Factors influencing the emergence of self-reliance in primary health care using traditional medicine: A scoping review.

Self-reliance is the responsible behavior and the ability of an individual to take care of one's own health using local resources. A substantial proportion of the population use traditional medicine (TM) for primary health care (PHC) in low- and middle-income countries (LMIC). The underlying philosophy of the TM approach is self-reliance due to its emphasis on culture, traditions, customs, and local resources. Given the complexity and ambiguity of how self-reliance emerges, there is a need to have clarity in its understanding and the practice in relation to TM. Hence, we conducted this review to synthesize the factors determining the emergence of self-reliance in PHC using TM in resource-poor settings with a specific focus on LMICs. We searched PubMed, Google scholar, and the Social Science Research Network databases, and conducted reference tracking of selected articles. We included articles published between 2000 and 2020 May. Thematic analysis was done using QDA-miner Lite software version 2.1. We retained 29 papers for review and analysis. A conceptual framework was developed that located factors influencing the emergence of self-reliance. Self-reliance manifests through a socially constructed interaction between factors from the macro (policy and environment) to the micro context (community and household). Due to the lack of explanatory models, there is a substantial gap between understanding self-reliance and its application in health policy and practice. Achieving comprehensive PHC and universal health coverage requires policy provisions to create an enabling environment in health-care facilities, communities, and households that allows the emergence of self-reliance.