Recent years have seen increasing momentum towards task shifting of basic health services, including using community health workers (CHW) to diagnose and treat common childhood illnesses. Yet few studies have examined the role of traditional healers in meeting families' and communities' health needs and liaising with the formal health system. We examine these issues in Tshopo Province in the Democratic Republic of the Congo, a country with high rates of child mortality (104 deaths per 1000 live births). We conducted 127 in-depth interviews and eight focus group discussions with a range of community members (mothers, fathers and grandmothers of children under 5 years of age) and health providers (CHWs, traditional healers, doctors and nurses) on topics related to care seeking and case management for childhood illness and malnutrition, and analysed them iteratively using thematic content analysis. We find significant divergence between biomedical descriptions of child illness and concepts held by community members, who distinguished between local illnesses and so-called 'white man's diseases.' Traditional healers were far less costly and more geographically accessible to families than were biomedical health providers, and usually served as families' first recourse after home care. Services provided by traditional healers were also more comprehensive than services provided by CHWs, as the traditional medicine sphere recognised and encompassed care for 'modern' diseases (but not vice versa). Meanwhile, CHWs did not receive adequate training, supervision or supplies to provide child health services. Considering their accessibility, acceptability, affordability and ability to recognise all domains of illness (biomedical and spiritual), traditional healers can be seen as the de facto CHWs in Tshopo Province. National and international health policymakers should account for and involve this cadre of health workers when planning child health services and seeking to implement policies and programmes that genuinely engage with community health systems.
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http://dx.doi.org/10.1136/bmjgh-2019-001529 | DOI Listing |
BMJ Paediatr Open
December 2024
Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA.
Background: To minimise the referral gap to pain psychology, the purpose of this study was to describe clinician-perceived patient suitability for pain psychology referral, develop a referral plan and outline essential elements of a referral conversation via a modified Delphi approach with multidisciplinary paediatric pain providers.
Methods: We employed a three-round modified Delphi approach consulting multidisciplinary paediatric pain providers (n=18) including physicians, psychologists, physical therapists, occupational therapists and nurse practitioners (PT, OT, NP). Based on the responses to an online survey (Round 1), initial statements regarding the pain psychology referral process were developed.
Ann Ital Chir
December 2024
Multidisciplinary Department of Medical-Surgical and Dental Specialties, Plastic Surgery Unit, Università degli Studi della Campania "Luigi Vanvitelli", 80138 Naples, Italy.
BMC Health Serv Res
December 2024
USAID Program for Accelerated Control of TB in Karamoja Region (PACT- Karamoja), Moroto City, Uganda.
Background: The Karamoja subregion is a high TB burden pastoralist community that previously had limited access to public health services. We explored the community's perceptions towards TB to better understand how healthcare services should be structured to meet the needs of the persons with TB and their households.
Methods: From September to October 2022, we conducted 12 focus group discussions (FGDs) and interviewed 95 persons (48 community members and 47 health workers).
Med Acupunct
December 2024
Department of Family Medicine, University of Texas Medical Branch, Galveston, Texas, USA.
Background: Traditional Chinese medicine (TCM) practices such as acupuncture and cupping have been practiced for thousands of years and recently gained more popularity and recognition because of their benefits. However, these practices are not unique to Eastern cultures and countries. The healing practices of folk healers like the of Indigenous communities in Latin America share striking similarities to their TCM counterparts, although not much literature exists on this topic.
View Article and Find Full Text PDFFront Neurol
December 2024
Balance and Dizziness Center, Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark.
Background: Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo. While various techniques and technologies have improved BPPV diagnostics and treatment, optimizing BPPV healthcare pathways requires a comprehensive understanding of the diagnostic modalities across diverse clinical settings.
Objective: To compare traditional manual BPPV diagnostics (MD) with diagnostics done with the aid of a mechanical rotation chair (MRC) when using videonystagmography goggles with both modalities.
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