scholarly journals ‘The medicine is not for sale’: Practices of traditional healers in snakebite envenoming in Ghana

2021 ◽  
Vol 15 (4) ◽  
pp. e0009298
Author(s):  
Jonathan Steinhorst ◽  
Leslie Mawuli Aglanu ◽  
Sofanne J. Ravensbergen ◽  
Chrisantus Danaah Dari ◽  
Kabiru Mohammed Abass ◽  
...  
Keyword(s):  
Wound Care ◽  
Traditional Healers ◽  
Medical Emergency ◽  
Wound Complications ◽  
Structured Interviews ◽  
Health Seeking ◽  
Middle Income ◽  
Care Givers ◽  
Bite Wounds ◽  
Improve Health

Background Snakebite envenoming is a medical emergency which is common in many tropical lower- and middle-income countries. Traditional healers are frequently consulted as primary care-givers for snakebite victims in distress. Traditional healers therefore present a valuable source of information about how snakebite is perceived and handled at the community level, an understanding of which is critical to improve and extend snakebite-related healthcare. Method The study was approached from the interpretive paradigm with phenomenology as a methodology. Semi-structured interviews were conducted with 19 traditional healers who treat snakebite patients in two rural settings in Ghana. From the Ashanti and Upper West regions respectively, 11 and 8 healers were purposively sampled. Interview data was coded, collated and analysed thematically using ATLAS.ti 8 software. Demographic statistics were analysed using IBM SPSS Statistics version 26. Findings Snakebite was reportedly a frequent occurrence, perceived as dangerous and often deadly by healers. Healers felt optimistic in establishing a diagnosis of snakebite using a multitude of methods, ranging from herbal applications to spiritual consultations. They were equally confident about their therapies; encompassing the administration of plant and animal-based concoctions and manipulations of bite wounds. Traditional healers were consulted for both physical and spiritual manifestations of snakebite or after insufficient pain control and lack of antivenom at hospitals; referrals by healers to hospitals were primarily done to receive antivenom and care for wound complications. Most healers welcomed opportunities to engage more productively with hospitals and clinical staff. Conclusions The fact that traditional healers did sometimes refer victims to hospitals indicates that improvement of antivenom stocks, pain management and wound care can potentially improve health seeking at hospitals. Our results emphasize the need to explore future avenues for communication and collaboration with traditional healers to improve health seeking behaviour and the delivery of much-needed healthcare to snakebite victims.

scholarly journals Men’s use of sexual health and HIV services in Swaziland: a mixed methods study

Sexual Health ◽  
2016 ◽  
Vol 13 (3) ◽  
pp. 265 ◽  
Author(s):  
Joelle Mak ◽  
Susannah H. Mayhew ◽  
Ariane von Maercker ◽  
Integra Research Team ◽  
Manuela Colombini
Keyword(s):  
Sexual Health ◽  
Hiv Testing ◽  
Adult Population ◽  
Healthcare Services ◽  
Traditional Healers ◽  
Service Users ◽  
Structured Interviews ◽  
Health Seeking ◽  
Hiv Services ◽  
Hiv Test

Background: Over one-quarter of the adult population in Swaziland is estimated to be HIV positive. Men’s use of sexual health (SH) services has significant implications for HIV prevention. This study aimed to understand Swazi men’s health-seeking behaviours in relation to SH and HIV services. Methods: A household survey was conducted in Manzini (n = 503), complemented by 23 semi-structured interviews and two focus group discussions (with a total of 10 participants). Results: One-third of male survey participants used SH services in the past year, most commonly HIV testing (28%). Service users were more likely to be sexually active (aOR 3.21, 95% CI: 1.81–5.68 for those with one partner; and aOR 2.35, 95% CI: 1.25–4.41 for those with multiple partners) compared with service non-users. Service users were less likely to prefer HIV services to be separated from other healthcare services (aOR 0.50, 95% CI: 0.35–0.71), or to agree with travelling further for their HIV test (aOR 0.52, 95% CI: 0.33–0.82) compared with non-users, after controlling for age-group and education. Men avoided SH services because they feared being stigmatised by STI/HIV testing, are uncomfortable disclosing SH problems to female healthcare providers, and avoided HIV testing by relying on their wife’s results as a proxy for their own status. Informal providers, such as traditional healers, were often preferred because practitioners were more often male, physical exams were not required and appointments and payment options were flexible. Conclusion: To improve men’s uptake of SH services, providers and services need to be more sensitive to men’s privacy concerns, time restrictions and the potential stigma associated with STI/HIV testing.

Traditional herbalists’ methods of treating mental disorders in Ghana

2018 ◽  
Vol 56 (1) ◽  
pp. 250-266 ◽  
Author(s):  
Lily N. A. Kpobi ◽  
Leslie Swartz ◽  
Cephas N. Omenyo
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Traditional Medicine ◽  
Mental Health Professionals ◽  
Specific Treatment ◽  
Mental Healthcare ◽  
Traditional Healers ◽  
Structured Interviews ◽  
Middle Income ◽  
Traditional Herbalists

The use of traditional medicine for the treatment of various disorders is not a new practice. Indeed, various categories of traditional healers form a large part of the healthcare workforce in many low- and middle-income countries, and given the paucity of mental health professionals in these countries, traditional and complementary medicine practitioners are utilised even more so for mental disorders. In Ghana, efforts have been made to formalise and standardise the work of traditional medicine practitioners. This goal is still mostly unmet, partly due to the lack of scientific knowledge of their beliefs, methods, and practices in mental healthcare. Very few studies have documented this knowledge. In this article, we report on some of the methods that are used by traditional Ghanaian herbalists in treating mental disorders. Eight herbalists working within the Greater Accra Region, who specialised in mental health, were interviewed through individual semi-structured interviews. Thematic analysis showed that traditional herbalists’ work in treating mental disorders revolved around four key themes: the method of diagnosis; the treatment methods used; the mode of administering the treatment; and the purpose of the specific treatment. These themes are discussed with reference to their potential implications for patients’ care and outcomes.

scholarly journals “We're actually more of a likely ally than an unlikely ally”: relationships between syringe services programs and law enforcement

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Carol Y. Franco ◽  
Angela E. Lee-Winn ◽  
Sara Brandspigel ◽  
Musheng L. Alishahi ◽  
Ashley Brooks-Russell
Keyword(s):  
Law Enforcement ◽  
Police Officers ◽  
Wound Care ◽  
Phenomenological Approach ◽  
Treatment Programs ◽  
People Who Use Drugs ◽  
Positive Relationships ◽  
Structured Interviews ◽  
Program Staff ◽  
Compliance With The Law

Abstract Background Syringe services programs provide sterile injection supplies and a range of health services (e.g., HIV and HEP-C testing, overdose prevention education, provision of naloxone) to a hard-to-reach population, including people who use drugs, aiming to prevent the transmission of infectious diseases. Methods We performed a qualitative needs assessment of existing syringe services programs in the state of Colorado in 2018–2019 to describe—their activities, needs, and barriers. Using a phenomenological approach, we performed semi-structured interviews with key program staff of syringe services programs (n = 11). All interviews were digitally recorded, transcribed, and validated. A data-driven iterative approach was used by researchers to develop a coding scheme to organize the data into major themes found across interviews. Memos were written to synthesize main themes. Results Nearly all the syringe program staff discussed their relationships with law enforcement at length. All syringe program staff viewed having a positive relationship with law enforcement as critical to the success of their program. Main factors that influence the quality of relationships between syringe services programs and law enforcement included: (1) alignment in agency culture, (2) support from law enforcement leadership, (3) police officers’ participation and compliance with the Law Enforcement Assisted Diversion (LEAD) program, which provides intensive case management for low-level drug offenders, and (4) implementation of the “Needle-Stick Prevention Law” and Drug Paraphernalia Law Exemption. All syringe program staff expressed a strong desire to have positive relationships with law enforcement and described how a collaborative working relationship was critical to the success of their programs. Conclusions Our findings reveal effective strategies to foster relationships between syringe services programs and law enforcement as well as key barriers to address. The need exists for both syringe services programs and law enforcement to devote time and resources to build a strong, positive partnership. Having such positive relationships with law enforcement has positive implications for syringe services program clients, including law enforcement being less likely to ticket persons for having used syringes, and encourage people who use drugs to seek services from syringe services programs, which can then lead them to other resources, such as housing, wound care, and substance use treatment programs.

Considerations for Translating Medical Devices Under Development From the Clinic to the Home: A Case Study in Providing Chronic Wound Care

2021 ◽  
Vol 10 (1) ◽  
pp. 238-242
Author(s):  
Ellen J. Bass ◽  
Justine S. Sefcik ◽  
Elease McLaurin ◽  
Rose Ann DiMaria-Ghalili
Keyword(s):  
Medical Devices ◽  
Chronic Wound ◽  
Wound Care ◽  
Clinical Protocol ◽  
Structured Interviews ◽  
Home Setting ◽  
Ultrasound Application ◽  
Research Assistants ◽  
Current Device

A prototype medical device and protocol that work well in a clinic would not necessarily work reliably in the home setting. The goal of this work is to identify factors to consider when translating a device evaluated in a clinic for use by home caregivers providing chronic wound care for persons living with dementia. One must consider the current device, the associated bundle, the protocol and how they may need to be modified. Semi-structured interviews with the research assistants who have applied a prototype device were conducted to generate a list of known issues with the current clinical protocol in terms of ultrasound application The researchers performed a set of specified tasks by following the current device protocol and explaining any difficulties with use\execution. They embellished the descriptions with details about what had happened with actual patients in the clinic. Using thematic analysis, analysts identified themes and subthemes. Issues potentially relevant to translating medical devices to the home are discussed.

scholarly journals Health workers’ perspectives on informed consent for caesarean section in Southern Malawi

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Wouter Bakker ◽  
Siem Zethof ◽  
Felix Nansongole ◽  
Kelvin Kilowe ◽  
Jos van Roosmalen ◽  
...  
Keyword(s):  
Informed Consent ◽  
Caesarean Section ◽  
Health Workers ◽  
Group Discussion ◽  
Legal Protection ◽  
Analytical Framework ◽  
Structured Interviews ◽  
Middle Income ◽  
Partial Disclosure ◽  
Labour Pains

Abstract Objective Informed consent is a prerequisite for caesarean section, the commonest surgical procedure in low- and middle-income settings, but not always acquired to an appropriate extent. Exploring perceptions of health care workers may aid in improving clinical practice around informed consent. We aim to explore health workers’ beliefs and experiences related to principles and practice of informed consent. Methods Qualitative study conducted between January and June 2018 in a rural 150-bed mission hospital in Southern Malawi. Clinical observations, semi-structured interviews and a focus group discussion were used to collect data. Participants were 22 clinical officers, nurse-midwives and midwifery students involved in maternity care. Data were analysed to identify themes and construct an analytical framework. Results Definition and purpose of informed consent revolved around providing information, respecting women’s autonomy and achieving legal protection. Due to fear of blame and litigation, health workers preferred written consent. Written consent requires active participation by the consenting individual and was perceived to transfer liability to that person. A woman’s refusal to provide written informed consent may pose a dilemma for the health worker between doing good and respecting autonomy. To prevent such refusal, health workers said to only partially disclose surgical risks in order to minimize women's anxiety. Commonly perceived barriers to obtain a fully informed consent were labour pains, language barriers, women’s lack of education and their dependency on others to make decisions. Conclusions Health workers are familiar with the principles around informed consent and aware of its advantages, but fear of blame and litigation, partial disclosure of risks and barriers to communication hamper the process of obtaining informed consent. Findings can be used to develop interventions to improve the informed consent process.

scholarly journals Needs of LMIC-based tobacco control advocates to counter tobacco industry policy interference: insights from semi-structured interviews

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e044710
Author(s):  
Britta Katharina Matthes ◽  
Lindsay Robertson ◽  
Anna B Gilmore
Keyword(s):  
Tobacco Control ◽  
Structural Changes ◽  
Tobacco Industry ◽  
Control Policy ◽  
Qualitative Description ◽  
Structured Interviews ◽  
Middle Income ◽  
Adoption And Implementation ◽  
National Coalition ◽  
Industry Policy

IntroductionAdvocacy is vital for advancing tobacco control and there has been considerable investment in this area. While much is known about tobacco industry interference (TII), there is little research on advocates’ efforts in countering TII and what they need to succeed. We sought to examine this and focused on low- and middle-income countries (LMICs) where adoption and implementation of the Framework Convention on Tobacco Control (FCTC) tend to remain slower and weaker.MethodWe interviewed 22 advocates from eight LMICs with recent progress in a tobacco control policy. We explored participants’ experiences in countering TII, including the activities they undertake, challenges they encounter and how their efforts could be enhanced. We used Qualitative Description to analyse transcripts and validated findings through participant feedback.ResultsWe identified four main areas of countering activities: (1) generating and compiling data and evidence, (2) accessing policymakers and restricting industry access, (3) working with media and (4) engaging in a national coalition. Each area was linked to challenges, including (1) lack of data, (2) no/weak implementation of FCTC Article 5.3, (3) industry ties with media professionals and (4) advocates’ limited capacity. To address these challenges, participants suggested initiatives, including access to country-specific data, building advocates’ skills in compiling and using such data in research and monitoring, and in coalition development; others aiming at training journalists to question and investigate TII; and finally, diverse interventions intended to advance a whole-of-government approach to tobacco control. Structural changes to tobacco control funding and coordination were suggested to facilitate the proposed measures.ConclusionThis research highlights that following years of investment in tobacco control in LMICs, there is growing confidence in addressing TII. We identify straightforward initiatives that could strengthen such efforts. This research also underscores that more structural changes to enhance tobacco control capacity building should be considered.

scholarly journals Treatment seeking patterns of the COVID-19 first wave patients: a narrative study from Dhaka, Bangladesh

2021 ◽  
Vol 8 (10) ◽  
pp. 4648
Author(s):  
Nahida Sultana Kazi ◽  
Shahedul Halim Kazi
Keyword(s):  
Public Awareness ◽  
Treatment Seeking ◽  
Pharmaceutical Drugs ◽  
Structured Interviews ◽  
Health Seeking ◽  
Telemedicine Service ◽  
New Era ◽  
Narrative Study ◽  
Current Article ◽  
Treatment Procedures

Background: The COVID-19 has already taken the lives of 4,088,281 people worldwide. To date, the deadly virus has killed 17,894 people in Bangladesh following a sharp increase in death per day. The current article focuses on the treatment-seeking patterns of COVID-19 patients during the first wave of the pandemic in the country. Methods: This is a qualitative study based on semi-structured interviews with 30 respondents selected purposively. The interviews were transcribed verbatim and analyzed narratively. Results: The study shows that 28 out of 30 participants pursued treatments from home, whilst, two individuals with comorbidity got admitted to the hospitals for weeks. This indicates that there is an association between comorbidity and hospitalization of the COVID-19 patients. The study reveals that the use of telemedicine service amidst COVID-19 has initiated a new era of health-seeking among people in Bangladesh. Similarly, media and the internet played a significant role in the quick access to information about the pandemic as well as to decide on the response and healing patterns of the participants. Besides the pharmaceutical drugs, using herbs was a common remedial process among the patients in the study. Conclusions: Like other countries, people in Bangladesh are also puzzled about the coronavirus and its treatment procedures. A proper response to the current situation, an effective preparedness policy, and public awareness are crucial for tackling the further destruction resulting from a highly infectious disease. 

scholarly journals Defining malaria risks among forest workers in Aceh, Indonesia: A formative assessment

2020 ◽  
Author(s):  
Lenny Lia Ekawati ◽  
Kelly C. Johnson ◽  
Jerry O. Jacobson ◽  
Carmen A. Cueto ◽  
Iska Zarlinda ◽  
...  
Keyword(s):  
Formative Assessment ◽  
Plasmodium Knowlesi ◽  
Malaria Prevention ◽  
Traditional Healers ◽  
Willingness To Participate ◽  
Health Seeking ◽  
Malaria Burden ◽  
Aceh Province ◽  
Deep Forest ◽  
Forest Activities

Abstract Background . Following a dramatic decline of malaria cases in Aceh province, geographically-based reactive case detection (RACD) was recently evaluated as a tool to improve surveillance with the goal of malaria elimination. While RACD detected few cases in households surrounding index cases, engaging in forest work was identified as a risk factor for malaria and infections from Plasmodium knowlesi —a non-human primate malaria parasite—were more common than expected. This qualitative formative assessment was conducted to improve understanding of malaria risk from forest work and identify strategies for targeted surveillance among forest workers. Methods. Between June and August, 2016, five focus groups and 18 in-depth interviews with forest workers and key informants were conducted in each of four subdistricts in Aceh Besar and Aceh Jaya districts. Themes included: types of forest activities, mobility of workers, interactions with non-human primates, malaria prevention and treatment-seeking behaviors, and willingness to participate in malaria surveys at forest work sites and using peer-referral. Results. Reported forest activities included mining, logging, and agriculture in the deep forest and along the forest fringe. Forest workers, particularly miners and loggers, described often spending weeks to months at work sites in makeshift housing, rarely utilizing mosquito prevention and, upon fever, self-medicating and seeking care from traditional healers or pharmacies rather than health facilities. Non-human primates are frequently observed near work sites, and most forest work locations are within a day’s journey of health clinics. Employers and workers expressed interest in undertaking malaria testing and in participating in survey recruitment by peer-referral and at work sites. Conclusions. Diverse groups of forest workers in Aceh are potentially exposed to malaria through forest work. Passive surveillance and household-based screening may under-estimate malaria burden due to extended stays in the forest and health-seeking behaviors. Active surveillance specifically targeting forest workers through work-site screening and/or peer-referral appears promising for addressing undetected infections.

scholarly journals Ethnopharmacological Study of Plants Used against Malaria by Traditional Healers in the Department of Bouna, North-Eastern Côte d'Ivoire

2020 ◽  
pp. 11-22
Author(s):  
Koffi Akissi Jeanne ◽  
Tano Konan Dominique ◽  
Kangah Orphée Michelle Alerte ◽  
Rasmane Na Ahou Kaddy ◽  
Ehoulé Kroa ◽  
...  
Keyword(s):  
Medicinal Plants ◽  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Traditional Healers ◽  
Oral Route ◽  
Structured Interviews ◽  
Ethnobotanical Survey ◽  
Cote D’Ivoire ◽  
Côte D'ivoire ◽  
Therapeutic Alternatives

Mosquitoes have developed resistance, hence the need for anti-malarial medicines. This resistance calls for therapeutic an interest to therapeutic alternatives, including the medicinal plants. An ethnopharmacological survey was conducted amongst 15 Traditional Healers, recommended by the National Program for the Promotion of Traditional Medicine using semi-structured interviews in the city of Bouna. The ethnobotanical survey conducted in 2019 has enabled the identification of 32 plant species belonging to 30 genera and grouped into 19 families. The most represented families were Fabaceae (5 species) Anacardiaceae (4 species), Annonaceae (3 species), Rubiaceae, Zingiberaceae, Asteraceae, and Combretaceae with 2 species each. The species were mostly trees (63.63%). Leaves were the most frequently used parts of the plants (44.4%). The results of our investigations show that the most used mode is the decoction (42.22%). The oral route (60%) is the most used mode of administration. These species complete the non-exhaustive list of medicinal plants that the populations of Cote d'Ivoire use. It was found out that, people in this area commonly use medicinal plants with trust they have built on the curative outcome witnessed. However, this creates a further work to test for the antiplasmodial activity and to develop of Traditional Improved Medicines (MTAs).

Sign in / Sign up

Export Citation Format

Share Document