (d) Preference for Traditional Medicine or None; and (e) Lack of Communication around Medications from Providers. Conclusion: Our findings support the growing call for cultural safety within medical settings and integrating NA/AI conceptualizations of health and well-being and traditional practices into western healthcare settings to better support NA/AI people.

Synthesis of Qualitative Evidence on Malaria in Pregnancy, 2005–2022: A Systematic Review

Qualitative research on malaria in pregnancy (MiP) is incipient, therefore its contextual, experiential and symbolic associated factors are unknown. This study systematizes the qualitative research on MiP, describes knowledge, perceptions and behaviors about MiP, and compiles individual, socioeconomic, cultural and health system determinants of MiP through a meta-synthesis in 10 databases. A total of 48 studies were included with 2600 pregnant women, 1300 healthcare workers, and 2200 relatives or community members. Extensive knowledge was demonstrated on ITN and case management, but it was lacking on SP-IPTp, risks and consequences of MiP. Attitudes were negative towards ANC and MiP prevention. There were high trustfulness scores and preference for traditional medicine and distrust in the safety of drugs. The main determinants of the Health System were rationing, copayments, delay in payment to clinics, high out-of-pocket expenses, shortage, low workforce and work overload, shortcomings in care quality, low knowledges of healthcare workers on MiP and negative attitude in care. The socioeconomic and cultural determinants were poverty and low educational level of pregnant women, distance to the hospital, patriarchal-sexist gender roles, and predominance of local conceptions on maternal-fetal-neonatal health. The meta-synthesis demonstrates the difficulty to detect MiP determinants and the importance of performed qualitative research before implementing MiP strategies to understand the multidimensionality of the disease.

Exploring Care Management for Older Adults with Illnesses as Family Members’ Responsibility : The need for Social Workers’ Support Services in Nigeria

Introduction: Aging oftentimes comes with health-related issues. Usually, family members are obliged to provide care management for older adults. They must perform this task despite their limited knowledge of their patients’ health conditions. Hence, securing care management for older adults with illnesses becomes a dilemma for consideration. Aims: Older adults require support in managing health conditions. This study hopes to promote the following: First, provide understanding of how family members perceive caregiving. Second, provide insight into family members’ management of health care challenges. Third, explore the need for geriatric support services in providing care for older adults. Methods: The study employed a qualitative research method. Focus Group Discussion was utilized to elicit data from 24 participants admitted to four health care facilities at Enugu-North, Nigeria. Results: Findings indicated that participants perceived care management for the older adults as a filial responsibility that should be provided till their demise. However, the majority experienced difficulties to this effect, other major concerns found include age and the older adult’s attitude, financial challenges, the changing contemporary society, and caregiving stress due to the care recipient’s health status. While many of the participants indicated a preference for traditional medicine as an alternative to rapidly increasing health service charges owing to lagging geriatric support; others were less reliant on the governmental welfare support services. Conclusions: With the government implementing aging and health care policies, Non-Governmental Organizations (NGOs) and Civil Society Organizations (CSOs) in collaboration with geriatric social workers can help develop care-aid programs for older adults’ healthy wellbeing.

Preference and Practice of Traditional Medicine and Associated Factors in Jimma Town, Southwest Ethiopia.

Background Traditional medicine is the sum total of knowledge, talents, and practices that are used to uphold health, as well as to avert, identify, improve, or treat illnesses. Sociodemographic/economic characteristics, culture, and environment can influence the preference and practice of traditional medicine. Objective To assess the preference and practices of traditional medicine and associated factors. Methods A community-based cross-sectional study was conducted among 271 residents of Jimma town. The data were collected by interviewing selected households. The households were selected by a simple random sampling technique. The data were analysed using SPSS version 20. Descriptive statistics were used for organizing, describing, and summarizing the data. Chi-square (X2) test was used to identify factors associated with the preference and practice of traditional medicine. Results More than half (221(81.5%)) of the participants practiced traditional medicine. Religion (X2 = 17.18; p=0.001), marital status (X2 = 15.42; p=0.001), occupation (X2 = 19.74; p=0.001), and educational level (X2 = 28.39; p ≤ 0.001) were the sociodemographic factors determining the use of traditional medicine. However, 25 (9.2%) of the participants preferred to use traditional medicine. Affordability (25 (100%)), religious affiliation (21 (84%)), and distance from home (20 (80%)) were some reasons for preference. Educational level (X2 = 15.56; p=0.04), marital status (X2 = 12.39; p=0.04), and occupation (X2 = 15.61; p=0.003) were the factors affecting their preference for traditional medicine. Conclusion A majority of the participants practiced traditional medicine use. Religion, marital status, occupation, and educational level were factors affecting the practice of the participants. More than half of the participants did not prefer to use traditional medicine. Affordability, religious affiliation, and distance from home were some reasons for preferring traditional medicine.

Why Do Patients with Mental Disorders Default Treatment? A Qualitative Enquiry in Rural Kwazulu-Natal, South Africa.

Although treatment default by psychiatric patients or mental health care users is a global challenge, this behavior is reported to be higher in South Africa. The Manguzi District Hospital in rural Kwa-Zulu Natal Province, South Africa, experiences high rates of treatment default by psychiatric patients. The objective of this study was to determine the reasons for treatment defaulting at Manguzi Hospital, KwaZulu-Natal Province, South Africa. An explorative qualitative design, using in-depth interviews, was conducted with mental health care users who had defaulted out-patient psychiatric treatment. Twenty-one mental health care users were interviewed before data saturation was reached. Nvivo version 11 was used to analyze the qualitative data. Major themes that emerged confirmed that social factors are key contributions to treatment defaulting, and these include denial of the mental disorders; belief that they are cured; lack of, or disintegration of social support; preference for traditional medicine; and flaws in the health care system. Social determinants of treatment outcomes for mental disorders require tailor-made support systems for patients in these rural communities, which include increase in health literacy and attention to the cultural understanding of mental disorders.

Community-informed research on malaria in pregnancy in Monrovia, Liberia: a grounded theory study

BackgroundLiberia is a West African country that needs substantial investment to strengthen its National Malaria Control Programme (NMCP), which was disrupted during the 2014–2016 Ebola epidemic. As elsewhere, Liberian pregnant women are especially vulnerable to malaria. Understanding prevention and treatment-seeking behaviours among the population is crucial to strategize context-specific and women-centred actions, including locally-led malaria research, to improve women’s demand, access and use of NMCP strategies against malaria in pregnancy.MethodsIn 2016, after the Ebola crisis, a qualitative inquiry was conducted in Monrovia to explore populations’ insights on the aetiology, prevention and therapeutics of malaria, as well as the community and health workers’ perceptions on the utility of malaria research for pregnant women. In-depth interviews and focus group discussions were conducted among pregnant women, traditional community representatives and hospital staff (n = 38), using a feminist interpretation of grounded theory.ResultsThe narratives indicate that some Liberians believed in elements other than mosquito bites as causes of malaria; many had a low malaria risk perception and disliked current effective prevention methods, such as insecticide-treated nets; and some would resort to traditional medicine and spiritual care to cure malaria. Access to clinic-based malaria care for pregnant women was reportedly hindered by lack of financial means, by unofficial user fees requested by healthcare workers, and by male partners’ preference for traditional medicine. The participants suggested that malaria research in Liberia could help to design evidence-based education to change current malaria prevention, diagnostic and treatment-seeking attitudes, and to develop more acceptable prevention technologies.ConclusionPoverty, insufficient education on malaria, corruption, and poor trust in healthcare establishment are structural factors that may play a greater role than local traditional beliefs in deterring Liberians from seeking, accessing and using government-endorsed malaria control strategies. To increase access to and uptake of preventive and biomedical care by pregnant women, future malaria research must be informed by people’s expressed needs and constructed meanings and values on health, ill health and healthcare.

Knowledge, attitude, and beliefs on epilepsy among adults in Erute South, Lira District, Uganda.

SummaryObjectiveTo assess the knowledge, attitudes, and beliefs of adults on epilepsy in Erute South County, Lira District, Uganda.MethodsA cross‐sectional study was conducted in rural Erute South County. Two hundred seventeen of 220 randomly selected adults 18 years or older participated in the study. A standardized self‐administered questionnaire (Attitudes towards persons with Epilepsy “ATPE”) was used for data collection. Protocol approval was sought from International Health Sciences University, and informed consent was obtained from participants at all times.ResultsTwo hundred seventeen of 220 invited community members completed the study. Females comprised the majority 51.6%.. Most of the respondents had a low level of knowledge on epilepsy. The mean ATPE scale knowledge score was 4.57 (standard deviation [SD] = 3.24) of a maximum score of 11. The male respondents almost had mean knowledge scores almost equal to their female counterparts (4.23, SD = 2.48; 4.51, SD = 2.54, respectively). Most respondents had negative attitudes toward epilepsy, with a mean ATPE attitude score of 73.2 (SD = 2.11) of a possible maximum score of 126. The mean attitude scores for the male and female respondents were 58.18 (SD = 4.23) and 86.62 (SD = 5.23), respectively. Most respondents had negative beliefs such as attributing epilepsy to supernatural spirits, heredity, and preference of traditional medicine and healers to conventional medicine as a treatment for epilepsy. A significant number of respondents expressed sympathetic feelings toward people living with epilepsy, specifically tolerance and kindness to those living with epilepsy.SignificanceFindings could benefit policymakers, the district health team, researchers, community members, affected families, and people with epilepsy in designing awareness strategies. Knowledge on epilepsy could improve the quality of life and care for people living with epilepsy, through reducing misconceptions and stigmatization in the communities where they live.

Epidemiology of snakebites in Kédougou region (eastern Senegal): comparison of various methods for assessment of incidence and mortality.

BackgroundAlthough considered a public health issue in Senegal, the actual incidence and mortality from snakebite are not known. In the present study, an epidemiological survey was carried out in Kédougou region, southeastern Senegal, where envenomations, particularly by Echisocellatus, are frequent and severe.MethodsThree sources of data were used: records from health centers and reports by health professionals; traditional healers; and household surveys.ResultsThe annual incidence and mortality provided by health centers were 24.4 envenomations and 0.24 deaths per 100,000 population, respectively. The annual incidence recorded by traditional healers was 250 bites per 100,000 inhabitants, but the number of deaths was unknown. Finally, the household surveys reported an annual incidence of 92.8 bites per 100,000 inhabitants and an annual mortality rate of 2.2 deaths per 100,000 inhabitants. The differences in incidence and mortality between the different methods were explained by significant bias, resulting in particular from the complex patient’s healthcare-seeking behavior. The incidence provided by health records should be used to specify the immediate quantitative requirements of antivenoms and places where they should be available first.ConclusionMandatory reporting of cases would improve the management of envenomation by simplifying epidemiological surveys. Patients’ preference for traditional medicine should prompt health authorities to urge traditional healers to refer patients to health centers according to defined clinical criteria (mainly edema and bleeding or neurotoxic symptoms). Finally, household surveys were likely to reflect the actual epidemiological situation. Poison Control Center of Senegal should continue its work to sensitize stakeholders and train health staff.

Preference and willingness to pay for traditional medicine services in rural ethnic minority community in Vietnam.

BackgroundTraditional medicine (TM) still plays an important role in a number of health care systems around the world, especially across Asian and African countries. In Vietnam, however, little is known about preference for traditional medicine use. This study assessed the prevalence of use, preference, satisfaction, and willingness to pay for TM services amongst rural ethnic minority community.MethodsA cross-sectional survey in three provinces in the North and South of Vietnam.ResultsThe results showed a high level of satisfaction with TM services, with more than 90 % of respondents reporting improved health status given the use of TM. Indicators for preference of TM over modern medicine are a longer distance to health station; being in an ethnic minority; being female; and having had higher service satisfaction. Although we did not have a comparison group, the high level of satisfaction with TM services is likely the result of a project targeting community health workers and the public regarding TM education and access promotion. Indeed, the community health workers are credited with relaying the information about TM more than any other sources. This suggests the importance of community health workers and community health centers in the promotion of TM use.ConclusionsEthnic minority people prefer the use of traditional medicine services that supports the expansion of national programs and promotion of traditional medications.

Pathways to mental health care by members of a rural community in South Africa

This study explored mental health help seeking pathways followed by Black South African rural community dwellers in the Limpopo province of South Africa. Ten participants (5 females and 5 males) aged between 18 and 59 years receiving services from a rural mental health care facility in the Limpopo province were the informants. They presented with psychotic disorders = 50%, substance-use mental disorders = 20%, mood disorders = 20% and epilepsy = 10%. They completed a semi-structured one-to-one interview on their pathways to mental health care services. Data were content analysed. The results showed that help seeking pathways for mental health involve several entry points. These include the utilisation of western medicine when experiencing acute symptoms, and a preference for traditional medicine when faced with chronic but manageable symptoms. The findings suggest that families and significant others are important facilitators for individuals navigating the mental health care pathways.

Determinants of antiretroviral adherence among HIV positive children and teenagers in rural Tanzania: a mixed methods study.

BackgroundAround 3.3 million children worldwide are infected with HIV and 90% of them live in sub-Saharan Africa. Our study aimed to estimate adherence levels and find the determinants, facilitators and barriers of ART adherence among children and teenagers in rural Tanzania.MethodsWe applied a sequential explanatory mixed method design targeting children and teenagers aged 2–19 years residing in Ifakara. We conducted a quantitative cross sectional study followed by a qualitative study combining focus group discussions (FGDs) and in-depth interviews (IDIs). We used pill count to measure adherence and defined optimal adherence as > =80% of pills being taken. We analysed determinants of poor adherence using logistic regression. We held eight FGDs with adolescent boys and girls on ART and with caretakers. We further explored issues emerging in the FGDs in four in-depth interviews with patients and health workers. Qualitative data was analysed using thematic content analysis.ResultsOut of 116 participants available for quantitative analysis, 70% had optimal adherence levels and the average adherence level was 84%. Living with a non-parent caretaker predicted poor adherence status. From the qualitative component, unfavorable school environment, timing of the morning ART dose, treatment longevity, being unaware of HIV status, non-parental (biological) care, preference for traditional medicine (herbs) and forgetfulness were seen to be barriers for optimal adherence.ConclusionThe study has highlighted specific challenges in ART adherence faced by children and teenagers. Having a biological parent as a caretaker remains a key determinant of adherence among children and teenagers. To achieve optimal adherence, strategies targeting the caretakers, the school environment, and the health system need to be designed.

Health Seeking Behaviour, Food Habit and Nutritional Assessment of an Elderly Group in Ile Ife, Nigeria

Health behaviour is a set of actions taken to protect, promote and maintain the health of an individual. In this study, health behaviour, food habit and nutrition were assessed using various heaths, socioeconomic and anthropometric indices. Through the use of multistage sampling procedures, 200 elders were studied at Ife Central Local Government. There was a validation of the semi-structured questionnaire and a checklist for screening malnutrition. Each item was scored one point where the respondent was vulnerable in regard to that item. The scores thus showed the degree of vulnerability, i.e., the higher the score, the vulnerable the person is likely to be. In interpreting, the score of the respondent, the standard of the nutrition screening initiative was adopted where 10% was regarded as not vulnerable, 10–30% as moderately vulnerable, and greater than 30% as highly vulnerable. There were records of data from the questionnaire using SPSS version 16 (Statistical Package for Social Science data Management Company) software. For data analysis, the SPSS software was used. The results revealed health behaviours included going for medical check-ups (38%) the use of quality drugs (70%) and a preference for traditional medicine (28%). Food habit divulges the fact that 63% eat thrice daily; 50% buy food from vendors and 94% have favourite foods. Factors such as nutrition knowledge and body mass index (BMI) correlated significantly with health behaviour (p<0.05). The mean nutritional vulnerability score was higher for women than men (p<0.05). The most vulnerable elders were those that patronised traditional health facility, fell sick weekly and had inconsistent access to food.